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PRNU 234 Med Surg 2 > Lecture 2 Gastric and Duodenal Disorders > Flashcards

Lecture 2 Gastric and Duodenal Disorders Flashcards

1
Q

what is gastritis?

A

inflammation of gastric mucosa

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2
Q

what is the typical duration of gastritis?

A

can last hours or days

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3
Q

risk factors for acute gastritis?

A

food/alcohol
viruses
stress
ASA and NSAIDs

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4
Q

risk factors for chronic gastritis?

A

H pylori
repeated exposure to agents that cause acute gastritis

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5
Q

complications of chronic gastritis

A

atrophy
ulcers
cancer
bleeding if inflammation is severe

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6
Q

clinical manifestations of acute gastritis

A

anorexia
rapid onset epigastric pain

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7
Q

clinical manifestations of chronic gastritis

A

belching, nausea, vomiting, pyrosis
vague epigastric pain relieved by eating

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8
Q

nursing management of gastritis

A

GI rest
slow reintroduction starting with clear liquids
bland small meals
eliminate irritating foods, alcohol, smoking
IV fluids and electrolytes

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9
Q

pharmacologic management of gastritis

A

PPI, H2 antagonist, antacids
sucralfate
B12 - impaired absorption
antibiotics for H pylori

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10
Q

risk factors for peptic ulcer disease

A

H pylori
NSAID use
Alcohol
Smoking
acid hypersecretory disorders
stress

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11
Q

types of peptic ulcers (location)

A

duodenal
gastric
esophageal

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12
Q

pathophysiology of peptic ulcer disease

A

erosion from gastric juice can occur if the epithelium has been damaged
can penetrate mucosa and extend into smooth muscle

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13
Q

how do clinical manifestations of duodenal ulcer and gastric ulcer differ?

A

duodenal ulcer causes epigastric pain 2-3 hours after eating and improves with food and antacids

gastric ulcer causes epigastric pain immediately after eating and is not relieved by antacids

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14
Q

how are clinical manifestations of duodenal and gastric ulcers the same?

A

epigastric pain
pyrosis
constipation or diarrhea
vomiting
bleeding
sour burps

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15
Q

diagnostic tests for PUD

A

EGD
CBC
fecal occult blood test
H pylori test

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16
Q

pharmacologic management of PUD

A

PPIs, H2 antagonists, sucralfate

discontinue NSAIDs

antibiotics if H. pylori

17
Q

diet for PUD

A

avoid spice, alcohol, coffee, caffeine
3 regular meals per day
avoid extreme food temps

18
Q

vagotomy

A

severs vagal nerve supply to proximal 2/3 of stomach to decrease stomach acid production of parietal cells by 75%

19
Q

pyloroplasty

A

enlarge pyloric opening to allow stomach to empty more easily

20
Q

antrectomy

A

distal 1/3 of stomach is excised and reattached to small intestine

21
Q

signs of peptic ulcer hemorrhage

A

hematemesis
melena

22
Q

assessing for hemorrhage in PUD

A

faintness, dizziness, nausea
vital signs
urinary output
H&H
occult blood stool test

23
Q

treating peptic ulcer hemorrhage

A

fluid resuscitation
endoscopic embolization

24
Q

signs and symptoms of perforation of the stomach

A

sudden severe abdominal and shoulder pain
vomiting
hypotension and tachycardia
tender and rigid abdomen

25
Q

post op care for perforated stomach ulcer

A

NGT
monitor fluid volume and electrolyte balances
monitor WBC and temp
antibiotics

26
Q

signs and symptoms of gastric outlet obstruction

A

nausea and vomiting
anorexia
epigastric fullness
distended abdomen

27
Q

managing gastric outlet obstruction

A

NGT
EGD
endoscopy
surgery - pyloroplasty

28
Q

risk factors for gastric cancer

A

diet - smoked foods, pickled vegetable, salted fish and meats, low fruit and vegetable intake
H. pylori
alcohol
smoking
family history
chronic gastritis and ulcers

29
Q

pathophysiology of gastric cancer

A

arise from mucus producing cells of inner lining
early lymph node involvement

30
Q

clinical manifestations of gastric cancer

A

indigestion
early satiety
weight loss
abd pain above umbillicus
anorexia
bloating after meals
nausea and vomiting
fatigue

31
Q

diagnosing gastric cancer

A

EGD
CT scan
CBC - gastric cancer can cause bleeding

32
Q

nutrition considerations for after gastrectomy

A

6 small feedings a day
antiemetics
fluids between meals, not with
supplement vitamin C, A, B12, and iron
may need TPN pre and post

32
Q

treating gastric cancer

A

radiation
chemotherapy
gastric resection

33
Q

3 things to monitor post gastrectomy

A

I/Os
daily weight
electrolytes

34
Q
A

PRNU 234 Med Surg 2 (7 decks)

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