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ATI Comprehensive > Med-Surg: GI, Hepatic, Pancreatic/2 > Flashcards

Med-Surg: GI, Hepatic, Pancreatic/2 Flashcards

1
Q

GERD contributing factors

6

A
  1. older
  2. obese
  3. smoking
  4. heavy alcohol use
  5. ingestion of very large meals
  6. obstructive sleep apnea
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2
Q

GERD manifestations

8

A
  1. dyspepsia (indigestion)
  2. regurgitation
  3. eructation
  4. flatulence
  5. coughing, hoarseness, wheezing
  6. water brash
  7. dysphagia
  8. odynophagia
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3
Q

GERD - limit or avoid foods that decrease LES pressure

6

A
  1. chocolate
  2. caffeine
  3. fried/fatty foods
  4. alcohol
  5. carbonated beverages
  6. spicy/acidic foods
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4
Q

GERD - teach (diet)

4

A
  1. dietary changes
  2. eat 4-6 small meals/day
  3. eat slowly and chew thoroughly
  4. eating nothing for at least 3 hours before bed
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5
Q

GERD - interventions

5

A
  1. diet
  2. elevate HOB 6-12 inches
  3. sleep on right side
  4. manage weight
  5. wear loose fitting clothes
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6
Q

GERD histamine blockers

2

A

famotidine

ranitidine

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7
Q

hiatal hernia

A

portion of the stomach protrudes through the esophageal hiatus of the diaphragm into the chest

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8
Q

hiatal hernia contributing factors

5

A
  1. high fat diet
  2. caffeinated drinks
  3. tobacco products
  4. meds (CCBs, anticholinergics, nitrates)
  5. obesity
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9
Q

hiatal hernia manifestations

8

A
  1. regurgitation
  2. persistent heartburn or dysphagia
  3. belching
  4. epigastric pain
  5. dysphagia
  6. breathlessness or feeling suffocated after eating
  7. chest pain that mimics angina
  8. symptoms worsen after a meal or when supine
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10
Q

hiatal hernia interventions

7

A
  1. prepare for barium swallow with fluoroscopy
  2. assess diet
  3. small freq meals
  4. avoid eating 3 hrs before bed
  5. sit upright 1-2 hour after meal
  6. avoid straining
  7. wear loose fitting clothes
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11
Q

PUD has a high risk for

A

perforation and bleeding

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12
Q

PUD contributing factors

9

A
  1. NSAIDs
  2. corticosteroids
  3. h. pylori infection
  4. uncontrolled stress
  5. stress
  6. caffeine
  7. alcohol
  8. type O blood
  9. ages 40-60
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13
Q

PUD manifestations

5

A
  1. dyspepsia
  2. dull, gnawing, burning, midepigastric and/or back pain with localized tenderness
  3. worsen with empty stomach
  4. relief with antacids
  5. decreased h and h
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14
Q

PUD dietary teaching

3

A
  1. avoid very cold and very hot foods
  2. eat 3 regular meals/day
  3. avoid caffeine, alcohol, decaffeinated coffee, milk, cream
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15
Q

PUD meds triple therapy

A

10-14 days - two antibiotics plus one PPI:

metronidazole or amoxicillin and clarithromycin plus PPI

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16
Q

PUD quad therapy adds what

A

bismuth salts

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17
Q

PUD meds - general

7

A
  1. antibiotics
  2. mucosal healing agents
  3. stool softeners
  4. antacids
  5. histamine receptor antagonists
  6. prokinetic agents
  7. PPIs
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18
Q

IBS

A

chronic disorder with recurrent diarrhea, constipation, and/or abd pain and bloating

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19
Q

IBS risk - diet, gender

A

high fat diet

female gender

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20
Q

IBS manifestations

7

A
  1. weight loss
  2. fatigue and malaise
  3. erratic bowel patterns
  4. abd pain relieved by defecation
  5. abd distention
  6. mucus with passage of stool
  7. colicky abd with diffuse tenderness
21
Q

abd pain relieved by defecation

A

IBS

22
Q

colickly abd with diffuse tenderness

A

IBS

23
Q

IBS - nursing interventions

4

A
  1. encourage a diet high in fiber
  2. encourage regular exercise
  3. stress reduction
  4. eat at regular times
24
Q

psyllium

A

bulk agent for IBS

25
Q

IBS complementary agents

3

A
  1. peppermint oil
  2. artichoke leaf extract
  3. caraway oil
26
Q

IBS and IBD

A

IBD inflammatory bowel disease is a more severe, autoimmune disorder and includes Crohn’s disease and UC

27
Q

IBS stands for

A

irritable bowel syndrome

28
Q

Crohn’s disease

A

inflammation of GI tract that extends through all layers; can occur anywhere in GI tract; most common in distal/terminal ileum; cobblestone appearance of ulcers that are separated by normal tissue

29
Q

CD contributing factors

6

A
  1. family history
  2. jewish ancestry
  3. bacterial infection
  4. smoking
  5. 15-40
  6. living in urban area
30
Q

abd pain in RLQ that doesn’t relieve with defication

A

CD

31
Q

CD manifestations

10

A
  1. abd pain RLQ, not relieved by defecation
  2. pain aggravated by eating
  3. low grade fever
  4. diarrhea, steatorrhea
  5. weight loss
  6. formation of fistulas
  7. usually no bleeding
  8. leukocytosis
  9. string sign on x ray
  10. low H/H, high ESR
32
Q

IBD: CD or UC - no bleeding usually

A

CD

33
Q

IBD: CD or UC - cobblestone

A

CD

34
Q

IBD: CD or UC - through all layers

A

CD

35
Q

CD nursing interventions

4

A
  1. promote rest
  2. record stools
  3. monitor/prevent fluid deficit
  4. nutrition - high calorie, high protein, low fiber, no diary
36
Q

CD complications

5

A
  1. intestinal obstruction
  2. perianal disease
  3. fluid electrolyte imbalances
  4. malnutrition
  5. fistulas, abscess
37
Q

UC

A

recurrent ulcerative and inflammatory disease of the superficial mucosa of the colon. usually begins in rectum and spreads proximally through the entire colon. characterized by contiguous ulcers

38
Q

UC contributing factors

7

A
  1. family hx
  2. jewish ancestry
  3. isotretinoin/accutane use
  4. female 15-25
  5. males 55-65
  6. white
  7. low fiber diet
39
Q

UC manifestations

9

A
  1. liquid, bloody stool (10-20 per day)
  2. low grade fever
  3. abd distention along colon
  4. high pitched bowel sounds
  5. LLQ pain
  6. anorexia, weight loss
  7. vomiting, dehydration
  8. sensation of urgent need to defecate
  9. hypocalcemia, anemia
40
Q

IBD: CD or UC - liquid, blood stools

A

UC

41
Q

IBD: CD or UC - 10 to 20 stools/day

A

UC

42
Q

IBD: CD or UC -high pitched bowel sounds

A

UC

43
Q

IBD: CD or UC - LLQ pain

A

UC

44
Q

IBD: CD or UC - hypocalcemia

A

UC

45
Q

IBD: CD or UC - sensation of urgent need to defecate

A

UC

46
Q

what helps differentiate CD and UC

A

bleeding is common in UC

47
Q 
UC nursing interventions
4
-promote
-monitor
-maintain
-monitor
A
  1. promote rest
  2. monitor stool
  3. maintain NPO during acute phase
  4. monitor for dehydration
48
Q

UC diet mgmt

2

A
  1. increase oral fluids

2. low residue, high calorie, high protein diet

49
Q

UC intervention - administer

2

A
  1. multivitamins

2. supplemental iron

ATI Comprehensive (17 decks)

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