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Nurs G140 Exam 3 > PUD > Flashcards

PUD Flashcards

1
Q

PUD Risk factors (6)

A
  • Helicobacter pylori infection
  • NSAIDS
  • excessive gastric secretion
  • no evidence for spicy foods, caffeinated drinks or milk
  • familial hx, blood type O
  • chronic pulmonary or kidney disease
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2
Q

SKIP CARD

A

SKIP

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3
Q

What is the best post meal (2-4 h) position for the GERD client?

A

high fowlers

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4
Q

Risk factors of GERD

A
  • obesity and diabetes
  • alcohol, tobacco, very hot beverages
  • smoking
  • position 1-4 hours after meals delaying stomach emptying
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5
Q

Most common risk factor for PUD

A

-H. pylori infection –> contaminated food, water, close contact with infected patients or emesis

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6
Q

ex of NSAIDS, who is at a higher incidence of PUD

A
  • ASA, ibuprofen

- geriatric population at higher incidence

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7
Q

what can cause excessive gastric acid secretion?

A

smoking and alcohol use

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8
Q

Stress ulcers –> physiologic stress, what can cause it? (4)

A
  • disease process
  • burns
  • shock
  • sepsis
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9
Q

Are stress ulcers different from PUD? do they spread quickly? Are they reversible?

A

yes they are different, they do spread quickly, they are reversible

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10
Q

PUD clinical manifestations (7)

A
  • dull, gnawing pain or burning sensation
  • mid epigastric or back pain (referred)
  • relief after eating *****
  • Pyrosis: heartburn
  • vomiting
  • diarrhea, consitapation
  • GI Bleed
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11
Q

Why does PUD cause vomiting?

A

due to gastric outlet obstruction –> pyloric spasm, scarring or swelling from inflammation

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12
Q

In PUD, s/s GI bleed? (5)

A

increased BUN, bloody vomitus or stool, sensation of fullness, hypotension, tachycardia

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13
Q

PUD assessment and diagnostic findings (4)

A
  • physical exam: epigastric pain and tenderness
  • upper endoscopy: direct visualization and biopsy
  • biopsy test, urea breath test, still antigen (H. pylori)
  • CBC, VS, FOBT
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14
Q

Collaborative Management PUD

A
  • antibiotics –> H. pylori

- manage gastric acidity (medications, lifestyle changes, surgery)

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15
Q

PUD Antibiotics (3)

A
  • metronidazole
  • amoxicillin
  • clarithromycin
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16
Q

PUD PPIs (2), what do they do?

A
  • pantoprazole
  • omeprazole

-decrease gastric acid

17
Q

H2 receptor blockers (2), what disease process are these not sued for?

A
  • famotidine
  • ranitidine

-not for H. pylori

18
Q

Cimetidine is contraindicated for patients on _____.

A

NSAIDs (decrease gastric acid)

19
Q

what do antacids do? When do you use them?

A

decrease acidity …. used after meals

20
Q

PUD conservative therapy (8 therapies) (1 goal)

A
  • cytoprotective: misoprostol, sucralfate (coats mucosa, give 30 minutes before meals)
  • avoid NSAIDs
  • follow prescribed regimen
  • maintenance H2 receptor blockers dosage
  • smoking cessation
  • diet change: avoid extreme temperatures, alcohol, caffeinated beverages, decaf coffee
  • 3 regular meals
  • eat tolerated foods
  • goal: avoid over secretion of acid
21
Q

GERD 2016

A

patients of PPIs were 32% more likely to have a decline in kidney function, 28% more likely to develop chronic kidney disease and 96% more likely to develop kidney failure compared to H2 blockers

22
Q

GERD 2018

A

-older adults on PPIs more at risk for GI infections (gut microbiome changes), PNA, and depression

23
Q

GERD 2020

A

N-nitrosodimethylamine (probable human carcinogen) use in manufacturing ranitidine

24
Q

PUD complications (4)

A
  • hemorrhage: bright red, dark coffee-ground like
  • perforation: sudden severe pain **, board-like abdomen, absent BS, changes in VS, bacterial peritonitis
  • peritonitis
  • gastric obstruction due to scarring, abcesses
25
Q

Post-op complication: dumping syndrome/ short bowel syndrome s/s (5)

A
  • cramping/pain
  • fast HR
  • sweating
  • nausea
  • diarrhea
26
Q

Post-op complication: dumping syndrome/ short bowel syndrome management (3)

A
  • nutritional support
  • six smaller meals
  • lie down for 30 minutes post meal (slows down food transit)
27
Q

Post surgical PUD client management (7)

A
  • monitor electrolytes, H/H, WBC, r/o metabolic alkalosis
  • monitor gastric aspirate changes, GI function
  • VS, I/O, F/E balance
  • Initiate nutrition with clear liquids
  • NG tube gentle irrigation only per order (risk for suture rupture) **
  • complications: suture ruptur, leakage, abscess
  • acute bleeding: bright red drainage, decreased BS (NOTIFY PROVIDER)***
28
Q

Post surgical client goal (4)

A
  • patient to maintain or gain weight (if underweight) **
  • functional GI tract
  • No GI bleeding ***
  • no intraabdominal complications

Nurs G140 Exam 3 (7 decks)

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