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Med Surg 2 > GI & Reproductive > Flashcards

GI & Reproductive Flashcards

1
Q

Risk for stomatitis

A

Viral infections
bacterial and fungal infections
Alcohol, tobacco mouthwash
Chemo and radiation
Allergy
Vitamin deficiency
Systemic diseases like chronic kidney disease, inflammatory bowel disease, 

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2
Q

Medical management of stomatitis

A

Frequent assessment of oral cavity
Oral mouth rinses 
Topical analgesic and anesthetics
 See dentist, one month prior to chemo or radiotherapy

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3
Q

Complications of stomatitis

A

Pain
Dysphagia
odynophagia (painful swallowing)


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4
Q

Assessment, findings of stomatitis

A

Dry, red, swollen and cracked oral mucosa
Mouth ulcers,
Canker, sores,
Open bleeding, mouth, sores,
Presence and inflammation, or irritant in other mucosal areas (vagina,rectum, esophagus)

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5
Q

What is a hiatal hernia

A

When a portion of the stomach protrude upward through the esophageal hiatus and into the thoracic cavity

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6
Q

Risk factors for hiatal hernias

A

Obesity
Pregnancy
Smoking

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7
Q

Clinical manifestations of hiatal hernias

A

Strictures (esophageal narrowing) and schatzkis rings (lower esophageal mucosal rings
Cameron lesions (single or multiple gastric you Roshan, and or ulcerations typically visualized at the level of the diaphragmatic hiatus an upper endoscopic examination

Type 1
Heartburn
Regurgitation
Chest pain
Dysphagia
Belching

Types 2
Feeling full after eating
Feeling breathless after eating
Feeling of suffocation
Chest pain that feels like angina
Increase symptoms when lying flat

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8
Q

What is Barrett esophagus?

A

With type one hernias, there is a Whiting of the Hiatal tunnel that allows part of the cardiac portion of the stomach to herniate upward with your lower stomach acids and enzymes to come into contact with esophageal tissue

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9
Q

Medications for hiatal hernias

A

antacids used to neutralize stomach acid.
Proton pump inhibitors, an H2, receptor antagonist are prescribed to to treat Gerd

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10
Q

Priority, nursing interventions for hernias

A

Breathlessness feeling of suffocation chest pain in palpitations
dysphagia
clinical manifestations of Gerd,
heartburn
Nausea, vomiting
Eructation (air bringing reflux material into mouth)
Iron deficiency

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11
Q

Positioning for hiatal hernia

A

Position patient supine on right side and elevate. Head of bed at least 30° after meals.

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12
Q

Hiatal hernia education

A

Limit, food and substances like spicy fat foods, caffeine, chocolate, carbonated, beverages, acidic foods, peppermint, alcohol, caffeinated, beverages, and certain medication’s, like calcium channel, blockers, anti-Cholinergic medication, and smooth muscle relaxers

Encourage patient to eat meals two hours before lying supine

Educate patient to wear nonrestrictive clothing

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13
Q

Risk factors associated with Gerd

A

Hiatal hernia
LES hypotension
Loss of esophageal motility
Increase compliance of hiatal canal
Increase states of gastric secretion
Eating large meals
Delete emptying of gastric contents
Obesity
Ascites
Type belts are girls
Presence of NG tube

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14
Q

Pathophysiology of Gerd

A

Retrograde flow of G.I. contents into the esophagus, resulting in inflammation

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15
Q

Medication is used to treat Gerd

A

Antacids(decrease gastric pH)
Histamine receptor antagonist (decrease gastric acid, production, short acting)
Prokinetic medication’s (increase, gastric emptying)
Proton pump, inhibitors (decrees, gastric acid, production, long lasting)

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16
Q

Clinical manifestations of Gerd

A

Heartburn (dyspepsia)
Severe apical chest pain
Odynphagia (painful swallowing)
Hemorrhage
Dental caries
Aspiration, pneumonia
Chronic cough
Morning hoarseness
Adult onset asthma
Laryngitis
Pharyngitis
Bronchitis
Regurgitation

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17
Q

Client education for Gerd

A

Limit irritating foods
Avoid smoking and alcohol
Avoid NSAIDS and aspirin
Encouraged to eat meals two hours before lying supine
Wear nonrestrictive clothing
Maintain ideal body weight

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18
Q

Risk factors for oral cancer

A

Habitual tobacco/alcohol use
Poor oral hygiene
Mechanical irritation, from dental appliances
Use of mouthwash, with high alcohol Content
Herpes Symplex virus
Human papillomavirus
Mutations
Abnormalities, such as nonhealing ulcers,leukoplakia (white patches) or erythroplakia (red patches)

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19
Q

Clinical manifestations of oral cancer

A

Oral bleeding
Raised area on the lip or in mouth
Oral answer it with poorly defined margins. Mucosal lesions are nodules. White and or red patches in the oral cavity
Increasing pain that radiates to the era neck
Dysarthria (difficulty speaking)
Dysphagia
Difficulty chewing
Oral factor
Regional lymph node involvement
Weight loss
Poor fitting dentures

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20
Q

Pathophysiology of oral trauma

A

Injury to specific bones of the face, including nasal mandibular and maxillary fractures, as well as soft tissue injuries in and around the mouth

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21
Q

Risk associated with oral trauma

A

Partial or complete airway occlusion

Because of rich blood supply to face, patient is at risk for significant blood loss with oral hemorrhage. This confer the compromise the airway.

Aspiration of teeth

Infection

Inability to consume adequate nutrition

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22
Q

Clinical manifestations of oral trauma

A

Increased respiratory rate
Stridor
Shortness of breath
Decreased oxygen saturation
HyperCarbia (elevated CO2 levels)
elevated heart rate
Changes in level of consciousness
Oral bleeding
Swelling and edema
Loss of teeth
Pain

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23
Q

What is acute gastritis

A

Characterized by an acute mucosal, inflammatory process that may be accompanied by hemorrhage into the mucosa

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24
Q

Causes of acute gastritis

A

Traumatic injuries : burns, severe infection, hepatic, renal, respiratory failure, or major surgeries

Chronic ingestion of irritating, food and alcohol

H. pylori

NSAIDs

Crohn’s disease

TB

Bile reflux

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25
Q

Clinical manifestations of gastritis

A

Epigastric pain
Nausea, vomiting
Weight loss,
Decreased appetite,
Changes in color of stool
Pain exacerbated with indigestion of spicy foods,

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26
Q

Signs and symptoms of ulcers

A

Burning epigastric pain, aggravated by fasting and improved with food, or an acid is a symptom of duodenal ulcer

With a gastric ulcer, pain is triggered or worsen by eating, usually occurring shortly after meals with little or no relief from antacids

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27
Q

Hematemesis

A

Vomiting of red blood, and indicates upper G.I. bleeding

28
Q

Helicobacter pylori puts pt at risk for

A

Gastritis

Peptic ulcer disease

Gastric cancer

29
Q

Treatment of H. pylori

A

Proton pump inhibitor plus 2 antibiotics

30
Q

Risk for hernias

A

Obesity
Smoking
Excessive wound tension
Malnutrition
Pregnancy
Certain medication, such as immunosuppressive agents

31
Q

What is a strangulated hernia

A

When blood supply is obstructed and patient shows signs of intestinal obstruction

32
Q

Clinical manifestations of hernias

A

Bulging or swelling outside of hernia

Ache that radiates in the area of hernia

Feelings of fullness or pressure in the area of hernia

33
Q

Clinical manifestations, of strangulated or incarcerated hernia

A

Patient may present with engorgement of the hernia nausea, vomiting, and abdominal distention

34
Q

Priorities for hernias

A

Discourage coughing

Avoid heavy, lifting for several weeks

Pain management

Observe incision for signs of infection

35
Q

What is IBS characterized as

A

Areas of bowel spasm, and dilation

36
Q

Possible causes of IBS

A

Gastrointestinal motility

Visceral hypersensitivity

Intestinal inflammation

Post infection

Bacterial overgrowth

Food sensitivity

Carbohydrate, malabsorption

Gluten sensitivity

Genetics

Psychosocial dysfunction

37
Q

IBS signs and symptoms

A

Lower left quadrant pain

Abdominal distention

alternating bouts of diarrhea and constipation

Pain increasing after eating, and is relieved with bowel movements

Patient may become anorexic with notable weight loss

38
Q

Medications used for IBS treatment

A

Anti-spasmodic agents- dicyclomine (bent to, antipas)

Antidiarrheals - loperamide (Imodium) , diphenoxylate hydrochloride (lomotil)

Guanylate Cyclades agonists - linaclotide (linzess)

Serotonerguc agents
tegaserod (zelnorm) in females
Alosetron (lotronex) for females

Selective type two chloride channel activator-lubiprostone for women

Antidepressants

SSRIs -paroxetine, fluoxetine (Prozac); sertraline (Zoloft)

Tricyclic antidepressants (TCAs) -amitriptyline (elavil); impramine (trofranil) ; nortriptyline (pamelor); desipramine (norpramin)

39
Q

What is ulcerative colitis

A

Chronic inflammatory disease that causes inflammation in the digestive tract

Affects the large intestine, and involves only the mucosa and submucosa

40
Q

Priority for ulcerative colitis

A

Fluid and electrolyte management

Rest frequently

41
Q

Treatment for ulcerative colitis

A

Patients who is medical management has failed or who have had experience complications, my undergo a colonectomy, and be cured of the disease, but not of the extraintestinal manifestations

Example excessive, long-term side effects of high-dose corticosteroids

42
Q

Patho Appendicitis

A

Acute inflammation of the vermiform appendix

43
Q

Signs/symptoms of appendicitis

A

Periumblilical abdominal pain

Anorexia

Nausea and vomiting

Pain shifted to the right lower quadrant of the abdomen with progression (McBurney’s point)!!!

Elevated WBC greater than 20,000 MM3 sign of perforation which exhibit signs of sepsis, including elevated temperature, tachycardia and decrease blood pressure

44
Q

What is rovsings sign

A

Presents when palpation of the left lower quadrant of the abdomen elicits pain in the right lower quadrant

-sign of appendicitis

45
Q

Testing for appendicitis

A

Clinical presentation in specific physical assessment findings

Maybe an ultrasound

CT scan most common

CBC and Serum electrolytes

46
Q

Risk for colorectal cancer

A

Family history

History adenomatous polyps

IBD for 10 years or more

Lynch syndrome

Physical inactivity

Obesity,

high fat diet

Cigarette use

Alcohol intake

In adequate intake of fruits and vegetables

Type two diabetes

Age

Industrialized countries

47
Q

Clinical manifestations of colorectal cancer

A

Ascending colon vague, abdominal pain, and or cramping change in bowel habits, anemia, and fatigue

Transverse colon pain, obstruction change in bowel habits, anemia, and fatigue

Descending colon pain change in bowel habits, bright, red bloody stool, and obstruction

Rectum blood in stool change in bowel habits, rectal discomfort and feeling of incomplete evacuation

48
Q

Screenings for colorectal cancer

A

Colonoscopy

49
Q

What is Crohn’s disease?

A

Chronic inflammatory bowel disease that affects the lining of the digestive track from mouth to anus, most common terminal ileum and colon

50
Q

What is hepatitis?

A

Inflammation of the liver cells, most commonly caused by a virus that impairs its ability to function normally

Women’s the ability of the liver to detoxify substances limits the production of proteins in clotting factors in alters the ability to store, vitamins, fats, and sugars

51
Q

Route of transmission for hepatitis A

A

Fecal, oral contaminated, water, or food

52
Q

Route of transmission for hepatitis B

A

Pre-cutaneous or mucosal

Blood body, fluids, needles, or sharp instruments

53
Q

Clinical manifestations of hepatitis

A

Abdominal pain

Irritability

pruritus (itching)

Malaise

Fever

Nausea, vomiting

Jaundice

Laboratory, abnormalities; elevated liver enzymes AST; alanine transaminase ALT; elevated bilirubin; elevated serum ammonia, and decreased albumin

54
Q

What is urticaria

A

Pale red, raised bumps on the skin
Associated w viral hepatitis

55
Q

What is hepatosplenomegaly

A

Enlarged liver= hepatomegaly
Enlarged spleen= splenomegaly

Associated w viral hep A

56
Q

Hemochromatosis

A

Excess build up of iron in the body associated w liver cancer

57
Q

Hepatic encephalopathy

A

Loss of brain function when a damaged liver doesn’t remove toxins from blood

58
Q

Calculous cholecystitis

A

w gallstones

59
Q

Acalculous cholecystitis

A

Without stones

60
Q

Murphy’s sign

A

-pain while palpating RUQ upon deep inspiration

  • may be noted in cholecystitis
61
Q

Cullens sign

A

-periumbilical bruising
-associated w acute pancreatitis
-indicate retroperitoneal hemorrhage

62
Q

Greys Turners sign

A

-flank bruising
-associated w acute pancreatitis
-can indicate retroperitoneal hemorrhage

63
Q

S/s of bowel obstruction

A

Vomiting undigested food or decal matter

64
Q

Sign of bowel perforation post endoscopy

A

High fever

(Emptying waste into abdominal cavity = peritonitis= sepsis)

65
Q

What is checked for nutritional status

A

Albumin and prealbumin

66
Q

McBurney’s point

A

Lower Right quadrant pain in cases of acute appendicitis

Med Surg 2 (4 decks)

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