Upper GI Flashcards
What is GERD?
A condition where gastric contents flow back into the esophagus due to a weakened lower esophageal sphincter
What are two risk factors for GERD?
Obesity and smoking
What are common symptoms of GERD?
Heartburn, regurgitation, dysphagia
What lifestyle changes can help manage GERD?
Avoid acidic foods, elevate head of bed, eat smaller meals
What medications treat GERD?
Antacids, H2 blockers, PPI
What is the most common cause of peptic ulcers?
H. Pylori infection
Name a diagnostic test for PUD
EGD (Esophagogastroduodenoscopy
What are symptoms of PUD?
Burning epigastric pain, nausea, hematemesis
How is PUD treated?
Antibiotics, PPIs, avoiding NSAIDS
What complication can arise from untreated PUD?
Perforation, bleeding, gastric outlet obstruction
What is a hiatal hernia?
Protrusion of the stomach through the diaphragm
What are two types of hiatal hernia?
Sliding and paraesophageal
What symptoms are common in hiatal hernia?
Heartburn, regurgitation, dysphagia
What lifestyle changes help with hiatal hernia?
Small meals, avoid lying down after eating
What is a surgical treatment for hiatal hernia?
Fundoplication
What is gastritis?
Inflammation of the stomach lining
What bacteria is associated with chronic gastritis?
H. pylori
What medications can cause gastritis?
NSAIDS, steroids, alcohol
How is gastritis diagnosed?
Endoscopy, biopsy, stool testing for occult blood
What are treatments for gastritis?
Antacids, PPIs, avoiding alcohol/NSAIDs
What are risk factors for esophageal cancer?
Dysphagia
How is esophageal cancer diagnosed?
Endoscopy with biopsy
What treatments exist for esophageal cancer?
Surgery, radiation, chemotherapy
What lifestyle change can help prevent esophageal cancer?
Avoid smoking and excessive alcohol consumption
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?
- Nasogastric (NG tube)
- Gastrostomy (G-tube)
- 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
