Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medical- Surgical > Mod 5 > Flashcards

Mod 5 Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

Where do hiatal hernia occur?

A

the opening in the diaphragm through which the esophagus passes becomes enlarged, and part of the upper stomach tends to move up into the lower portion of the thorax.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Are hiatal hernias more common in men or women?

A

Women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 2 types of hiatal hernias?

A

Sliding-(axial)or type I, hiatal hernia occurs when the upper stomach and the gastro esophageal junction are displaced upward and slide in and out of the thorax.

paraesophageal hernia occurs when all or part of the stomach pushes through the diaphragm beside the esophagus. Paraesophageal hernias are classified as types II, III, or IV.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of hiatal hernia accounts for 90% of esophageal hiatal hernias?

A

Sliding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are nursing intervention for hiatal hernias?

A
  • small feeding that can pass thru the esophagus
  • not to recline for 1 hour after meals to prevent reflux or movement of the hernia and to elevate the hob on 4-8 inch blocks to prevent the hernia from sliding upward
  • Surgery is indicated in about 15% of patients
  • may require emergency surgery to correct torsion (twisting) of the stomach or other body organ that leads to restriction of blood flow to that area
  • Bland diet
  • avoid coffee
  • alcohol
  • smoking (increases gastric acid secretions); -eat sitting up
  • avoid tight clothes
  • wt reduction
  • avoid bending at the waist.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the surgical intervention for a hiatal hernia?

A

Nissen fundoplicaton: thru a transabdominal incision the fundus of the stomach is wrapped around the lower 4-6 cm of the esophagus and is sutured in place. The upper part of the stomach and cardioesophageal junction are sutured to the median arcuate ligament.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is an Abdominal Hernia?

A

protrusion of an organ or structure thru the wall of the cavity in which it’s naturally contained.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is an Inguinal hernia?

A

a hernia in which a loop of intestine enters the inguinal canal, sometimes filling the entire scrotal sack. Results from congenital or acquired weakness of abdominal wall, coupled with sustained increased intra-abdominal pressure from coughing or straining.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is an Umbilical hernia?

A

failure of the umbilical orifice to close. Common in children, obese people, and people with increased abdominal pressure such as ascites.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a Ventral hernia?

A

(incisional) weakness in abdominal wall on incision line.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a Femoral hernia?

A

below inguinal ligament is a round bulge, more frequent in women due to changes during pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are Non surgical treatment for hernia?

A
  • Truss-to wear for support, does not cure,
  • abdomen binder
  • scrotal sac supporter.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are Major complication of a hernia?

A

obstruction, usually surgical repair is done before this occurs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a Reducible hernia?

A

Mass can be replaced back into the abdomen with pressure and when lying down.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a Incarcerated hernia?

A

(irreducible) cannot be reduced and intestinal flow may be obstructed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a Strangulated hernia?

A

blood and intestinal flow thru intestinal hernia ceases completely.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What kind of Surgical treatment is done for a hernia?

A

Inguinal Herniorrhaphy is done before strangulation occurs: when done if elective, no not do if coughing, sneezing, due to pressure it puts on incision site. Do deep breath, not cough: After surgery splint if coughing, check for urinary retention, edema, elevate scrotum (ice pack) narcotics for pain, antibiotics to prevent epididymitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the S/S of hiatal hernia?

A

are heartburn, regurgitation, and dysphasia, but at least 50% of patients are asymptomatic. Sliding hiatal hernias is often implicated in reflux. The patient with paraesophageal hernia usually feels a sense of fullness after eating or chest pain or there may be no s/s.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

PUD occurs most frequently in people between what ages?

A

40-60

20
Q

How are peptic ulcer referred to?

A

As there location

gastric, duodenal, or esophageal ulcer,

21
Q

what is PUD?

A

It is an excavation (hollowed-out area) that forms in the mucosal wall of the stomach, in the pylorus (the opening between the stomach and duodenum), in the duodenum (the first part of the small intestine), or in the esopha

22
Q

How do you know is someone has PUD?

A

They have an ulcer

23
Q

What causes PUD?

A

Erosion of a circumscribed area of mucous membrane is the cause.

24
Q

What pathogen causes PUD?

A

Most common cause is H. pylori, which may be acquired through ingestion of food and water. Person-to-person transmission may also occur thru close contact and exposure to emesis.

25
Q

What are signs and symptoms of PUD?

A 
-dull gnawing pain or burning sensation in the midepigastric region or in the back.  
Other symptoms include:
-pyrosis (heartburn)
-vomiting
-constipation or diarrhea
-bleeding
26
Q

What are the 2 most common causes of UGI tract bleeding from Peptic Ulcers?

A

gastritis and hemorrhage

27
Q

What is the most common complication of PUD?

A

Hemorrhage

occurs in 10-20% of patients with peptic ulcers.

28
Q

What will occur if a PUD patient is experiencing hemorrhage?

A

-Melena or hematemesis.
The vomited blood can be bright red, or it can have dark “coffee grounds” appearance from the oxidation of hemoglobin to methemoglobin. When the hemorrhage is large, most of the blood is vomited. When the hemorrhage is small, much or all of the blood is passed in the stools, which appear tarry black b/c of the digested hgb. Monitor for faintness, dizziness, n&v, which may precede or accompany bleeding. Monitor v/s, evaluate for tachycardia, hypotension, and tachypnea. Monitor H&H.

29
Q

What is PUD perforation ?

A

is the erosion of the ulcer thru the gastric serosa into the peritoneal cavity without warning. It is an abdominal catastrophe and requires immediate surgery.

30
Q

What is PUD Penetration?

A

It is erosion of the ulcer thru the gastric serosa into adjacent structures such as the pancreas, biliary tract, or gastrohepatic omentum.

31
Q

What are symptoms of penetration?

A

-back and epigastric pain not relieved by medications that were effective in the past.

Penetration requires surgical intervention.

32
Q

What are S/S of perforation?

A

-sudden severe upper abdomen pain (persisting and increasing in intensity); pain may be referred to shoulders, especially the rt shoulder, b/c of irritation to the phrenic nerve in the diaphragm.

  • Vomiting and collapse (fainting)
  • Extremely tender and rigid (boardlike) abdomen
  • Hypotension and tachycardia, indicating shock
33
Q

When dose a Pyloric obstruction occur?

A

occurs when the area distal to the pyloric sphincter becomes scarred and stenosed from spasm or edema from scar tissue that forms when an ulcer alternately heals and breaks down.

34
Q

What might the patient experience if they have a Pyloric obstruction?

A

The patient may have n&v, constipation, epigastric fullness, anorexia, and later, wt loss.

35
Q

What will they do if a Pyloric obstruction is suspected?

A

Place a NG tube (a residual of more than 400 mL strongly suggest obstruction), usually and UGI study or endoscopy of performed to confirm pyloric obstruction.

36
Q

How will they manage a Pyloric obstruction?

A

Decompression of the stomach and management of ECF volume and electrolyte balance may improve the patient’s condition and avert the need for surgical intervention. A balloon dilation of the pylorus via endoscopy may be beneficial. If balloon is unsuccessful, surgery in the form of vagotomy and antrectomy or gastrojejunostomy and vagotomy may be required.

37
Q

What kind of dietary modification will be made for a patient with PUD?

A
  • avoid over-secretion of acid and hyper motility in the GI
  • avoiding extremes of temperature of food & beverage and over stimulation from consumption of meat extract, alcohol, coffee, (including decaffeinated coffee), milk products.
  • eat three regular meals a day. Small frequent meals are not necessary as long as an antacid or histamine blocker is taken.
  • Eat foods as tolerated (if it bothers you, don’t eat it)
38
Q

What is enteral nutrition and when would it be used?

A

Nutritional formula feeding infused through a tube directly into the gastrointestinal tract

  • used if the patient has a fictional gi
39
Q

What is parenteral nutrition?

A

A method of supplying nutrients to the body by intravenous route

40
Q

What is Crohn’s disease?

A

is a chronic inflammatory bowel disease of unknown etiology, usually affecting the terminal segment of the small intestine, the colon or both. Inflammatory process extends through all layers of bowel wall.

41
Q

What are symptoms of Crohn’s disease?

A

onset is insidious, abdomen pain, diarrhea, wt loss, crampy pain after meals due to increased peristalsis, and constant irritating discharge. It can perforate or it can form intra abdominal and anal abscesses. Melena, malabsorption syndrome: during a colonoscopy the mucosa has a cobblestone appearance.

42
Q

What Diagnostic test are done for Crohn’s disease?

A

Diagnostic test: Barium enema reveals classic string sign of terminal ileum due to being constricted.

43
Q

What is a lavage used for?

A

Flush the stomach with water or other fluids and remove ingested toxins or other harmful materials

44
Q

How do you manage Crohn’s disease?

A
  • low residue bland diet with vitamin supplements.
  • If severe, monitor wt, h&h, fluid balance, and steroids (for inflammation) may be used to treat along with surgery.
45
Q

What is Ulcerative Colitis?

A

is an inflammatory, often chronic disease of unknown cause that affects the mucosa and submucosa of the colon. Usually begins in the rectum and sigmoid colon and extends upward into the entire colon. It produces congestion, edema, and ulcerations that develop into abscesses. Has systemic complications and increased mortality rate.

46
Q

What are symptoms of Ulcerative Colitis?

A
  • diarrhea with mucus and blood, pass 10-20 stools dailyintermittent
  • tenesmus (spasmodic contraction of anal or bladder sphincter with pain and persistent desire to empty the bowel or bladder)
  • anorexia
  • wt loss
  • fever
  • vomiting
  • dehydration
  • hypocalcemia
  • anemia.

Medical- Surgical (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions