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Nursing IV > Nutrition & Elimination (Gas#9&10) > Flashcards

Nutrition & Elimination (Gas#9&10) Flashcards

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1
Q

Major enzymes & secretions in the mouth

A

saliva, salivary amylase

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2
Q

Major enzymes & secretions in the stomach

A

Hydrochloric acid, pepsin, intrinsic factor

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3
Q

Major enzymes & secretions in the small intestine

A

Amylase, Lipase, Trypsin

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4
Q

When assessing eating habits of a pt, how many hours do you refer to?

A

72 hours

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5
Q

When do you want to use a Guaiac test?

A

use this test for increased risk of stress ulcer, it detects the presence of fecal occult blood

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6
Q

What can you see when doing an endocopy?

A

esophagus, stomach, duodenum

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7
Q

Preparation for Endoscopy

A

sign consent, take out dentures, glasses, jewelry, NPO 8-12 hrs, throat spray, maybe IV conscious sedation, maybe narcotic analgesic, not scheduled after drinking barium for a min of 2 days

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8
Q

Do you have to be NPO for an Endoscopy?

A

Yes 8-12 hrs

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9
Q

Post procedure Endoscopy

A

No eating/drinking until gag reflex returns, vs, observe for signs of perforation, expect belching, asses LOC

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10
Q

Signs of perforation after an Endoscopy

A

bleeding, elevated temp, pain, dyspnea, subcutaneous emphysema

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11
Q

What does an upper GI series show?

A

tumors, hernias, ulcers, diverticula in the esophagus, esophagus varices, strictures, rate of peristalsis

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12
Q

What kind of contrast media is used with an upper GI series?

A

barium, air

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13
Q

why is a laxative & fluids given after a upper GI series?

A

to remove barium which can cause an obstruction

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14
Q

pre procedure upper GI series

A

low residual diet 2-3 days prior, NPO & no smoking 8-12 hrs prior, can take 1-2 hrs

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15
Q

Do you expect & not expect after an upper GI series

A

you expect light (grayish) stools for several days & if there is no BM in 2-3 days, call DR b/c that could mean the barium has caused an impaction

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16
Q

When does a cleft lip usually occur?

A

2nd month in embryonic development

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17
Q

where does a cleft palate open into?

A

the nasal passage

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18
Q

when would you asses a cleft palate

A

with a gloved finger before first feeding

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19
Q

what problems do babies have with a cleft palate?

A

difficulty maintaining suction & swallowing

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20
Q

Feeding instructions for parents with a baby with cleft lip/cleft palate

A

small frequent feedings, there will be a choking noise, burp often(after q ounce) because they swallow more air, don’t feed longer than 45 minutes

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21
Q

Hygiene instructions for parents with a baby with cleft lip/cleft palate

A

give h20 after eating, use bulb syringe to remove formula from mouth, DO NOT PLACE ON ABDOMEN

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22
Q

nipple selection for baby with cleft lip/cleft palate

A

easily compressed nipples (orthodontic, preemie, newborn nipples, haberman feeder, rechet feeder

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23
Q

bottle selection for baby with cleft lip/cleft palate

A

bottle can be squeezed

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24
Q

when would a cleft lip be repaired?

A

2 wks-3months

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25
Q

when would a soft cleft palate be repaired?

A

3-6 months

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26
Q

when would a hard cleft palate be repaired?

A

12-18 months; before speech affected

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27
Q

Post op care for cleft lip/cleft palate repair

A

do NOT place on abdomen, HOB elevated to prevent aspiration, suction equip & endotracheal tube, careful feeding (place on unaffected side) guard suture line!!

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28
Q

what are parents with babies who have cleft lip/palates taught to use/o to guard suture lines?

A

elbow/vest restraints, logan bow or adhesive straps, minimize crying, clean suture line

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29
Q

Biggest risk factor for CA?

A

tobacco & alcohol

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30
Q

oral cancer manifestations

A

painless sore in mouth that doesn’t heal, any lesion present for more than 2 wks:hard, difficulty chewing, speaking, blood tinged mucus

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31
Q

s/s of oral cancer of the larynx

A

pain with swallowing (esp hot liquids), lump in neck, halitosis

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32
Q

Pre-op care for a total laryngectomy because of cancer of the larynx (surgery is palliative care)

A

prepare for no speech, trach, plan for post-op communication, involve speech therapist

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33
Q

After a radical neck dissection, which cranial nerve is involved and what do you want to remember

A

XI (11 which controls swallowing, shoulder drop); Do not put pt in supine because of shoulder drop

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34
Q

oral cancer post-op care

A

have ET tube handy, maybe enternal/TPN feeding, once eating, allow to feed self in privacy first, may need artificial saliva, humidifier, anticholinergic for drooling, stop smoking!, shoulder drop

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35
Q

Post op radical neck dissection care

A

put call bell within reach! (they wont be able to speak), watch for swallowing, bleeding probs, wound drains & pressure dressing, put in fowler’s, may have difficulty lifting & moving head, suction carefully ( watch suture lines)

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36
Q

post op air way management for a laryngectomy because of cancer of the larynx (surgery is palliative care)

A

TCDB, HOB elevated to reduce pressure on suture lines, ambu bag & extra laryngectomy at bedside

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37
Q

post op wound care for laryngectomy because of cancer of the larynx (surgery is palliative care)

A

like trach (at least q 8 hrs), wound drains to suction in order to reduce hematoma formation, if bleeding occurs get help

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38
Q

when can a laryngectomy tube be removed?

A

when stoma is healed after 6-8 wks

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39
Q

why wont a pt who had a laryngectomy aspirate?

A

because trach is no longer attached to GI tract

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40
Q

stoma care after a laryngectomy

A

do not get wet, cover for showers, shaving, no swimming, stop smoking, mouth to stoma for CPR, dont lay flat

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41
Q

Most common complication of GERD

A

Esophagitis

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42
Q

Esophagitis & what is it caused by

A

inflammation of the esophagus; caused by GERD, Burns, swallowing corrosive solutions, NG tube, Excess vomiting, Radiation

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43
Q

Esophagitis treatment

A

treat underlying condition

44
Q

Esophagus cancer causes

A

chronic trauma: GERD, stricture, alcohol, smoking

45
Q

Esophagus cancer s/s

A

usually none until well advanced, dysphagia with liquids then with solids, lump in throat, regurgitation, halitosis, aspiration pneumonia, anorexia, WT LOSS (40-50 lbs in 2-3 months), chronic cough, anemia

46
Q

Esophagus cancer diagnostics

A

Barium swallow, bronchoscopy (b/c this usually metastasis to lungs), CT?MRI

47
Q

Treatment for Esophagus cancer

A

radiation, palliative, chemo, stent placement to keep esophagus open, surgery (esophagus is replaced by intestine)

48
Q

Nursing management for cancer of the esophagus

A

elevate HOB, increase calories & protein because they need energy for treatment, TPN or PEG

49
Q

Gastritis

A

irritant breaks down stomachs protective mucus

50
Q

s/s of gastritis

A

dyspepsia, vomiting, diarrhea (gastroenteritis), possible bleeding (black stools)

51
Q

whats a big concern with gastritis

A

bleeding

52
Q

Causes of gastritis

A

NSAIDS, steroids, contaminated food, alcohol

53
Q

treatment of gastritis

A

start NPO then clear liquids then bland diet if they cant tolerate it they will show s/s of gastritis, reduce nicotine, alcohol, caffeine, IV fluids prn, treat hemorrhage (gastric lavage with saline); antiemetics& antacids

54
Q

medications for treatment of gastritis

A

anti-emetics, antiacids

55
Q

Chronic gastritis & cause

A

prolonged inflammation, irreversible atrophy of mucosa & parietal cells caused by H. pylori

56
Q

treatment of chronic gastritis

A

healthy lifestyle, B12 injec. b/c they have no intrinsic factor, anticholinergic, antacids, treat H. Pylori infection, NPO until able to tolerate food (then clear liquids etc.), may need NG tube

57
Q

Gastroesophageal Reflux Disease (GERD)

A

gastric acids rise into esophagus

58
Q

s/s of Gastroesophageal Reflux Disease (GERD)

A

heartburn, regurgitation, pain after eating & at night, belching, sore throat, hoarseness, anemia

59
Q

Gastroesophageal Reflux Disease (GERD) treatment

A

change in lifestyle behavior: reduce nicotine, alcohol, caffeine, fatty/spicy foods, eat small frequent meals, avoid laying down for 2 hrs after meals, avoid eating 3 hours before bed

60
Q

Gastroesophageal Reflux Disease (GERD) rules on eating

A

small frequent meals, avoid laying down for 2 hrs after meals, avoid eating 3 hours before bed

61
Q

Antacids that contain magnesium

A

Maalox, Gaviscon, Gelusil, Mylanta, Riopan

62
Q

Maalox, Gaviscon, Gelusil, Mylanta, Riopan

A

Antacids that contain magnesium

63
Q

Antacids that contain Aluminium

A

Aludrox, Amphojel, Tums

64
Q

Aludrox, Amphojel, Tums

A

Antacids that contain Aluminum

65
Q

side effect of antacids that contain magnesium

A

diarrhea

66
Q

side effect of antacids that contain aluminum

A

constipation

67
Q

Proton Pump Inhibitors action

A

stops acid production

68
Q

Prilosec (omeprazole) & Prevacid (lansoprazole) are what are what are they used for?

A

Proton Pump Inhibitors, used for GERD, do not use for more than 8 wks short term use only

69
Q

Nexium (espmeprazole) is what & how long can you use it

A

Proton Pump Inhibitor; long term daily

70
Q

Proton Pump Inhibitor; long term daily

A

Nexium (espmeprazole)

71
Q

short term proton pump inhibitors

A

Prilosec (omeprazole) & Prevacid (lansoprazole)

72
Q

H2 Antagonists action

A

block histamine2 (decreases gastric acid secretions

73
Q

Pepcid (Famotidine), Zantac (ranitidine), Axid (nizatidine)

A

H2 Antagonists

74
Q

H2 Antagonists

A

Pepcid (Famotidine), Zantac (ranitidine), Axid (nizatidine)

75
Q

when should you take H2 Antagonists?

A

before meals

76
Q

Reglan (etoclopramide), Urecholine (bethanechol), Motilium (dompendone)

A

GI stimulants

77
Q

GI stimulants

A

Reglan (etoclopramide), Urecholine (bethanechol), Motilium (dompendone)

78
Q

When do you take GI stimulants?

A

take before meals & an hour before sleep

79
Q

are GI stimulants for long term or short term use?

A

short term use only

80
Q

whats a side effect of reglan to remember

A

it can cause extraparadial effects so dont give to someone with parkinson

81
Q

Carafate (sucralfate)

A

provides protective coating to ulcer sites, inhibits pepsin activity in gastric secretions, take on empty stomach with water

82
Q

Peptic ulcer disease

A

break down of mucosal barrier in esophagus, stomach, pylorus or duodenum causing exposure to hydrochloric acid & pepsin

83
Q

Peptic ulcers are caused by

A

NSAIDS, H.Pylori, acid hypersecretion

84
Q

Peptic ulcer risk factor

A

40-60 yrs old, family hx, blood type O, smoking, alcohol

85
Q

Peptic ulcer s/s

A

relieved by eating food & antacids,melena (tarry stools), vomiting, burning hunger-like pain, pain may radiate to back, pain when stomach is empty

86
Q

Peptic ulcer treatment

A

2antibiotics, bisuth, PPI, stop nicotine, alcohol, caffeine, NSAIDS, eat REGULARLY

87
Q

Peptic ulcer nutrition

A

low fat, low CHO diet, teaching nutrition is big, avoid liquids with meals because it promotes feeling full

88
Q

biggest complication of Peptic ulcer disease

A

hemorrhage

89
Q

s/s of Peptic ulcer hmorrhage

A

hypovolemia (faint, hypotension, tachycardia),

90
Q

if its a small peptic ulcer bleed patient will be vomiting or pooping?

A

pooping it

91
Q

if its a large peptic ulcer bleed patient will be vomiting or pooping it?

A

vomiting

92
Q

surgical treatment for peptic ulcer hemorrhage?

A

2/3 or 3/4 of stomach can be removed & may need a vagotomy

93
Q

s/s of peptic ulcer perforation

A

sudden increase in abdominal pain, rigid abdomen, shock

94
Q

treatment of peptic ulcer perforation

A

antibiotics, surgery, assess for peritonitis

95
Q

Cancer of the stomach is caused by

A

H.Pylori, blood type A, increased nitrates in diet

96
Q

Post op gastrectomy

A

expect some bloody NG drainage but notify dr if bright red, after NG is out ay have dysphagia if had vagotomy

97
Q

early Dumping syndrome

A

a large amount of fluid at once

98
Q

early dumping syndrome initial s/s, as circulating blood decreases s/s, & when does it occur

A

n/v, diahrrea, abdominal pain, ascirculating blood decreases youll get weakness, dizziness, tachycardia, occurs within 10-20 mins

99
Q

late Duping Syndrome

A

rapid absorption of carbs causes a quick spike in blood sugar levels , body compensates by over secreting insulin causing bs levels to drop

100
Q

late Dumping Syndrome s/s & when does it occur

A

shakiness, sweating, confusion, weakness, FAINTING, occurs 1-3 hrs

101
Q

treatment of Dumping Syndrome

A

eat small frequent meals, eat protein & fat at each meal, avoid concentrated sugars, restrict lactose

102
Q

Pyloric Stenosis

A

hypertrophy of pyloric sphincter which leads to edema which leads to inflammation which leads to obstruction

103
Q

Pyloric Stenosis s/s

A

projectile vomiting after eating, still hungry after vomiting, palpable mass in RUQ, rapid dehydration,

104
Q

When does Pyloric Stenosis usually occur & what happens if mom had it

A

occurs 4-6 weeks, if mom had it baby has 20% of getting it

105
Q

Pyloric Stenosis treatment

A

IV fluids, surgery (pyloromyotomy)

106
Q

important things to remember with Post op Pyloric Stenosis surgery (pyloromyotomy)

A

small feedings place on right side with head elevated, **incision is near diaper line

107
Q

How is Pyloric Stenosis identified

A

ultrasound, barium swallow

Nursing IV (20 decks)

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