Gastrointestinal disorders Flashcards
Which of the following physiologic factors contribute to GERD?
a. accelerated gastric emptying
b. irritation from reflux of the stomach
c. competent lower esophageal sphincter
d. increased esophageal clearance
A accelerated gastric emptying
A patient with GERD describes painful swallowing, which symptom does the nurse identify?
a. dyspepsia
b. regurgitation
c. odynophagia
d. dysphagia
c. odynophagia
Which of the following risk factors for GERD is not associated with compromised function of the lower esophageal sphincter?
a. obesity
b. diabetes
c. pregnancy
d. large hiatal hernia
b. diabetes
A patient reports frequent heartburn twice a week for the past 4 months. What other symptoms reported by the patient may indicate the patient has GERD?
a. bitter taste in mouth
b. dry cough
c. melena
d. difficulty swallowing
e. smooth, red tongue
f. Murphy’s sign
a, b, d
The nurse is aware that which factors are related to the development of GERD?
a. delayed gastric emptying
b. eating large meals
c. hiatal hernia
d. obesity
e. viral infections
a, b, c, d
- Your patient, who is presenting with signs and symptoms of GERD, is scheduled to have a test that assesses the function of the esophagus’ ability to squeeze food down into the stomach and the closer of the lower esophageal sphincter. The patient asks you, “What is the name of the test I’m having later today?” You tell the patient the name of the test is:
a. lower esophageal gastrointestinal series
b. transesophageal echocardiogram
c. esophageal manometry
d. esophageal pH monitoring
c. esophageal manometry
Which pathogen is strongly associated with peptic ulcer?
a. bifidobacterium bifidum
b. escherichia coli
c. helicobacter pylori
d. COVID virus
c. h. pylori
Your patient who has been diagnosed with Chronic Gastritis for 3 years presents to your primary care office complaining of worsening epigastric pain, stating “I’m still taking Protonix every day, but my symptoms have been getting worse.” How would you explain the main difference between Gastritis and Peptic Ulcer disease?
A. You have actually had Peptic Ulcer disease this whole time.
B. With your worsening symptoms, I think you may have developed a peptic ulcer in addition to Gastritis. I’m ordering a scope to see what’s going on.
C. I wouldn’t worry about it, sometimes symptoms worsen during periods of stress
D. Have you ingested any foreign objects recently?
B. With your worsening symptoms, I think you may have developed a peptic ulcer in addition to Gastritis. I’m ordering a scope to see what’s going on.
Acute gastritis often heals within a few ____, especially when injurious agents such as NSAIDs and alcohol are stopped.
days
Gastric ulcer and duodenal ulcers both are called ____ ulcers; risk factors include ___ and use of NSAIDs
peptic; H. pylori infection, ZES
A nurse is completing an assessment of a client who has a gastric ulcer. Which of the following findings should the nurse expect? (Select all that apply)
A. Client reports that pain relieved by eating
B. Client states that pain often occurs at night
C. Client reports a sensation of bloating
D. Clients states that pain occurs 30min to 1 hr after a meal
E. Client experiences pain upon palpation of the epigastric region
b, c, e
A nurse is completing discharge teaching for a client who has an infection due to Helicobacter pylori. Which of the following statements by the client indicates understanding of the teaching?
A. “I will continue my prescription for corticosteroids.”
B. “I will schedule a CT scan to monitor improvement.”
C. “I will take a combination of medications for treatment.”
D. “I will have my throat swabbed to recheck for this bacteria.”
C. “I will take a combination of medications for treatment.”
A nurse is teaching a client who has a new diagnosis of dumping syndrome following gastric surgery. Which of the following information should the nurse include in the teaching?
a. Eat three moderate-sized meals a day
b. Drink at least one glass of water with each meal
c. Eat a bedtime snack that contains a milk product
d. Increase protein in the diet
D. Increase protein in the diet
Eat a high-protein, high-fat, lower-fiber, and moderate to-low carbohydrate diet
- Which peptic ulcer disease drug is useful to protect patients against NSAID-induced ulcers?
a. Magnesium hydroxide
b. Omeprazole
c. Esomeprazole
d. Misoprosol
d. Misoprosol
The health care provider has prescribed quadruple therapy for a patient with PUD due to H. Pylori infection. Which drugs will the nurse expect to administer? Select all that apply.
a. A proton pump inhibitor (PPI)
b. Sucralfate
c. Two antibiotics
d. A histamine H2 antagonist
e. Bismuth
f. Two antacids
a, c, e
- Which medications are used in the treatment of Crohn’s Disease and ulcerative colitis? SELECT-ALL-THAT-APPLY:
a. Guanylate Cyclase-C agonists
b. Anticholinergics
c. 5-Aminosalicylates
d. Antacids
e. Corticosteroids
f. Immune suppressors
c, e, f
Cholecystitis
S/Sx: Blumberg’s sign (rebound tenderness)
Blumberg’s sign
Cholecystitis
Kehr’s sign
liver trauma
GERD
S/Sx: regurgitation, heartburn, belching, nausea, dysphagia
Dx: barium swallow, EGD, pH test
Diet: low fat, avoid acid and alcohols
- avoid tight-fitting clothes
Hepatitis A
transmission: fecal-oral
risk: children and young adults
S/Sx: anorexia, jaundice, weight loss, dark-colored urine, pale feces
Dumping syndrome
Tx goal: decrease gastric emptying - increase protein intake, decrease fiber intake, drink fluids between meals.
Paracentesis procedure
- empty bladder prior to the procedure
- no sedation required
- fasting not required
hepatic encephalopathy
accumulation of toxic substances due to liver disease
S/Sx: mental status changes, behavior changes, increased ICP, edema, hypertension, confusion, lethargy
Tx: treat underlying cause
- lactulose - increases gastric emptying
- antibiotics
rifaximin - decreases risk of encephalopathy
Celiac disease nutrition
low fiber diet
Cirrhosis diet
high protein, low fat, low sodium
Esophageal varices
S/Sx: hematemesis, melena, shock
Tx: saline lavage, ligation, balloon tamponade
Meds: beta blockers, vasoconstrictors (vasopressin, octreotide)
diet: avoid alcohol, straining, hard foods. Chew thoroughly
Hiatal hernia
S/Sx: GERD, N/V, hemorrhage, obstruction, strangulation
Postop care: ambulation ASAP, support during coughing, elevate HOB
Zenker’s diverticulum
extra sac btwn esophagus and trachea that can impede swallowing
S/Sx: dysphagia, regurgitation, coughing, halitosis, infection
Tx: diverticulum resection
Peritonitis
S/Sx: rigid abdomen, abdominal pain, third-spacing, elevated WBC
Appendicitis
S/Sx: rebound tenderness, pain at McBurney’s Pt (RLQ), WBC left shift
Ulcerative colitis
wide-spread inflammation
S/Sx: bloody, mucousy stools
Tx: bowel rest, antidiarrheals, anti-inflammatories
diet: increase fluid & proteins, decrease fiber
Crohn’s Disease
skip-lesions
S/Sx: steatorrhea
Tx: bowel rest, loperamide
diet: low residue, high protein/calorie
Diverticulitis
LLQ pain, bloody tarry stools
diet: low fiber, high fluid, low fat
PUD
S/Sx: abd pain after meals
diet: mild food, avoid alcohol, sugar, caffeine. High protein, high fat, low fiber, low carb
H. pylori treatment
2 PPI + bismuth salt + 2 antibiotics
Cirrhosis labs
- Hi INR, LFTs, bilirubin, ammonia, creatinine
- low albumin, RBC, H/H, Plt
Cirrhosis diet
high calorie, high carb, high protein, low sodium.
vitamin supplements
liver transplant diet
high calorie, moderate fat, low salt/protein
pancreatitis diet
high protein, low fat. Avoid caffeine, alcohol, smoking
Hepatitis diet
high carb, high calorie, high protein, low fat, low fiber
Foods that cause colostomy odor, gas
fish, eggs, garlic, beans, dark and leafy vegetables, carbonated drinks, diary, corn
Foods that decrease colostomy odor, gas
buttermilk, cranberry juice, yogurt, crackers, toast
Colostomy diet
regular diet immediately postop except for high fiber foods (2 months)
