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Marie- NUR 280 > GI Disorders > Flashcards

GI Disorders Flashcards

1
Q

GI assessment

A

Asses:
- swallowing
- indigestion
- belching
- nausea and vomiting
- appearance of emesis
- medications
- ask about laxatives
- infections
- abdominal pain (type and location)
- weight changes
- bowel movements
- diet

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2
Q

dysphagia

A
  • difficulty swallowing
  • begins with solid food and progresses to liquids
  • usually a neuromuscular dysfunction/problem with cranial nerves
  • structural abnormalities of esophagus (like strictures or achalasia)
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3
Q

odynophagia

A

painful swallowing

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4
Q

how is dysphagia diagnosed

A

with a barium swallow test

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5
Q

what is the main concern with dysphagia

A

aspiration

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6
Q

what do we teach patients with dysphagia

A

sit up while eating

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7
Q

nursing considerations for dysphagia

A

nutrition, reduce aspiration risk, rely on speech therapy for help

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8
Q

GERD

A

a problem with the tone of the lower esophageal sphincter allows stomach acid to regurgitate into the esophagus

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9
Q

gastoparesis

A
  • delayed stomach emptying
  • will exacerbate GERD
  • metaplasia of esophageal cells may occur resulting in Barret’s esophagus
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10
Q

s/s GERD

A
  • dysphagia
  • heartburn
  • epigastric pain
  • regurgitation
  • dyspepsia
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11
Q

common causes of GERD

A
  • obesity
  • pregnancy
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12
Q

left untreated GERD can cause

A
  • GI bleeds
  • high risk for cancer (neoplasia)
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13
Q

how is GERD diagnosed

A

upper endoscopy

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14
Q

treatment for GERD

A
  • lifestyle changes: weight loss, smoking cessation, HOB elevation
  • laparoscopic antireflux fundoplication
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15
Q

causes of upper GI bleed

A
  • peptic ulcer disease
  • esophageal varices
  • esophageal cancer
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16
Q

acute upper GI bleed

A
  • worse for the client than chronic
  • caused by rupture, tear, perforation, immediate blood loss
  • hypotension
  • tachycardia
  • hypovolemia
  • hematemesis
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17
Q

what will client complain of with an acute upper GI bleed

A
  • weakness
  • fatigue
  • SOB
  • high anxiety
  • severe mental status changes
  • feelings of impending doom
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18
Q

chronic upper GI bleed

A
  • body is able to compensate better
  • caused by small tear or opening causing gradual blood loss
  • iron deficiency
  • melena (dark tarry stool)
  • occult blood in stool
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19
Q

what will a client complain of will a chronic GI bleed

A
  • tiredness
  • iron deficiency anemia
  • pain
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20
Q

how is an upper GI bleed diagnosed

A
  • CBC: hematocrit/hemoglobin decreased
  • fecal occult blood test
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21
Q

treatment for acute GI bleed

A
  • this is an emergency situation!!!
  • hemodynamic stabilization- STOP THE BLEEDING!!
  • endoscopic techniques to stop bleeding
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22
Q

treatment for chronic GI bleed

A
  • meds
  • PPIs: (proton pump inhibitors) pt on this med for 6-8 weeks and then reevaluate
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23
Q

hiatal hernia

A
  • stomach pushes up through an opening in the diaphragm- may be asymptomatic
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24
Q

sliding hiatal hernia

A
  • stomach pushes up through esophagus
  • LES weakened
  • same s/s as GERD:
  • dysphagia
  • heartburn
  • belching
  • epigastric discomfort
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25
Q

rolling hiatal hernia

A
  • sits next to esophagus
  • structural abnormality in diaphragm
  • s/s:
  • acute chest pain (feels like an MI)
  • bloating
  • trouble swallowing
  • upset stomach
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26
Q

how are hiatal hernias diagnosed

A

upper endoscopy

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27
Q

treatment for hiatal hernias

A
  • PPIs
  • H2 blockers
  • prevent reflux
  • treat sliding like GERD (sit up after eating), sleep with HOB up
  • surgery
  • lifestyle changes
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28
Q

gastritis

A
  • inflammation of the stomach lining
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29
Q

causes of acute gastritis

A
  • erosive
  • similar to GERD
  • meds (NSAIDs, aspirin, corticosteroids
  • infection
  • acute stress
  • bile reflux
  • alcohol abuse
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30
Q

s/s acute gastritis

A
  • heartburn
  • epigastric pain
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31
Q

how is acute gastritis diagnosed

A

upper endoscopy

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32
Q

treatment for acute gastritis

A
  • remove causative agents
  • PPIs, H2 blockers
  • remove underlying cause and it is usually reversible
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33
Q

causes of chronic gastritis

A
  • worse for the body
  • non erosive, more irritating
  • H. pylori, may have it for months before coming in
  • decreased intrinsic factor (vitamin B12 absorption)
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34
Q

s/s chronic gastritis

A
  • atrophy of glandular stomach lining
  • gnawing pain
  • hematemesis
  • weight loss
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35
Q

how is chronic gastritis diagnosed

A
  • upper endoscopy
  • biopsy (can be precancerous to stomach cancer
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36
Q

treatment for chronic gastritis

A
  • antibiotics for H. pylori (long term treatment)
  • PPIs, H2 blockers
37
Q

gastroenteritis

A
  • stomach flu
  • irritation of lining of the stomach, small or large intestine by a pathogen or toxin
  • always caused by infection
  • characterized by diarrhea
38
Q

other s/s of gastroenteritis

A
  • nausea/vomiting
  • diarrhea
  • lost electrolytes
    -borborygmi
39
Q

treatment for gastroenteritis

A
  • IV fluid replacement/ID (in severe cases)
  • treat causative agent
  • symptom management
  • if viral normally lasts about 12-72 hrs
  • if bacterial it lasts until the bacteria is killed off
40
Q

peptic ulcer disease

A

inflammatory erosion of stomach or duodenum (duodenum more common)

41
Q

causes of PUD

A
  • hypersecretion of stomach acid, not enough protection from acid
  • H. pylori! (most common cause)
  • NSAIDs
  • stress
  • alcohol abuse
  • excessive caffeine
  • smoking
  • sometimes genetic
42
Q

s/s PUD

A
  • sudden, excruciating epigastric pain and abdominal rigidity
  • intense pain
  • once perforated = vomit blood
43
Q

how is PUD diagnosed

A

upper endoscopy

44
Q

treatment for PUD

A
  • reduce acid levels
  • protect gastric lining
  • no spicy/fatty foods
  • antibiotic therapy (if H. pylori)
  • smoking cessation
  • avoid foods that cause problems
  • stress management
  • avoid late night eating
  • surgery:
  • gastrojejunostomy (Billroth 2)
  • gastroduodenostomy (Billroth 1)
45
Q

short bowel syndrome

A
  • any process that leaves fewer than 200 cm of small intestine (normal length is 600 cm)
  • remaining intestine eventually adapts and increase the organ’s ability to absorb nutrients
  • will never go back to normal
46
Q

what is the small intestine responsible for

A

nutrient absorption

47
Q

acute phase(short bowel syndrome)

A
  • first 3 months after bowel removal
  • careful monitoring of nutrition/supplements
  • look for signs of dehydration
  • high intestinal fluid loss and gastric hypersecretion
  • dramatic weight loss
  • vitamin indeficient
48
Q

adaptation phase (short bowel syndrome)

A
  • next 12 to 18 months after bowel removal
  • foods introduced slowly, one at a time
  • small intestine will begin to adapt to the new regimen
  • villi will grow/increase in length to increase absorption of nutrients
49
Q

maintenance phase (short bowel syndrome)

A
  • lifelong
  • clients will be on lifelong medications, dietary plans
  • maintaining new normal, education
50
Q

small bowel obstruction

A
  • something is obstructing the movement of food through small intestine
  • can be acute or chronic and partial or complete
  • post surgery is a common cause of acute SBO (complete)
  • chronic is bc of an inflammatory process
  • usually starts partial and can become complete
51
Q

s/s small bowel obstruction

A

will depend on the severity of the blockage and what is causing it
- pain
- nausea/vomiting
- hyperactive bowel sounds (partial)
- diarrhea (partial)
- absent bowel sounds (complete)

52
Q

how is SBO diagnosed

A

abdominal xray

53
Q

treatment for SBO

A
  • depends on what is causing it
  • for partial obstruction:
  • NG tube for gastric decompression
  • NPO
  • Medications
  • for complete obstruction:
  • surgery
54
Q

constipation

A
  • common problem, especially in the elderly
  • can result in fecal impaction and obstipation(sensation to defecate with no passage of stool or gas)
  • very hard stool
  • less than 3 stools per week or very difficult bowel movements
55
Q

how is constipation diagnosed

A

barium contrast`

56
Q

treatment for constipation

A
  • dietary fiber (20-35 g/day)
  • adequate fluids
  • laxatives
  • suppositories
  • medications
57
Q

inflammatory bowel disease

A

bowel = infalmed

58
Q

Crohn’s disease

A
  • chronic, full thickness inflammatory processes
  • skip lesions/cobblestoning
  • malabsorption/nutritional deficiencies common
59
Q

what is the location of Crohn’s disease

A

GI tract from mouth to anus, but more common in the ileum

60
Q

s/s Crohn’s disease

A
  • diarrhea
  • abdominal pain
  • distension
61
Q

how is Crohn’s disease diagnosed

A

colonoscopy, biopsy

62
Q

Crohn’s disease treatment

A
  • diet management
  • antidiarrheals
  • immunosuppressants
  • surgery to remove diseased tissue
63
Q

complications of Crohn’s disease

A
  • obstruction
  • microperforations
  • chronic inflammation
  • increased DVT and PE risk
64
Q

ulcerative colitis

A
  • pseudo polyps in colon only
  • just lining that ulcerates
  • continuous lesions
65
Q

location of ulcerative colitis

A

colon and rectum

66
Q

s/s ulcerative colitis

A
  • diarrhea
  • abdominal pain
  • distention
67
Q

how is ulcerative colitis diagnosed

A

colonoscopy to distinguish from Crohn’s

68
Q

treatment for ulcerative colitis

A
  • corticosteroids
  • antinflammatorys
  • mesalime enema
  • surgery
69
Q

large bowel obstruction

A
  • contents cannot move through large intestine
  • high mortality rate if not diagnosed/treated w/in first 24 hours
  • bowel becomes dilated above obstruction
69
Q

s/s large bowel obstruction

A
  • abdominal pain
  • abdominal distention
  • abdominal tenderness
  • abdominal rigidity
70
Q

s/s large bowel obstruction partial blockage

A

high pitched bowel sounds

71
Q

s/s large bowel obstruction complete blockage

A
  • no bowel sounds
  • no feces in rectum
72
Q

how is a large bowel obstruction diagnosed

A
  • abdominal xray
  • elevated WBC
73
Q

treatment for large bowel obstruction

A
  • fluid replacement !
  • intestinal decompression with NG tube or colorectal tube
  • surgery:
  • anastomosis
  • colectomy
74
Q

irritable bowel syndrome

A
  • bowel is irritated
  • abdominal pain and altered bowel activity
  • diarrhea
  • constipation
  • pain
  • bloating
  • common condition
  • chronic abdominal pain lasting at least 6 months with bouts of diarrhea and constipation
  • no known etiology
75
Q

risk factors for IBS

A
  • female
  • under 40 yo
  • stress
76
Q

alarm symptoms for IBS

A
  • weight loss
  • family GI history
  • iron deficiency anemia
  • rectal bleeding
  • age >50 years
77
Q

how is IBS diagnosed

A
  • patient symptoms
  • rule out other causes
78
Q

treatment for IBS

A
  • regulate bowel movements
  • bulk laxatives, antidiarrheals
  • stress management
79
Q

diverticulosis

A

happens when bowel wall weakens, not inflamed

80
Q

diverticulitis

A

diverticula collect intestinal content and become inflamed

81
Q

diverticular disease

A

diverticula form due to weakened bowel wall, collect intestinal contents, become diverticulosis, become inflamed, and then diverticulitis

82
Q

s/s diverticular disease

A
  • depends on severity and location
83
Q

how is diverticular disease diagnosed

A
  • abdominal xray
  • lower GI series
  • CT scan
84
Q

treatment for diverticular disease

A
  • dietary modification (high fiber, low amounts of red meat
  • adequate fluid/fiber intake
  • severe cases may require resting the colon (NPO)
85
Q

volvulus

A
  • twisting of large intestine
  • most common in sigmoid colon
  • results in LBO
  • twisting = blood supply cut off
  • will not untwist by itself, must be done surgically
85
Q

volvulus

A
  • twisting of large intestine
  • most common in sigmoid colon
  • results in LBO
  • twisting = blood supply cut off
  • will not untwist by itself, must be done surgically
86
Q

s/s volvulus

A
  • bilious vomiting
  • abdominal pain
  • colicky then steady pain
  • abdominal tenderness

Marie- NUR 280 (12 decks)

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