GI Exam 2

Question 1

Pathogenic N/V

Answer 1

related to disease

Question 2

Iatrogenic N/V

Answer 2

stemming from disease treatment (chemo)

Question 3

Psychogenic N/V

Answer 3

Resulting form psychological state (Stress)

Question 4

4 causes N/V

Answer 4

pathogenic, iatrogenic, psychogenic, fluid and electrolyte imbalance

Question 5

Pathophysiology of vomiting

Answer 5

vomiting is caused by stimulation of the chemo-receptor trigger zone which stimulates the vomiting center in the medulla by some type of stimulus

Question 6

Subjective assessment N/V

Answer 6

patient identifies factors preceding or related to N/V

Question 7

objective assessment N/V

Answer 7

time of vomiting, color, amount, consistency of emesis, fluid and electrolytes, dehydration

Question 8

Nurse management of N/V

Answer 8

NPO until tolerate fluids (clear)
HOB elevated
replace fluid and electrolytes
NG tube
good mouth care

Question 9

N/V diet

Answer 9

effervescent fluids, bland food

Question 10

N/V medications

Answer 10

Zofran (prevent nausea)

Reglan (increase fastric emptying)

Question 11

Gastritis

Answer 11

inflammation of the fastric mucosa

cause- H Pylori, long term NSAID and steroids, ETOH

Question 12

Acute Gastritis

Answer 12

S&S: epigastric pain, anorexia, N/V

Dx: H. Pylori testing (stool blood)

Question 13

Treatment acute gastritis

Answer 13

NPO, fluid and electrolyte replacement
antiemetics
eliminate cause

Question 14

Chronic gastritis

Answer 14

Recurrent inflammation (autoimmune)
no intrinsic factor produced- pernicious anemia
closelt associated with gastric CA
Tx: avoid irritant, B12 injections for life

Question 15

Upper GI bleed

Answer 15

atrial- bright red (hematoemesis)

venous- slow ooz (coffee ground emesis)

Question 16

Upper GI bleed causes

Answer 16

medication (asprin, NSAID, steroid)
esopageal varices
ulcers

Question 17

Upper GI bleed diagnosis

Answer 17

endoscopy, barium swallow, cat scan , bleed scan

Question 18

Upper GI bleed Emergency treatment

Answer 18

Assess VS shock
IV fluid, NG tube
oxygen

Question 19

Peptic ulcer disease

Answer 19

Erosion of the GI mucosa resulting from digestive action of HCl and pepsin

Question 20

Acute peptic ulcer disease

Answer 20

superficial efoision and minimal inflamation

Question 21

Chronic peptic ulcer disease

Answer 21

long duration
erosion thru muscular layer
fibrosis and scar tissue form

Question 22

Causes of peptic ulcers

Answer 22

gram neg bacteria- H. pylori. drug induced. stress induce

tx- antibiotics

Question 23

Gastic ulcer

Answer 23

normal or increased acid secretions.bile reflux from duodenum

Question 24

Duodenal ulcer

Answer 24

increased acid secretion from increase parietal cell

hypersecretion occurs at unusual times-between meals and at night

Question 25

S&S peptic ulcer

Answer 25

burning, gnawing pain, pain worse on empty stomach, pain awakens patient at night

Question 26

Treatment peptic ulcers

Answer 26

Drug therapy- antacids, PPI, abx
bland diet
avoid stress

Question 27

Antacids

Answer 27

neutralizes gastric acid

give 1-3 hours after meals and at bed time

Question 28

Histamin receptor antagonists

Answer 28

block H2 receptor to reduce HCl acid secretions (zantac)

Question 29

Proton pump inhibitor

Answer 29

stop secretion of HCl to raise stomach pH (protonix)

Question 30

Anticholinergics

Answer 30

inhibit gastric secretion, decrease gastric motility

SE: DRY MOUTH, N/V, DECREASE VISUAL ACUITY, URINARY RETENTION

Question 31

Sucralfate

Answer 31

covers ulcer and prevents erosion

Question 32

Reglan

Answer 32

increases gastric motility and emptying. aniemetic

Question 33

Most common complication of peptic ulcer

Answer 33

hemorrhage
hematemesis or melana first sign
tx- saline lavage and cautorize ulcer

Question 34

Perforation

Answer 34

most serious complication of peptic ulcer
gastric contence spill into peritoneal cavity = peritonitis
S&S- sudden abdominal pain, board abdomen, absent bowel sounds, shallow RR, shock