Stomach Problems Flashcards
1
Q
Acute Gastritis CMs
A
- Rapid onset of epigastric pain or discomfort
- N/V
- Hematemesis (vomiting blood)
- Gastric hemorrhage; life-threatening emergency
- Dyspepsia (indigestion)
- Anorexia
2
Q
Chronic Gastritis CMs
A
- Vague report of epigastric pain tht is relieved by food
- Anorexia
- N/V
- Intolerance of fatty & spicy foods
- Pernicious anemia
3
Q
Acute Gastritis - Interventions
A
-
Treated symptomatically & supportively bc the healing process is spontaneous
> drug therapy
> blood transfusion if bleeding
> fluid replacement for dehydration
> surgery w/ major bleeding
4
Q
Chronic Gastrtitis - Interventions
A
- Varies w/ cause:
> drug therapy
> elimination of causative agent; EX: H. pylori treated w/ antimicrobials
> treatment of any underlying disease
> avoidance of toxic substances
5
Q
Gastritis Interventions - Drug Therapy
A
-
H2-Receptor Antagonists
> Famotidine - Pepcid, Nizatidine - Axid
> blocks gastric secretions -
Mucosal Barrier
> Sucralfate - Carafate, Sulcrate -
Antacids
> Maalox, Mylanta
> buffering agent -
Proton Pump Inhibitors
> Omeprazole - Prilosec, Pantoprazole - Protonix
> suppress gastric acid secretion -
Vitamin B12
> prevention or treatment of pernicious anemia (chronic gastritis)
5
Q
Peptic Ulcer Disease - Assessment
A
- Hx
-
Physical assessment/CMs:
> dyspepsia; most common symp: sharp, burning, gnawing pain
> epigastric tenderness
> N/V -
Lab Assessment:
> serologic testing for H. pylori antibodies
> dcrd H/H, if bleeding
> stool may be positive for occult blood, if bleeding -
Diagnostic Testing
> EGD
> nuclear medicine scan to test for blleding; no special prep, pt injected w/ a contrast medium, GI system scanned for presence of bleeding after a waiting period
6
Q
Peptic Ulcer Disease - Interventions
A
-
Diet
> bland diet may assist in relieving symps
> teach pt to exclude foods tht cause discomfort
> avoid bedtime snacks, alcohol, tobacco, caffeine-containing beverages, & both caffeinated & decaffeinated coffees -
Complementary & Alternative Therapies
> hypnosis
> imagery
> yoga
> mediation techniques
7
Q
Peptic Ulcer Disease - Medications
antacids
H2 antagonists
mucosal barrier fortifier
A
-
Antacids
> incrs pH of gastric contents by deactivating pepsin -
H2 Antagonsits
> dcrs gastric acid secretions by blocking histamine receptors in parietal cells -
Mucosal Barrier Fortifier
> binds w/ bile acids & pepsin to protect stomach mucosa
> stimulates mucosal protectiong
> may cause stools to be discolored black
8
Q
Peptic Ulcer Disease - Medications
proton pump inhibitors
prostaglandin analogs
A
-
Proton Pump Inhibitors (PPI)
> suppresses H, K-ATPase enzyme system of gastric acid secretion -
Prostaglandin Analogs
> stimulates mucosal protection & dcrs gastric acid secretions, helps resist mucosal injury in pts taking NSAIDs and/or high-dose corticosteroids
9
Q
Peptic Ulcer Disease - Purpose of Meds
A
-
Eliminate H. pylori infection
> PPI triple therapy; PPI + 2 antibiotics like metronidazole (Flagyl) & tetracycline or clarithromycin (Biaxin) & amoxicillin (Amoxil) for 10-14 days
> PPI quadruple therapy; PPI + any 2 antibiotics above + bismuth (Pepto-Bismol) - Heal ulcerations
- Prevent recurrence
- Provide pain relief
10
Q
Complications of PUD
A
- Hemorrhage
- Perforation
- Pyloric Obstruction
- Intractable Disease
11
Q
Small Bowel Obstruction - CMs
A
- Abd discomfort or pain
- Upper or epigastric abd distention
- Nausea & early, profuse vomiting
- Possible visible peristaltic waves in upper & middle abdomen
- Obstipation (no passage of stool)
- Severe fluid & electrolyte imbalances
12
Q
Intestinal Obstruction - Assessment
lab
A
- WBC usually noraml unless a strangulated obstruction present or perforation
- H/H, creatinine, BUN values are often elevated bc of dehydration
- Na, Cl, K dcrd bc of loss of fluid & electrolytes
-
Amylase may be elevated w/ strangulated obstructions
> can cause damage to pancreas
13
Q
Intestinal Obstruction - Assessment
imaging
A
- Abd computerized tomography scan (CT)
- Abd ultrasound
-
Sigmoidoscopy or colonoscopy
> not used when perforation or complete obstruction is suspected
14
Q
Intestinal Obstruction - Nonsurgical Interventions
A
- NPO
-
NGT
> placed to low intermittent suction - Assess the NGT for proper placement, patency, & output q4
- Assess & record passage of flatus & character of BMs daily
- Assess & treat nausea
-
IV fluid replacement & maintenance
> parenteral nutrition may be indicated if pt has chronic nutriontional problems or has been NPO for an extended period - Monitor VS, weight, I&Os
-
Monitor pain
> incr or change may indicate perforation of intestine or peritonitis
> opioid analgesics may be temporarily withheld so CMs of perforation or peritonitis are not masked
> discomfort if generally less w/ nonmechanical obstruction -
Assist pt to obtain a position of comfort w/ frequent position changes to promote incrd peristalsis
> semi-fowler’s position may help alleviate pressure of abd distention on chest
