gastric and duodenal disorders Flashcards by Katie James

BMI <18.5 means…

underweight

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BMI >30 means…

obese

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how do you calculate BMI

height in inches vs body weight in pounds

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what are some causes of hiatal hernia

weakened muscle
age related changes
injury
persistent pressure

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whats happening with hiatal hernia

stomach through diaphragm

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how will a client present with hiatal hernia

small = asymptomatic
acid reflux
possible bulge in abd
difficulty swallowing
CP or abd pain
SOB
vomiting blood (coffee ground lookin) and black tarry stools

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what are some labs and diagnostics for hiatal hernia

xray
EGD

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what meds can help with hiatal hernia

antacids
H2 blockers
PPI

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what are some complications of hiatal hernia

very large = surgery
strangulation/ischemia

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whats a surgical intervention for hiatal hernia

nissen fundoplication

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describe nursing focus and education for hiatal hernia

smaller frequent meals
avoid triggers
stay upright after eating
eat 2-3hrs bfore bed
maintain healthy weight
stop smoking
elevate HOB
med compliance
discuss complications

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what are some causes of gastritis

H. pylori (contaminated foods)
NSAIDs
older age
excessive alc
stress
autoimmune (crohns)

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whats happening with gastritis

injury to gastric mucosa
HCL damage/inflammation

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how will the client present with gastritis

asymptomatic
gnawing/pyrosis
N/V, anorexia
fullness in abd even after small meals
if severe: hematochezia, hematemeiss, melena

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what are some labs and diagnostics for gastritis

EGD (with biopsy if H. pylori suspected)
H&H and CBC

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what meds can help with gastritis

antibiotics (clarithromycin, amoxicillin, metronidazole) for H. pylori
PPI (omeprazole): daily, slows HCL production
H2 (ranitidine): PRN, slows HCL production
antacids (TUMS)

describe surgical interventions for gastritis

if severe = surgery

what are some complications of gastritis

ulcers
bleeding
pernicious anemia
stomach CA (rare)

describe nursing focus and education for gastritis

often self resolving
eat smaller, more frquent meals
avoid irritating foods
avoid alc
avoid NSAIDs (tylenol for pain relief)
H. pylori
assess for bleeding

what are some causes of PUD

H. pylori (most common)
long term NSAID/ASA
other meds like SSRIs

whats happening with PUD

increased acid and decreased mucus
stomach lining eroding
open sores (ulcers)

how will the client present with PUD

asymptomatic
gnawing/burning epigastric pain
bloating/belching
fatty food intolerance (duodenal ulcer)
pyrosis
nausea
gastric vs duodenal
seldom: vomiting and hematemesis

what are some labs and diagnostics for PUD

stool testing (occult)
CBC/BMP
EGD w/ biopsy
fluoroscopy

what meds can help with PUD

H. pylori:
- triple antibiotic
- PPI/H2/antacids

not H. pylori:
-PPI/H2/antacids

alternative medicine

what are some complications of PUD

- internal bleeding - infection - obstruction - refractory ulcers

describe nursing focus and education for PUD

- have meds ready for attack: ranitidine not omeprazole for attacks - avoid NSAIDs: talk to doc about PPI/H2 if you have to - avoid triggers - choose healthy diet - consider probiotic foods - milk doesnt do shit for ya - adequate sleep = stronger immune system = less stress

what are some possible triggers for PUD

- smoke (interferes with stomach lining) - alcohol (limit or avoid) - spicy foods - stress (healthy coping)

describe obesity

- metabolic disease characterized by fat that accumulates so that health is impaired - BMI >30 = obese - associated with significant morbity and mortality - low self esteem, impaired body image, depression, diminshed quality of life - environmental, genetic, metabolic, cultural, socioeconomic factors

describe lifestyle modification for obesity

- weight loss diet and behavioral modification and exercise - dieticians with meal planning - acupuncture and hypnosis?

name some anti-obesity meds

- orlistat - lorcaserin - sibutramine HCL PULLED meds have many unwanted adverse effects meds rarely result in weight loss >10% of total body weight

why would gastric bypass (aka roux-en-y) be used

- when diet and exercise dont work - when serious health probs occur - conditions: BMI >40 or BMI 35-39.9 w/ serious weight related health issues

whats happening with gastric bypass (aka roux-en-y)

- small puch from stomach - connected to small intestine - bypass stimach and duodenum - walnut size stomach (one ounce)

what are some risks of gastric bypass (aka roux-en-y)

- same as general surgeries - dumping syndrome - bowel obstruction - hypoglycmia - malnutrition - stomach perforation - ulcers - gallstones

describe education for gastric bypass (aka roux-en-y)

- counseling before and after - presurgery weight loss goals - physical activity programs - tobacco stop - inpatient 3-5days - progressive diet - vitamin/mineral supplementation - 3-6mo of malaise - psychosocial aspects