GI

Question 1

What is gerd?

Answer 1

Inflow of gastric contents into the lower esophagus.

Question 2

What test diagnose gerd?

Answer 2

Barium swallow/UGI
Endoscopy
Esophageal manometry

Question 3

Nursing considerations for gerd

Answer 3

pt. teaching re diet
avoiding large meals
stay upright after meals
no etoh, tobacco, high acid foods
peppermint chocolate
lose weight if abd. obese
no tight clothes
HOB 30 degrees

Question 4

Nursing considerations for Esophageal Disorders

Answer 4

monitor ability to swallow and intake nutrition is priority

pain meds and reassure pain is not heart attack

promote swallowing

monitor affect nutrition and hydration

Question 5

what is gastritis

Answer 5

infammation of the stomach

Question 6

nursing consideratins for gastritis

Answer 6

dietary changes until symptoms resolve
clear liquid then bland
monitor for electrolyte imbalance until n/v resolves

Question 7

what is PUD

Answer 7

H.pylori infection

Question 8

what causes PUD pain

Answer 8

local erosion in the mucosal layer

Question 9

PUD can occur in

Answer 9

stomach &/or duodenum

Question 10

diagnostic testing for PUD

Answer 10

H. Pylori testing
     gastric sample
     urea breath testing
      IgG serum
     stool sample for H.pylori & occult blood
EGD

Question 11

nursing considerations for PUD

Answer 11

monitor pain, nausea
diet teaching 
   no/limit ETOH
   tobacco
   caffeine
   chocolate
   no foods that cause discomfort
   eat smaller, more frequent meals
monitor signs of gastric bleeding

Question 12

meds for PUD

Answer 12

proton pump inhibitors
histamine2 antagonist
prostglandin analogues
antacids
sucralfate
antibiotics (usually 2) flagyl and
   amox.
   biaxin/ clarithromycin
   TCN

Question 13

nursing care for obese pts.

Answer 13

restoring healthy weight, lifestyle, body image

Question 14

what is gastric sx

Answer 14

sx involve the partial or complete removal of stomasch

Question 15

indications for gastric sx

Answer 15

advanced PUD
emergency management for perforation
gastric ca
modification for wt loss

Question 16

pre-op for gastric sx

Answer 16

monitor v/s I&O
establish/maintain IV access
monitor daily sts and calorie intake
teach dietary changes post op
verbalize fears/concerns
monitor NG for patency(working) & bleeding

Question 17

post–op for gastric sx

Answer 17

monitor v/s and oxygenation
return of bowel sounds
NG for patency, output
labs for changes in hgb/calcium
maintain pain control
encourage turn,cough,deepbeath & incentive spirometer use
poss. need for b12, D, calcium,iron folate

Question 18

what is dumping syndrome

Answer 18

rapid emptying of stomach ontents into small intestine

Question 19

manifestations of early dumping syndrome

Answer 19

vertigo,syncope,pallor,diaphoresis,tachycardia,palpations

Question 20

manifestations of late dumping syndrom

Answer 20

abd. distention , crmping, borborygmi, nausea, dizziness, diaphoresis, confusion

Question 21

nursing considerations for dumping syndrome

Answer 21

encourage to lie down after meals

teach dietary changes
limit amt of fluid ingested at one time
eliminate liquids w/meals & for 1 hr before/after eating
avoid milk, concentrated sugars
consume hi protein, hi fat, lo to mod carb diet
small, frequent meals
monitor postprandial hypoglycemia
monitor i&O, pt. weight

Question 22

manifestations of gastric cancer

Answer 22

often asymptomatic until metastasis to surrounding organs

vague when occur
  epigastric discomfort
  indigestion
  wt loss
  feeling of fullness after eating
  anorexia
  weakness

Question 23

diagnostic test for gastric cancer

Answer 23

barium swallow/UGI
CT/MRI
Endoscopic exam and bx
Labs tumor markers

Question 24

therapeutic interventions for gastric cancer

Answer 24

partial/total gastric resection

chemo and radiation following surgery

Question 25

nursing interventions for gastric cancer

Answer 25

allow to berbalize fears/emotions educate lifestyle changes need for vit b12 injs tube feedings monitor I&O, v/s, wt monitor function of NG and output

Question 26

disorders of oral cavity

Answer 26

``` caries oral infs periodontal disease pyorrhea-gums,bone,supporting structures gingivitis- gums inflammed leukoplakia oral cancer ```

Question 27

nursing considerations for oral disorders

Answer 27

promote food/fluid intake HOB elevated, suction prn monitor bleeding/hoarseness oral care q 2hr

Question 28

what is esophageal varices

Answer 28

swollen fragile blood vessels in the esophagus

Question 29

what causes esphageal varices

Answer 29

restricted blood flow in the liver due to etoh damage/hepatitis

Question 30

manifestations of esophageal varices

Answer 30

hematemesis melena hypotension tachycardia

Question 31

nursing interventions for esphageal varices

Answer 31

``` monitor for aspiration be prepared for transfusion(large gauge) meds propanolol=decrease hr vasopressin/octreotide=decrease hepatic portal inflow ```

Question 32

what is fecal impaction

Answer 32

hard mass of stool in folds of rectum

Question 33

manifestations of fecal impaction

Answer 33

``` liquid fecal seepage freq. nonproductive urge to defecate rectal pain feeling of illness anorexia abd. distention n/v ```

Question 34

nursing intervention of fecal impaction

Answer 34

oil retention enema cleansing enema 4 hrs later digital removal daily cleansing enemas

Question 35

manifestations of diarrhea

Answer 35

cramps, sore anus, fatigue weakness, frequent liquid stools

Question 36

nursing interventions of diarrhea

Answer 36

``` monitor I&O, daily wt, skin turgor observe/document stool characteristics drink adequate amts of fluids skin integrity taking antibiotics suggest yogurt/probiotics ```

Question 37

meds for diarrhea

Answer 37

antidiarrheals diphenozylate loperamide