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Care of Adult/Older Exam #3 (5701) > Upper GI (N/V, GERD) > Flashcards

Upper GI (N/V, GERD) Flashcards

1
Q

Most common manifestation of most GI diseases

A

N/V

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2
Q

feeling of discomfort in the epigastric region, with a desire to vomit

A

Nausea

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3
Q

Etiology of GI Disorders

A 
Pregnancy
Infectious disease
CNS-meningitis, tumors
CV-HF, MI
Metabolic-DB, Addison’s, RF
Side Effects-chemo, opioids, digoxin
Post-operative complication
Psychological-stress, fear
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4
Q

Complications of severe vomiting

A
  • Electrolyte imbalance
    • Potassium, sodium, chloride, hydrogen
  • Metabolic alkalosis-loss of gastric hydrochloric acid
  • Metabolic acidosis-emesis from the small intestine (less common)
  • Pulmonary aspiration in unconscious or decreased gag reflex
    • Semi-fowlers or side lying
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5
Q

Most common cause of N/V?

A

gastroenteritis

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6
Q

When to see MD –
A) Vomiting __ or __
B) No urination
C) Other

A

A) > 24 hours or > 3x/day
B) for 8 hours
C) Headache, Stiff neck,
Severe abdominal pain

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7
Q

Abdominal Assessment

A
  • Auscultate bowel sounds in all four quadrants
  • 5-30/minute normal
  • > 30 hyperactive
  • <5 hypoactive
  • None in 5 minutes absent = Medical Emergency
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8
Q

Partially digested food several hours after eating indicates?

A

gastric outlet obstruction or delayed emptying

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9
Q

Coffee ground emesis and bright red blood indicates?

A

upper GI bleed

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10
Q

Medications to treat N/V

A 
Anticholinergics-scapolamine
Antihistamines-Hydroxyzine
Phenothiazine-prochlorperazine
Prokinetic-metoclopraminde 
Serotonin antagonist-ondansetron
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11
Q

Common side effects of antinausea meds?

A

Dry mouth, hypotension, sedation, rash, and constipation

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12
Q

Tx for severe cases N/V?

A
  • Hydration with:
    • IV fluid
    • Electrolytes
    • Glucose
  • TPN
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13
Q

Gastric Lavage: ______mL of fluid is instilled at a time.

A

50-100 mL

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14
Q

Process of removing an NG Tube

A 
Instill 50mL of air into tube
Ask client to take a deep breath and hold
Pinch tube 
Slowly withdraw
Oral care after
Document
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15
Q

Nursing Interventions for Patient with NG tube, initiating introduction of food?

A
  • Initiate clear liquids
    • Administer broth and Gatorade with caution due to high NA content
  • Assess tolerance
  • Assess bowel sounds
  • Advance to soft bland diet
    • Toast, crackers
  • Provide oral care
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16
Q

Nondrug Therapy for N/V?

A

Acupuncture
Herbs – ginger or peppermint
Relaxation breathing exercises
Change in position/activity

17
Q

Syndrome based on chronic symptoms or mucosal damage secondary to reflux of gastric contents into the lower esophagus

A

Gastroesophageal Reflux Disease (GERD)

18
Q

Most common GI problem in adults?

A

Gastroesophageal Reflux Disease (GERD)

19
Q

Common causes of Gastroesophageal Reflux Disease (GERD)?

A
  • Hiatal hernia
  • decreased esophageal clearance
  • esophageal motility
  • decreased gastric emptying
  • Pregnancy and obesity
  • Cigarette and cigar smoking
20
Q

Most common S/S of GERD?

A
  • Heartburn (pyrosis)
  • Dyspepsia
  • Regurgitation
21
Q

Uncommon S/S of GERD?

A
  • Respiratory symptoms
    • wheezing, coughing, SOB
  • Chest pain
  • Otolaryngologic symptoms
22
Q

How to diagnose GERD?

A
  • H&P-diagnosed by symptoms
  • Persistent reflux more than 2x week
  • Upper GI endoscopy (EGD) with biopsy
  • Barium swallow
  • Motility studies
23
Q

Drug Therapy for GERD?

A
  • H2-receptor blockers-reduce acid production
  • Proton pump inhibitor (PPI)-reduce acid production and help heal the espophagus
  • Antacids-neutralize the acid, quick short relief, take 1-3 hours before meals and at HS
24
Q

Teaching Nursing Interventions

A
  • Avoid triggers
  • Smoking cessation
  • Weight reduction
  • Diet
  • Elevate HOB bed 6-8 inches
  • Stress reduction
25
Q

Diet Teaching for a patient with GERD?

A
  • Small frequent meals
  • Avoid: chocolate, peppermint, tomatoes, coffee, tea, orange juice, red wine
  • Avoid milk at HS, late night snacking
  • Chewing gum and oral lozenges may decrease symptoms
  • Do not lie down after a meal-wait 3 hours
26
Q

How long should a patient diagnosed with GERD wait to lie down after eating?

A

3 hours

27
Q

Complications of GERD

A
  • Esophagitis
  • Barret’s esophagus
  • Cough, bronchospasm, asthma, pneumonia
    • Caused by irritation or aspiration of gastric content
  • Dental Erosion
28
Q

Esophagitis

A 
Esophagitis
Inflammation of the esophagus
Ulcerations
Bleeding
Dysphagia
29
Q

Barret’s esophagus

A

Pre-cancerous lesions

Care of Adult/Older Exam #3 (5701) (8 decks)

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