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GI Disorders > GERD > Flashcards

GERD Flashcards

1
Q

Contraindication and what client should used H2 receptor antagonist cautiously?

A

Contraindicated: Hypersensitivity
Use cautiously: Impaired renal and hepatic function

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2
Q

Action and indication of H2 Receptor Antagonist

A

-Suppresses gastric acid secretion
-Alleviate Heartburn sx
-Promote healing of GERD

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3
Q

Route of Cimetidine (Tagamet) and Ranitidine (Zantac)

A

PO, IV and IM

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4
Q

What H2 Receptor antagonist should NOT be taken with food?

A

Cimetidine (Tagamet)
Rationale: it can delay the drug absorption

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5
Q

What is the effect of antacids while taking Cimetidine (Tagamet) ?

A

-Taking antacid decrease absorption of oral Cimetidine (Tagamet)
-when taking both Cimetidine (Tagamet) and antacid, at least 1 HOUR apart

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6
Q

What are the possible s/e of Cimetidine (Tagamet) ?

A

M- mental confusion
A - agitation
P - psychosis

D -depression
A -anxiety
D- disorientation

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7
Q

When and Why was Cimetidine (Tagamet) dosage is reduced in pt with GERD?

A

-if client have impaired renal fx (causes nephrotoxicity)
-When drug is administered with Warfarin Na, Phenytoin, Theophylline and Lidocaine ( to prevent drug interaction)

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8
Q

Taking Ranitidine is not affected by food?
T or F

A

True

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9
Q

What H2 receptor antagonist doesn’t need to be administered with food?

A

Famotidine (Pepcid) and Nizatidine (Acid)

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10
Q

5 overall consideration in H2 Receptor Antagonist:

A
  1. If prescribed OD, take drug at bedtime
  2. Take the drug 1 hour before and after taking ANTACID
  3. Avoid cigarette smoking, alcohol and NSAIDS
  4. Long term use: M-drug can lead to gynecomastia and impotence and F- lead to breast tenderness
  5. A/E:
    Diarrhea, Rashes and bruises, Confusion, Fatigue and Malaise
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11
Q

At least 5 PPI drugs?

A

P- Pantoprazole (Protonix)
R- Rabeprazole ( Aciphex)
O- Omeprazole ( Prilosec)
L- Lansoprazole (Prevacid)
E- Esomeprazole ( Nexium)

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12
Q

Common S/E of PPI:

A

H- headache
A- abdominal pain
N- nausea
D- diarrhea

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13
Q

Nursing responsibility on PPI:

A
  1. If prescribed TID, instruct to take before breakfast and at bedtime; but if OD, take it at bedtime
  2. Monitor the liver function test (AST, ALT, Bilirubin) since its nephrotoxic
    3.Avoid cigarette smoking, alcohol, aspirin and NSAIDs to promote healing
    4.Do not chew the tablet to prevent to reduce the drug potency
  3. Report black tarry stool (GI bleeding), diarrhea and abdominal pain
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14
Q

What are the extrapyramidal effects of Metoclopramide?

A

-Dysarthria -Twitching movements
-Dysphagia -Weakness of A and L
-Loss of balance -Tardive Dyskinesia
-Gait disturbances

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15
Q

Nsg. Responsibility of Metoclopramide?

A
  1. TID, 30 mins before breakfast and at bedtime
  2. by direct IVP over 1-2 mins or
    Slow infusion over 15-30 mins
  3. Avoid alcohol or CNS depressants
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16
Q

Nutrition and Lifestyle Mng. of client with GERD

A
  1. Eliminate acidic foods like spicy, caffeine, tomato products and citrus
  2. Avoid peppermint, chocolate, alcohol and fatty foods.
  3. Eat smaller meal, refrain eating 3 hrs before bedtime
  4. Stay upright (Semi fowler’s position) for 2 hrs after meal
  5. Elevate HOB 6-8 inch blocks
  6. Avoid smoking
  7. Avoid tight clothing and bending
  8. Avoid very hot and cold beverages
  9. Avoid salicylates (Aspirin) , phenylbutazone (NSAIDs)
17
Q

Other term of GERD

A

Reflux esophagitis

18
Q

Other name of Lower esophageal Sphincter

A

Cardiac sphincter

19
Q

Causes of GERD:

A

-Decreased pressure / incompetent LES (relaxed)
-Pyloric stenosis
-Nicotine
-High Fatty Foods
-Xanthine Derivatives ( Theophylline and Aminophylline)
-Ganglionic Stimulants ( Pilocarpine,
-Acetylcholine, Lobeline and Lidocaine)
-Beta adrenergic agents (Propranolol and Metoprolol)
-Elevated estrogen/progesterone level

20
Q

Assessment of GERD:

A

How n Dude?
H- heartburn D- Dysphagia
O- odynophagia U- Upp. adm dc
W- water brash D- Dyspepsia
E- Eructation
N- N/V E- Epigastric Pain

21
Q

What are avoided in GERD?

A

-P 4C A 2F
-A N A
- eating 2 hrs before bedtime and tight clothing

22
Q

Diet in GERD

A

Low fat
Hight Protein
Hight Fiber

23
Q

Surgery done in GERD

A

Nissen fundoplication
AKA “Gastric Wrap Around”

24
Q

Indication/ Purpose of aluminum hydroxide

A

To treat hyperphosphatemia

25
Q

Effect of Aluminum compounds in some meds:

A

Decrease effects of tetracycline, Warfarin sodium, and digoxin

26
Q

Aluminum compounds and Sodium bicarbonate have high Na Contents so used it cautiously in patient with:

A

HTN
CHF

27
Q

Common s/e of aluminum and Ca compounds

A

CONSTIPATION

28
Q

Prominent s/e of Mg Compounds

A

Diarrhea

29
Q

Contraindication of Mg Compounds

A

Appendicitis
Renal Impaired

30
Q

Antidote

A

Ca Gluconate

31
Q

What foods are avoided when having Ca Compounds:

A

Milk and Vit. D supplements

32
Q

Common s/e or sx of Milk alkali Syndrome

A

F- fatigue
U- urinary frequency
N-Nausea / Vomiting

H-headache
A-Anorexia

33
Q

Interventions for Antacids

A

-Take meds in regular schedules, 1-3 hrs before each meals and at Bedtime
-Tablet is chewed followed by full glass of water or milk
-Max. benefit- Gastric pH is above 5

34
Q

What can be result of IV administration of Cimetidine (Tagamet ) ?

A

Hypotension
Dysrhythmia

35
Q

Possible effect of Cimetidine (Tagamet)

A

M- mental confusion D- depression
A- agitation A- anxiety
P- psychosis D- disorientation

36
Q

What drug classification wherein food delays absorption ?

A

Antacids
-best taken 1-2hrs after meals

37
Q

S/E of Cimetidine (H2 receptor antagonist)

A

MAPDAD + DIG

GI Disorders (5 decks)

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