lewis ch 41 upper GI problems Flashcards
3 precipitating causes of vomiting
- pathogenic (obstruction, viral)
- latrogenic (chemo, radiation, meds)
- pregnancy (morning sickness)
what does bright red emesis mean
active bleeding
what does coffee-ground emesis mean
old blood/lower GI bleed
what does fecal odor in vomit mean
backflow of intestinal content into stomach - typically lower GI obstruction
what imbalance could vomiting lead to
metabolic alkalosis
until a diagnosis is confirmed, what can you do for a vomiting patient
NPO status
IV fluids
possible NG suction
what increases patient risk for aspiration with vomiting
decreased LOC
flat HOB
health history factors for gastritis
gastric irritants smoking stress H. Pylori alcohol abuse
2 characteristics of gastritis
- epigastric tenderness
- GI discomfort (N/V, bloating, anorexia)
risk factors for GERD (7)
- obesity
- alcohol
- smoking
- meds
- caffeine
- spicy/fatty foods
- lying down after eating
characteristics of GERD (5)
- regurgitation
- pain radiates to back and neck
- heart burn
- dyspepsia
- burping, bloating and pain after meals
diet alterations for treating GERD
less of:
- fatty foods
- wine, alcohol
- spicy foods
- chocolate
- caffeine
nursing treatment for GERD (4)
- 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)
what time of day should a patient take a PPI med for GERD
before first meal of day
antacids that contain _______ can cause constipation
aluminum
antacids that contain _________ can cause diarrhea
magnesium
3 signs pneumothorax (lung collapse)
- dyspnea
- chest pain
- cyanosis
what surgery can be done for GERD
laparoscopic fundoplication (lap nissen)
common risk factors peptic ulcer disease (4)
- stress
- H. pylori
- alcohol
- smoking
S+S gastric ulcers (5)
- weight loss
- HCL normal or hyposecretion
- pain 1/2-1 hour after meals
- vomiting
- eating may increase pain
S+S duodenal ulcers (2)
- pain 2-3 hours after meals
- food may decrease pain
nursing care for peptic ulcer disease (4)
- hourly VS
- NG tube
- IV fluid replacement
- regular mouth care
S+S hemorrhage with peptic ulcer (3)
- increase in amount and redness of aspirate
- increased amount of blood in gastric contents
- decreased pain
S+S perforation with peptic ulcer (4)
- sudden severe generalized abdominal pain and severe shoulder pain
- rigid boardlike abdomen
- shallow respirations
- bowel sounds diminished or absent
nursing care for perforation from peptic ulcer (6)
- VS q15-30minutes
- stop all drugs and feedings
- IV fluids increased
- pain meds
- antibiotics
- possible surgery
nursing care for gastric outlet obstruction (4)
- constant NG aspiration
- regularly irrigate NG tube
- clamp NG tube intermittently and check for residual volume
- accurate I/O
lifestyle changes for peptic ulcer disease (3)
- appropriate dietary changes
- no smoking
- no/less alcohol
