Exam 3 Study Guide - Stomach Disorders Flashcards
1
Q
Acute Gastritis CMs
A
- Rapid onset of epigastric pain or discomfort
- N/V
- Hematemesis (vomiting blood)
- Gastric hemorrhage; life-threatening emergency
- Dyspepsia (indigestion)
- Anorexia
2
Q
Chronic Gastritis CMs
A
- Vague report of epigastric pain tht is relieved by food
- Anorexia
- N/V
- Intolerance of fatty & spicy foods
- Pernicious anemia
2
Q
Acute Gastritis - Interventions
A
-
Treated symptomatically & supportively bc the healing process is spontaneous
> drug therapy
> blood transfusion if bleeding
> fluid replacement for dehydration
> surgery w/ major bleeding
3
Q
Chronic Gastrtitis - Interventions
A
- Varies w/ cause:
> drug therapy
> elimination of causative agent; EX: H. pylori treated w/ antimicrobials
> treatment of any underlying disease
> avoidance of toxic substances
4
Q
Gastritis Interventions - Drug Therapy
A
-
H2-Receptor Antagonists
> Famotidine - Pepcid, Nizatidine - Axid
> blocks gastric secretions -
Mucosal Barrier
> Sucralfate - Carafate, Sulcrate -
Antacids
> Maalox, Mylanta
> buffering agent -
Proton Pump Inhibitors
> Omeprazole - Prilosec, Pantoprazole - Protonix
> suppress gastric acid secretion -
Vitamin B12
> prevention or treatment of pernicious anemia (chronic gastritis)
5
Q
Hemorrhage
A
- Complication of Peptic Ulcer Disease
- Emergency & life threatening
- Occurs more often in pts w/ gastric ulcers & in older adults
6
Q
Perforation
A
- Complication of Peptic Ulcer Disease
- Surgical emergency & can be life threatening
- Symptoms include sharp, sudden pain beginning in the mid-epigastric region & spreads over entire abdomen
- Abdomen is tender, rigid, & boardlike
7
Q
Pyloric Obstruction
A
- Complication of Peptic Ulcer Disease
- Symptoms include abdominal bloating & N/V
8
Q
Intractable Disease
A
- Complication of Peptic Ulcer Disease
- Characterized by a lack of response to conservative management & w/ symps tht interfere w/ ADLs
9
Q
Peptic Ulcer Disease - Assessment
A
- Hx
-
Physical assessment/CMs:
> dyspepsia; most common symp: sharp, burning, gnawing pain
> epigastric tenderness
> N/V -
Lab Assessment:
> serologic testing for H. pylori antibodies
> dcrd H/H, if bleeding
> stool may be positive for occult blood, if bleeding -
Diagnostic Testing
> EGD
> nuclear medicine scan to test for blleding; no special prep, pt injected w/ a contrast medium, GI system scanned for presence of bleeding after a waiting period
10
Q
Peptic Ulcer Disease - Interventions
A
-
Diet
> bland diet may assist in relieving symps
> teach pt to exclude foods tht cause discomfort
> avoid bedtime snacks, alcohol, tobacco, caffeine-containing beverages, & both caffeinated & decaffeinated coffees -
Complementary & Alternative Therapies
> hypnosis
> imagery
> yoga
> mediation techniques
11
Q
Peptic Ulcer Disease - Medications
antacids
H2 antagonists
mucosal barrier fortifier
A
-
Antacids
> incrs pH of gastric contents by deactivating pepsin -
H2 Antagonsits
> dcrs gastric acid secretions by blocking histamine receptors in parietal cells -
Mucosal Barrier Fortifier
> binds w/ bile acids & pepsin to protect stomach mucosa
> stimulates mucosal protectiong
> may cause stools to be discolored black
12
Q
Peptic Ulcer Disease - Medications
proton pump inhibitors
prostaglandin analogs
A
-
Proton Pump Inhibitors (PPI)
> suppresses H, K-ATPase enzyme system of gastric acid secretion -
Prostaglandin Analogs
> stimulates mucosal protection & dcrs gastric acid secretions, helps resist mucosal injury in pts taking NSAIDs and/or high-dose corticosteroids
13
Q
Peptic Ulcer Disease - Purpose of Meds
A
-
Eliminate H. pylori infection
> PPI triple therapy; PPI + 2 antibiotics like metronidazole (Flagyl) & tetracycline or clarithromycin (Biaxin) & amoxicillin (Amoxil) for 10-14 days
> PPI quadruple therapy; PPI + any 2 antibiotics above + bismuth (Pepto-Bismol) - Heal ulcerations
- Prevent recurrence
- Provide pain relief
14
Q
Gastric Cancer - Etiology & Genetic Risks
A
- H. pylori largest risk factor
- Medical Hx Risk Factor: pernicious anemia, gastric polyps, chronic atrophic gastritis, & achlorhydria (absence of secretion of hydrochloric acid)
- Diet Risks: eating pickled food, nitrates from processed foods, added salt & low intake of fruits & veggies
- Incrd Risk: gastric surgery, Barrett’s esophagus from prolonged or severe GERD
15
Q
Gastric Cancer Symptoms
A
- Early Stages: heartburn & abdominal discomfort
- Late Stages: progressive weight loss & N/V
16
Q
Gastric Cancer - Diagnostic Testing
A
- EGD for definitive diagnosis
- CT, PET, & MRI are used in determining the extent of disease & planning therapy
17
Q
Gastric Cancer Interventions
nonsurgical
surgical
A
-
Nonsurgical
> drug therapy, radiation and/or chemotherapy -
Surgical
> resection of tumor
> total gastrectomy
> subtotal (partial) gastrectomy
18
Q
Gastric Cancer - Interventions
pt/family teaching
A
- Surgical dressing changes
- Review manis of incisional infection
- Side effects of radiation therapy/chemotherapy (N/V, fatigue)
- Instruct pt to eat small, frequent meals
- Avoid dinking liquids w/ meals
- Avoid foods tht cause discomfort
- Eliminate caffeine & alcohol consumption
- Stop smoking
- B12 injections
- Lie flat after eating for short time
19
Q
Dumping Syndrome - Early Manifestations
A
-
Occurs w/in 30 mins of eating
> vertigo
> tachcardia
> syncope
> sweating
> pallor
> palpitations
> desire to lie down
20
Q
Dumping Syndrome - Late Manifestations
A
-
Occurs 90 mins to 3 hrs after eating
> caused by a release of an excessive amnt of insulin
> dizziness
> light-headedness
> palpitations
> diaphoresis
> confusion
21
Q
Dumping Syndrome - Interventions
A
- Dcr amnt of food taken at one time
- Eliminate liquids ingested w/ meals
- Eat high protein, high fat, & low to moderate carbohydrate
- In severe cases some meds are used tht slows stomach & intestinal motility
