lewis ch 41 upper GI problems Flashcards

1
Q

3 precipitating causes of vomiting

A
  • pathogenic (obstruction, viral)
  • latrogenic (chemo, radiation, meds)
  • pregnancy (morning sickness)
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2
Q

what does bright red emesis mean

A

active bleeding

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3
Q

what does coffee-ground emesis mean

A

old blood/lower GI bleed

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4
Q

what does fecal odor in vomit mean

A

backflow of intestinal content into stomach - typically lower GI obstruction

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5
Q

what imbalance could vomiting lead to

A

metabolic alkalosis

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6
Q

until a diagnosis is confirmed, what can you do for a vomiting patient

A

NPO status
IV fluids
possible NG suction

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7
Q

what increases patient risk for aspiration with vomiting

A

decreased LOC

flat HOB

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8
Q

health history factors for gastritis

A
gastric irritants
smoking
stress
H. Pylori
alcohol abuse
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9
Q

2 characteristics of gastritis

A
  • epigastric tenderness

- GI discomfort (N/V, bloating, anorexia)

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10
Q

risk factors for GERD (7)

A
  • obesity
  • alcohol
  • smoking
  • meds
  • caffeine
  • spicy/fatty foods
  • lying down after eating
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11
Q

characteristics of GERD (5)

A
  • regurgitation
  • pain radiates to back and neck
  • heart burn
  • dyspepsia
  • burping, bloating and pain after meals
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12
Q

diet alterations for treating GERD

A

less of:

  • fatty foods
  • wine, alcohol
  • spicy foods
  • chocolate
  • caffeine
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13
Q

nursing treatment for GERD (4)

A
  • elevate HOB 30
  • don’t lie down for 2-3 hours after eating
  • don’t eat right before bed
  • avoid factors that cause reflex (smoking, alcohol, caffeine, acidic foods)
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14
Q

what time of day should a patient take a PPI med for GERD

A

before first meal of day

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15
Q

antacids that contain _______ can cause constipation

A

aluminum

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16
Q

antacids that contain _________ can cause diarrhea

A

magnesium

17
Q

3 signs pneumothorax (lung collapse)

A
  • dyspnea
  • chest pain
  • cyanosis
18
Q

what surgery can be done for GERD

A

laparoscopic fundoplication (lap nissen)

19
Q

common risk factors peptic ulcer disease (4)

A
  • stress
  • H. pylori
  • alcohol
  • smoking
20
Q

S+S gastric ulcers (5)

A
  • weight loss
  • HCL normal or hyposecretion
  • pain 1/2-1 hour after meals
  • vomiting
  • eating may increase pain
21
Q

S+S duodenal ulcers (2)

A
  • pain 2-3 hours after meals

- food may decrease pain

22
Q

nursing care for peptic ulcer disease (4)

A
  • hourly VS
  • NG tube
  • IV fluid replacement
  • regular mouth care
23
Q

S+S hemorrhage with peptic ulcer (3)

A
  • increase in amount and redness of aspirate
  • increased amount of blood in gastric contents
  • decreased pain
24
Q

S+S perforation with peptic ulcer (4)

A
  • sudden severe generalized abdominal pain and severe shoulder pain
  • rigid boardlike abdomen
  • shallow respirations
  • bowel sounds diminished or absent
25
Q

nursing care for perforation from peptic ulcer (6)

A
  • VS q15-30minutes
  • stop all drugs and feedings
  • IV fluids increased
  • pain meds
  • antibiotics
  • possible surgery
26
Q

nursing care for gastric outlet obstruction (4)

A
  • constant NG aspiration
  • regularly irrigate NG tube
  • clamp NG tube intermittently and check for residual volume
  • accurate I/O
27
Q

lifestyle changes for peptic ulcer disease (3)

A
  • appropriate dietary changes
  • no smoking
  • no/less alcohol