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NUR3220 ADULT HEALTH I > Exam 3 Study Guide - Stomach Disorders > Flashcards

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
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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
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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
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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
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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)
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5
Q

Hemorrhage

A
  • Complication of Peptic Ulcer Disease
  • Emergency & life threatening
  • Occurs more often in pts w/ gastric ulcers & in older adults
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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
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7
Q

Pyloric Obstruction

A
  • Complication of Peptic Ulcer Disease
  • Symptoms include abdominal bloating & N/V
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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
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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
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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
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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
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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
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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
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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
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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

NUR3220 ADULT HEALTH I (13 decks)

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