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NU342.01 HPA1 Health Promotion Across the Lifespan > Exam 3 Upper GI > Flashcards

Exam 3 Upper GI Flashcards

1
Q

where does digesting begin to occur?

A

the mouth

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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
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3
Q

describe periodontal disease

A

infection and inflammation of the gums

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4
Q

identify the two stages of periodontal diseases

A
  • gingivitis
  • periodontitis
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5
Q

describe gingivitis

A

early stage; the gums become swollen and red and may bleed

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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

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7
Q

periodontal disease is related to what systemic diseases?

A

CVD, DM, RA

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8
Q

What mineral helps prevent periodontal disease?

A

flouride

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9
Q

define xerostomia

A

dry mouth

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10
Q

lifestyle/diet changes for xerostomia?

A
  • encourage fluid intake
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11
Q

lifestyle/diet changes for oral health?

A
  • refrain from alcohol, smoking
  • reduce starches and sugars
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12
Q

describe dysphagia as it relates to GI function

A

difficulty moving food through the esophagus

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13
Q

briefly describe odynophagia

A

acute pain on swallowing

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14
Q

describe functional dysphagia

A

sensation of difficulty swallowing without abnormalities nor injury

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15
Q

briefly describe health effects of esophageal disorders

A
  • affects food, fluid intake
  • jeopardizes wellness
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16
Q

identify two esophageal motility disorders

A
  • achalasia
  • esophageal spasm
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17
Q

briefly describe achalasia

A

esophageal muscle malfunction

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18
Q

briefly describe diverticula of the GI tract

A

outpouching anywhere along the mucosal lining throughout the GI tract

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19
Q

briefly describe a Zeniker diverticulum

A

lower part of the throat meets up with the upper part of the esophagus

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20
Q

the full name of GERD

A

gastroesophageal reflux disease

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21
Q

briefly describe Barrett’s esophagus

A

lining of esophagus damaged by long-term acid reflux

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22
Q

identify the three chief causes of esophagitis

A
  • oral drugs
  • chemical burns
  • thoracic irradiation
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23
Q

briefly describe the cause of chemical induced esophagitis

A

ingestion of a caustic substance

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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
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25
Q

describe symptoms of esophagitis

A
  • retrosternal chest pain
  • dysphagia
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26
Q

how to diagnose esophagitis

A
  • rule out other reasons for “chest pain”
  • endoscopy for erythema, strictures, pill fragments
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27
Q

medications for esophagitis

A
  • proton pump inhibitors
  • antiacids
  • antiemetics
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28
Q

full name of endoscopy “EGD”

A

esophagogastroduodenoscopy

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29
Q

briefly describe hiatal hernia

A

portion of stomach rises above diaphragm muscle

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30
Q

identify the two types of hiatal hernias

A
  • sliding
  • paraoesophageal
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31
Q

briefly describe sliding hiatal hernia

A

esophagus and stomach move upward allowing some of the stomach to peek through opening in diaphragm

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32
Q

briefly describe paraoesophageal hiatal hernia

A

portion of the stomach herniates through the diaphragm and becomes stuck

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33
Q

describe symptoms specific to sliding hiatal hernia

A

pyrosis, regurgitation, dysphagia

food slides back up!

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34
Q

identify possible complications of hiatal hernias

A
  • hemorrhage, strangulation,
  • obstruction, volvulus
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35
Q

briefly describe volvulus

A

twist

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36
Q

briefly describe strangulation

A

loss of blood supply; ischemic

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37
Q

identify common symptoms of hiatal hernias

A
  • intermittent epigastric pain after eating
  • fullness after eating
  • food intolerance, nausea, vomiting
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38
Q

identify how to manage hiatal hernias

A
  • 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
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39
Q

identify purpose of surgery for hiatal hernia

A

to relieve complications, not to fix hernia

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40
Q

describe gastroesophageal reflux disease

A

backflow of gastric/duodenal contents into esophagus casing mucosal injury

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41
Q

identify main causes of gastroesophageal reflux disease

A
  • incompetent sphincter
  • pyloric stenosis
  • hiatal hernia
  • motility disorder
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42
Q

identify lifestyle/diet risk factors for gastroesophageal reflux disease

A

the trifecta:
tobacco use, coffee, alcohol

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43
Q

identify possible complications of gastroesophageal reflux disease

A
  • stricture, ulcer, esophagitis, metaplasia
  • chronic pulmonary disease, asthma
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44
Q

dietary changes for gastroesophageal reflux disease

A

low-fat, avoid “the usuals”
plus avoid milk, bubbly drinks

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45
Q

describe eating schedule for gastroesophageal reflux disease

A

avoid eat/drink 2hr before sleep, HOB 30*

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46
Q

identify medications for gastroesophageal reflux disease

A
  • antiacids (neutralize)
  • H-2 blockers (less secretion)
  • proton pump inhibitors (less production)
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47
Q

treatment for Barrett’s Esophagus

A

endoscopic ablation to prevent dysplasia/EAC (monitor w/ biopsies)

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48
Q

how does gastroesophageal reflux disease cause chronic pulmonary disease?

A

reflux makes it all the way to aspirate into lungs

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49
Q

describe the qualitative changes to the tissues with gastroesophageal reflux disease

A

damaged tissues toughen up and become less compliant

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50
Q

describe Barrett’s Esophagus

A

the lining of esophageal mucosa change at the cellular level

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51
Q

identify the long-term complications of Barrett’s Esophagus

A

esophageal adenocarcinoma (EAC)

52
Q

identify lifestyle/diet risk factors for Barrett’s Esophagus

A

smoking, obesity

53
Q

identify nonmodifiable risk factors for Barrett’s Esophagus

A

family history of it, long-term GERD, EAC

54
Q

identify lifestyle/diet risk factors for Esophageal Tumors

A

smoking, alcohol

55
Q

identify nonmodifiable risk factors for Esophageal Tumors

A

GERD, Barrett’s Esophagus

56
Q

identify symptoms of Esophageal Tumors

A

can be asymptomatic
* dysphagia (unable to pass food)
* pain
* pyrosis
* may feel full or stuck

57
Q

define pyrosis

A

heartburn, a burning sensation in the stomach, chest, or throat (it may move around)

58
Q

diagnostics for Esophageal Tumors

A

needle biopsy, endoscopy

59
Q

identify the urgent complication of a gastrostomy or jejunostomy

A

premature dislodgement of the tube - the hole will close quickly

60
Q

describe Esophageal Varices

A

superficial blood vessels “bulge inward” creating “outpouchings of blood”

61
Q

name some of the many possible causes of Esophageal Varices

A
  • cirrhosis, heart failure, Budd-Chari syndrome
  • blood clots, sarcoids, schistosomiasis
  • Wilson’s disease, hemochromatosis
62
Q

describe sarcoidosis

A

chronic granulomas junking up the organ

63
Q

describe schistosomiasis

A

worm infection

64
Q

describe hemochromatosis

A

iron overload

65
Q

briefly describe Budd-Chiari syndrome

A

a type of venous obstruction in the liver

66
Q

identify key risk factor for Esophageal Varices

A

alcoholism

67
Q

identify nonmodifiable risk factors for Esophageal Varices

A

liver diseases/failure

68
Q

identify modifiable risk factors for Esophageal Varices

A

abuse of alcohol, Tylenol, NSAIDs

69
Q

identify symptoms of Esophageal Varices

A

think liver problems and blood loss:
* pallor, hypotension, dyspnea, tachycardia,
* jaundice, ascites,
* palmar erythema, spider nevi

70
Q

identify quickly fatal complication of Esophageal Varices

A

variceal hemorrhage

71
Q

identify systemic complications of Esophageal Varices

A

hypovolemic shock,
encephalopathy,
sepsis,

72
Q

identify major organ complications of Esophageal Varices

A

aspiration pneumonia,
acute kidney injury,
liver failure

73
Q

identify esophageal complications of Esophageal Varices

A

infection,
strictures,

74
Q

describe typical pain rating of Esophageal Varices

A

typically not painful

75
Q

identify typical labs ordered for Esophageal Varices

A

CBC,
iron levels,
liver function,
clotting studies

76
Q

least invasive diagnostic for Esophageal Varices

A

CT scan

77
Q

best method for visualizing Esophageal Varices

A

Esophagogastroduodenoscopy (EGD)

78
Q

describe use of NG tube with Esophageal Varices

A
  • avoid NG tube
  • may be used to remove blood from stomach (and monitor bleeding)
79
Q

what should the nurse do if profuse bleeding is suspected with Esophageal Varices?

A

prep for surgery and prioritize blood hemodynamic stability!

80
Q

for what purposes are medical interventions ordered for Esophageal Varices?

A

support blood pressure,
antibiotic prophylaxis

81
Q

identify medications typically ordered for Esophageal Varices

A

for BP support:
* beta-adrenergic blockers
* “pressins”
* IV fluid volume replacements
for prophylaxis:
* antibiotics

82
Q

identify procedures to treat problematic esophageal varices

A
  • endoscopic sclerosis, band ligation
  • self-expanding metal stent
83
Q

liver-related surgeries related to esophageal varices

A
  • divert portal blood away from liver
  • liver transplant
84
Q

how to educate the patient on bodily functions with esophageal varices?

A
  • avoid coughing, sneezing, vomiting
  • avoid bearing down with BMs
85
Q

describe the pattern of gastritis in the GI tract

A

shallow lesions all over the stomach lining

86
Q

describe gastritis

A

disruption of the mucosal barrier that protects the stomach from digestive juices

87
Q

briefly describe the kinds of causes for acute gastritis

A

overload of the stomach’s usual protective measures

88
Q

describe symptom onset of acute gastritis

A

rapid onset of symptoms with acute gastritis

89
Q

briefly describe the kinds of causes for chronic gastritis

A

prolonged inflammation, atrophy

90
Q

identify key cause of chronic gastritis

A

H. Pylori

91
Q

describe erosive gastritis

A

holes in the mucosa

92
Q

identify erosive causes of gastritis

A

meds, alcohol, bile reflux, radiation

93
Q

identify nonerosive causes of gastritis

A

H. Pylori

94
Q

describe pain with acute gastritis

A

epigastric pain near heart

95
Q

identify symptoms specific to erosive gastritis

A

melena, hematemesis, hematochezia

96
Q

describe melena

A

black tarry stool due to upper GI bleed

97
Q

describe hematemesis

A

bright red blood in vomit

98
Q

describe hematochezia

A

fresh blood with stool

99
Q

identify symptoms common to all types of gastritis

A

anorexia, nausea, vomiting

100
Q

identify symptoms specific to acute gastritis

A

dyspepsia, hiccough,

101
Q

identify symptoms specific to chronic gastritis

A

fatigue, pyrosis, belching, halitosis, early satiety, sour taste in mouth

102
Q

which anemia can lead to chronic gastritis?

A

pernicious anemia (B12 deficiency)

103
Q

describe management of acute gastritis

A
  • stop ingesting harmful/triggers
  • NG suction substances
  • meds
104
Q

identify medications for acute gastritis

A
  • antacids,
  • H-2 blockers,
  • proton pump inhibitors
105
Q

describe management of chronic gastritis

A

diet, rest, stress, avoid alcohol, avoid NSAIDs

106
Q

describe use of antibiotics for gastritis

A

assists with eradicating H. Pylori in the mucosa

107
Q

describe use of antidiarrheal for gastritis

A

suppresses H. Pylori and promotes mucosa healing (aka: protects)

108
Q

identify the key antidiarrheal for gastritis

A

bismuth subsalicylate

109
Q

identify the use of H-2 Receptor Antagonists for gastritis

A

H-2 blockers decrease acid production

110
Q

identify the use of Proton Pump Inhibitors for gastritis

A

PPIs decrease acid secretion

111
Q

identify specific diet used for acute gastritis

A

NPO

112
Q

nursing considerations with diet for gastritis

A
  • clear liquids
  • discourage caffein, alcohol, cigarettes (refer for counselling)
  • promote fluid balance
  • monitor for dehydration, electrolyte imbalance
113
Q

describe the pattern of Peptic Ulcer Disease in the GI tract

A

focused area that goes deep into mucous lining

114
Q

describe Peptic Ulcer Disease

A

erosion of a mucous membrane forms an excavation in the stomach, pylorus, duodenum, or esophagus

115
Q

identify nonmodifiable risk factors for Peptic Ulcer Disease

A

associated with H. Pylori
* excessive stomach acid
* family history

116
Q

identify lifestyle/diet risk factors for Peptic Ulcer Disease

A
  • alcohol, smoking
  • long-term use of NSAIDs
117
Q

identify symptoms of Peptic Ulcer Disease

A
  • dull, gnawing pain or burning in mid-epigastrium
  • heartburn, vomiting
118
Q

describe physical assessment findings with Peptic Ulcer Disease

A
  • abdominal tenderness
  • abdominal distention
119
Q

identify diagnostic tests for Peptic Ulcer Disease

A
  • guaiac test
  • biopsy for H. Pylori
  • upper endoscopy
  • CBC
120
Q

what is the guaiac test for?

A

fecal occult blood

121
Q

medications for healing from Peptic Ulcer Disease

A
  • H-2 blocker
  • Proton Pump Inhibitor
  • Antacid
122
Q

medications for H. Pylori infection associated with Peptic Ulcer Disease

A

“quadruple therapy”
* 3 antibiotics
* plus bismuth subsalicylate

123
Q

identify prophylactic medications for NSAID ulcers (Peptic Ulcer Disease)

A

“healing meds” PLUS
* misoprostol (additional barrier protection of mucosa)

124
Q

describe the purpose of surgical intervention for Peptic Ulcers

A

only used when “intractable to other treatments” to prevent rupture (but prognosis is bad anyway)

125
Q

what is the most common location for a Peptic Ulcer?

A

duodenum (it does not have the protective mechanisms of the stomach but is the first stop out of the stomach)

126
Q

the nurse monitors for what complications of Gastritis OR Peptic Ulcer Disease?

A
  • hemorrhage
  • perforation, penetration
  • gastric outlet obstruction

NU342.01 HPA1 Health Promotion Across the Lifespan (3 decks)

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