GI Flashcards by Kristen Shimkus

What is GERD

Gastro esophageal reflux disease
When stomach acid backflows into esophagus

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What are manifestations of GERD?

Heartburn
Dental problems
Esophagitis
Failure to thrive
Regurgitation
Flatulence
Difficulty swallowing
Vomiting
Dry throat

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What types of medications are used for GERD?

Proton pump inhibitors (omeprazole)
H2 blockers (ranitidine)
Antacids (hydroxide)

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What are nursing management options for GERD?

Medication
Positioning (not laying down for 2 hours after eating)
Diet (low acid, low spice, high fiber, small frequent meals)

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What are foods bad for acid reflux?

Coffee
Alcohols
Fast food
Soda
Chocolate
Garlic
Onions
Tomato’s
Citrus
Peppermint
Spice
Dairy

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What are good foods for acid reflux?

Ginger
Leafy greens
Brown rice
Coconut
Celery
Berries
Melon
Banana
Fennel
Avocados
Apple
Pears

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What are nursing goals for GERD?

Improve nutrition
Relieve pain
Prevent aspiration
Enforce health education
Relieve anxiety prevent injury

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What are proton pump inhibitors?

They reduce gastric acid by inhibiting the cellular pump of gastric parietal cells

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What is sub word for proton pump inhibitors?

“Zole”

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What is a precaution to remember about PPIs?

Long term use can increase risk for fractures

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What are antacids?

Neutralize excess acid
Increase LES (lower esophageal sphincter) pressure

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When should antacids be taken?

When acid secretion is at its highest (1-3 hrs after eating and at bedtime)

Do not take any other meds before or after by 1 hour

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What is a H2 receptor antagonists?

Reduces secretion of acids (longer onset than antacids, but longer effects)

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What is sub word for H2 blockers?

“Ine”
Ranitidine
Famotidine
Cimetidine
Nixatidine

Think histaMINE - ends in INE (eene)

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What is important to know about H2 blockers?

Use cautiously with kidney disease
Take with meals and at bedtime
Do not take with antacids for 1 he

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What are prokinetics?

Increased mobility of esophagus and stomach

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What is the main prokinetic?

Metoclopramide

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What is a peptic under?

An excavation that forms in the mucosal wall of the stomach, in pylorus, in duodenum or esophagus

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What are the different types of peptic ulcers?

Gastric
Duodenal
Esophageal

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What are different things that cause peptic ulcers?

H pylori
NSAIDs and Salicylates
Illnesses (pancreatitis, hepatic disease, Crohn’s disease, ect)
Excessive HCl
Irritants
Blood type (O is more likely)

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What are the manifestations of a peptic ulcer?

Pain
pyrosis (heartburn)
Vomiting
Constipation and diarrhea
Bleeding

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What are medical management options to treat peptic ulcers?

Pharmacological
Stress reduction
Rest
Smoking cessation
Diet changes

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What is chronic gastritis?

Similar etiology and management to GERD and PUD

What diet is recommended for gallbladder disease

Low fat
Calorie restricted
High protein

What diet is recommended for diarrhea

Liquid Low fiber Regular Fluid and electrolyte replacement

What type of diet is recommended for constipation

High fiber Increase fluids

What type of diet is recommended for peptic ulcer?

Bland

What type of diet is recommended for hypertension, HF, CAD?

Low salt Calorie restricted Fat controlled

What are manifestations of diarrhea?

Increased frequency Increased fluid in stools Abdominal cramps Distention Borborygmus (hear stomach noises) Anorexia/thirst Painful spasms of anus Tenesmus (cramping pain in rectal area)

What are complications of diarrhea?

Electrolyte and fluid imbalance Dehydration Dysrhthmias Skin issues (rash)

What are manifestations of fecal incontinence?

Minor soiling Occasional urgency Loss of control Complete incontinence

What are pt learning needs for fecal incontinence?

Bowel training program Skin care Emotional support

What is IBS

Chronic functional disorder that has recurrent abdominal pain with disordered bowl movements (diarrhea or constipation)

What are manifestations of IBS

Alteration in bowl Pain Bloating Abdominal distention

What are treatments for IBS?

Medication Complimentary meds Diet changes Avoid dairy Drink fluids Avoid alcohol Smoking sessation Relaxation techniques

What are manifestations of celiac disease?

Diarrhea Steatorrhea Abdominal pain Abdominal distention Flatulence Weight loss

What is appendicitis?

Appendix becomes inflamed and edematous Inflammation increases pressure causing edema and obstruction of orifice Once obstructed- appendix becomes ischemic, bacterial overgrowth occurs, and eventually gangrene or perforation occurs

What is diverticular disease?

Sac like herniation of lining of bowel that extends through a defect in the muscle layer

What is diverticu- Losis?

Multiple diverticula without inflammation

What is diverticu-litis?

Infection and inflammation of diverticula

What is the most common site for diverticula ?

Sigmoid colon

What are manifestations of colorectal cancer?

Change in bowl habits Blood in stool (occult, tarry, bleeding, tenesmus) Obstruction; pain, feeling of incomplete evacuation

What are different anorectal conditions?

Proctits Anorectal abscess Anal fistula Anal fissure Hemorrhoid Pilonidal sinus or cyst

What are nursing interventions for a ot with Anorectal condition such as fistula, fissure, hemorrhoid, etc)

2L of water per day High fiber food Bulk laxatives Stool softener Topical meds Promote peeing a lot Hygiene and sitz baths Monitor for complications Educate on self care

What is ulcerative colitis?

Edema and inflammation in rectum and rectosigmoid colon

What can ulcerative colitis lead to?

Obstruction Colin cancer Pernicious anemia

What is chron’s disease?

Inflammation and ulceration of entire GI tract (mouth to anus) All bowl layers are involved and Lesions and fistulas are more likely

What can chrohns disease lead to?

Malabsorption and malnutrition

What is diverticulitis?

Inflammation and infection of bowel mucosa caused by bacteria, food, or fecal matter trapped in diverticula

What are expected findings with ulcerative colitis?

Abdominal pain/cramping Left lower quadrant Anorexia Weight loss Fever Diarrhea Stools may have: mucus, blood, or pus Abdominal distention Abdominal tenderness / firmness High pitched bowel sounds Rectal bleeding

How many stools per day with ulcerative colitis?

15-20 liquid stools

What are expected findings with Crohn’s disease?

Abdominal pain/cramping Right lower quadrant Anorexia Weight loss Fever Diarrhea Abdominal distention Abdominal tenderness / firmness High bitched bowel sounds Steatorrhea (fat in poop)

How many stools per day with Crohn’s disease?

5 loose stools w/ mucus or puss no blood

What are expected findings for diverticulitis?

Acute onset of abdominal pain Lower left quadrant N/V Fever Chills Tachy Abdominal distention

What medications are used to treat UC and Crohns?

5-aminosaliclic acids (anti inflammatory meds) Corticosteroids Immunosuppressants Immunomodulators Antidiarrheal

What are 5-aminosalicylic acids?

Anti-inflammatory meds Sumfonamides