GI Flashcards
What is gerd?
Inflow of gastric contents into the lower esophagus.
What test diagnose gerd?
Barium swallow/UGI
Endoscopy
Esophageal manometry
Nursing considerations for gerd
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
Nursing considerations for Esophageal Disorders
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
what is gastritis
infammation of the stomach
nursing consideratins for gastritis
dietary changes until symptoms resolve
clear liquid then bland
monitor for electrolyte imbalance until n/v resolves
what is PUD
H.pylori infection
what causes PUD pain
local erosion in the mucosal layer
PUD can occur in
stomach &/or duodenum
diagnostic testing for PUD
H. Pylori testing
gastric sample
urea breath testing
IgG serum
stool sample for H.pylori & occult blood
EGDnursing considerations for PUD
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
meds for PUD
proton pump inhibitors histamine2 antagonist prostglandin analogues antacids sucralfate antibiotics (usually 2) flagyl and amox. biaxin/ clarithromycin TCN
nursing care for obese pts.
restoring healthy weight, lifestyle, body image
what is gastric sx
sx involve the partial or complete removal of stomasch
indications for gastric sx
advanced PUD
emergency management for perforation
gastric ca
modification for wt loss
pre-op for gastric sx
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
post–op for gastric sx
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
what is dumping syndrome
rapid emptying of stomach ontents into small intestine
manifestations of early dumping syndrome
vertigo,syncope,pallor,diaphoresis,tachycardia,palpations
manifestations of late dumping syndrom
abd. distention , crmping, borborygmi, nausea, dizziness, diaphoresis, confusion
nursing considerations for dumping syndrome
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
manifestations of gastric cancer
often asymptomatic until metastasis to surrounding organs
vague when occur epigastric discomfort indigestion wt loss feeling of fullness after eating anorexia weakness
diagnostic test for gastric cancer
barium swallow/UGI
CT/MRI
Endoscopic exam and bx
Labs tumor markers
therapeutic interventions for gastric cancer
partial/total gastric resection
chemo and radiation following surgery
nursing interventions for gastric cancer
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
disorders of oral cavity
caries oral infs periodontal disease pyorrhea-gums,bone,supporting structures gingivitis- gums inflammed leukoplakia oral cancer
nursing considerations for oral disorders
promote food/fluid intake
HOB elevated, suction prn
monitor bleeding/hoarseness
oral care q 2hr
what is esophageal varices
swollen fragile blood vessels in the esophagus
what causes esphageal varices
restricted blood flow in the liver due to etoh damage/hepatitis
manifestations of esophageal varices
hematemesis
melena
hypotension
tachycardia
nursing interventions for esphageal varices
monitor for aspiration be prepared for transfusion(large gauge) meds propanolol=decrease hr vasopressin/octreotide=decrease hepatic portal inflow
what is fecal impaction
hard mass of stool in folds of rectum
manifestations of fecal impaction
liquid fecal seepage freq. nonproductive urge to defecate rectal pain feeling of illness anorexia abd. distention n/v
nursing intervention of fecal impaction
oil retention enema
cleansing enema 4 hrs later
digital removal
daily cleansing enemas
manifestations of diarrhea
cramps, sore anus, fatigue weakness, frequent liquid stools
nursing interventions of diarrhea
monitor I&O, daily wt, skin turgor observe/document stool characteristics drink adequate amts of fluids skin integrity taking antibiotics suggest yogurt/probiotics
meds for diarrhea
antidiarrheals
diphenozylate
loperamide
