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CMPA412 > GERD, Gastritis, PUD, Dumping Syndrome > Flashcards

GERD, Gastritis, PUD, Dumping Syndrome Flashcards

1
Q

Backward flow (reflux) of stomach contents into the
esophagus resulting to inflammatory changes of the
esophageal mucosa

A

GERD

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2
Q

Hallmark of GERD: ? (acute symptoms of inflammation)

A

Reflux Esophagitis

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3
Q

GERD Causes:
Inappropriate relaxation of the ?
Gastric volume or ? is elevated
Delayed ?

A

Lower Esophageal Sphincter/ Decrease LES
Intra-abdominal pressure
Gastric Emptying

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4
Q

GERD CM: substernal or retro- sternal burning sensation
- pain radiate to the neck, jaw, back (mimic ANGINA or
MI

A

Heartburn/Pyrosis

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5
Q

GERD CM: warm fluid traveling up the throat (sour or bitter taste)
- danger for aspiration (note for crackles in the lungs)

A

Regurgitation

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6
Q

GERD CM: “water brash”

A

Hypersalivation

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7
Q

GERD CM: Difficulty of swallowing

A

Dysphagia

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8
Q

GERD CM: Painful swallowing

A

Odynophagia

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9
Q

GERD CM: change of the normal squamous cell epithelium to columnar epithelium

A

Barrett’s Epithelium

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10
Q

GERD CM: Chronic ? especially at ? (due to position)

A

Cough
Night

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11
Q

GERD CM:
? belching
? gas
? after eating

A

Eructation
Gas
Bloating

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12
Q

GERD DT: Most accurate method

A

24 hour ambulatory pH monitoring

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13
Q

GERD DT: small catheter is placed through the nose into the distal esophagus, pH is continuously monitored & recorded)

A

24 hour ambulatory pH monitoring

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14
Q

GERD DT: Endoscopy

A

Esophagogastroduodenoscopy

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15
Q

GERD DT: “motility testing”

A

Esophageal Manometry

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16
Q

GERD DT: water-filled catheters are inserted via the client’s nose or mouth & slowly withdrawn while measurements of LES pressure & peristalsis are recorded); not specific enough to establish a diagnosis of GERD

A

Esophageal Manometry

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17
Q

GERD Management: Avoid foods containing

A

Caffeine, Cocoa, Alcohol, High in Calorie (Fatty food)

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18
Q

GERD Management: Restrict spicy & acidic foods ?

A

Orange Juice, Tomatoes

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19
Q

GERD Management: ? beverages increases pressure in the stomach

A

Carbonated

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20
Q

GERD Management: sleep in the ? position to minimize the nighttime episodes of reflux

A

Left Lateral (Side-lying)

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21
Q

GERD Management: Small frequent meals

A

4-6 meals a day

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22
Q

GERD Management: Remain in upright position for atleast ? after eating

A

1-2 hrs

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23
Q

GERD Management: Elevate hob ? inches using wooden blocks or foam wedge

A

8-12 inches

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24
Q

GERD Management: Do not wear ?

A

Constrictive clothing

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25
Q

GERD Management: Chew ? and follow with ? right after

A

Antacids
Water

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26
Q

GERD Pharmacotherapy: neutralizes HCL & deactivating pepsin

A

Antacids

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27
Q

GERD Pharmacotherapy: Antacids

A

Aluminum Hydroxide
Magnesium Hydroxide
Maalox
Mylanta

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28
Q

GERD Pharmacotherapy: Decreases acid production of parietal cells

A

H2 Receptor Blockers

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29
Q

GERD Pharmacotherapy: H2 Receptor Blockers

A

Famotidine
Ranitidine (Zantac)
Cimetidine (Tagamet)
Nizatidine

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30
Q

GERD Pharmacotherapy: main treatment for GERD

A

Proton Pump Inhibitors

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31
Q

GERD Pharmacotherapy: inhibition of proton pump of the parietal cell thereby decreases acid secretion

A

PPI

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32
Q

GERD Pharmacotherapy: PPI

A

Omeprazole, Lansoprazole, Rabeprazole, Pantropazole, Esomeprazole

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33
Q

GERD Pharmacotherapy: Increases gastric emptying

A

Metoclopramide

34
Q

GERD Pharmacotherapy: the physician applies
radiofrequency energy through needles placed near
gastroesophageal junction inhibiting the vagus nerve
thus reducing the discomfort of the client. It will
reshape the ring of muscles in the lower esophagus.

A

Endoscopic Therapy (Stettra Procedure)

35
Q

is an inflammation of the gastric mucosa, is
classified as either acute or chronic

36
Q

Gastritis Cause: It usually stems from ingestion of a ?, ?, or ? substance

A

Corrosive
Erosive
Infectious

37
Q

Gastritis Cause: ? and ?, chemotherapeutic drugs, steroids, acute alcoholism and food poisoning (typically caused by Staphylococcus organisms) are common causes.

A

Aspirin
NSAIDs

38
Q

Gastritis Cause: Food substances including excessive amounts of tea, carbonated drinks and pepper can precipitate acute gastritis. Foods with a rough texture or those eaten at an extremely ? can also damage the stomach mucosa

A

Tea, Carbonated Drinks, Pepper
Rough Texture
High Temperature

39
Q

Gastritis CM:
? discomfort
Feeling of ?, early
Severe ?
Sometimes ? is the only manifestation

A

Epigastric
Fullness, Satiety
N&V
GI Bleeding

40
Q

Gastritis CM

A

Belching
Flatulence
Cramping
Hematemesis

41
Q

Gastritis CM: When contaminated food is the cause of gastritis, ? usually develops within ? of ingestion

A

Diarrhea
5 hours

42
Q

Gastritis Pharmacotherapy: Anti – emetic drugs like Inj. ? or Tab, ? are frequently effective in vomiting.

A

Perinorm
Domperidone

43
Q

Gastritis Pharmacotherapy: ?, ? are effective to reduce the pain.

A

Antacids
H2 Blockers

44
Q

Gastritis Pharmacotherapy: If ingestion of NSAIDs is a problem, a ? may be prescribed to protect the stomach mucosa and inhibit gastric acid secretion.

A

Prostaglandin E1 (PGE1) Analog

45
Q

Chronic Gastritis: which causes a reddened, edematous mucosa with small erosions and hemorrhages

A

Superficial Gastritis

46
Q

Chronic Gastritis: which occurs in all layers of the
stomach, develops frequently in association with gastric ulcer and gastric cancer, and is invariably present in pernicious anemia; it is characterized by a decreased number of parietal and chief cells.

A

Atrophic Gastritis

47
Q

Chronic Gastritis: which produces a dull and nodular
mucosa with irregular, thickened, or nodular rugae;
hemorrhages occur frequently

A

Hypertrophic Gastritis

48
Q

Chronic Gastritis Cause: Infection with ? or ? may lead to chronic gastritis.

A

Helicobacter Pylori
Gastric Surgery (Gastro-Jejunostomy)

49
Q

Chronic Gastritis Complications

A

Bleeding
Pernicious Anemia
Gastric Cancer

50
Q

Mucosa: release hydrochloric acid along with intrinsic factor

A

Parietal Cells

51
Q

Mucosa: release pepsinogen which mixes with hydrochloric acid and becomes PEPSIN

A

Chief Cells

52
Q

Mucosa: release gastrin

53
Q

Defense System: coats the gastric layer and protects the cells from acids

A

Bicarbonate (HCO3)

54
Q

Defense System: regulates perfusion to stomach, causes stomach cells to release mucous rich in bicarb, controls acid amounts via the parietal cells

A

Prostaglandin

55
Q

PUD Cause: 90% of duodenal ulcers and up to 80% of gastric ulcers are caused by ?

56
Q

PUD Cause: they work to decrease the production of prostaglandins

A

Long tern NSAIDs

57
Q

PUD Cause: tumor formation that causes increased release of gastrin which increases stomach acid production.

A

Zollinger-Ellison Syndrome

58
Q

PUD DT: ? indicates bleeding, ? in stool specimen

A

Decrease Hgb/Hct
Occult Blood Test (Guiac Test)

59
Q

PUD DT: patient will ingest a urea tablet and if h. pylori is present it will break down urea into ammonia and carbon dioxide. Breath samples will be analyzed for abnormally high carbon dioxide levels.

A

Urea Breath Test

60
Q

PUD DT: normal gastric acidity in gastric ulcer (increase in duodenal ulcer)

A

Gastric Analysis

61
Q

PUD CM: ? and ? pain
described as burning, dull, or ? pain

A

Indigestion, Epigastric
Gnawing

62
Q

PUD CM: Food makes pain worst (pain ? after eating)

A

Gastric Ulcer
1-2 hours

63
Q

PUD CM: Weight loss

A

Gastric Ulcers

64
Q

PUD CM: Severe: vomit blood more common

A

Gastric Ulcer

65
Q

PUD CM: Pain happens when stomach empty… food makes it BETTER (pain ? after eating)

A

Duodenal Ulcer
3-4 hours

66
Q

PUD CM: Wake in middle of night with pain

A

Duodenal Ulcer

67
Q

PUD CM: Weight normal

A

Duodenal Ulcer

68
Q

Severe: tarry, dark stool from GI bleeding

A

Duodenal Ulcer

69
Q

PUD Pharmacotherapy: Antibiotics for H. pylori infection

A

Metronidazole (Flagyl)
Tetracycline
Pepto-bismol

70
Q

PUD Pharmacotherapy: Anticholinergics (decrease gastric juice secretion)

A

Probanthine, Pirenzepine

71
Q

PUD Surgery: distal end of the stomach is removed, and the remainder is anastomosed to the duodenum

A

Gastroduodenostomy (Billroth I)

72
Q

PUD Surgery: removal of the antrum and distal portion of the stomach and duodenum with anastomosis of the remaining portion of the stomach to the jejunum

A

Gastrojejunostomy (Billroth II)

73
Q

PUD Surgery: Transection of vagus nerve that eliminates the acid-secreting stimulus to gastric cells & causing a decrease gastric acid secretion

74
Q

PUD Surgery: removal of 75% - 85% of the stomach

A

Subtotal Gastrectomy

75
Q

PUD Surgery: removal of the antrum of the stomach to eliminate the gastric phase of digestion

A

Antrectomy

76
Q

PUD Surgery: creating a passage between the body of the stomach & the jejunum to permit neutralization of gastric acid by regurgitation of alkaline duodenal contents into the stomach

A

Gastroenterostomy

77
Q

PUD Surgery: removal of the entire stomach with a loop of jejunum anastomosed to the esophagus

A

Esophagojejunostomy (Total Gastrectomy)

78
Q

PUD Post-operative: Measure drainage accurately to determine necessity for ? replacement; notify physician if there is no drainage. Anticipate frank, red bleeding for ? ; Do not manipulate the tube and ensure its ?

A

Fluid and Electrolyte
12-24 hrs
Patency

79
Q

PUD Post-operative: Place client in ? or ? position to promote chest expansion; Teach client to ? high upper abdominal incision before turning, coughing, and deep breathing

A

Mid - High Fowlers
Splint

80
Q

PUD Post-operative: After removal of NG tube, provide ? with gradual introduction of small amounts of ? at frequent intervals; Monitor weight daily. Assess for ?; if present, instruct client to eat ? at a slower pace

A

Clear liquids
Bland foods
Regurgitation
Smaller amounts of food

CMPA412 (7 decks)

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