Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Care of Adult/Older Exam #3 (5701) > GI Bleed > Flashcards

GI Bleed Flashcards

1
Q

Upper Gastrointestinal Bleeding: Esophageal Origin

A

chronic esophagitis-GERD, irritating medications, alcohol, cigarettes, esophageal varices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Upper Gastrointestinal Bleeding: Stomach and Duodenal Origin

A

Bleeding peptic ulcers caused by: NSAIDS, ASA, corticosteroids (irritate and disrupt mucosal barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

melena

A

Black tarry stools, indicative of an upper GI bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

small amounts of blood in gastric secretions

A

occult bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diagnostics for a GI Bleed?

A
  • Diagnosed by Endoscopy (EGD)
  • Angiography
  • CBC-low H/H
  • BUN-elevated
  • Electrolytes-loss of electrolytes through emesis/stool
  • PT-increased risk for bleeding
  • Liver enzymes
  • ABG - monitor resp status
  • Blood type/cross match-blood type
  • Occult bleeding-assess stool/emesis
  • UA-looking for dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Liver failure increases the risk of _________ (GI related).

A

esophageal varices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why would the BUN be elevated in a GI bleed?

A

due to blood proteins broken down by GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

GI bleeds are diagnosed by?

A

Endoscopy (EGD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nursing Assessments for a GI Bleed?

A
  • Monitor VS q15-30 min
  • Emphasis on ABC’s & early identification of Shock
  • Assess LOC, BP, HR, peripheral pulses and perfusion, presence or absence of neck vein distension, abdominal assessment
  • Frequent Resp, CV, GI, I&O assessments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

GI BLEED Treatment

A
  • Patient is NPO
  • Hydrate (Insert 2 large bore IV’s)
    • Isotonic crystalloid fluids (LR)
  • Blood transfusions
    • Watch for fluid overload
    • Monitor urine output
  • IV infusion or IV push Proton Pump Inhibitor (Protonix)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

1st line tx for GI bleed?

A

Endoscopic hemostasis - hopefully within 24hrs of the bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nursing Interventions: Teaching for GI Bleed

A
  • Smoking cessation
  • Avoid alcohol, stress, OTC drugs
  • Medication adherence
  • S/S of upper and lower GI bleed
  • Side effects of medications (ASA, NSAIDS, COUMADIN)
    • Potential for bleeding even with low dose aspirin taken daily
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Inflammation and breakdown of the normal gastric mucosal barrier by HCL acid and pepsin

A

Gastritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Gastritis Caused by?

A
  • Drugs-ASA, NSAIDS
  • Diet-alcohol, spicy
  • Microorganisms-H-Pylori
  • Environmental-Smoking
  • Pathophysiologic
    • hiatal hernia, stress
  • Other- NG tube, EGD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

S/S of Acute Gastritis?

A
  • anorexia
  • N/V
  • epigastric tenderness
  • feelings of fullness
  • hemorrhage is associated with alcohol and may be only symptom
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Gastritis is diagnosed by ?

A

endoscopy (EGD) with biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of Gastritis?

A

NPO, IVF, Possible NG Tube, PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Nursing Interventions: Teaching for Gastritis?

A
  • diet modification (Individualize)
  • Decrease alcohol intake
  • Smoking cessation
  • Tx H-Pylori,
19
Q

Erosion of the GI mucosa from the digestive action of HCL acid and pepsin

A

Peptic Ulcer Disease (PUD)

20
Q

Peptic Ulcer Disease (PUD) is caused by?

A
  • H. Pylori
  • alcohol
  • nicotine
  • stress
  • ASA & NSAIDS
21
Q

Manifestations of Duodenal Ulcers?

A
  • Mid-epigastric pain may radiate to back
  • Burning or cramping 2-5 hours after eating –relief obtained with antacids and food
  • More common in men esp. 35 -45 age group
22
Q

Manifestations Gastric Ulcers

A

High epigastric dyspepsia occurring 1-2 hours after eating
Food aggrevated deep ulcers
More prevalent in women & older adults

Higher mortality rate

23
Q

Duodenal Ulcer Risk factors

A
  • H. pylori
  • alcohol
  • smoking
  • COPD
  • Chronic Renal Failure
24
Q

Gastric Ulcer Risk factors

A

H. Pylori, bile reflux, smoking, medications

25
Q

Peptic Ulcer Disease is diagnosed by?

A

Endoscopy (EGD) with biopsy

26
Q

Diagnostics for Peptic Ulcer Disease?

A
  • Barium Contrast Study
  • Lab test
    • CBC
    • H/H
    • Similar to GI bleed if hemorrhage or perforation present
    • WBC
    • Liver enzymes
    • Amylase
    • Stool Studies
27
Q

Nursing Interventions for Peptic Ulcer Disease?

A
  • Advance diet as tolerated
    • start with clear liquids
  • Teach:
    • Avoid foods that cause gastric distress (spicy, acidic)
    • Alcohol and smoking cessation
    • Side effects of OTC medications
    • Drug therapy
    • Decrease stress
    • S/S of recurrence
28
Q

Drug therapy for Peptic Ulcer Disease?

A
  • PPI or H2 receptor blockers,
  • antacids
  • antibiotics if H. Pylori present
29
Q

Complications of Peptic Ulcer Disease?

A
  • Hemorrhage (most common)
    • Vomiting of blood, change in VS
  • Perforation (most lethal- may cause infection)
  • Gastric outlet obstruction
30
Q

Signs of perforation of a Peptic Ulcer?

A
  • Sudden severe pain, rigid abdomen, found with knees drawn in, grunting respirations
31
Q

Signs of a Gastric outlet obstruction with a Peptic Ucler?

A

N/V, abdominal distention despite having NG tube

32
Q

Treatment of PUD Complications: hemorrhage?

A
  • NPO
  • IVF
  • Hemorrhage (if present)
    • Stop Bleeding
    • Restore blood volume
33
Q

Treatment of PUD Complications - Perforation (if present)?

A
  • NPO
  • IVF
  • Stop bleeding
  • Surgical intervention
  • Restore blood volume
  • Antibiotics-delay OR to get antibiotics started
34
Q

Treatment of PUD Complication - Gastric outlet obstruction (if present)?

A
  • NPO
  • IVF
  • NG to decompress stomach
  • Fluid and electrolytes
35
Q

partial removal of the lower 2/3 of the stomach

A

Gastrectomy

36
Q

severing of the vagus nerve

A

Vagotomy

37
Q

englargement of the pyloric sphincter

A

Pyloroplasty

38
Q

Vagotomy

A
  • severing of the vagus nerve

- Decreases gastric acid secretion

39
Q

Gastrectomy

A

partial removal of the lower 2/3 of the stomach

40
Q

Pyloroplasty

A

englargement of the pyloric sphincter

41
Q
  • Mid-epigastric pain may radiate to back
  • Burning or cramping 2-5 hours after eating –relief obtained with antacids and food
  • More common in men esp. 35 -45 age group
A

S/S of a duodenal ulcer

42
Q
  • Sudden severe pain, rigid abdomen, found with knees drawn in, grunting respirations
A

signs of perforation of a Peptic Ulcer

43
Q
  • High epigastric dyspepsia occurring 1-2 hours after eating
  • Food aggrevated deep ulcers
  • More prevalent in women & older adults
  • Higher mortality rate
A

Manifestations Gastric Ulcers

Care of Adult/Older Exam #3 (5701) (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions