GI Agents, Nutrition & Electrolyte Replacement, Herbal Therapy

Question 1

drugs that act by coating the wall of the GI tract and absorbing bacteria or toxins that cause diarrhea (EX: kaolin, pectin, Pepto-Bismol)

Answer 1

Adsorbents

Question 2

the active ingredients in marijuana approved for clinical use to alleviate nausea & vomiting resulting from cancer treatment

Answer 2

Cannabinoids

Question 3

drugs used to eliminate fecal matter; “laxative”

Answer 3

Carthartics

Question 4

cerebral center lying near the medulla that causes vomiting when stimulated

Answer 4

Chemoreceptor Trigger Zone (CTZ)

Question 5

drugs that act as lubricants and stool softeners used to prevent constipation

Answer 5

Emollients

Question 6

“hyperolmolar laxatives” including salts or saline products, lactulose, and glycerin

Answer 6

Osmotics

Question 7

“harsh” carthartics that cause water stool with abdominal cramping

Answer 7

Purgatives

Question 8

drugs that promote ulcer healing by neutralizing hydrochloric acid and reducing pepsin activity; do not coat the ulcer; two types: systemic & nonsystemic

Answer 8

Antacids

Question 9

thick, viscous, mucous material that provides a barrier between the mucosal lining and acidic gastric secretions; maintains the integrity of the gastric lining and is a defense against corrosive substances

Answer 9

Gastric Mucosal Barrier (GMB)

Question 10

ulcer frequently occurring because of breakdown of the GMB

Answer 10

Gastric Ulcer

Question 11

ulcer caused by hypersecretion of acid from the stomach passing into the duodenum because of (1) insufficient buffers to neutralize gastric acid in the stomach (2) defective pyloric sphincter or (3) hypermotility of the stomach

Answer 11

Duodenal Ulcer

Question 12

inflammation or erosion of the esophageal mucosa caused by a reflux of gastric acid content from the stomach into the esophagus

Answer 12

Gastroesophogeal Reflux Disease (GERD)

Question 13

popular drugs used in the treatment of gastric and duodenal ulcers that block the H2 receptors of the parietal cells in the stomach, thus reducing gastric acid secretion and concentration (EX: ranitidine, cimetidine, axid)

Answer 13

Histamine2 Receptor Antagonists (H2 Blockers)

Question 14

acid released by the parietal cells of the stomach influenced by histamine, gastrin & acetylcholine

Answer 14

Hydrochloric Acid

Question 15

broad term used for an ulcer occurring in the esophagus, stomach or duodenum within the upper GI tract

Answer 15

Peptic Ulcer

Question 16

ulcer resulting from the reflux of acidic gastric secretions into the esophagus as a result of a defective or incompetent cardiac sphincter

Answer 16

Esophageal Ulcer

Question 17

digestive enzyme activated at a pH of 2

Answer 17

Pepsin

Question 18

ulcer following a critical situation such as extensive trauma or major surgery (burns, cardiac surgery)

Answer 18

Stress Ulcer

Question 19

Nonpharmacological Management Techniques for Upper GI Disorders

Answer 19

Lifestyle changes!!!, low-fat food, increased exercise, eliminate alcohol, avoid chocolate, avoid caffeine, elevate HOB on blocks

Question 20

vitamin required for development & maintenance of healthy eyes, gums, teeth, skin, hair & selected glands…needed for fat metabolism…in fortified milk, butter, eggs, leafy green & yellow veggies & fruits…naturally only in cod, halibut, shark & tuna…deficiency= dry skin, poor tooth development, night blindness

Answer 20

Vitamin A (Retinol)

Question 21

vitamin that promotes use of sugars (energy) & required for good function of nervous system & heart…in enriched breads/cereals, yeast, liver, pork, fish, milk, lentils, blackstrap molasses…deficiency= sensory disturbances, retarded growth, fatique, anorexia, Wernicke encephalopathy (alcohol abuse)

Answer 21

Vitamin B1 (Thiamine)

Question 22

vitamin that promotes body’s use of carbs, proteins & fats by releasing energy to cells & required for tissue integrity…in milk, enriched breads/cereals, liver, lean meat, eggs, almonds, wheat germ, soy, leafy green veggies…deficiency= visual defects (blurred vision & photophobia), cheilosis, rash on nose, extremity numbness

Answer 22

Vitamin B2 (Riboflavin)

Question 23

vitamin important in metabolism, protein synthesis, & formation of RBC…in lean meat, leafy green veggies, whole-grain cereals, yeast, bananas, salmon, soybeans, seeds, nuts, avacados, carrots…deficiency= neuritis, convulsions, dermatitis, anemia, lymphopenia

Answer 23

Vitamin B6 (Pyroxidine)

Question 24

vitamin that functions as a building block of nucleic acids, forms RBC & facilitates functioning of nervous system…in liver, kidney, fish, milk, eggs, chicken, turkey…deficiency= GI disorders, poor growth, anemias (pernicious anemia) vegetarians

Answer 24

Vitamin B12 (Cobalamin)

Question 25

vitamin that helps in formation of genetic materials & proteins for the cell nucleus, assists in intestinal functioning & prevents selected anemias...in leafy green veggies, yellow fruits/veggies, yeast, organ meats, black-eyed peas, lentils...deficiency= decreased WBC & clotting factors, anemias, intestinal disturbances, depression (400 mcg/day in pregnancy)

Answer 25

Folic Acid (Folvite)

Question 26

vitamine that promotes body's use of carbs, fats & proteins for the cell nucleus and is essential in formation of specific hormones & nerve-regulating substances...in eggs, leafy green veggies, nuts, liver, kidney, skim milk, seeds, nuts, wheat germ, salmon...deficiency= unknown in humans

Answer 26

Pantothenic Acid

Question 27

vitamin in all body tissues necessary for energy-producing reactions and assists in nervous system...in eggs, meat, liver, beans, peas, enriched bread/cereals...deficiency= retarded growth, pellagra, HA, memory loss, anorexia, insomnia

Answer 27

Niacin

Question 28

vitamin that synthesizes fatty acids & glucose for energy production and required by body chemical systems...in eggs, milk, leafy green veggies, liver, kidney...deficiency= unknown in humans

Answer 28

Biotin

Question 29

vitamin that helps tissue repair & growth and required in formation of collagen...in citrus fruits, cantaloupe, tomatoes, leafy green veggies, sweet red peppers, potatoes, strawberries, kiwi...deficiency= poor wound healing, bleeding gums, scurvy, predisposition to infection

Answer 29

Vitamin C (Ascorbic Acid)

Question 30

vitamin that promotes the use of phosphorus & calcium and important for strong teeth & bones...in fortified milk, egg yolk, tuna, salmon, liver...deficiency= Rickets in children, osteomalacia in adults

Answer 30

Vitamin D (Calciferol)

Question 31

vitamin that protects fatty acids & promotes formation and functioning of RBC, muscle, other tissues...in whole grain cereals, wheat germ, veggie oils, lettuce, sunflower seeds, milk, eggs, meat, avocados, asparagus...deficiency= breakdown of RBC

Answer 31

Vitamin E (Alpha-Tocopherol)

Question 32

vitamin essential for blood clotting...in leafy green veggies, liver, cheese, egg yolk, veggie oil, tomatoes...deficiency= increased clotting time, leading to increased bleeding & hemorrhage

Answer 32

Vitamin K

Question 33

Categories for Justification of Vitamin Supplements

Answer 33

malabsorption, diarrhea, infectious dx, chronic dx (Chron's, celiac), inability to use vitamins (liver dx, renal dx, hereditary deficiencies), increased vitamin loss (fever from infection, hyperthyroidism, dialysis, cancer, starvation, crash diets), increased vitamin requirements (pregnancy, early childhood, cancer, alcoholism, GI surgery, special diets)

Question 34

Fat-Soluble Vitamins

Answer 34

K.A.D.E...slowly metabolized, stored in fatty tissue, liver & muscle

Question 35

mineral that is vital for hemoglobin formation (60% is found in hemoglobin)...in meat, fish, poultry, grains, veggies...increased doses needed during pregnancy...deficiency= fatigue, intolerance to cold, pale skin, anemia

Answer 35

Iron

Question 36

Non-Heme Iron Absorption is Impaired By?

Answer 36

taking with coffee, tea, calcium, dried peas, rice, spinach, berries & cholocate

Question 37

Non-Heme Iron Absorption is Enhanced By?

Answer 37

taking with vitamin C rich foods (OJ or tomato products)

Question 38

Ususal Dose of Ferrous Sulfate (Iron)

Answer 38

325 mg daily...PO, IM or IV

Question 39

mineral that is a component of hemoglobin synthesis, wound healing, excess amounts = Wilson's dx

Answer 39

Copper

Question 40

mineral that helps with common cold, excess= copper deficiency

Answer 40

Zinc

Question 41

mineral that enhances the action of insulin...helps with diabetes & weight loss

Answer 41

Chromium

Question 42

mineral that is an antioxidant...excess= garlic odor

Answer 42

Selenium

Question 43

the most plentiful mineral in the body responsible for bone & teeth formation, blood clotting & nerve transmission...RDA 1000-1500 mg/day...in milk, cheese, yogurt, fortified OJ, almonds

Answer 43

Calcium

Question 44

calcium supplement that is least expensive & is better absorbed when taken with food

Answer 44

Calcium Carbonate

Question 45

calcium supplement that contains citric acid which is better absorbed in elderly people, less likely to cause constipation & better absorbed in empty stomach

Answer 45

Calcium Citrate

Question 46

Nursing Interventions for IV Calcium

Answer 46

(1) assess renal fxn prior to administration (2) SLOW IV infusion (3) close pt. monitoring (4) monitor IV site

Question 47

the most common intracellular cation that is poorly stored in the body but is necessary for the transmission of nerve impulses & contract of the heart, skeletal & smooth muscles...RDA 40-60 mEq/day

Answer 47

Potassium

Question 48

Reasons Patients Need Potassium Supplements

Answer 48

(1) on antibiotics (PCN) (2) taking K+ wasting diuretics (thiazides, loop diuretics)

Question 49

Treatment for Hypokalemia

Answer 49

PO: liquid, powder or tablet that is irritating to stomach so give with full glass of fluid...IV: NEVER GIVE PUSH, ALWAYS DILUTE

Question 50

Treatment for Hyperkalemia

Answer 50

K+ restriction, IV sodium bicarbonate, 10% calcium gluconate, insulin/glucose, kayexelate (PO or rectal enema)

Question 51

Treatment for Hyponatremia

Answer 51

H2O restriction, 0.9% normal saline for mild case, 3% saline for levels of <115 mEq/L

Question 52

Symptoms of Hypernatremia

Answer 52

FIRED! = Fever, Flushed Skin, Restless, Increased fluid retention, Increased BP, Edema, Decreased urinary output, Dry mouth

Question 53

Treatment of Hypernatremia

Answer 53

dietary restrictions (2 of 4 gm/day)

Question 54

electrolyte that promotes transmission of neuromuscular activity & contraction of myocardium

Answer 54

Magnesium

Question 55

Treatment of Hypermagnesemia

Answer 55

calcium gluconate

Question 56

Treatment of Hypomagnesemia

Answer 56

IV Mg sulfate

Question 57

enteral feeding that is lactose free

Answer 57

Isocal

Question 58

enteral feeding that is high in protein

Answer 58

Ultracal

Question 59

enteral feeding that is high in fiber

Answer 59

Jevity

Question 60

enteral feeding that is for diabetics

Answer 60

Glucerna

Question 61

enteral feeding that is for respiratory patients

Answer 61

Pulmocare

Question 62

Advantages of Continuous Enteral Feeding

Answer 62

improve tolerance, reduce risk of aspiration, increased time for nutrient absorption

Question 63

Disadvantages of Continuous Enteral Feeding

Answer 63

restricts ambulation, more expensive

Question 64

enteral feeding administered at specified times throughout the day generally in smaller volumes & at slower rate thatn bolus feedings but in larger/faster volumes than continuous drip feedings

Answer 64

Intermittent Enteral Feeding

Question 65

enteral feeding administered via continuous drip over a period of 8-16 hrs usually nocturnally

Answer 65

Cyclic Enteral Feeding

Question 66

ALERT Campaign for Enteral Safety

Answer 66

Aseptic technique, Label enteral equipment, Elevate HOB 30 deg, Right patient/formula/tube, Trace all lines/tubing back to patient

Question 67

least desirable method of supplying nutrients to the body via IV for severe GI disturbances & patients unable to meet nutritional requirements...must be given over 24 hours & patient must be weaned off

Answer 67

Total Parenteral Nutrition (TPN)

Question 68

line used to give isotonic or mildly hypertonic solutions during administration of TPN

Answer 68

PICC Line

Question 69

line used when large amount of carbs are given through subclavian or internal jugular veins

Answer 69

Central Venous Catheter

Question 70

Potential Complications of TPN

Answer 70

Pneumothorax, Air embolism, Hyper/Hypoglycemia, Hypervolemia, Infection

Question 71

herb used for external pain relief & burn relief, constipation...S/E= arrythmias neuropathies, edema

Answer 71

Aloe Vera

Question 72

herb used for digestive complaints, sedative effects...S/E= urticaria, bronchoconstriction if allergic to daisy or ragweed

Answer 72

Chamomile

Question 73

herb used as all-purpose woman's tonic frequently mixed with fillers (vit B12)

Answer 73

Don Quai

Question 74

herb that stimulates immune system used for colds, flu, recurrent URI & UTI...hepatoxic

Answer 74

Echinacea

Question 75

herb that detoxifies & increased immune fxn, decreases platelet aggregation used for hypercholesterolemia & mild HTN

Answer 75

Garlic

Question 76

herb used to stimluate digestion, as antispasmodic, to decrease platelet aggregation

Answer 76

Ginger

Question 77

herb used as antioxidant, peripheral vasodilator & increased blood flow to CNS, helps with memory, decreased platelet aggregation

Answer 77

Ginkgo Biloba

Question 78

herb used as antidepressant, antiviral, for anxiety, sleep disorders...drug interactions with transplant meds & antidepressants, not for HIV patients

Answer 78

St. John's Wort

Question 79

herb that increases liver cell regeneration, slows cirrhotic disease, increases quality of life

Answer 79

Milk Thistle

Question 80

herb used at mild sedative and sleep-inducing agent, "herbal valium" for anxiety...has dirty sock odor

Answer 80

Valerian

Question 81

herb that decreases size of prostate, "plant catheter"

Answer 81

Saw Palmetto

Question 82

act that classified herbs as "dietary supplements", made premarket testing not required, clarified marketing regulations...made no claims about prevention or curing of specific diseases

Answer 82

Dietary Supplement Health & Education Act of 1994

Question 83

group of harmful chemicals

Answer 83

free radicals

Question 84

used as a measurement of the concentration of IV solutions compared with the osmolality of body fluids

Answer 84

Tonicity

Question 85

another name of total parenteral nutrition (TPN)

Answer 85

Hyperalimentation (HA)