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NCLEX Review - GI > Peptic Ulcer Disease > Flashcards

Peptic Ulcer Disease Flashcards

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1
Q

Peptic Ulcer Disease (PUD)

description

A

ulceration in mucosa of wall of the stomach, pylorus, duodenum or esoph.

damage may reach as deep down to muscle

PUDs are classifed as esophogreal, gastric, or duodenal

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2
Q

Gastric Ulcers

description

A

ulceration of the mucosal lining that extends to the submucosal lining of the stomach

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3
Q

Gastric Ulcers

RF

A

Stress

smoking

steroid use

NSAIDs

ETOH

past history

H. pylori infection

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4
Q

Gastric Ulcers

complications

A

hemorrhage

perforation

pyloric obstruction

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5
Q

Gastric Ulcers

assessment

A

gnawing sharp pain in or to the left of the mid-epigastric region occuring 30-60 min after a meal

hematemesis > melena

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6
Q

Gastric Ulcers

interventions

A

monitor VS and for SS of bleeding

Admin small, frequent bland feedings during active phase

admin H2 antagonists to lower acid secretion

admin antacids to lower pH

admin anticholinergics to lower motility

admin mucosal barrier protectorants 1 hr before meals

admin prostaglandins for protective antisecretory actions

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7
Q

Gastric Ulcers

eduction

A

no ETOH

avoid caffeine or chocolate products

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8
Q

Gastric Ulcers

interventions during active bleedings

A

VS closely

assess for dehydration, hypovolemia, shock, sepsis, respiratory insufficiency

NPO and give IV

I/O

monitor H/H

admin blood as prescribed

prep meds as needed for vasocontriction

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9
Q

Gastric Ulcers

sugical interventions

A

gastrectomy

vagotomy

gastric resection

Billroth I

Billroth II

Pyloroplasty

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10
Q

Gastrectomy

esophago-jejun-ostomy

esophago-duodun-ostomy

A

removal of the stomach with esoph attached to the jejunum or duodenum

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11
Q

Vagosomy

A

division of the vagus nerve to cut impulses that stim acid secretions in the stomach

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12
Q

gastric resection

antrectomy

A

removal of the lower stomach along with vagotomy

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13
Q

Billroth I

Gastro-duoden-ostomy

A

partial gastrectomy with the rest anastomosed to the duodenum

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14
Q

Bilroth II

Gastrojejunostomy

A

partial gastrostomy but anastomosed to the jejunum

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15
Q

Pyloroplasty

A

enlargement of the pylorus to prevent or decrease pyloric obstruction increasing gastric emptying

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16
Q

Gastric Ulcers

postoperative interventions

A

VS

Fowlers

Fluids for electrolytes

assess bowel sounds

monitor NG suction

NPO for 1-3 day until paristalsis returns

progressive diet from clear water onwards

monitor for postoperative complications (hemorrhage, dumping syndrome, diarrhea, hypoglycemia, B12 deficincy)

17
Q

why shouldnt NG tubes be irrigated or removed following Gastric surgery unless prescribed ?

A

RF disruption of the Gastric sutures

monitor to prevent strain on the internal suture site

18
Q

Duodenal Ulcer

description

A

break in the duodenal mucosa

19
Q

Duodenal Ulcer

RF

A

H pylori infection

ETOH

smoking

Stress

caffeine

asprin/NSAIDs

steroids

20
Q

Duodenal Ulcer

complications

A

bleeding

perforations

gastric outlet obstructions

intractable disease

21
Q

Duodenal Ulcer

assessment

A

burning pain in mid-epigastric area 1.5-3 hours after eating and at night that wakes pt

melena > hematemesis

pain is often relieved by eating

22
Q

Duodenal Ulcer

interventions

A

VS

small freq bland meals

adequate rest

no smoking; avoiding ETOH, caffeine, asprin, steroids, NSAIDs

H2 anatagonists or PPIs

23
Q

Duodenal Ulcer

surgical interventions

A

only is unresponsive to meds

or if hemorrhage, perforation, obstruction occurs

24
Q

dumping syndrome

description

A

rapid emptying of stomach contents into SI following gastric resection

25
Q

dumping syndrome

assessment

A

SS occuring 30 min after eating

NV

abd fullness, and cramping

Diarrhea

palipations and TC

perspiration

weakness and dizziness

borborygmi (loud gurgling <=bowel hypermotility)

26
Q

dumping syndrome

education

A

avoid sugar, salt and milk

high protein, high fat, low carb diet

small meals and avoid drinks with meals

lie down after meals

take antispasmodic meds to delay gastric emptying

NCLEX Review - GI (19 decks)

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