Upper GI Flashcards by Lacy Cope

What is GERD?

A condition where gastric contents flow back into the esophagus due to a weakened lower esophageal sphincter

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What are two risk factors for GERD?

Obesity and smoking

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What are common symptoms of GERD?

Heartburn, regurgitation, dysphagia

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What lifestyle changes can help manage GERD?

Avoid acidic foods, elevate head of bed, eat smaller meals

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What medications treat GERD?

Antacids, H2 blockers, PPI

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What is the most common cause of peptic ulcers?

H. Pylori infection

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Name a diagnostic test for PUD

EGD (Esophagogastroduodenoscopy

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What are symptoms of PUD?

Burning epigastric pain, nausea, hematemesis

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How is PUD treated?

Antibiotics, PPIs, avoiding NSAIDS

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What complication can arise from untreated PUD?

Perforation, bleeding, gastric outlet obstruction

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What is a hiatal hernia?

Protrusion of the stomach through the diaphragm

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What are two types of hiatal hernia?

Sliding and paraesophageal

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What symptoms are common in hiatal hernia?

Heartburn, regurgitation, dysphagia

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What lifestyle changes help with hiatal hernia?

Small meals, avoid lying down after eating

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What is a surgical treatment for hiatal hernia?

Fundoplication

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What is gastritis?

Inflammation of the stomach lining

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What bacteria is associated with chronic gastritis?

H. pylori

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What medications can cause gastritis?

NSAIDS, steroids, alcohol

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How is gastritis diagnosed?

Endoscopy, biopsy, stool testing for occult blood

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What are treatments for gastritis?

Antacids, PPIs, avoiding alcohol/NSAIDs

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What are risk factors for esophageal cancer?

Dysphagia

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How is esophageal cancer diagnosed?

Endoscopy with biopsy

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What treatments exist for esophageal cancer?

Surgery, radiation, chemotherapy

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What lifestyle change can help prevent esophageal cancer?

Avoid smoking and excessive alcohol consumption

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How is obesity defined?

Greater than 30

What are complications of obesity?

Diabetes, hypertension, heart disease

What types of bariatric surgery exist?

Gastric bypass, sleeve gastrectomy

What is dumping syndrome?

Rapid gastric emptying causing nausea and diarrhea

How is dumping syndrome managed?

Small frequent meals, avoiding high-sugar foods

What is a PEG tube?

Percutaneous endoscopic gastrostomy tube

What position should a client be in during tube feeding?

Semi-Fowler’s

What is an important nursing intervention for tube feedings?

Checking residuals

What is a complication of tube feedings?

Aspiration pneumonia

What should the nurse do if aspiration is suspected?

Stop the feeding immediately

What labs are elevated in liver disease?

AST, ALT, bilirubin

What is a symptom of liver disease?

Jaundice

What diet is recommended for liver disease?

Low protein if encephalopathy is present

What medication is given for high ammonia levels?

Lactulose

What are signs of hepatic encephalopathy?

Confusion, asterixis

What is achalasia?

Failure of the lower esophageal sphincter to relax

What is Barrett’s esophagus?

Precancerous changes in esophageal lining

What is steatorrhea?

Fatty, foul-smelling stools

What is Curling’s ulcer?

Stress ulcer following burns

What is a common symptoms of gastric cancer?

Early satiety

What is hematemesis?

Vomiting blood

What is hematochezia?

Bright red blood in stool

What is melena?

Black, tarry stool

What is a nasoenteric tube used for?

Decompression or feeding

What is a contraindication for metronidazole?

Alcohol consumption

What finding suggests a peptic ulcer perforation?

Rigid abdomen

What should a client be instructed to do while taking omeprazole?

Take it before meals

What is the primary symptom of esophageal cancer?

Dysphagia

What finding would indicate hemorrhage from a gastric ulcer?

Coffee-ground emesis

What medication helps prevent NSAID-inducted ulcers?

Misoprostol

What would be a complication of GERD?

Barrett’s esophagus

What dietary change would be appropriate for a client with GERD?

Avoiding caffeine and acidic foods

What is the primary treatment for H. Pylori?

PPIs and antibiotics

What would be a priority intervention when caring for someone who just had a PEG tube placed?

Verify tube placement before feedings

What would be a symptom that is associated with perforation of a gastric ulcer?

Sudden severe abdominal pain

What is the primary concern with esophageal varices?

Hemorrhage

When taking sucralfate, what would indicate the client understands before they take the medication?

They know to take on an empty stomach

What would be a likely cause if a client with a history of gastric bypass surgery, reports being dizzy, sweating, and diarrhea after eating?

Dumping syndrome

What symptom suggests esophageal cancer in the early stages?

Difficulty swallowing

What are two major risk factors for esophageal cancer?

Smoking and alcohol abuse

Which type of esophageal cancer is most common in the middle esophagus?

Squamous cell carcinoma

Which esophageal disorder is characterized by the lower esophageal sphincter failing to relax?

Achalasia

What are two complications of esophageal cancer?

Obstruction and perforation into the mediastinum

What is a serious complication of a perforated peptic ulcer?

Peritonitis

What test is used to confirm the presence of H. Pylori?

Urea breath test or biopsy during endoscopy

What is TPN used for?

To provide total nutrition when enteral feeding is not possible

How is TPN administered?

Through a central vein (PICC line)

What is a major risk of TPN?

Infection (sepsis)

What electrolyte imbalance is a concern when stopping TPN too quickly?

Rebound hypoglycemia

What are three types of GI tubes?

1. Nasogastric (NG tube) 2. Gastrostomy (G-tube) 3. Jejunostomy (J-tube)

PPI: Omeprazole (Prilosec)

Used for: GERD, Peptic Ulcer Disease (PUD), Gastritis Watch for: Long-term use increases fracture risk and B12 deficiency

PPI: Lansoprazole (Prevacid)

Used for: GERD, PUD, Zollinger-Ellison syndrome Watch for: Diarrhea, C. Diff infection, headaches

PPI: Pantoprazole (Protonix)

Used for: GERD, Stress ulcer prophylaxis Watch for: Monitor magnesium levels (risk of hypomagnesemia)

PPI: Esomeprazole (Nexium)

Used for: GERD, erosive esophagitis Watch for: Risk of kidney disease and vitamin deficiencies

Antacids: Calcium Carbonate (Tums)

Used for: GERD, heartburn Watch for: hypercalcemia, kidney stones with overuse

Antacids: Aluminum Hydroxide (Amphojel)

Used for: GERD, PUD Watch for: Constipation, hypophosphatemia with long-term use

Antacids: Magnesium Hydroxide (Milk of Magnesia)

Used for: GERD, constipation Watch for: Diarrhea, avoid in renal failure (magnesium accumulation)

Cytoprotective Agents: Sucralfate (carafate)

Used for: Peptic ulcers, GERD (off-label) Watch for: Take on an empty stomach, space out from other meals

Cytoprotective agents: Misoprostol (Cytotec)

Used for: NSAID-induced ulcer prevention Watch for: Avoid in pregnancy (causes uterine contractions & abortion)

Antibiotics for H. Pylori

Metronidazole: Flagyl Watch for: Avoid alcohol Clarithromycin: Biaxin Watch for: QT prolongation, GI upset, risk of C. Diff Amoxicillin Watch for: allergic reactions Tetracycline Watch for: avoid in pregnancy (stains teeth, inhibits bone growth) Bismuth Subsalicylate Watch for: Pepto-Bismol-black stools/tongue, avoid in children (Reye’s syndrome risk)

GI Motility Agents

Metoclopramide: Reglan Watch for: risk of tardive dyskinesia with long-term use Erythromycin Watch for: QT prolongation, GI upset

Anti-emetics

Ondansetron: Zofran Watch for: QT prolongation, headache, constipation Promethazine: Phenergan Watch for: Sedation, hypotension, extravasation risk if IV given incorrectly