Exam 3 Flashcards
GERD risk factors/triggers
Caffeine
Alcohol
Chocolate
Spicy/fried foods
Smoking
S/S of GERD
Similar to MI
Coughing/wheezing at night
Belching
Nausea
Hoarseness
GERD occurs when
30-60 min after meal
Exacerbated with laying down or bending forward
Hiatal hernia
Part of stomach protrudes through esophageal hiatus into chest cavity
Hiatal hernia what to report
SOB
Abd pain with N/V and fever
Hiatal hernia teaching
Symptoms worse after eating
Elevate HOB
No late meals- small freq meals
Gastritis
Inflamed stomach
Could have edema, hemorrhage or erosion of mucosa
Gastritis teaching/nursing interventions
Don’t take with NSAIDS or ASA
Priority- hydration status/ electrolytes
Daily wts, strict I&Os and VS’s
Peptic ulcer disease causes
Break in mucosa lining of GI tract from continued contact with gastric juice
Smoking
Highest risk for Peptic ulcer disease
H. Pylori infection
Peptic ulcer disease tx/screening
Screen for H. pylori - HP breath test or endoscopy
Steroids exacerbate peptic ulcer
S/S of Peptic ulcer disease
Inflammation and pain (worse after/during eating a meal)
May occur late at night
Minimal bleeding- occult blood in dark/tarry stools
N/V
Wt loss/ anorexia
Belching
Dyspepsia/ indigestion
Distended abdomen that’s painful
Peristalsis diminishes
Paralytic ileus develops
What to report for Peptic ulcer disease
Tachycardia
Hypotension
Vomiting blood
Perforation is medical emergency
Medication Tx for Peptic ulcer disease
Sucralfate - mucosal barrier fortifier
Gastric cancer
Develops over years-changes in stomach lining
Gastric cancer teaching
Administer protein & vitamins for tissue repair
Eat small, freq meals
Diet high in fiber and water but reduce fluids between meals
Tx for gastric cancer
Gastrectomy- lifelong B12 shots after
Screening for gastric cancer
Adults over 45
Endoscopy & sigmoidoscopy q5yrs
Colonoscopy q10yrs
IBS
Abd pain and cramping- diarrhea, constipation
Risk factors for IBS
Caffeine
Alcohol
Carbonated beverages
Diet high in fats & gas producing foods
Smoking
Stress
anxiety/depression
Intestinal obstruction
Partial/complete blockage of bowel
Mechanical obstruction
From stool, food, tumor or adhesions
Non-mechanical obstruction
Paralytic ileus
Tx of abdominal obstruction
Managing fluid/electrolyte imbalances
Treating cause with f obstruction
Relieving symptoms
Surgery if gastric decompression (NG tube) doesn’t relieve symptoms
Small bowel obstruction S/S
Distended Abd
Bloated sensation
Altered bowel sounds
Complete SBO can lead to reverse peristalsis and propel contents towards mouth
Resection surgery
Ileostomy/colonoscopy could be permanent or temporary for bowel onstruction
Stoma care
Pouch changed weekly
Empty when 1/3-1/2 full
Stoma deep pink- skin barrier AROUND stoma not on
Hot liquids help with cramping
Distention/cramping=warm compresses or lightly massage abd
NO enemas
Large bowel obstruction S/S
Constipation/ obstipation
Intermittent lower Abd cramping
Ribbon like stools
Sign of bowel perforation
Sudden sever pain
Board-like abdomen
Dx of bowel obstruction
Barium enema - reveals distended, air filled colon
Monitor for bowel movements after enema (barium can harden)
Appendicitis
Appendix inflamed and fills with pus
S/S of appendicitis
Severe Abd pain with guarding
Fever
High WBC
Pin at McBurney’s point (location of appendix)
Rebound tenderness
Pain relieved by bending knees
Peritonitis S/S
Board-like abd
Tx of peritonitis
NG decompression
TPN
Colloids (plasma/blood cells)
Gastroenteritis
“Stomach flu”
Inflammation is stomach/small intestine
Gastroenteritis S/S
Diarrhea
Abd pain
Cramping
Low K
N/V
Fever
Distention
Rectal tenesmus (urge to go)
Excessive borborygmi (bowel sounds)
Tx for gastroenteritis
Replace electrolytes
IV fluids
Monitor cardiac dysrhythmias
Inflammatory bowel disease
Unknown etiology
Chronic-incurable
Crohns & ulcerative colitis
Diet for inflammatory bowel disease
Lean meats
Legumes
Water
NO corn, nuts, alcohol or gassy foods/beverages
Tx for inflammatory bowel disease
Monoclonal antibodies (adalimumab/humira)
Lowers immune system- protective isolation
Crohn’s disease
Inflammatory bowel disease
Fistulas can develop- cobblestone appearance of lumen
S/S of Crohn’s disease
RLQ abd pain
N/V
REPORT- cold-like symptoms/sore throat
Tx for Crohn’s disease
Monoclonal antibody (-mumab)
Teaching for Crohn’s disease
Self administer B12 injections
If sick- total bowel rest and on TPN
May have fecal matter emesis
May have frequent stools- diarrhea/mucous/bloody
Ulcerative colitis
Inflammatory bowel disease
Only large intestine- hemorrhages, abscess
Risk for colon cancer
S/S of Ulcerative colitis
Pain in LLQ
Blood/mucous/pus in stool
Urgent sensation to go
5-30 stools a day- usually bloody
Wt loss/anorexia
Fatigue/weakness
Fever
Dx of Ulcerative colitis
Anemia
High WBC
Fluid/electrolyte imbalances
Albumin/folic acid levels low
Stool cultures
Diverticulosis
Pouches that bulge from colon (aneurysms of colon)
Need adequate fluid and high fiber diet
Risk factors for Diverticulosis
Over 40
Obese
Smoker
Physically inactive
Diet high in animal products
NSAIDS/steroids/opiods
No specific diet triggers attacks