Brainscape's Knowledge GenomeTM

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


See full index

NURS 2056 > Upper GI > Flashcards

Upper GI Flashcards

1
Q

What is nausea?

A

feeling of discomfort in epigastrium with a conscious desire to vomit

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

what is vomiting?

A

forceful ejection of partially digest food and secretions from the upper go tract

  • can occur when GI tract becomes overly irritated, excited or distended
  • Autonomic nervous system activated before vomiting occurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does vomiting affect SNS and PNS?

A

SNS - tachycardia, tachypnea, diaphoresis
PNS - relaxation of lower esophageal sphincter, increase in gastric motility, increase in saliva

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

what are clinical manifestations of nausea and vomiting?

A

nausea is a SUBJECTIVE symptom

anorexia, dehydration, watch YouTube to know key exam symptoms

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

what do you do if the patient has nausea and vomiting?

A

medications and NPO until ethology confirmed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is GERD? gastroesophageal reflux disease

A

Reflux of gastric contents into the lower esophagus

  • causes esophageal irritation and inflammation

results when defines of lower esophagus are overwhelmed by the reflux of stomach acidic contents into esophagus

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

what are clinical manifestations of Gerd?

A
  • heartburn (pyrosis) : burning tight sensation felt in lower sternum and spreads upward to the throat or jaw (RULE OUT CARDIAC CHEST PAIN)
  • respiratory symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are 2 main complications of GERD?

A

1) Esophagitis - inflammation of esophagus, shows up as esophageal strictures from scar tissue formation

2) Barrett’s esophagus - esophageal metaplasia ( Precancerous lesion) ; cell changes from chronic reflux, POTENTIAL to develop into esophageal cancer

other complications include; dental erosion from acid reflux into mouth, respiratory complications

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

what are some inter professional care for GERD?

A

main is lifestyle modifications

diet, quit smoking, lose weight

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

what is hiatal hernia?

A

herniation of a portion of the stomach into the esophagus through an opening (hiatus) in the diaphragm (aka diaphragmatic hernia and esophageal hernia)

  • weakening of the muscles in the diaphragm around the esophagastric opening: intra abdominal pressure like obesity, preggo, tumours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are symptoms of hiatal hernia?

A

asymptomatic or similar presentation to GERD

treated like GERD; 2 options
1) lifestyle modifications and meds
2) surgical therapy ; fundoplication

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

what is the barium swallow study?

A

swallow barium (contrast medium) to visualize esophageal, stomach and small intestine disorders with fluroscopy and radiographic images

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is gastritis?

A

inflammation of gastric mucosa

breakdown in normal gastric mucosal barrier that protects the stomach tissue from auto digestion by HCL and pepsin

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

what causes gastritis?

A

NSAIDS, some meds
Alcohol, spicy/irritating foods
H.pylori infection
Autoimmune

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

what are some clinical manifestations of gastritis?

A
  • anorexia
  • nausea vomiting
  • feeling of fullness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what does chronic gastritis cause?

A

cobalamin (VITAMIN B12) deficiency from lack of absorption contributes to development of anemia and neurological complications

17
Q

what are diagnostic studies for gastritis?

A
  • history of drug and alcohol use
  • endoscopic exam with biopsy
  • CBC
  • stool
  • test for H.pylori
18
Q

what are nursing managements for gastritis?

A

1) eliminating cause
2) supportive care ; bed rest, NPO, IV fluids if vomiting
3) Meds - to reduce irritation of gastric mucosa

19
Q

discuss gastric cancer

A

adenocarcinoma of the stomach wall

caused by: H.pylori infection, Epstein Barr virus, type A blood

S&S:
Anemia - chronic blood loss
Peptic ulcer disease symptoms - pain, indigestion, weight loss

treatment:
surgical removal or radiation/chemo shows little results

20
Q

discuss surgical therapy for gastric cancer

A

removing the tumour by resecting as much of the stomach as necessary and a margin of normal tissue

Total gastrectomy with esophagojejunostomy (basically NO stomach.
- anastomosis of the lower end of the esophagus to the jejunum
- chest cavity exposed; chest tube placed
- NGT removed after a few days
- Vitamin deficiency (C, D, K, B-Complex absorbed in upper part of small intestines)

21
Q

what are the 4 types of blood loss in upper GI bleeding?

A

1) Esophagus - secondary to cirrhosis of liver
2) Esophagitis
3) Mallory-Weiss tear (from sever retching and vomiting)
4) Stomach or duodenum - peptic ulcer disease, acute gastritis, stress ulcers

22
Q

what are the 5 types of blood consistency?

A

1) bright red blood - blood has not been in contact with stomach acid secretions

2) “coffee grounds” vomitus - blood and contents have been in stomach and changed by contact with gastric secretions

3) Melena - black, tarry stools, slow bleeding from an upper GI source

4) Hematemesis - bloody vomitus appearing as fresh, bright red blood or having “coffee grounds” appearance (dark, grainy digested blood)

5) Occult bleeding - small amounts of blood in gastric secretions, vomitus or stools not apparent by appearance; detectable by guaiac test

23
Q

what are emergency assessments and management?

A

most upper GI bleeds stop spontaneously

  • vital signs Q15-30 minutes
  • monitor for S&S of shock
  • Labs
  • Fluid replacement 16 or 18 gauge PIV for fluid/blood replacement
24
Q

why does Hgb and Hct not help in estimating degree of blood loss? for upper GI bleeding?

A

Hgb and Hct may not help in estimating degree of blood loss but provide a
baseline for treatment – Hct may reflect blood loss 4-6 hours post fluid
replacement – do blood work q4-6h

25
Q

how do you check hydration for upper GI bleed?

A

urine specific gravity test

indwelling catheter to monitor UOP Q1H

26
Q

what is diagnostic tool for upper GI bleed?

A

endoscopic procedures to identify source of bleeding through direct visualization

27
Q

what are the 3 aims of meds for upper GI bleed?

A

1) Decrease bleeding
- Epinephrine during endoscopy (causes tissue edema and
pressure)
- Sclerosant during endoscopy (causes inflammation and fibrosis)

2) Decrease HCl secretion
- H2-receptor blockers (ranitidine) or PPI (pantoprazole) IV
- Somatostatin analogue IV (octreotide) decreases splanchnic
blood flow and acid secretion

3) Neutralize the HCl that is present
- Antacids

28
Q

discuss peptic ulcer disease

A

basically erosion of the GI mucosa that results from the digestive action of HCL and pepsin

2 types:
1) acute ulcers; superficial erosion and minimal inflammation

2) chronic ulcers; trod through muscular wall with formation of fibrous tissue

29
Q

what are the key differences in gastric vs duodenal ulcers?

A

gastric is superficial, mostly in women and mostly located in antrum

duodenal is penetrating, 1-2cm of the duodenum, mostly in men.

watch YouTube video for key NCLEX highlights

30
Q

what is stress-related mucosal disease?

A

acute ulcer that develops after a major physiological insult such as trauma or surgery

  • a form of erosive gastritis
31
Q

what are clinical manifestations of peptic ulcer disease?

A

no pain is common or other symptoms

NOTE: gastric and duodenal mucosal NOT risk in sensory fibres thats why you aint feeling it lol

duodenal ulcer pain: burning, cramp like, mid-epigastric region

gastric ulcer pain: burning, gaseous, high in epigastrium

32
Q

what is the most common peptic ulcer complication?

A

hemorrhage because of the erosion of the granulation tissue at base of ulcer through a major blood vessel

33
Q

what is the most lethal complication?

A

perforation where spillage of gastric contents into peritoneal cavity

  • looks like sudden, dramatic onset of upper abdominal pain that spreads throughout the belly
34
Q

another misc complication?

A

gastric outlet obstruction

  • ulcers in antrum (basically a block at the base of the stomach). this causes the stomach to increase contractile force needed to empty the stomach and over time your stomach looses its tone
35
Q

what are the diagnostic studies for peptic ulcers?

A

endoscopy
H.pylori tests - stool test gold standard

36
Q

what are some inter professional care to keep in mind for peptic ulcer disease?

A

conservative therapy: diet, STOP smoking
surgical therapy

37
Q

what are 4 surgeries you an get for peptic ulcer disease?

A

1) partial gastrectomy

2) gastrojejunostomy - partial gastrectomy with removal of 2/3 of stomach

3) vagotomy - severing of the vagus nerve, decreases gastric motility and gastric emptying

4) pyloroplasty - surgical enlargement of the pyloric sphincter to facilitate the easy passage of contents from stomach
- mostly done after vagotomy
- vagotomy + pyloroplasty = increase gastric emptying

38
Q

discuss dumping syndrome

A

pt experiences vagal symptoms after meal (15-30min) which leads to weakness or dizziness

  • direct result of surgical removal of a large portion of stomach + pyloric sphincter

watch YouTube video

39
Q

what are 2 post op complications for peptic ulcer disease?

A

1) bile reflux gastritis : result in reflux alkaline gastritis - vomitting relives the distress temporarily

2) postprandial hypoglycemia : variant of dumping syndrome, symptoms same as hypoglycaemic reaction

NURS 2056 (14 decks)

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