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Medsurg Exam 3 > GI Disorders > Flashcards

GI Disorders Flashcards

1
Q

patho of the mouth in digestion

A

responsible for chewing with mechanical digestion

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2
Q

patho of esophagus in digestion

A

Is a hollow muscular tube that carries food & liquid from the mouth to the stomach. It does this by peristalsis.

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3
Q

patho of stomach in digestion

A
  • Stores food during eating
  • Secretes digestive fluids
  • Moves partially digested
    food (chyme) into the small intestine
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4
Q

patho of small intestine in digestion

A

digestion from stomach
absorption of nutrients

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5
Q

patho of large intestine in digestion

A

absorbs water and electrolytes from food that has not been digested yet
* defecation rids the body of any waste leftover from food and removes it through the rectum and anus

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6
Q

parts involved in digestion

A

Mouth
Esophagus
Stomach
Small and large intestine
Rectum

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7
Q

factors in a balanced diet

A

Macronutrients
-Carbohydrates, fats, proteins
Micronutrients
-Vitamins, minerals, electrolytes
Water

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8
Q

healthy diet promotion by the nurse:

A

Begins with assessment of nutritional status
Education and cultural competence are key
Social determinants of health should be part of assessment

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9
Q

Modifications made to a basic diet to meet the needs of the patient

A

modified diet

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10
Q

Used when nutrition cannot be maintained orally, but GI function intact

A

enteral nutrition

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11
Q

nutrition for when the GI tract is not functioning

A

total parenteral nutrition

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12
Q

types of modified diets

A

Clear Liquid
Full Liquid
Pureed (blenderized)
Soft (bland, low-fiber)
Mechanical Soft
Dysphagia

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13
Q

advance diet as tolerated:

A

watch how pt tolerates each diet
wait at least 2-3 hours for response

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14
Q

placement for parenteral nutrition

A

through central vein
through peripheral vein

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15
Q

placement for routes of enteral nutrition

A

stomach (nasogastric)
duodenum (nasoduodenal)
jejunum (nasojejunal)
gastrostomy (stomach)
jejunostomy (SI)

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16
Q

how is enteral nutrition administered

A

via tube to the stomach, duodenum or jejunum

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17
Q

delivery methods for enteral nutrition

A

Continuous infusion
Cyclic feeding
Intermittent
Bolus

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18
Q

Enteral Nutrition Nursing Considerations

A

Tube placement verification
Maintain patency
Presence of bowel sounds
Gastric residuals
HOB 30 degrees
Oral care

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19
Q

Enteral Nutrition Complications

A

Aspiration
N/V and abdominal discomfort
Diarrhea or constipation
Dumping syndrome - feeding too much too fast
Electrolyte imbalances

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20
Q

Nutrition provided via peripheral or central venous routes
Highly concentrated formulas of macronutrients, electrolytes, vitamins, and trace elements

A

parenteral nutrition

21
Q

Parenteral Nutrition Nursing Considerations

A

Monitor solution for “cracking” or separation - always send back
Double nurse verification
Monitor blood sugars Q4-6 hours
Do not administer medications or blood products in same line
If new bag is not available, administer dextrose in water
Maintain sterility
Daily weights (notify MD >1kg/day)

22
Q

Parenteral Nutrition Complications

A

Infection and sepsis
Hyperglycemia
Electrolyte imbalances
Fluid overload
Refeeding Syndrome (respiratory, cardiac, and neuro changes)

23
Q

acute vs chronic peptic ulcer disease

A

Acute
-Superficial erosion
-Minimal inflammation
-Short duration: resolves quickly when cause is identified and removed

Chronic
-Long duration
-Muscular wall erosion with formation of fibrous tissue
-Present continuously for many months or intermittently throughout person’s lifetime
-More common than acute erosions

24
Q

2 types of peptic ulcers

A

duodenal - mucosis is damaged and cannot protect against damage
gastric - lining is disrupted

25
Q

clinical manifestations of duodenal ulcers

A

Weight gain
Pain 2-3 hours after eating
pain relieved with eating
Vomiting
Melena
Perforation

26
Q

clinical manifestations of gastric ulcers

A

Weight loss
Immediate pain
Vomiting
Hemorrhage

27
Q

complications of PUD

A

Hemorrhage (dizzy, hypotension, chest pain)
Perforation (fever, rebound tenderness, hard abdomen)
Penetration
Pyloric Obstruction

28
Q

medications for PUD

A

H2R Blockers (ranitidine, famotidine)
PPI (Omeprazole, Pantoprazole)
Antibiotics (amoxicillin, clarithromycin)
Antacids
Bismuth Salts

29
Q

treatment for PUD

A

Surgery
Endoscopy
Decompress the bowel
PRBC’s
Electrolyte replacement

30
Q

nursing diagnosis for PUD

A

Acute pain
Ineffective health management
Nausea

31
Q

overall goals for PUD

A

Adhere to prescribed therapeutic regimen
Experience a reduction in or absence of discomfort
Exhibit no signs of GI complications
Have complete healing
Make appropriate lifestyle changes to prevent recurrence

32
Q

health promotion for PUD

A

Identify patients at risk
Lifestyle changes
Teach patient to report to health care provider symptoms related to gastric irritation
Teach patient s/s of hemorrhage, perforation, and obstruction

33
Q

Acute care for PUD

A

NPO
NG tube with intermittent suctioning
IV fluid replacement
Explain treatment measures to patient/family
Provide regular mouth care
Cleanse and lubricate nares

34
Q

Expected outcomes for PUD

A

Have pain control without the use of analgesics
Verbalize understanding of the treatment regimen
Commit to self-care and management
Have no complications

35
Q

terms under IBD

A

Chrons
UC

36
Q

factors of UC

A

Start in rectum and through the entire colon
Ulcerations, inflammations and shedding of the epithelium
Mucosa is edematous and inflamed
Abscesses that line the mucosa
Ulcers bleed easily- bloody stools
Narrowing of colon

37
Q

clinical manifestations for Chrons disease

A

Steatorrhea
Weight loss
Crampy pain after meals
Joint disorders
Skin lesions
Ocular disorders
Oral ulcers

38
Q

clinical manifestations for UC

A

Rectal bleeding
Anemia
Anorexia
Hypoalbuminemia

39
Q

clinical manifestations for both Chrons and UC

A

Fever (increased WBC and ESR)
Abdominal pain
Fatigue
Diarrhea
Weight loss
Electrolyte Imbalance
High-pitched bowel sounds

40
Q

complications of Chrons

A

Intestinal obstruction/stricture
Malnutrition
Fistulas common
Perforation/peritonitis
Fluid and electrolyte imbalance

41
Q

complications of UC

A

Toxic megacolon (colonic distension)
Hemorrhage
Perforation/peritonitis
Fluid and electrolyte imbalance

42
Q

diagnostic testing for IBD

A

CBC
-Hgb and Hct
ESR (Erythrocyte sedimentation rate)
Electrolytes
Albumin
WBC
CT scan
Barium series
Sigmoidoscopy/Colonoscopy

43
Q

surgical options for Chrons

A

Strictureplasty
Resection (recurrence common)
Intestinal transplant

44
Q

surgical options for UC

A

Total Colectomy with Ileoanal Reservoir
Total Proctocolectomy with Permanent Ileostomy
Total Proctocolectomy with continent Ileostomy

45
Q

medications for IBD

A

Aminosalicylates – reduce inflammation
-Sulfasalazine - photosensitivity
Corticosteroids – reduce inflammation
-Not for long-term use
Immunosuppressants
-Cyclosporine, methotrexate
Immunomodulators – suppress immune response
-mabs (infliximab), frequently given as infusions
Antidiarrheals
-May increase risk of toxic megacolon

46
Q

nursing diagnoses for IBD

A

Diarrhea
Fluid volume deficit
Imbalanced nutrition: less than body requirements
Disturbed body image

47
Q

overall goals for IBD

A

Reducing inflammation
Suppression of inappropriate immune response
Rest diseased bowel
Improve quality of life

48
Q

nursing implementation for IBD

A

Monitor fluid and electrolytes
Monitor I&Os closely
Assess for s/s dehydration
Teach high protein, high calorie, low fiber diet
Teach s/s of complications
Weight 1 – 2 times weekly
Provide TPN during exacerbations and rest the bowel

49
Q

evaluation for IBD

A

Exacerbations decreased and manageable
Effective immune suppression with minimal complications
Patient maintains quality of life
Maintenance of body image

Medsurg Exam 3 (4 decks)

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