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Adult health 2 > Exam 3: GI content > Flashcards

Exam 3: GI content Flashcards

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1
Q

What is primary stomatitis

A

inflammation of the oral mucosa

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2
Q

What are the s/s of primary stomatitis and the complications

A

painful ulceration (s) place pt at risk for bleeding and infection

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3
Q

What is the treatment for primary stomatitis

A

topical analgesic application (lidocaine) to opioids or antifungal medications

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4
Q

What is secondary stomatitis

A

Candidiasis –> painful infection caused by the fungus candida albicans

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5
Q

Treatment for secondary stomatits

A

treat with nystatin swish and spit

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6
Q

Oral tumors/oral cancers signs

A

bleeding from mouth, poor appetite, difficult swallowing, weight loss, thick or absent saliva, pain, lump in cheek

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7
Q

What cancer is related to HPV

A

oropharyngeal cancer

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8
Q

What is GERD

A

occurs as a result of regurgitation–backward flow of stomach contents into esophagus

–> obesity and H. pylori may also contribute to reflux

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9
Q

Hiatal hernia will ________ risk for GERD

A

increase

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10
Q

GERD complications

A

ulceration, hemorrhage, adenocarcinoma

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11
Q

S/S GERD

A

heartburn

regurgitation

water brash

frequent belching

nocturnal cough, wheezing, hoarseness

dysphagia or odynophagia (difficulty swallowing)

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12
Q

What are alarm symptoms of GERD

A

dysphagia, odynophagia, anemia, bleeding, weight loss

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13
Q

Diagnostic testing for GERD

A

pH monoitoring–> below 4

Endoscopy

Biopsy to r/o cancer

Manometry: sphincter and muscle function

Barium swallow: hiatal hernia

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14
Q

What surgical procedure do we use for GERD when there is a hiatal hernia

A

laparoscopic Nissen Fundoplication

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15
Q

What is the stretta procedure with GERD

A

The procedure uses radio frequency energy to reshape the lower esophageal sphincter (LES) muscle ring. This strengthens the sphincter, which helps restore the natural barrier that prevents stomach acid from entering the esophagus

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16
Q

What are the different types of hiatal hernias

A

sliding: type l

paraesophageal or rolling: type ll through lV

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17
Q

What is the diagnostic test for a hiatal hernia

A

barium swallow study with fluoroscopy is the most specific –> EGD may be performed for sliding hernias

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18
Q

What are 2 complications of rolling hernias

A

obstruction and/or strangulation

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19
Q

What diet do we want for hiatal hernias

A

high carb, low protein, and increased fluid intake

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20
Q

When we place an NG tube for a hiatal hernia what is the normal coloration

A

drainage bloody then green within 8 hours

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21
Q

What is dyspepsia

A

describe symptoms such as pain, discomfort, fullness, nausea, burning, belching

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22
Q

Gastritis is commonly caused by

A

H. pylori

NSAID use

Local irritation from radiation

autoimmune causes

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23
Q

How do we treat acute gastritis

A

remove causative agent, NPO –advance diet, antacids, H2 receptor antagonists, PPI, monitor for bleeding

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24
Q

How do we treat chronic gastritis

A

treat H. pylori, diet, meds, possibly B-12 injections to treat anemia due to lack of intrinsic factors produced by the stomach lining

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25
Q

What conditions favor gastric ulcer

A

normal gastric acid secretion and delayed stomach emptying with increased diffusion of gastric acid back into stomach tissues

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26
Q

What conditions favor duodenal ulcers

A

normal diffusion of acid back into stomach tissue with increased secretion of gastric acid and increased stomach emptying

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27
Q

What is the triple H pylori treatment modality

A

clarithromycin, amoxicillin, and a PPI all given twice daily for 14 days

(metronidazole can be used instead of amoxicillin)

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28
Q

What is the bismuth quadtruple therapy for H pylori

A

bismuth subsalicylate, metronidazole, tetracycline, and PPI give for 14 days

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29
Q

PUD complications

A

hemorrhage, perforation, intractable pain and obstruction

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30
Q

How do we diagnose a GI bleed

A

nuclear medicine –> bleeding scan

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31
Q

What is a perforation

A

erosion of ulcer through wall of stomach or duodenum –> gastric secretions spill into the abd cavity resulting in peritonitis

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32
Q

S/S of a perforation

A

abdominal pain, rebound tenderness, rigid abdomen (board-like), decreased BS and VS changes

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33
Q

What are the classifications of irritable bowel syndrome

A

D: diarrhea
C: constipation
A: alternating
M: mix

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34
Q

What do labs look like with irritable bowel syndrome

A

usually normal, increased exhaled hydrogen

35
Q

Health teaching with irritable bowel

A

30 to 40 grams of fiber daily

promote normal bowel function

36
Q

Drug therapy for irritable bowel

C:
D:

A

C: lubiprostone, linaclotide
D: olosetron (serotonin antagonist)

37
Q

What do we monitor for with irritable bowel

A

obstruction or ischemic colitis

38
Q

Diverticulitis is

A

perforation and peritonitis

39
Q

S/S of diverticulitis

A

LLQ pain, low grade fever, N/V

common cause of lower GI bleeding (bright blood)

40
Q

Chrons disease vs UC

A

chrons: skip lesions, abd pain in RLQ and diarrhea –> steatorrhea

UC: abd pain and bloody diarrhea –> electrolyte imbalance

41
Q

Extraintestinal symptoms of IBD

A

arthritis, skin rashes

42
Q

Chrons is most often in

A

terminal ileus

43
Q

What color stoma is a medical emergency

A

dark red, dusky colored stoma

44
Q

With stoma care we must monitor for

A

s/s of ischemia, unusual bleeding, seperation, retraction, prolapse, skin rash

45
Q

What do we clean the stoma with

A

tap water

46
Q

What are hemorrhoids

A

masses of dilated blood vessels

47
Q

What is the difference between internal and external hemorrhoids

A

There are two types of hemorrhoids: Internal hemorrhoids, which are located inside the rectum and often less painful than external hemorrhoids. External hemorrhoids, which are found under the skin around the anus and are generally more painful

48
Q

With an anorectal surgery what is our main priority to monitor for

A

hypotension and dizziness

49
Q

Cholelithioasis

A

stone formation

50
Q

Cholecystitis

A

acute or chronic inflammation

51
Q

Risk factors for gallbladder issues

A

female, fluffy, fertile, fatty meals

52
Q

S/S of acute gallbladder issues

A

RUQ abd pain, positive murphys signs, jaundice, fever

53
Q

Charcot’s triad for gallbladder

A

acute obstructive cholangitis

fever w/ chills, abd pain, jaundice

54
Q

What diets do we want with gallbladder issues

A

high fiber, low fat diet

55
Q

Acute pancreatitis

A

severe condition

rapid onset (hours/days)

can become necrotic

56
Q

Chronic pancreatitis

A

ongoing and fibrotic

progressive and permanent

gallstones or excessive alc association

57
Q

What are the main findings in terms of labs for pancreatitis

A

increased amylase, lipase, and bili

amylase in urine

58
Q

s/s of pancreatitis

A

tachy, fever, stabbing pain that worsens with eating and radiates to the back, hypotension, jaundice, decreased BS, grey turners and cullens signs

59
Q

What type of aggressive fluid do we give to pancreatitis patients

A

LR

60
Q

Hep vaccines are for

A

HAV and HBV

61
Q

HAV specific recommendations

A

proper handwashing

avoid contaminated food or water

62
Q

HCV specific recommendations

A

avoid IV drug use or sharing needles

63
Q

Viral hepatitis stages

A

pre-icteric: profound anorexia, malaise, nausea and vomiting, a newly developed distaste for cigarettes (in smokers), and often fever or right upper quadrant abdominal pain

icteric: Jaundice (yellowing of the skin and whites of the eyes) develops. Other symptoms may subside. Anorexia, nausea and vomiting may worsen

post-icteric: subsiding symptoms, energy levels increase

64
Q

Normal ALT

A

4 to 36

65
Q

Normal AST

A

8 to 33

66
Q

Normal ALK phosphate

A

4.5 to 13

67
Q

Normal bili

A

less than 1.0

elevated is greater than 2.5

68
Q

HCV curative therapy

A

ledipasvir (harvoni)

sofosbuvir (epclusa)

69
Q

INterferon vs ribavirin side effects for HCV

A

interferon: flu like, depression, hair thin, diarrhea, insomnia

ribavirin: anemia, anorexia, cough, rash, pruritis, dyspnea

70
Q

Chronic HBV primary treatment

A

peginterferon alpha 2a (pagasys) subcut for 48 weeks–minimum

interferon alfa-2b (intron A) subcut injection

71
Q

A patient has been diagnosed with hepatitis A . Which of the following assessment findings would the nurse anticipate?
A) dark stools
B) weight gain
C) malaise
D) LUQ pain

A

C: malaise

72
Q

Which finding confirms that the patient is in the icteric phase of hepatitis

A

C: jaundice

73
Q

mechanical obstruction

A

blocked by problems outside the intestine (adhesion, fibrous band, chrons, tumors)

74
Q

Non-mechanical obstruction

A

paralytic ileus or adynamic ileus

75
Q

What is a strangulation obstruction a result of

A

tumor, hernias, fecal impactions, strictures, intussusception (bowel telescoping on itself), volvulus (twisting), fibrosis, vascular disorder, and adhesion

76
Q

With mechanical obstruction _______ peristalsis and secretions

A

increased

77
Q

Causes of paralytic ileus

A

intestinal handling
electrolyte imbalances (hypokalemia)
peritonitis
vascular insufficiency (ischemia)

78
Q

S/s of non mechanical obstruction

A

singultus (hiccups)

constant, diffuse discomfort

abdominal distention

decreased to absent bowel sounds (borboygmi-peristalsis waves visible)

vomiting

79
Q

Small bowel obstruction

A

pain accompanied by visible peristalsis waves in upper and middle abdomen

upper or epigastric abdominal distention

N/V

ostipation

severe fluid and electrolyte imbalance (low sodium, cl, K)

80
Q

Small bowel obstruction is associated with metabolic

A

alkalosis (if high)

81
Q

Large bowel obstruction is associated with metabolic

A

acidosis

82
Q

Large bowel obstruction

A

lower abdominal cramping and distention

no or minimal vomiting

obstipation

no major electrolyte imbalance

83
Q

What medication do we give for a paralytic ileus

A

alvimopan

Adult health 2 (15 decks)

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