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Exam 3: Gastrointestinal Flashcards

1
Q

Four mechanisms that cause ulcers

A
  • Increased contact with HCl acid
  • Increased contact with pepsin
  • Decreased mucosal resistance
  • H. pylori
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2
Q

Three patient behaviors that can cause ulcers

A
  • Stress
  • Smoking
  • Meds (ASA, NSAIDs)
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3
Q

What does hematemesis look like?

A

Coffee grounds

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4
Q

Prep for an upper GI series (3)

A
  • NPO
  • 16 oz barium solution (chalky)
  • Milk of magnesia to offset constipation caused by barium
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5
Q

Before a gastroscopy… (4)

A
  • Patient is NPO
  • Attain consent
  • Monitor VS, O2 sat
  • Administer IV and IV sedation
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6
Q

What do you watch for after a gastroscopy? What could this lead to?

A

Sudden abdominal pain–> could be perforation

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7
Q

Four sxs involved with perforation

A
  • Profuse sweating
  • Shallow breathing
  • Hard abdomen
  • Sudden abdominal pain
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8
Q

How long after an upper GI series or gastroscopy should patient be NPO?

A

Til gag reflex returns

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9
Q

What two labs do you check for a patient with an ulcer?

A
  • WBC

- BUN

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10
Q

Six med categories for ulcer patient

A
  • Antacids
  • Cytroprotective
  • Antispasmotic
  • Histamine 2 agents
  • Proton Pump inhibitors
  • H. Pylori agents
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11
Q

3 antacids (ulcer)

A

Milk of magnesia
Mylanta
Maalox

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12
Q

Cytroprotective drug (ulcer)

A

Sucralfate (carafate)

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13
Q

Antispasmotic drug (ulcer)

A

Banthine

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14
Q

Histamine 2 Antagonists (ulcer) - 2

A

Cimetidine (Tagamet)

Zantac

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15
Q

Proton pump inhibitors (ulcer) - 4

A

Omeprazol (Prilosec)
Prevacid
Nexium
Protonix

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16
Q

3 H. Pylori agents

A

Prevacid
Amoxicillin
Bilaxin

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17
Q

______ has diarrheal effect and ______ has a constipation effect. Most antacids are both.

A

MAGNESIUM

ALUMINUM

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18
Q

Most antacids have a very high ______ content – especially ______.

A

SODIUM

AKLASELTZER

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19
Q

Mechanism of sucralfate

A

CYTROPROTECTIVE

Take it an hour before meals, it mixes with stomach acid and forms a paste that adheres to - and protects - the ulcer

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20
Q

Histamine 2 antagonists should not be given with…

A

antacids (they will slow H2 antagonist absorption)

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21
Q

Role of Histamine 2

A

Stimulates production of HCl acid (GI specific)

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22
Q

Function of a proton pump inhibitor

A

helps block acid production

23
Q

Common H. Pylori treatment

A
  • Proton pump inhibitor

- Two antibiotics

24
Q

Before and after: Gastroduodenostomy (Bilroth 1)

A

Bottom half of stomach is removed

Top half of stomach is re-connected to duodenum

25
Before and after: Gastrojejunostomy (Bilroth 2)
Bottom half of stomach is removed | Top half of stomach is re-connected to jejunum
26
Before and after: Gastrectomy (total)
Stomach is removed, lower esophagus is attached to duodenum
27
Levine v. Salem Sump:
Levine is only one tube - intermittent suctioning required Salem is two tubes - second tube must be connected to low pressure suction at all times
28
What vitamin do you give to patients after GI surgery?
Vitamin B12
29
_____ or ______ is associated with dumping syndrome
- Large meals or - High amount of simple carbs after a total gastrectomy
30
Prevention of dumping syndrome (2)
- Small frequent meals - Lie down for a half hour after eating (after total gastrectomy)
31
How dumping syndrome occurs with a large meal:
Food is hypertonic, so fluid enters the small bowel. There is not enough volume in the intravascular space, so the body sets off a vasomotor response
32
Vasomotor response for dumping syndrome (5)
- Tachycardia - Palpitations - Dizziness - Weakness - Hypotension
33
Hypoglycemic reaction for dumping syndrome (6)
- Tachycardia - Palpitations - Dizziness - Weakness - Diaphoresis - Trembling
34
Early symptoms of colon cancer:
Absent or vague
35
Later symptoms of colon cancer (5)
- Melena - Pain - Change in bowel habits - Anemia - Anorexia / Weight loss
36
4 risk factors for colon cancer
- Family history - Age (40+) - Diet (fat, protein, simple carbs) - Smoking
37
Five types of tests to detect / diagnose colon cancer
``` - Rectal exam for stool guiac tests sigmoidoscopy colonoscopy lower GI series CAT scan, MRI or Ultrasound ```
38
How often should a patient get a rectal exam for stool guiac tests?
Yearly
39
How often should a patient get a sigmoidoscopy?
every 5 years
40
How often should a patient get a colonoscopy?
every 10 years
41
Bowel prep before test or surgery | Diet
Low-residue diet for 1-2 days Then clear fluids, laxatives, cleansing enema NPO 8 hours prior to test surgery
42
What is given before bowel surgery to remove some of the bacteria?
Aminoglycosides
43
3 post-op nursing goals: Colostomies
``` #1: Help the patient cope #2: Prevent complications #3: Maintain nutrition ```
44
Potential complications after a colostomy (7)
- Paralytic ileus - Bowel obstruction - Peritonitis - Wound infectoin - Atelectasis - Pneumonia - Pain
45
What nutrition should be administered after... - A colostomy? - An ileostomy?
- Normal diet | - Low residue diet
46
Irrigating ostomies: - Yes: 2 - No: 2 - NEVER: 1
Yes: Descending and sigmoid colostomy No: Ascending and transverse colostomy Never: Ileostomy
47
With a colostomy, the contents become _____ as you _____
more solid | travel closer to the end of the digestive system
48
Consistency of contents: Ileostomy
Liquid
49
What type of ostomies can have constipation
Sigmoid colostomies only
50
With what ostomy is food blockage possible?
ileostomy -- CHEW a lot
51
Which ostomy has a normal diet?
Colostomy
52
Restrictions for ostomies (2)
No contact sports | No heavy lifting
53
Contraindicated to eat/ take with ileostomy (5)
- Laxatives - Enteric coated pills - Time release pills - Fresh fruit - Raw veggies or nuts

Med Surg (13 decks)

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