GI Flashcards
What is GERD
Gastro esophageal reflux disease
When stomach acid backflows into esophagus
What are manifestations of GERD?
Heartburn
Dental problems
Esophagitis
Failure to thrive
Regurgitation
Flatulence
Difficulty swallowing
Vomiting
Dry throat
What types of medications are used for GERD?
Proton pump inhibitors (omeprazole)
H2 blockers (ranitidine)
Antacids (hydroxide)
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)
What are foods bad for acid reflux?
Coffee
Alcohols
Fast food
Soda
Chocolate
Garlic
Onions
Tomato’s
Citrus
Peppermint
Spice
Dairy
What are good foods for acid reflux?
Ginger
Leafy greens
Brown rice
Coconut
Celery
Berries
Melon
Banana
Fennel
Avocados
Apple
Pears
What are nursing goals for GERD?
Improve nutrition
Relieve pain
Prevent aspiration
Enforce health education
Relieve anxiety prevent injury
What are proton pump inhibitors?
They reduce gastric acid by inhibiting the cellular pump of gastric parietal cells
What is sub word for proton pump inhibitors?
“Zole”
What is a precaution to remember about PPIs?
Long term use can increase risk for fractures
What are antacids?
Neutralize excess acid
Increase LES (lower esophageal sphincter) pressure
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
What is a H2 receptor antagonists?
Reduces secretion of acids (longer onset than antacids, but longer effects)
What is sub word for H2 blockers?
“Ine”
Ranitidine
Famotidine
Cimetidine
Nixatidine
Think histaMINE - ends in INE (eene)
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
What are prokinetics?
Increased mobility of esophagus and stomach
What is the main prokinetic?
Metoclopramide
What is a peptic under?
An excavation that forms in the mucosal wall of the stomach, in pylorus, in duodenum or esophagus
What are the different types of peptic ulcers?
Gastric
Duodenal
Esophageal
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)
What are the manifestations of a peptic ulcer?
Pain
pyrosis (heartburn)
Vomiting
Constipation and diarrhea
Bleeding
What are medical management options to treat peptic ulcers?
Pharmacological
Stress reduction
Rest
Smoking cessation
Diet changes
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
