Interventions Gastrointestinal Assessment and Problems

Question 1

Barrett’s epithelium

Answer 1

More resistant to acid and therefore supports esophageal healing.
Considered premalignant
Can produce esophageal stricture

Question 2

Clinical manifestations of GERD

Answer 2

Dyspepsia (heartburn)
Regurgitation (backward flow of the throat)
Belching and Flatulence after eating

Question 3

Assessment of GERD

Answer 3

Auscultate lungs for crackles (aspiration)
Ask about coughing, hoarseness, or wheezing at night.
Bronchitis may occur in those who have long-term regurgitation.
Water brash
Dysphagia (difficulty swallowing)
Odynophagia (painful swallowing)
Chronic cough (mostly at night)

Question 4

Older Adults and GERED

Answer 4

Incidence of heartburn decreases.
More serious complications are increased.
Atypical cheast pain
Ear, nose and throat infections
Pulmonary problems (aspiration pneumonia)
Sleep apnea
Asthma
Barrett’s esophagus and esophageal erosions more common

Question 5

Endoscopic Therapies for GERD

Answer 5

Stretta procedure- Uses radiofrequency energy that reduces vagus nerve activity.
gastroplication procedure- the physician tightens the lower esophageal sphincter through the endoscope using sutures near the sphincter.

Question 6

Interventions for hernia

Answer 6

Health teaching
Avoid eating late in the evening
Avoid foods associated with reflux
Reduce body weight if indicated
Sleep with HOB elevated
Remain upright several hours after eating
Avoid straining 
Avoid excessive vigorous exercise
Avoid clothing that is restrictive clothing around the waist

Question 7

Advantages of MIE

Answer 7

Less blood loss during surgery; fewer blood transfusions
Decreased healing and recovery time
Decreased trauma to the body
No large incisions
Less postoperative pain
Shorter hospital stay (5 to 7 days rather than 7 to 10 days)

Question 8

type of ulcers

Answer 8

Gastric ulcers
Duodenal ulcers
Stress ulcers

Question 9

Zollinger-Ellison Syndrome

Answer 9

a rare disease that is manifested by upper GI tract ulceration, increased gastric acid secretion, and one or more duodenal or pancreatic tumors.

Question 10

Zollinger-Ellison Syndrome treatment

Answer 10

Proton pump inhibitors
H2-receptor antagonists
Surgical resection of tumor

Question 11

Gastric Cancer risks

Answer 11

H. pylori
Pernicious anemia
Gastric polyps
Chronic atrophic gastritis
Achlorhydria (absence of secretion of hydrochloric acid)
Eating pickled foods
Nitrates from processed foods
Salt added to food
Diet low in fruits and vegetables

Question 12

Surgery for Gastric Cancer

post op

Answer 12

Prevent atelectasis, paralytic ileus, wound infection
Monitor for return of bowel sounds.
Monitor VS for signs of bleeding or infection
Monitor wound
Keep HOB elevated to prevent aspiration