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Nurs. 309 > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

0
Q

Which statement is true about Barretts epithelium in the patient with GERD?

A

While the body heals, a different type of cell forms on the lower part of the esophagus

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1
Q

Which physiologic factor contributes to GERD?

A

Irritation from refluxate

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2
Q

Which statements about GERD are correct?

A
  1. Overweight and obese patients are at an increased risk

2. It is a common upper gastrointestinal disorder in the US

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3
Q

Dyspepsia

A

Pain described as a substernal or retrosternal burning sensation that tends to move up and down the chest in a wavelike fashion

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4
Q

Water brash

A

Reflex salivary hypersecretion in response to reflux

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5
Q

Dysphagia

A

Difficulty swallowing

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6
Q

Odynophagia

A

Painful swallowing

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7
Q

Globus

A

Feeling of something in the back of the throat

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8
Q

Eructation

A

Belching

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9
Q

Pyrosis

A

Retrosternal burning

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10
Q

A patient is scheduled to have several diagnostic tests to verify the medical diagnosis of GERD. Which diagnostic test is the most accurate method of diagnosing this disorder?

A

24 hour ambulatory pH monitoring

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11
Q

The nurse has provided teaching to a patient with GERD. Which statement by the patient indicates the teaching has been effective.

A

I wont lift heavy objects

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12
Q

A patient is on nizatidine therapy for the treatment of GERD. Which sign indicates that the patient may be having an adverse effect associated with this drug?

A

Dysrhythmia

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13
Q

A patient who has been prescribed Reglan is being disharged home. Which statement by the patient indicates a need for further discharge teaching by the nurse?

A

I will take the drug after meals

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14
Q

Which statement is true about the drug Aciphex for treatment of GERD?

A

PAtients who use this drug should be instructed to wear sunscreen

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15
Q

A patient has returned to the unit after a stretta procedure for GERD. Which action by the student nurse requires the supervising nurse to intervene?

A

A nasogastric tube is prepared for insertion

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16
Q

Which lifestyle adjustment may a patient have to make to best control GERD?

A

Attain and maintain ideal body weight

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17
Q

WHich statements will the nurse include when providing health teaching for a patient with haitial hernia

A
  1. Elevate the head of the bed at least 6 inches for sleeping at night
  2. Remain in the upright position several hours after eating
  3. Avoid straining or excessive vigorous exercise
  4. avoid wearing clothing that is to tight
  5. Avoid eating in the late evening
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18
Q

Hiatal hernias are also called………..hernias

A

Diagphramatic

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19
Q

What diagnostic test best identifies a hiatal hernia?

A

Barium swallow study with fluoroscopy

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20
Q

Barretts epithelium is considered ……. even though it is new epithelium

A

Premalignant

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21
Q

The nurse has provided postoperative teaching for a patient who underwent a laparoscopic nissen fundoplication. Which statement by the patient indicates a need for additional teaching?

A

ill discontinue the antireflux drugs

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22
Q

What is the primary focus of care after conventional surgery for hiatal hernia?

A

Prevention of respiratory complications

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23
Q

GERD can be cause of which adult onset disorders?

A
  1. Dental caries
  2. Laryngitis
  3. Asthma
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24
Q

The nurse is assessing a patients nasogastric drainage following a fundoplication procedure. How does the nurse expect to find the drainage to appear the first 8 hours after surgery?

A

Dark brown

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25
Q

The nurse is giving discharge instructions to a patient after fundoplication procedure. Which activities is the patient instructed to avoid?

A
  1. Drinking more than 8 oz of water at a time
  2. Chewing gum
  3. Drinking with a straw
  4. Eating gas producing foods
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26
Q

A patient is prescribed Protonix. What does the nurse tell the patient is the major action of this medication?

A

It inhibits gastric acid secretion

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27
Q

A patient is undergoing a workup for squamous cell carcinoma of the esophagus. What are the two primary risk factors associated with the development of this carcinoma?

A

Tobacco use and heavy alcohol intake

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28
Q

The definitive diagnosis for esophageal cancer is made with which procedure?

A

Esophageal ultrasound with fine needle aspiration

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29
Q

Nonsurgical treatment options for cancer of the esophagus can include which therapies?

A
  1. Swallowing therapy
  2. Chemoradiation
  3. Targeted therapies
  4. Photodynamic therapy
  5. Endoscopic therapies
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30
Q

Which are pathologic changes associated with acute gastritis?

A

Vascular congestion
Edema
Acute inflammatory cell infiltration

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31
Q

Which are possible complications of chronic gastritis?

A

Pernicious anemia
Gastric cancer
Decreased gastric acid secretion
Peptic ulcer disease

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32
Q

True or false

the diagnosis of gastritis is made solely on clinical symptoms

A

False

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33
Q

True or false

The onset of infection with H. pylori can result in acute gastritis

A

True

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34
Q

True or false

Long-term use of acetaminophen creates a high risk for acute gastritis

A

False

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35
Q

True or false

Atrophic gastritis is a type of chronic gastritis that is seen most often in older adults

A

True

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36
Q

The nurses teaching a patient about health promotion and maintenance to prevent gastritis. Which information does the nurse include?

A
  1. A balanced diet can help prevent gastritis
  2. If you stop smoking there is less of a chance that you will develop gastritis
  3. Yoga has been found to be effective in preventing gastritis
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37
Q

The patient with chronic gastritis is being admitted. Which symptom does the nurse identifies being associated with this patient’s condition?

A

Pernicious anemia

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38
Q

When teaching the patient about pernicious anemia which statement is the nurse include?

A

Pernicious anemia results in a deficiency of vitamin B 12

39
Q

The patient comes to the emergency department reporting rapid onset of epigastric pain with nausea and vomiting. The patient says the pain is worse than any heartburn he has had, and that he has not had an appetite for the past day. What does the nurse suspect this patient has?

A

Acute gastritis

40
Q

Which diagnostic test is the gold standard for diagnosing gastritis?

A

Esophagogastroduodenoscopy EGD

41
Q

The nurses teaching a patient about Vantech prescriber gastritis. Which statement by the patient indicates effective teaching by the nurse?

A

This drug will block the secretions of my stomach

42
Q

The patient with acute gastritis is receiving treatment of blocking buffer gastric acid secretions to relieve pain. Which drug does the nurse identify as an anti-secretory agent (proton pump inhibitor)

A

Omeprazole (Prilosec )

43
Q

The nursing student caring for patient was the duodenal ulcer is about to administer proton pump inhibitor. Which statement about this medication is true?

A

These drugs should not be used for a prolonged period of time because they may contribute to osteoporotic related fractures

44
Q

The nurses teaching a patient being discharged home about taking prescribed medications that include Carafate. Which statement by the patient indicates teaching has been affected?

A

Sulcralfate works to heal my ulcer

45
Q

True or false

peptic ulcer is a term used to describe all gastric and duodenal ulcers

A

True

46
Q

True or false

Prostaglandins increased stomachs resistance to ulceration

A

True

47
Q

True or false

Cushing’s ulcer is a type of stress ulcer commonly seen in patients with expensive burn

A

False, curlings ulcer

48
Q

True or false

IV Pepcid or protonic’s are often prescribed to prevent stress ulcers

A

True

49
Q

True or false

Hematemesis usually indicates bleeding at or below the duodenojejunal junction

A

False, at or above

50
Q

True or false

Cox 2 inhibitors such as Celebrex are less likely to cause mucosal damage to the stomach as compared to NSAIDs

A

True

51
Q

Drug therapy for peptic ulcer disease is implemented for which purposes?

A
  1. Pain relief
  2. Eliminate H. pylori infection
  3. Heal ulceration
  4. Prevent reoccurrence
52
Q

Magnesium hydroxide (Maalox)

A

Observe the patient for the side effect of diarrhea

53
Q

Omeprazole (Prilosec )

A

Caution patients taking Plavix that this drug may reduce its effectiveness

54
Q

Esomeprazole (nexium)

A

Assess the patient for hepatic problems because theyll need to take a lower dose of this drug

55
Q

Misoprostol (cytotec)

A

Useful for patients to protect against NSAID induced ulcers

56
Q

Which statement about the use of antacids in the treatment of gastric ulcers this true?

A

Avoid using antacids with phenytoin (Dilantin)

57
Q

Patient with peptic ulcer disease is receiving Maalox . Which actions of the nurse take in regards to administering this medication?

A
  1. Give the medication two hours after the patient meal
  2. Do not give other drugs within 1 to 2 hours of antacid
  3. Assess the patient for a history of renal disease before giving Maalox
  4. Assess the patient for history of heart failure before giving Maalox
  5. Observe the patient for the side effect of diarrhea
58
Q

The nurses provided instructions for a patient prescribed Carafate to treat a gastric ulcer. Which statement by the patient indicated the teachings been effective?

A

I will take this drug on an empty stomach

59
Q

A patient is admitted with an upper G.I. bleed. Which finding that the nurse expect to assessing the patient?

A

Syncope

60
Q

The patient develops an active upper G.I. bleed. Which is a priority at the nurse takes and caring for the patient?

A
  1. Provide oxygen
  2. Start one or two large bore IV lines
  3. Prepare to infuse 0.9% normal saline solution or lactated ringers solution
  4. Prepare for NG tube insertion
61
Q

When performing an assessment on a patient with an active upper GI bleed, which conditions does the nurse identify as common causes of upper GI bleeding?

A
  1. Esophageal cancer and varices
  2. Duodenal ulcer
  3. Gastritis
  4. Gastric cancer
62
Q

The LPN is caring for a patient with an NG tube. The supervising nurse intervenes when the LPN attempts to perform which action?

A

Lubricate the tube with a petroleum based product

63
Q

The student nurse is performing a gastric lavage on a patient with an active upper GI bleed. Which action by the student requires intervention by the supervising nurse?

A

Using an ice cold solution to lavage the stomach

64
Q

Which drug is the drug of choice for aggressive acid suppression to prevent rebleeding in a patient with a gastric bleed?

A

Ocetreotide (sandostatin)

65
Q

Which are findings in a patient who has Zollinger-Ellison syndrome?

A
  1. Gastrinomas
  2. Steatorrha
  3. Increased amounts of gastric acid
66
Q

The nurse is caring for several patients with gastric and duodenal ulcers. Which differential features of gastric ulcers compared to duodenal ulcers does the nurse identify?

A

Normal secretion or hyposecretion

Hematemesis more common

67
Q

The nurse is performing a physical assesment on a patient admitted to the unit with gastric cancer. Which findings indicate signs of distant metastasis?

A
  1. Virchows nodes
  2. Blumers self
  3. Sister mary joseph nodes
  4. Krukenberg tumor
68
Q

The nurse is assessing a patient who has had a total gastrectomy and notes bright red blood in the NG and abdominal distention. What does the nurse do next?

A

Inform the surgeon of these findings

69
Q

True or false

Dumping syndrome is a term that refers to a group of vasometer symptoms that occur after eating

A

True

70
Q

True or False

Late dumping syndrome is caused by a release of an excessive amount of insulin

A

True

71
Q

True or false

To manage dumping syndrome, the patient needs to eliminate liquid ingested with meals

A

True

72
Q

True or false

Patients with dumping syndrome are instructed to eat a diet that is high in carbohydrates and low in fat and protein

A

False

73
Q

True or false
After gastric resection, patients should be assessed for the development of atrophic glossitis which occurs secondary to vitamin B 12 deficiency

A

True

74
Q

The nurse is teaching a patient with dumping syndrome about diet. Which statement by the patient indicates that teaching has been effective?

A

I will use sugar free gelatin with caution

75
Q

Which statement about general principles of diet therapy for patients with dumping syndrome is true?

A

Patients with dumping syndrome should have liquids between meals only

76
Q

True or false
irritable bowel syndrome is a functional G.I. disorder characterized by chronic recurrent diarrhea, constipation, and abdominal pain and bloating

A

True

77
Q

True or false

No actual pathophysiologic changes occur in IBS

A

True

78
Q

True or false

Symptoms of IBS typically begin in late adulthood

A

False, young adulthood

79
Q

True or false

IBS is the most common digestive disorder seen in clinical practice

A

True

80
Q

True or false

Most common symptom of IBS is pain in the right lower quadrant of the abdomen

A

False, left lower quad

81
Q

True or false

Hydrogen breath test maybe use in the diagnostic phase of the disease

A

True

82
Q

True or false
A newer group of drugs used to manage IBS are the muscarinic receptor antagonist which act by inhibiting intestinal motility

A

True

83
Q

Which drug is the drug of choice for the treatment of IBS when pain is the predominant symptom?

A

Amitiptyline ( Elavil)

84
Q

The nurse is teaching a patient with IBS about complementary and alternative therapies for the disease. Which patient statments indicate that the teaching has been effective?

A

I should exercise regularly to help manage the disease

Peppermint oil has been used to expel gas and relax spastic intestinal muscle

85
Q

Reducible

A

Contents of the sac can be replaced in the abdominal cavity by gentle pressure

86
Q

Femoral

A

A plug of fat in the femoral canal enlarges and eventually close the peritoneum and often the urinary bladder in sack

87
Q

Umbilical

A

Acquired as a result of increased intra-abdominal pressure

88
Q

Indirect inguinal

A

Sack forms from the peritoneum that contains a portion of the intestine I omentum. Hernia pushes downward at an angle into the inguinal canal

89
Q

Incarcerated

A

Cannot be replaced back into the abdominal cavity

90
Q

Strangulated

A

Blood supply to the herniated bowel segment is cut off

91
Q

Incisional

A

Occurs at the site of the previous surgical incision

92
Q

The nurses performing an abdominal assessment on a patient suspected of having an abdominal hernia. The nurse also takes the abdomen and determines the absence of bowel sounds. What does the nurse suspect in this patient?

A

Obstruction and strangulation

93
Q

Which are true statements about caring for a patient with a truss?

A

The trusses only used after the hernia has been reduced by the physician and powder should be applied to the skin under the truss daily

94
Q

Which activity does the nurse tell the patient to avoid after surgery for hernia repair?

A

Coughing

95
Q

What do postoperative measures for a male patient who has had an inguinal herniorrhaphy include?

A

Elevating the scrotum on a pillow

Nurs. 309 (18 decks)

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