Exam 3 Upper GI Flashcards
1
Q
where does digesting begin to occur?
A
the mouth
2
Q
describe the effects of poor oral health
A
- types and amounts of foods
- how well food is mixed with digestive enzymes
- may hinder communication
3
Q
describe periodontal disease
A
infection and inflammation of the gums
4
Q
identify the two stages of periodontal diseases
A
- gingivitis
- periodontitis
5
Q
describe gingivitis
A
early stage; the gums become swollen and red and may bleed
6
Q
describe periodontitis
A
advanced stage; the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out
7
Q
periodontal disease is related to what systemic diseases?
A
CVD, DM, RA
8
Q
What mineral helps prevent periodontal disease?
A
flouride
9
Q
define xerostomia
A
dry mouth
10
Q
lifestyle/diet changes for xerostomia?
A
- encourage fluid intake
11
Q
lifestyle/diet changes for oral health?
A
- refrain from alcohol, smoking
- reduce starches and sugars
12
Q
describe dysphagia as it relates to GI function
A
difficulty moving food through the esophagus
13
Q
briefly describe odynophagia
A
acute pain on swallowing
14
Q
describe functional dysphagia
A
sensation of difficulty swallowing without abnormalities nor injury
15
Q
briefly describe health effects of esophageal disorders
A
- affects food, fluid intake
- jeopardizes wellness
16
Q
identify two esophageal motility disorders
A
- achalasia
- esophageal spasm
17
Q
briefly describe achalasia
A
esophageal muscle malfunction
18
Q
briefly describe diverticula of the GI tract
A
outpouching anywhere along the mucosal lining throughout the GI tract
19
Q
briefly describe a Zeniker diverticulum
A
lower part of the throat meets up with the upper part of the esophagus
20
Q
the full name of GERD
A
gastroesophageal reflux disease
21
Q
briefly describe Barrett’s esophagus
A
lining of esophagus damaged by long-term acid reflux
22
Q
identify the three chief causes of esophagitis
A
- oral drugs
- chemical burns
- thoracic irradiation
23
Q
briefly describe the cause of chemical induced esophagitis
A
ingestion of a caustic substance
24
Q
identify the best way to reduce drug induced esophagitis
A
- always take pills with a drink! (200-250ml)
- sit up, avoid lying with drug
- take pills 30+ minutes before bed
- eat meal after taking pills
25
describe symptoms of esophagitis
* retrosternal chest pain
* dysphagia
26
how to diagnose esophagitis
* **rule out other reasons for "chest pain"**
* **endoscopy** for erythema, strictures, pill fragments
27
medications for esophagitis
* proton pump inhibitors
* antiacids
* antiemetics
28
full name of endoscopy "EGD"
esophagogastroduodenoscopy
29
briefly describe hiatal hernia
portion of stomach rises above diaphragm muscle
30
identify the two types of hiatal hernias
* sliding
* para**o**esophageal
31
briefly describe sliding hiatal hernia
esophagus and stomach move upward allowing some of the stomach to peek through opening in diaphragm
32
briefly describe paraoesophageal hiatal hernia
portion of the stomach herniates through the diaphragm and becomes stuck
33
describe symptoms specific to sliding hiatal hernia
pyrosis, regurgitation, dysphagia
| food slides back up!
34
identify possible complications of hiatal hernias
* hemorrhage, strangulation,
* obstruction, volvulus
35
briefly describe volvulus
twist
36
briefly describe strangulation
loss of blood supply; ischemic
37
identify common symptoms of hiatal hernias
* intermittent epigastric pain after eating
* fullness after eating
* food intolerance, nausea, vomiting
38
identify how to manage hiatal hernias
* frequent, small meals (easily pass through)
* **avoid recline** for 1 hour after eating
* elevate HOB 4-8 inches to prevent hernia moving upward
* avoid acid reflux triggers
39
identify purpose of surgery for hiatal hernia
to relieve complications, not to fix hernia
40
describe gastroesophageal reflux disease
backflow of gastric/duodenal contents into esophagus casing mucosal injury
41
identify main causes of gastroesophageal reflux disease
* incompetent sphincter
* pyloric stenosis
* hiatal hernia
* motility disorder
42
identify lifestyle/diet risk factors for gastroesophageal reflux disease
**the trifecta**:
tobacco use, coffee, alcohol
43
identify possible complications of gastroesophageal reflux disease
* stricture, ulcer, esophagitis, metaplasia
* chronic pulmonary disease, asthma
44
dietary changes for gastroesophageal reflux disease
low-fat, avoid "the usuals"
plus avoid milk, bubbly drinks
45
describe eating schedule for gastroesophageal reflux disease
avoid eat/drink 2hr before sleep, HOB 30*
46
identify medications for gastroesophageal reflux disease
* antiacids (neutralize)
* H-2 blockers (less secretion)
* proton pump inhibitors (less production)
47
treatment for Barrett's Esophagus
**endoscopic ablation** to prevent dysplasia/EAC (monitor w/ biopsies)
48
how does gastroesophageal reflux disease cause chronic pulmonary disease?
reflux makes it all the way to aspirate into lungs
49
describe the qualitative changes to the tissues with gastroesophageal reflux disease
damaged tissues toughen up and become less compliant
50
describe Barrett's Esophagus
the lining of esophageal mucosa change at the cellular level
51
identify the long-term complications of Barrett's Esophagus
esophageal adenocarcinoma (EAC)
52
identify lifestyle/diet risk factors for Barrett's Esophagus
smoking, obesity
53
identify nonmodifiable risk factors for Barrett's Esophagus
family history of it, long-term GERD, EAC
54
identify lifestyle/diet risk factors for Esophageal Tumors
smoking, alcohol
55
identify nonmodifiable risk factors for Esophageal Tumors
GERD, Barrett's Esophagus
56
identify symptoms of Esophageal Tumors
**can be asymptomatic**
* dysphagia (unable to pass food)
* pain
* pyrosis
* may feel full or stuck
57
define pyrosis
heartburn, a burning sensation in the stomach, chest, or throat (it may move around)
58
diagnostics for Esophageal Tumors
needle biopsy, endoscopy
59
identify the urgent complication of a gastrostomy or jejunostomy
premature dislodgement of the tube - **the hole will close quickly**
60
describe Esophageal Varices
superficial blood vessels "bulge inward" creating "outpouchings of blood"
61
name some of the many possible causes of Esophageal Varices
* cirrhosis, heart failure, Budd-Chari syndrome
* blood clots, sarcoids, schistosomiasis
* Wilson's disease, hemochromatosis
62
describe sarcoidosis
chronic granulomas junking up the organ
63
describe schistosomiasis
worm infection
64
describe hemochromatosis
iron overload
65
briefly describe Budd-Chiari syndrome
a type of venous obstruction in the liver
66
identify key risk factor for Esophageal Varices
alcoholism
67
identify nonmodifiable risk factors for Esophageal Varices
liver diseases/failure
68
identify modifiable risk factors for Esophageal Varices
abuse of alcohol, Tylenol, NSAIDs
69
identify symptoms of Esophageal Varices
think liver problems and blood loss:
* pallor, hypotension, dyspnea, tachycardia,
* jaundice, ascites,
* palmar erythema, spider nevi
70
identify quickly fatal complication of Esophageal Varices
variceal hemorrhage
71
identify systemic complications of Esophageal Varices
hypovolemic shock,
encephalopathy,
sepsis,
72
identify major organ complications of Esophageal Varices
aspiration pneumonia,
acute kidney injury,
liver failure
73
identify esophageal complications of Esophageal Varices
infection,
strictures,
74
describe typical pain rating of Esophageal Varices
typically not painful
75
identify typical labs ordered for Esophageal Varices
CBC,
iron levels,
liver function,
clotting studies
76
least invasive diagnostic for Esophageal Varices
CT scan
77
best method for visualizing Esophageal Varices
Esophagogastroduodenoscopy (EGD)
78
describe use of NG tube with Esophageal Varices
* avoid NG tube
* may be used to remove blood from stomach (and monitor bleeding)
79
what should the nurse do if profuse bleeding is suspected with Esophageal Varices?
prep for surgery and prioritize blood hemodynamic stability!
80
for what purposes are medical interventions ordered for Esophageal Varices?
support blood pressure,
antibiotic prophylaxis
81
identify medications typically ordered for Esophageal Varices
for BP support:
* beta-adrenergic blockers
* "pressins"
* IV fluid volume replacements
for prophylaxis:
* antibiotics
82
identify procedures to treat problematic esophageal varices
* endoscopic sclerosis, band ligation
* self-expanding metal stent
83
liver-related surgeries related to esophageal varices
* divert portal blood away from liver
* liver transplant
84
how to educate the patient on bodily functions with esophageal varices?
* avoid coughing, sneezing, vomiting
* avoid bearing down with BMs
85
describe the pattern of gastritis in the GI tract
shallow lesions all over the stomach lining
86
describe gastritis
disruption of the mucosal barrier that protects the stomach from digestive juices
87
briefly describe the kinds of causes for **acute** gastritis
overload of the stomach's usual protective measures
88
describe symptom **onset** of acute gastritis
rapid onset of symptoms with acute gastritis
89
briefly describe the kinds of causes for **chronic** gastritis
prolonged inflammation, atrophy
90
identify key cause of chronic gastritis
H. Pylori
91
describe erosive gastritis
holes in the mucosa
92
identify erosive causes of gastritis
meds, alcohol, bile reflux, radiation
93
identify nonerosive causes of gastritis
H. Pylori
94
describe pain with acute gastritis
epigastric pain near heart
95
identify symptoms specific to erosive gastritis
melena, hematemesis, hematochezia
96
describe melena
black tarry stool due to upper GI bleed
97
describe hematemesis
bright red blood in vomit
98
describe hematochezia
fresh blood with stool
99
identify symptoms common to all types of gastritis
anorexia, nausea, vomiting
100
identify symptoms specific to acute gastritis
dyspepsia, hiccough,
101
identify symptoms specific to chronic gastritis
fatigue, pyrosis, belching, halitosis, early satiety, sour taste in mouth
102
which anemia can lead to chronic gastritis?
pernicious anemia (B12 deficiency)
103
describe management of acute gastritis
* stop ingesting harmful/triggers
* NG suction substances
* meds
104
identify medications for acute gastritis
* antacids,
* H-2 blockers,
* proton pump inhibitors
105
describe management of chronic gastritis
diet, rest, stress, avoid alcohol, avoid NSAIDs
106
describe use of antibiotics for gastritis
assists with eradicating H. Pylori in the mucosa
107
describe use of antidiarrheal for gastritis
suppresses H. Pylori and promotes mucosa healing (aka: **protects**)
108
identify the key antidiarrheal for gastritis
bismuth subsalicylate
109
identify the use of H-2 Receptor Antagonists for gastritis
H-2 blockers decrease acid **production**
110
identify the use of Proton Pump Inhibitors for gastritis
PPIs decrease acid **secretion**
111
identify specific diet used for acute gastritis
NPO
112
nursing considerations with diet for gastritis
* clear liquids
* discourage caffein, alcohol, cigarettes (refer for counselling)
* promote fluid balance
* monitor for dehydration, electrolyte imbalance
113
describe the pattern of Peptic Ulcer Disease in the GI tract
focused area that goes deep into mucous lining
114
describe Peptic Ulcer Disease
erosion of a mucous membrane forms an excavation in the stomach, pylorus, duodenum, or esophagus
115
identify nonmodifiable risk factors for Peptic Ulcer Disease
**associated with H. Pylori**
* excessive stomach acid
* family history
116
identify lifestyle/diet risk factors for Peptic Ulcer Disease
* alcohol, smoking
* long-term use of NSAIDs
117
identify symptoms of Peptic Ulcer Disease
* dull, gnawing pain or burning in mid-epigastrium
* heartburn, vomiting
118
describe physical assessment findings with Peptic Ulcer Disease
* abdominal tenderness
* abdominal distention
119
identify diagnostic tests for Peptic Ulcer Disease
* guaiac test
* biopsy for H. Pylori
* upper endoscopy
* CBC
120
what is the guaiac test for?
fecal occult blood
121
medications for **healing** from Peptic Ulcer Disease
* H-2 blocker
* Proton Pump Inhibitor
* Antacid
122
medications for H. Pylori infection associated with Peptic Ulcer Disease
"quadruple therapy"
* 3 antibiotics
* plus bismuth subsalicylate
123
identify prophylactic medications for NSAID ulcers (Peptic Ulcer Disease)
"healing meds" PLUS
* misoprostol (additional barrier protection of mucosa)
124
describe the purpose of surgical intervention for Peptic Ulcers
only used when "intractable to other treatments" to prevent rupture (but prognosis is bad anyway)
125
what is the most common location for a Peptic Ulcer?
duodenum (it does not have the protective mechanisms of the stomach but is the first stop out of the stomach)
126
the nurse monitors for what complications of Gastritis OR Peptic Ulcer Disease?
* hemorrhage
* perforation, penetration
* gastric outlet obstruction
