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Adult Nursing II - Exam 1 > Week 2 - GI (part 1) > Flashcards

Week 2 - GI (part 1) Flashcards

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1
Q

Medical Management of Gastritis

Gastrointestinal - KNOW THIS!!!

A
  • Reduce Anxiety
  • Promote Optimal Nutrition
  • Discourage caffeine, EtOH, & cigarettes
  • Promote Fluid Balance
  • **Pain releif measures)
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2
Q

What is gastritis?

Gastrointestinal Powerpoint

A

inflammation of the stomach lining

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3
Q

A nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data should the nurse consider most significantly related to the etiology of the problem?

a.) Consumes one or more protein drinks per day
b.) Takes OTC antacids frequently throughout the dayl
c.) Smokes 1 pack of cigarettes daily
d.) Reports a hx of social drinking on a weekly basis

Gastrointestinal Powerpoint

A

C.) Smokes 1 pack of cigarettes daily

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4
Q

A nurse is caring for a patient hospitalized with an exacerbation of chronic gastritis. What health topic should the nurse emphasize?

a.) Strategies for maintaining an alkaline gastric environment
b.) Safe technique for self suctioning
c.) Techniques for positioning correctly to promote gastric healing
d.) Strategies for avoiding irritating foods & beverages

Gastrointestinal Powerpoint

A

D.) Strategies for avoiding irritating foods & beverages

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5
Q

What is peptic ulcer disease? Why do these ulcers form?

Gastrointestinal

A

Ulcer in the lining of the GI tract

Form due to:
* Gastric Acid
* Pepsin (HCl + pepsinogen; breaks down food)
* breakdown of stomach defenses

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6
Q

What is H. pylori and how does it lead to peptic ulcer disease?

Gastrointestinal Powerpoint

A
  • cells that spiral into the lining of the stomach
  • Able to survive because it is able to breakdown stomach acid
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7
Q

What is the most common site of peptic ulcer formation?

Gastrointestinal Powerpoint

A

Duodenum

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8
Q

What is the difference in the signs & symptoms of Gastric & Duodenal peptic ulcers?

Gastrointestinal - KNOW THIS!!!

A

Gastric
* Epigastric pain
* food makes pain worse
* Pain = dull, achy
* weight loss
* Severe ulcer can cause GI bleeding - coffee ground or bright red emesis

Duodenal
* Epigastric pain
* food makes pain better
* pain wakes you up at night
* Pain = gnawing
* normal weight
* Severe ulcer can cause GI bleeding - black tarry stool

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9
Q

Gastric vs. Duodenal Peptic Ulcer Disease (due to H. pylori)

Gastrointestinal - KNOW THIS!!!

A

GASTRIC:
* food makes it WORSE
* DULL, ACHY pain
* weight LOSS

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10
Q

Potential Complications of Peptic Ulcer Disease

Gastrointestinal - KNOW THIS!!!

A
  • GI bleeds
  • Perforation of stomach lining
  • Bowel blockage at pylorus
  • Increased risk of GI cancer
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11
Q

What is Dumping Syndrome? What are early & late symptoms?

Gastrointestinal - KNOW THIS!!!

A

Rapid gastric emptying or food moving too quickly through the stomach

  • Early Sx: abdominal swelling, nausea, diarrhea
  • Late Sx: dizziness, sweating, weakness
  • Acts hypertonic - pulls H2O out of the bowel causing abdominal swelling
  • Heart tries to compensate –> leads to hypertensive state –> which can lead to syncope
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12
Q

What is dumping syndrome?

Gastrointestinal - KNOW THIS!!!

A

Food enters the intestines too quickly & cannot be digested properly

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13
Q

Signs & Symptoms of Dumping Syndrome

Gastrointestinal - KNOW THIS!!!

A

EARLY:
* swollen abdomen
* nausea
* diarrhea

LATE:
* dizziness
* sweating
* weakness

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14
Q

Complications of Dumping Syndrome

Gastrointestinal - KNOW THIS!!!

A
  • GI bleeds
  • Perforation
  • Peritonitis
  • Obstruction

peritonitis = inflammation / swelling / redness

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15
Q

Patient Education for Dumping Syndrome

Gastrointestinal - KNOW THIS!!!

A
  • Small, frequent meals
  • Lie down for 30 minutes after eating
  • Don’t drink fluids w/ meals (wait 30 minutes)
  • Avoid sugary foods & liquids
  • Eat high protein & fiber
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16
Q

Patient Education on Diet for Ulcers

Gastrointestinal - KNOW THIS!!!

A
  • Avoid spicy food
  • Avoid acidic food
  • Consume low fiber foods (bland & easy to digest)
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17
Q

Medications for Peptic Ulcers

Gastrointestinal - KNOW THIS!!!

Antacid Medications Help Basic Peptic Ailments

A

Antacid Medications Help Basic Peptic Ailments

  • Antacids: neutralize stomach acid
  • Mucosal healing (Carafate)
  • H2 Receptor Blockers: reduce HCl production (ranitidine / Zantac & Pepcid)
  • Bismuth: coats stomach lining (Pepto bismal)
  • PPIs: attach to proton pump to redcue HCl (Prilosec & Protonix)
  • Antibiotics: kill H. pylori (Biaxin, Flagyl, Tetracycline, Amoxicilin)
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18
Q

Diagnostic imaging & physical assessment have revealed that a patient with PUD has suffered a perforated ulcer. The nurse recognizes that emergency interventions must be performed as soon as possible in order to prevent the development of what complication?

a.) Peritonitis
b.) Gastritis
c.) Gastroesophageal reflux
d.) Acute pancreatitis

A

A.) Peritonitis

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19
Q

What is hematochezia & what causes it??

Gastrointestinal - KNOW THIS!!!

A

bright red, bloody stool

  • caused by lower GI bleed
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20
Q

What is melena & what causes it?

Gastrointestinal - KNOW THIS!!!

A

Black / tarry stool

  • caused by upper GI bleed (blood has time to mix with gut flora)
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21
Q

Post-Op diet for bariatric surgery

Gastrointestinal Powerpoint - KNOW THIS!!!

A
  • 6 small meals totaling 600 - 800 calories per day intiially
  • 6 small meals (800 - 1000 calories per day) once diet is soft / regular
  • High protein diet is recommended
  • Be mindful / look for signs of dumping syndrome
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22
Q

Key interventions for gastric cancer

Gastrointestinal Powerpoint - KNOW THIS!!!

A
  • Fowler’s position for comfort (releives pressure on abdomen & promotes gastric emptying)
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23
Q

True or False: older adults with gastric cancer may have no gastric symptoms

Gastrointestinal Powerpoint

A

True

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24
Q

What are hemorrhoids & fissures?

Intestional & Rectal Dx

A

Hemorrhoids: swollen veins in rectum (internal & external)

Fissures: tears in the rectum

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25
Q

IBS Triggers

Intestional & Rectal Disorders - KNOW THIS!!!

A
  • Chronic stress
  • Sleep deprivation
  • Surgery
  • Infections
  • Diverticulitis
  • Certain foods
26
Q

Signs & Symptoms of IBS

Intestional & Rectal Disorders - KNOW THIS!!!

A
  • Alteration in bowel patterns
  • Pain
  • Bloating
  • Abdominal distension
27
Q

What is malabsorption? What are symptoms / findings?

Intestional & Rectal Dx

A

Inability of digestive system to absorb 1+ major vitamins, minerals, or nutrients

  • Diarrhea or frequent, loose, bulky, foul-smelling stools
  • High-fat content
  • Often grayish stool
  • Manifested by weight loss & vitamin / mineral deficiency
28
Q

What is a major complication of appendicitis? What are signs & symptoms?

Intestional & Rectal Disorders - KNOW THIS!!!

A

Major complication = Peritonitis

Signs & Symptoms:
* RLQ Pain
* Abdominal pain
* Point of McBurney’s
* Poor appetite
* Elevated temperature
* Nausea / vomiting
* Desire to be in fetal position
* Increased WBCs
* eXperiences rebound tenderness

29
Q

What are signs & symptoms of appendicitis?

Intestional & Rectal Disorders - KNOW THIS!!!

A

RLQ Pain

  • Abdominal pain
  • Point of McBurney’s will have most pain** (RLQ)**
  • Poor appetite
  • Elevated temperature
  • Nausea / vomiting
  • Desire to be in fetal position
  • Increased WBCs
  • eXperiences rebound tenderness
30
Q

What are signs of peritonitis?

Intestional & Rectal Disorders - KNOW THIS!!!

A
  • Increased HR, Respirations, Temperature
  • ** Abdominal Pain** (very intense)
  • Abdominal distention / bloating
31
Q

What symptoms would the nurse expect to find for a patient with appendicitis? Select all that apply

a.) RLQ pain
b.) Anorexia
c.) Hypothermia
d.) Nausea
e.) Projective vomiting

Intestional & Rectal Dx - KNOW THIS!!!

A

RLQ Pain (a), Anorexia (b), & Nausea (d)

32
Q

What is diverticulosis

Intestional & Rectal Dx

A

multiple diverticula w/out inflammation

33
Q

What is diverticulitis?

Intestional & Rectal Dx

A

infection & inflammation of diverticula

34
Q

………. is a complication of diverticulosis?

Intestional & Rectal Dx

A

Diverticulitis

Person must’ve had diverticulosis in order to develop diverticulitis

35
Q

Signs & Symptoms of Diverticulitis

Intestional & Rectal Dx - KNOW THIS!!!

A
  • Pain in abdomen (mainly LLQ) (LLQ pain)
  • Observe abdominal bloating & blood in stool (bloating & blood in stool)
  • Unrelenting cramping (cramping)
  • Constipation
  • High temperature
36
Q

Signs & Symptoms of Diverticular Disease

Intestional & Rectal Disorders - KNOW THIS!!!

A
  • Pain in the abdomen (LLQ)
  • Observe abdominal bloating & blood in stool
  • Unrelenting cramping
  • Constipation
  • High temperature
37
Q

Treatment of Diverticular Disease

Intestional & Rectal Disorders - KNOW THIS!!!

A
  • IV or PO antibiotics
  • Drainage of out pouch
  • High fiber diet
  • NPO
38
Q

What should the nurse include in the discharge teaching plan for a patient who has diverticulitis? (Select all that apply)

a.) Decrease daily fluid intake
b.) Adhere to a low fiber diet
c.) Avoid strawberries & tomatoes
d.) Decrease carbohydrates
e.) Avoid nuts & corn

Intestional & Rectal Dx

A

Adhere to a low fiber diet (b), Avoid strawberries & tomatoes (c), Avoid nuts & corn (e)

39
Q

What is the difference in the location of Crohn’s disease & Ulcerative colitis?

Intestional & Rectal Dx

A

Crohn’s: anywhere from oral to anus

UC: lower part of intestinal tract

40
Q

What is Crohn’s Disease?

Intestional & Rectal Disorders - KNOW THIS!!!

A
  • Affects WHOLE bowels
  • Inflammation & ulcers in GI tract
  • Periods of flare ups & remissions
41
Q

Signs & Symptoms of Crohn’s Disease

Intestional & Rectal Disorders - KNOW THIS!!!

A
  • Diarrhea
  • Cramping
  • Ulcers
  • Anal fissures
  • Loss of appetite
  • Weight loss
  • Abdominal Bloating
42
Q

What is ulcerative colitis (UC)?

Intestional & Rectal Dx

A

Affects the COLON & RECTUM

43
Q

Signs & Symptoms of Ulcerative Colitis

Intestional & Rectal Disorders - KNOW THIS!!!

A

Urgent / frequent need to have BMs
Loss of weight due to constant diarrhea, low RBCs (anemia)
Cramps in abdomen
Electrolyte imbalances, Elevated temperature
Rectal bleeding
Severe diarrhea (pus, blood, mucous)

ULCERS

Urgent BMS
Weight Loss & Low RBCs (anemia)
Cramps
Electrolyte imbalance & elevated temp
Rectal bleeding
Severe diarrhea

44
Q

What are the difference in symptoms for UC & Crohn’s Disease?

Intestional & Rectal Dx - KNOW THIS!!!

A

UC: Electrolyte imbalances, elevated temperature, rectal bleeding, low RBCs (anemia)

  • *Crohn’s Disease: ulcers, anal fissures, loss of appetite, abdominal bloating
45
Q

Nursing Interventions for Crohn’s

Intestional & Rectal Disorders - KNOW THIS!!!

A
  • Smoking cessation
  • Monitor weight,
  • Monitor GI system (BMs, pain /bloating, frequency of BMs, ostomy care, administer TPN, calculate I&Os, record frequency/characteristic & amount of stools)
  • May be NPO w/ IV hydration
  • Importance of regular colon screening
46
Q

Signs & Symptoms of Toxic Megacolon

Intestional & Rectal Disorders - KNOW THIS!!!

A
  • abdominal distention
  • fever
  • diarrhea
  • abdominal pain
  • dehydration
  • tachycardia
  • hypoactive or absent bowel sounds
47
Q

Diets to Avoid during Flare Ups of Crohn’s or UC

Intestional & Rectal Dx - KNOW THIS!!!

A
  • High-Fiber Foods (require a lot of digestion & gut needs to rest)
  • Food hard to digest like nuts, raw veggies or fruit, etc.
  • Allergen type foods: dairy, wheat, fish, etc.
  • Avoid spicy foods
  • Avoid high-fat foods
  • Avoid gluten
  • Avoid gas causing foods
48
Q

A patient with Crohn’s disease has been experiencing 20 watery stools per day. What is the nurse’s priority assessment?

a.) Heart rate
b.) Blood pressure
c.) Electrolytes
d.) Urinary output

Intestional & Rectal Dx

A

C.) Electrolytes

49
Q

Nursing Interventions for TPN

Intestional & Rectal Dx - KNOW THIS!!!

A

Maintain Optimal Nutriton
* Daily weight at same time of day
* Accurate I&O
* Caloric count
* Trace elements included in solution

Preventing Infection
* Appropriate catheter & IV site care
* Strict sterile technique for dressing changes
* Wear mask when changing dressing
* Assess insertion site
* Assess for indicators of infection
* Proper IV & tubing care

Maintaining Fluid Balance
* Use infusion pump! (flow rate should not be increased or decreased rapidly. If fluid runs out, hang 10% dextrose solution)
* Monitor indicators of fluid balance & electrolyte levels
* I&O
* Weights
* Monitor blood glucose

50
Q

What does the superior laryngeal nerve effect?

Oral & Esophageal Dx

A

SWALLOWING
* can lead to aspiration

51
Q

Risk factors for oral cancer

Early & Late Stage Symptoms of Oral Cancer

Oral & Esophageal Disorders - KNOW THIS!!!

A

Risk Factors: EtOH use, tobacco use, men, 40+ years old, African Americans

Early Stage:
* painless sore or mass that won’t heal

Late Stage
* tenderness
* difficulty chewing, swallowing, speaking
* coughing up blood-tinged sputum
* enlarged cervical lymph nodes

52
Q

Early symptoms of Oral Cancer

Oral & Esophageal Disorders - KNOW THIS!!!

A

Few to no symptoms
* painless sore or mass that does NOT heal
* indurated ulcer with raised edges
* May bleed easily & present with red or white patch

53
Q

What are signs / symptoms of later stage oral cancer?

Oral & Esophageal Dx

A
  • Tenderness
  • Difficulty swallowing, chewing, or speaking
  • Coughing up blood-tinged sputum
  • Enlarged cervical lymph nodes
54
Q

What is dysphagia?

Oral & Esophageal Dx

A

difficulty swallowing

55
Q

What is achalasia (motility disorders)?

Oral & Esophageal Dx

A

stricture at the base of the esophagus causing a decrease in peristalsis

56
Q

What signs & symptoms are usually present with esopahgeal cancer?

Oral & Esophageal Disorders - KNOW THIS!!!

A
  • Dysphagia
  • Sensation of mass in the throat
  • Regurgitation
57
Q

Risk factors for esophageal cancer

Oral & Esophageal Disorders - KNOW THIS!!!

A
  • GERD
  • EtOH use
  • Tobacco use
58
Q

What should you always be concerned about for patients undergoing a partial or radical neck dissection?

Oral & Esophageal Dx

A

AIRWAY

59
Q

What is GERD?

Oral & Esophageal Disorders - KNOW THIS!!!

A

Backflow of gastric contents into the esophagus

60
Q

Management of GERD

Oral & Esophageal Dx - KNOW THIS!!!

A
  • eat 4 - 6 small meals per day
  • avoid coffee, tea, & chocolate
  • avoid snacking before meals
  • avoid fluids during meals (causes peristalsis to occur quickly & we want perstalsis to occur slowly so that food can digest)

MEDICATIONS
* Antacids
* H2 receptor antagonists
* Prokinetic agents
* PPIs (first line)
* Reflux inhibitors
* Surface agents / alginate-based barriers
* Inhibitors of transient lower esophageal sphincter relaxations (TLESRs)

61
Q

What is GERD? What are risk factors? What should the patient’s diet be? What medicaitons can be given for GERD?

Oral & Esophageal Disorders - KNOW THIS!!!

A

backflow of gastric contents into the esophagus

Risk Factors: older age, beret’s esophagus, angina, EtOH, H. pylori, tobbacco

Diet:
* Avoid caffeine, EtOH, beer, soda, etc.
* Eat 4 - 6 small meals per day
* No meals or fluids 2 hours before bed

MEDS:
* Antacids
* H2 blockers
* PPIs
* Prokinetics (reglan) - not for long-term use

Adult Nursing II - Exam 1 (6 decks)

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