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Med Surg > Exam 3: Gastrointestinal > Flashcards

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
Q

Before and after: Gastrojejunostomy (Bilroth 2)

A

Bottom half of stomach is removed

Top half of stomach is re-connected to jejunum

26
Q

Before and after: Gastrectomy (total)

A

Stomach is removed, lower esophagus is attached to duodenum

27
Q

Levine v. Salem Sump:

A

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
Q

What vitamin do you give to patients after GI surgery?

A

Vitamin B12

29
Q

_____ or ______ is associated with dumping syndrome

A
  • Large meals or
  • High amount of simple carbs

after a total gastrectomy

30
Q

Prevention of dumping syndrome (2)

A
  • Small frequent meals
  • Lie down for a half hour after eating

(after total gastrectomy)

31
Q

How dumping syndrome occurs with a large meal:

A

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
Q

Vasomotor response for dumping syndrome (5)

A
  • Tachycardia
  • Palpitations
  • Dizziness
  • Weakness
  • Hypotension
33
Q

Hypoglycemic reaction for dumping syndrome (6)

A
  • Tachycardia
  • Palpitations
  • Dizziness
  • Weakness
  • Diaphoresis
  • Trembling
34
Q

Early symptoms of colon cancer:

A

Absent or vague

35
Q

Later symptoms of colon cancer (5)

A
  • Melena
  • Pain
  • Change in bowel habits
  • Anemia
  • Anorexia / Weight loss
36
Q

4 risk factors for colon cancer

A
  • Family history
  • Age (40+)
  • Diet (fat, protein, simple carbs)
  • Smoking
37
Q

Five types of tests to detect / diagnose colon cancer

A 
- Rectal exam for stool guiac tests
sigmoidoscopy
colonoscopy
lower GI series
CAT scan, MRI or Ultrasound
38
Q

How often should a patient get a rectal exam for stool guiac tests?

A

Yearly

39
Q

How often should a patient get a sigmoidoscopy?

A

every 5 years

40
Q

How often should a patient get a colonoscopy?

A

every 10 years

41
Q

Bowel prep before test or surgery

Diet

A

Low-residue diet for 1-2 days
Then clear fluids, laxatives, cleansing enema
NPO 8 hours prior to test surgery

42
Q

What is given before bowel surgery to remove some of the bacteria?

A

Aminoglycosides

43
Q

3 post-op nursing goals: Colostomies

A 
#1: Help the patient cope
#2: Prevent complications
#3: Maintain nutrition
44
Q

Potential complications after a colostomy (7)

A
  • Paralytic ileus
  • Bowel obstruction
  • Peritonitis
  • Wound infectoin
  • Atelectasis
  • Pneumonia
  • Pain
45
Q

What nutrition should be administered after…

  • A colostomy?
  • An ileostomy?
A
  • Normal diet

- Low residue diet

46
Q

Irrigating ostomies:

  • Yes: 2
  • No: 2
  • NEVER: 1
A

Yes: Descending and sigmoid colostomy
No: Ascending and transverse colostomy
Never: Ileostomy

47
Q

With a colostomy, the contents become _____ as you _____

A

more solid

travel closer to the end of the digestive system

48
Q

Consistency of contents: Ileostomy

A

Liquid

49
Q

What type of ostomies can have constipation

A

Sigmoid colostomies only

50
Q

With what ostomy is food blockage possible?

A

ileostomy – CHEW a lot

51
Q

Which ostomy has a normal diet?

A

Colostomy

52
Q

Restrictions for ostomies (2)

A

No contact sports

No heavy lifting

53
Q

Contraindicated to eat/ take with ileostomy (5)

A
  • Laxatives
  • Enteric coated pills
  • Time release pills
  • Fresh fruit
  • Raw veggies or nuts

Med Surg (13 decks)

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