upper GI Flashcards
GERD
a) patho
b) risk factor
a) Incompetent Lower esophageal sphincter
Increased abdominal pressure
b) obesity,pregnent
hiatal hernia
stress
Alcohol,chocolate,fatty food,tabacco,caffeine
Manifestations
Heartburn(pyrosis)
Chest pain
Dyspepsia(indigestion)
Regurgitation
Respiratory (coughing, whezzing, dyspnea)
pain worse when bending,straining, laying down should be up right
Complications
cause aspiraton?
Asthma exacerbations
sinus, ear infections
aspiration pnemonia
Diagnositic
endoscopy
barium swallon
manometry
GERD
care
Diet and life style change!!!
Weight reduction
Elevating HOB
Smoking cessation
Avoid acidic food
-coffee
-alcohol
-soda
-wine
Avoid Fat food
Small frequent meal
Walk daily
GERD
medications
Proton Pump Inhibiter
PPI(prazole)
-most effective
-decrease stomach acid production
-long term or high doses may incrase risk of fracture and kidney disease, vit B and magnesium deficiency
-increase risk of c-diff in hospitalized pt
monitor for fever, diarrhea
GERD
Histamine2 receptor blockers
H2 receptor blockers (tidine)
-reducing secrition of acid
-take with meals at bedtime
Endoscopy
a) what is it?
b) before
c) after
a) ulcers or tumors can be directly seen
b) NPO for 8hr
local anesthesia throat spray(sedation)
Need ride home
c) NPO untill gas reflex returned
Hiatal Hernia
a) sliding
b) rolling/paraoesphageal
a) most common
the upper portion of the stomach “slides” up
d/t increased abdominal pressure
b) more serious type
life threated
stomach can slowely die
Manifestations
Sliding
heartburn
refulex
chest pain
dysphagia
rolling
fullness after eating
breathnessless
worse when reclining
Hiatal Hernia
Risk factor
Aging structural changes
Increased abdominal pressure
Obesity
Kyphosis
Pepticulcer
a) patho
b) risk lifestyle
a) Erosion of GI mucosa from HCL and pepsin
腐食、溶ける
b) Alcohol
Coffee
Smoking
Stress
H.Pylori major risk factor?
Infection likely occur in childhood with transmission from family member from family member to child.
Pepticulcer
Clinical Manifestations
Gastric
High epigastric burning 1-2 hrs after meals
Burning or gaseous pressure in epigastrium(right over the stomach)
Greater in older women age 50-60
Eat more feel worse
Pepticulcer
Clinical Manifestations
Duodenal
Most common
Mid-epigastric burning 2-5 hrs after meals,midmorning, midafternoon, middle of night
relieved by food and antacids
Greater risk in younger men (25-45)
Eat more,feel better
Acute exacerbations
Hospitalization needed
NGT
NPO
IV hydration
Avoid alcohol & tobacco
Avoid irritating foods
Reduce stress-quiet and restful enviroment
Assess for perforation, hemorrhage, obstruction
Acute and Chronic
gastritis
a) patho
b) risk factor
a) inflamation caused by brakdown in normal gastric mucosal barrier
b) diet(spicy food,alcohol)
drug(NSAIDs)
microorganisum(H.pulori,staphy)
stress,pain, anxiety
Manifestations
Anorexia
N/V
Epigastric tenderness and pain
Felling full
melena(bleedng stool)
Acute
management
Assess for dehydration
(diarrhea,vomiting)
NGT(sever cases)
H2 blocker
PPI
Clonic
managemant
Eliminate underkying cause
Lifestyle changes
-Non-irritating, frequent small meal
-Smoking cessation
A pt tells the nurse that her mother had been nausated all dat and has vomited twice. Before the nurese hangs up and calls the HCP, she should tell the M.J to?
a) administer antiemetic drugs and assess her mther’s skin turgor
b) offer her mother large quantities of Gatorade to decrease the risk for sodium depletion
c) give her mother sips ater and elevate the head of her bed to prevent aspiration
d) giver her mother a high proteing liquid supplement to deink to mainntatin her nutirional need
c
The nurse teaching young aduls about behaviors that put them at risk for oral cancer includes
a) discouraging use of chewing gum
b) avoiding use of perfumed lip gross
c) avoiding use of smokeless tabacco
d) doscouranging drinking of carnonate drinks
c
Which instructions would the nurse include in a teaching plan for a pt with mild GERD?
a) the best time to take an as-needed antacid is 1-3 hrs after a meal
b) A glass of warm milk at bedtime will decrease your discomfort at night
c) Do not chew gum, the excess saliva will cause you to secrete more acid
d) limit your intake of foods high in protein because they take longer to digest
a
The nurse is teaching the pt and family that PUC are
a) caused by stressful lifestyle and other acid-producing factors, such as H, pylori
b) inherited within families and reinforced by bacterial spread of staphylococcus in childhood
c) promoted by factors that cause oversecretion of acid, such as excess dietary fats, smoking and alcohol use
d) promoted by a combination of factors that cause erosion of the gastric mucosa, including certain drugs and H, pylori
d
An optimal teaching plan for an outpatient with stomach cancer receiving radiation theray should include information about?
a) cancer support group, alopecia and stomatitis
b) nutrition supplement ostomy care, and support groups
c) prosthetic devices, wound and skin care, and grief care provide
d) wound skin care,nutrition, drugs, and community resources
d
The teaching plan for the pt being discharged after an acute episode of upper GI bleeding includers information about the importance of SATA?
a) limiting alcohol intake to 1 serving per day
b) Onlu taking aspirin with milk or brad product
c) avoiding taking aspirin and drugs containing aspirin
d) only talking drugs prescribed by the health care provide
e) taking drugs 1 hr before mealtime to prevent further bleeding
c,d
