Exam 5 Flashcards
How should a client with GERD eat meals and modify lifestyle?
- low fat diet
- small meals with fluid between
- sit upright 2-3hrs after meals
- AVOID milk and eating before bedtime
- HOB 30 degrees or heater
- weight reduction
When should meds for GERD (like -prazole) be taken concerning meals?
Take BEFORE meals
Barrett’s esophagus is a complication of GERD. Some more examples are….
Teeth decay, aspiration, bleeding from strictures of blood vessels
Manifestations of hiatal hernia include…
Heartburn (pyrosis), dyspepsia, regurgitation, chest pain, respiratory symptoms
***symptoms similar to GERD
What are serious complications of hiatal hernias?
Hemorrhage, stenosis, strangulation, aspirational
**also GERD, ulcers, esophagitis
What should be monitored in clients taking PPIs for GERD or Hernias?
Monitor for hypocalcemia, hypomagnesemia, vitamin b12 deficiency, pneumonia, osteoporosis-related fractures
What food intake should you teach clients on PPIs?
Magnesium-rich foods like spinach, almonds, yogurt and avocados
A patient with arthritis that takes NSAIDs may have…
GI bleeding
What medication is taken instead of NSAIDs to avoid GI complications?
Celebrex (celecoxib)
What population is more at risk for PUD?
Older clients that are taking NSAIDs (may be asymptomatic)
What is a good treatment option for patients struggling with nutrition due to ulcers?
Sucralfate
-give 1-2 hrs before or after antacid
-coats lining
This complication of ulcers is a medical emergency…
Perforation
What is the main symptom of peritonitis?
Rigid abdomen
What should patients with ulcers monitor at home?
Blood in stool, change in stool appearance
What are the predisposing factors of stomach cancer?
- SMOKED FOODS, salted fish and meat, pickled vegetables
- H.pylori infection
How is dumping syndrome prevented?
Rest after eating!!! Also, increase fluid
If a patient had a GI surgery and is using an NG tube, what should you never do if the tube is misplaced?
NEVER reinsert or reposition
*you can irrigate
What is the main concern in C.diff patients?
Infection control precautions, preventing spread
*second is fluid volume loss
What is a risk of taking alosetron for IBS?
Ischemic colitis
Manifestations of Crohn’s disease (and ulcerative colitis) include….
Diarrhea, cramping
Weight loss
Abdominal pain
Fever
Fatigue
Some rectal bleeding
What is the key difference in symptoms of Ulcerative colitis and Crohn’s disease?
Bloody diarrhea in ulcerative colitis
What complications can be seen in both ulcerative colitis and Crohn’s disease clients?
Hemorrhage
Abscess and fistulas
Toxic megacolon (common in UC)
What complication is more seen from Crohn’s disease?
Small bowel obstruction
What tests are used to tell of inflammation in the body?
Erythrocyte sedimentation rate and C-reactive protein
What are the side effects of corticosteroids (and amino salicylates)?
Headache
Easy bruising
Increased facial hair
Leg edema
Fatigue, N/V
Changes in appetite
Changes in menstruation
Lightheadedness
What are side effects of immunosuppressants?
Reddened eyes
Hair loss
Headache
Tiredness
Changes in appetite
Lightheadedness
What are side effects of biologics?
Headache
Runny nose
Yeast infection
Face flushing
Nausea/indigestion
What type of feedings are preferred for IBD clients?
Liquid enteral feedings
What is the greatest risk factor for colorectal cancer?
Having first degree relatives with colorectal cancer
What is the number one symptom of colorectal cancer?
Change in bowel habits
What is the only cure for colorectal cancer?
Surgery (colectomy)
For scrotal edema from hernias, what is the post op care?
Ice and elevation
What builds up when the liver fails?
Ammonia
What changes are seen with abnormal ammonia levels?
Cognitive changes
What medication is used to decrease ammonia levels?
Lactulose
Ascites is a complication of cirrhosis. What are some interventions to take?
Sodium restriction, diuretics (spironolactone), paracentesis
What is the acronym that signifies risk factors for osteoporosis and what does it stand for?
C - calcium and vitamin D deficiency
A - age (>65)
L - lifestyle (excessive alcohol, smoking, sedentary)
I - inherited (family history, white/asian women)
U - underweight (low body weight)
M - medications (corticosteroids, anti seizure, thyroid replacements)
What are the nursing care methods for patients with osteoporosis?
Proper nutrition
Calcium and vitamin D supplements
Exercise
Prevention of falls and fractures
Drug therapy
In clients with osteoporosis, what’s the best method of reversing the disease?
Weight bearing exercise
Bisphosphonates like alendronate are the drug therapy for osteoporosis. What are some side effects of this medication?
GASTRITIS
Anorexia
Weight Loss
osteonecrosis (rare)
What are some good dietary sources of calcium for osteoporosis patients?
Milk, yogurt, turnip greens, cottage cheese, ice cream, sardines, spinach
What is the proper administration of bisphosphonates (like alendronate)?
- take 30 min before food or other meds
- take with a full glass of water
- sit or stand for 30 minutes after taking med
If not enough dietary calcium is taken for osteoporosis m, what supplements can be taken?
Calcium carbonate
Calcium citrate
*take in divided doses (500mg for best absorption)
Supplemental vitamin D is usually given…
800 to 1000 units per day
*mainly for post menopausal, older adults, home bound, northern climates
In clients with osteoarthritis, ice application is good for _____ and heat application is good for ______
Ice for acute inflammation
Heat for stiffness
The most classic integumentary symptom of lupus is…
Butterfly rash
Pregnancy, infection and sunlight can exacerbate….
Systemic Lupus Erythematosus
Clients with fibromyalgia should avoid what muscle irritants?
Sugar, caffeine, alcohol
