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NURB 3130 > Upper GI Disorders > Flashcards

Upper GI Disorders Flashcards

1
Q

GI Imaging

A
  • allows to see abnormalities in esophagus & stomach
  • monitor for constipation afterwards
  • no eating or smoking the day before
  • informed consent
  • assess allergies
  • stool may be chalky and white due to barium taken before surgery
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2
Q

upper gi endoscopy

A
  • anesthetic agent (propofol, benzos)
  • intraop: monitor vitals
  • post procedure: gag reflux
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3
Q

lower gi colonoscopy

A
  • anesthetic agent
  • preop: med given to clear intestines
  • air injected so may have pain postop (ambulate to expel)
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4
Q

contributing factors to dental caries

A
  • malnutrtion
  • poor oral hygiene
  • dry mouth
  • genetics
  • dental plaque
  • bad water
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5
Q

manifestations of dental caries

A
  • halitosis
  • tooth pain
  • erosion
  • discoloring of teeth
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6
Q

dental caries interventions

A
  • good nutrition and hygiene

- visit dentist regularly

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7
Q

salivary gland, oral mucosa, and pharyngeal disorders contributing factors

A
  • tobacco
  • etoh
  • aging
  • dehydration
  • radiation
  • stress
  • malnutrition
  • poor oral hygiene
  • immunosuppression
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8
Q

salivary gland, oral mucosa, and pharyngeal disorders manifestations

A
  • pain, cheesy white plaques (candidiasis)
  • inflammation/redness
  • persistent, painful oral lesion that won’t heal
  • xerostomia (dry mouth)
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9
Q

salivary gland, oral mucosa, and pharyngeal disorders nursing implications

A
  • good oral hygiene
  • good nutrition
  • monitor swallowing
  • comfort measures for pain
  • monitor for infection
  • promote positive self image
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10
Q

conditions that may require enteral therapy

A
  • alcoholism
  • choronic depression
  • anorexia nervosa
  • cancer therapy
  • coma
  • covalescent care
  • debilitation
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11
Q

open system for feedings

A
  • avoid bacterial contamination
  • don’t hang for more than 4-8 hours
  • bag & tubing needs to be changed every 24 hours
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12
Q

closed system

A
  • prefilled and sterile
  • must be ran through controlled system
  • hang 24-48 hours at room temperature
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13
Q

continuous via pump (NG)

A
  • measure residual volume every 4 hours

- frequent abdominal assessment

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14
Q

bolus/intermittent by gravity (PEG)

A

-check residuals before every feeding

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15
Q

prior to admin feedings

A
  • elevate HOB

- verify proper placement (x ray, tape placement, gastric pH)

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16
Q

assessing tolerance of enteral feedings

A
  • response to feedings
  • labs: albumin, electrolytes
  • mucous membranes
  • urinary output
  • weight
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17
Q

assess of pt on enteral feedings

A
  • s/s of dehydration
  • amount of formula taken in by pt
  • increase bs levels, decrease UO, sudden weight gain, & edema
  • s/s of infection and complications
  • I&O
  • weekly weights
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18
Q

high residual

A
  • 2 hours of feeding or 100-150 mls

- stop feeding, notify dr, allow stomach to empty & try again, assess abdomen for bowel sounds or gas

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19
Q

potential complications of enteral feedings

A
  • constipation
  • diarrhea
  • gas/bloating/cramping
  • tube displacement
  • dehydration and azotemia
  • refeeding syndrome
  • n/v
  • aspiration pneumonia
  • nasopharyngeal irritation
  • tube obstruction
  • hyperglycemia
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20
Q

preventing dumping syndrome

A
  • slow formula
  • admin feedings at room temp by continuous drip if tolerated
  • remain in semi fowler’s for 1 hour after feeding
  • use minimal amount of water to flush before and after
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21
Q

hiatal hernia

A
  • opening in diaphragm where esophagus normally passes is enlarged
  • part of stomach moves up into lower portion of thorax
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22
Q

contributing factors of hiatal hernia

A
  • high fat diet
  • caffeinated beverages
  • tobacco products
  • obesity
  • meds: anticholinergics, nitrates, ccb
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23
Q

manifestations of hiatal hernia

A
  • persistent heartburn & dysphagia
  • regurgitation
  • belching
  • epigastric pain
  • chest pain that mimics angina
  • feeling of suffocation after eating
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24
Q

hiatal hernia diagnostics

A
  • barium swallow

- egd

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25
hiatal hernia nursing interventions
- educate of barrium seallow - diet hx - smaller, frequent meals - sit up after meals - don't eat atleast 3 hours before bed time - elevate HOB - try weight loss - loose clothing - drink more when eating - monitor for complications (gi bleeding, barret esophagus, chronic cough, pulmonary fibrosis)
26
perforation
- hole in esophagus | - results from several causes
27
manifestations of perforation
- severe retrosternal pain with dysphagia - infection - fever - leukocytosis - severe hypotension
28
diagnostics for perforation
- barium swallow - esophagram - CT
29
perforation treatments
- npo - iv fluids - abx - close monitoring in icu - prep for surgical repair or esophagostomy
30
postop implications for perforations
- npo 7 days - en/pn - abx - repeat esophagram verifying no leaks or ileus
31
gerd
- les problem, backflow of gastric or duodenal contents into esophagus - possible esophageal mucosal injury
32
contributing factors to gerd
- large, late meals - elderly - obesity - stress - smoke - heavy etoh - osa
33
gerd manifestations
- pyrosis - regurgitation - dyspepsia - hypersalivation - pulmonary problems - hoarseness, difficulty swallowing, sore throat - chest pain that mimics angina
34
gerd complications
- dental erosion - ulcerations in pharynx/esophagus: esophageal metaplasia & barrett's esophagus (precancerous lesion) - laryngeal damage - esophageal strictures - adenocarcinoma - pulmonary: cough, bronchospasm, laryngospasm; potential for asthma, bronchitis & pneumonia
35
gerd management
- no chocolate, caffeine, etoh, smoking, carbonated beverages, fried, fatty - small meals - no eating atleast 3 hours before bed time - weight management - stress reduction - loose clothing - keep hob elevated - admin meds - endoscopy
36
gerd drug therapy
- ppi - h2 receptor blockers - antacids - antiulcer, protectants, - cholineric - prokinetic drugs
37
gerd surgical therapy
nissen fundoplication
38
barrett esophagus
- alteration in esophageal lining caused by reflux | - only known precursor to esophageal adenocarcinoma
39
barrett esophagus manifestations
gerd sx with frequent heartburn
40
barrett esophagus diagnostics
- egd with reddened esophageal lining | - biopsies with evidence of dysplasia
41
barrett esophagus management
- depends on stage of dx | - close monitoring: biopsy, PPI
42
gastritis
- inflammation of the gastric mucosa from the breakdown in gastric mucosal barrier - stomach tissue unprotected from autodigestion by HCl acid and pepsin - results in tissue edema and possible hemorrhage
43
drugs that can cause gastritis
- NSAIDs | - corticosteroids
44
diets that can cause gastrits
- etoh | - spicy foods
45
microorganism that causes gastritis
h. pylori
46
enviornmental factors that can cause h. pylori
- smoking - radiation - renal failure - sepsis - stress
47
manifestations of gastritis
- hiccups - full when eating - errosive: hemorrhage, occult bleeding
48
manifestations of chronic gastritis
- pyrosis | - fatigue
49
gastritis diagnostics
- ednoscopy with biopsy and histologic exam - cbc - diagnostics to detect h. pylori
50
acute gastritis supportive care
- npo - iv fluids - rest - antiemetics - no etoh or NSAIDs - NG tube (observe for bleeding) - promote fluid balance, monitor electorlytes - advance liquids as tolerated, no caffeine - offer smoking cessation measures
51
PUD contributing factors
- h. pylori - nsaid, corticosteroids - stress - smoking, etoh - caffeine - age 40-50 - type o blood - familial tendency - lifestyle factors
52
pud manifestations
- dyspepsia - bloated - belch - vomiting undigested food w/out nausea - melena - decreased hgb, hct - midgastric or back pain - sx worse with empty stomach - relief with antacid
53
pud diagnostics
-egd with biopsy -chest x-ray -stool specimen -barium contrast -cbc/h&h -
54
pud interventions
- smoke/etoh cessation - dietary modifications: same as other, and no milk - surgery: pyloroplasty, vagotomy, antrectomy
55
pud drug therapy
- h2r blockers - ppi - antacids - anticholinergics - abx: kills h. pylori, treatment lasts 7-14 days - sucralfate, misoprostol
56
pud complications
- hemorrhage | - perforation
57
interventions for pud related hemorrhage
- monitor for hypovolemic shock | - stabilize until can get pt to surgery or endoscopy lab- fluids and blood products
58
pud perforation
- duodenal more prevalent - can cause peritonitis - bacterial peritonitis can occur rapidly, small ones heal themselves, large ones require immediate surgical closure
59
manifestations of pud peritonitis
- sudden, dramatic,s severe generalized abdomen and shoulder pain - rigid, board like abdomen - keep knees drawn up - tachycardia, weak pulse; shallow, grunting, rapid respirations - absent bowel sounds, n/v - hypovolemic due to third spacing
60
treating pud peritonitis
- notify hcp - frequent vitals, q 15-30 min - stop all ng, oral feedings, drugs - continue/increase iv fluids - ng tube, continuous suction - restore volume: lr, albumin, prbc - foley, hourly i&o - broad spectrum abx - pain meds - surgery (open or laprascopic)

NURB 3130 (7 decks)

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