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Adult health II final > Exam 3: Stomach disorders, Non-inflammatory intestinal problems > Flashcards

Exam 3: Stomach disorders, Non-inflammatory intestinal problems Flashcards

1
Q

Chronic Gastritis: Type A (non-erosive) etiology

A
  • Inflammation of the gastric glands, fundus & body of the stomach
  • Autoimmune link
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2
Q

Chronic Gastritis: Type B etiology

A
  • Involves the glands of the antrum, may also involve the entire stomach
  • Caused by H. pylori infection
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3
Q

Chronic Gastritis: Atrophic etiology

A
  • Affects all layers of the stomach, decreases number of cells
  • Older adults
  • Toxins, H. pylori, autoimmune
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4
Q

Pathogenesis of peptic ulcer: most common cause and second most common

A

Most common cause

  • Infection with H. pylori (HP) is the most common cause of gastric and duodenal ulcers
  • Additional factors must be involved: 50% harbor HP, but only 10% develop PUD

Second most common cause
- NSAIDs

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5
Q

Peptic ulcer diagnostics

A
  • serologic testing (testing for H. pylori antibodies)
  • Breath test (screening tool) (swallowing a capsule, liquid, or pudding that contains urea with special carbon. Patient exhales and sepecial carbon atom found= bacterium is present)
  • EGD (esophagogastroduodenoscopy)
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6
Q

Management of GI bleeding

A
  • Serial H and H
  • # 1 priority: Obtain and monitor vital signs closely
  • Oxygen
  • Fluid and blood replacement
  • Large bore NG tube
  • Lavage (with room temperature solution and 200-300 mL)
  • EGD
  • Acid suppression
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7
Q

Gastric cancer treatment

A
  • Surgical resection (Gastrectomy
  • Chemotherapy
  • Radiation
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8
Q

Gastric cancer complications

A
  • Dumping syndrome
  • Alkaline reflux gastropathy
  • Afferent loop syndrome
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9
Q

Dumping syndrome: Early symptoms (30 min after meal)

A
  • Vasomotor response

- Vertigo, tachycardia, syncope, sweating, palpitations

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10
Q

Dumping syndrome: Late symptoms (90 min to 3 hours)

A
  • Excessive release of insulin

- Dizziness, lightheadedness, diaphoresis, confusion

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11
Q

Irritable Bowel Syndrome Types: IBS-D symptoms

A

Primary symptom is diarrhea

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12
Q

Irritable Bowel Syndrome Types: IBS-C symptoms

A

Primary symptom is constipation

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13
Q

Irritable Bowel Syndrome Types: IBS-M symptoms

A

Mixture of diarrhea and constipation

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14
Q

Irritable Bowel Syndrome Types: IBS-A symptoms

A

Alternates between constipation and diarrhea

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15
Q

Irritable Bowel Syndrome assessment

A
  • Fatigue, malaise, abdominal pain, changes in bowel pattern or consistency of stools, passage of mucus
  • Nausea, belching, gas, bloating, anorexia
  • Assess location, intensity and quality of pain
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16
Q

Irritable Bowel syndrome diagnostic

A

Hydrogen breath test

  • NPO for 12 hours
  • Ask for allergy to sucrose
  • clear water but that’s it
  • breath test before they give you sucrose and then wait an hour to do another test

Caused by - absorption of a dairy product
- caffeinated beverages

17
Q

Irritable Bowel Syndrome medications: For IBS-C

A
  • psyllium (Metamucil) (cause to have a BM)
  • linaclotide (Linzess)
  • lubiprostone (Amitiza)(only used in women) (take it with food and water, increases fluids in intestines)
18
Q

Irritable Bowel Syndrome medications: For IBS-D

A
  • loperamide (Imodium)
  • psyllium (Metamucil) (formed stool)
  • alosetron (Lotrenex) (only approved for woman) (post market analysis- had bad effects. Decreases motility, severe constipation, perforation and death. Not first choice. Treatment for 6 months before taking this.) report any Constipation
19
Q

Irritable Bowel Syndrome medications: General

A
  • rifaximin (Xifaxan) (control affects of inflammation, antibiotic)
  • darifenacin (Enablex) (same as above)
  • amitriptyline (Elavil)
  • Complementary therapies
    Probiotics, Accupuncture, moxibustion (Acu-Moxa)
20
Q

Colorectal cancer risk factors

A
  • Age >50 yr
  • Genetic predisposition, personal/family history of cancer
  • Familial adenomatous polyposis (FAP)
  • Hereditary nonpolyposis colorectal cancer (HNPCC)
  • Infection
  • Helicobacter pylori, Streptococcus bovis, HPV
  • Smoking, heavy ETOH, lack of exercise, high fat, low fiber diet
  • Inflammatory bowel disease
21
Q

Colorectal cancer symptoms

A
  • Rectal bleeding, anemia, change in stool consistency/shape

- Fatigue, abdominal fullness, vague abdominal pain, unintentional weight loss

22
Q

Colorectal cancer; Stage 1

A

tumor invades up to muscle layer

23
Q

Colorectal cancer: Stage 2

A

tumor invades up to other organs or perforates peritoneum

24
Q

Colorectal cancer: Stage 3

A

any level of tumor invasion, up to 4 regional lymph nodes

25
Q

Colorectal cancer: Stage 4

A

any level of tumor invasion; many lymph nodes affected with distant metastasis

26
Q

Colorectal cancer: Treatment

A

Chemotherapy
FOLFOX
- FOL: leucovorin (LV) (folinic acid) (increase the effectiveness of 5-FU)
- F: 5-fluorouracil (5-FU) (only in system for short time),
- OX: oxaliplatin (Eloxatin)

Antiangiogenesis
- Bevacizumab (Avastin)

Epidermal growth factor receptor inhibitor (EGFRI)

  • cetuximab (Erbitux)
  • panitumumab (Vectibix)
27
Q

Colostomy types: Ascending

A
  • done for right sided tumors
28
Q

Colostomy Types: Transverse (double-barreled)

A
  • intestinal obstruction or perforation
  • The proximal one, closes to the small intestine: drains feces
  • The distal stoma drains mucus
29
Q

Colostomy types: Descending

A
  • Done for left sided tumors
30
Q

Colostomy types: Sigmoid

A
  • Done for rectal tumors
31
Q

Colostomy care

A
  • Pink, moist, blood flow is present, not blue
  • Goal for assessment, skin around stoma is very fragile because the acidity of the drainage can leak around it
  • Soap and water to wash the drainage off.
  • Don’t let bag get completely full
32
Q

Abdominal trauma: Liver

A

Most common organ injured in penetrating trauma

2nd most common in blunt trauma

33
Q

Abdominal trauma: Liver assessment

A

Inspection for ecchymosis
Abdominal CT scan
Grade I - VI

34
Q

Abdominal trauma: Liver Treatment and nursing interventions

A

Treatment

  • Stable: non-operative management
  • Unstable- surgical repair

Nursing interventions

  • Monitor for signs of hemorrhage
  • Monitor response to treatment
35
Q

Abdominal trauma: Spleen

A

Most common organ injured in blunt trauma

36
Q

Abdominal trauma: Spleen assessment

A
  • Abdominal CT scan

- Grade I - V

37
Q

Abdominal trauma: Spleen Treatment and nursing interventions

A

Treatament
Stable: Medical management
Unstable: Surgical intervention

Nursing interventions
Monitor for signs of hemorrhage

38
Q

Abdominal trauma: Intestinal injuries diagnostics

A

FAST, CT scan of abdomen or DPL

  • Free fluid
  • Free air
  • Mesenteric hematoma
  • FAST (Focused assessment sonogram for trauma) looking for type of blood or perforation that is occurring
  • DPL (Peritoneal lavage) looking for blood
39
Q

Abdominal perfusion pressure (APP) calculation and normal range

A
  • APP= MAP-IAP
  • Should be maintained at more than 50-60 mmHg to
    maintain adequate perfusion.

Adult health II final (14 decks)

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