Upper GI Disorders
Sepsis
Perforation from a PUD can lead to possible ___________.
Pain
Post op care for fundoplication (LNF) includes ________ Control (duh).
lower esophageal sphincter (LES)
Ring of muscles between the esophagus and the stomach. Also called cardiac sphincter. Prevents backflow of gastric contents into the esophagus.
Confusion, melena, H/H, syncope
Symptoms of an upper GI bleed include... • Acute _______________ • _____________ (dark brown/tarry stools) • bright red or coffee ground textured vomitus • Decreased ___/___ • Weak peripheral pulses • symptoms of shock (hypotension/tachycardia) • vertigo, dizziness or lightheadedness • _____________ (loss of consciousness)
X-ray
What diagnostic test may be ordered if a patient is suspected to have a perforation from PUD?
pH testing
What is the most accurate and definitive way to diagnose GERD?
EDG
What is the most accurate means of diagnosing PUD and testing a sample for H. pylori?
Serum testing
What is the most common way to diagnose PUD?
Hemorrhage
What is the most serious complication from PUD?
PPI triple therapy (1 PPI, 2 Antibiotics)
What is the pharmacologic tx for PUD?
Fatty, spicy, acidic, chocolate
What types of foods should patients try to get rid of to alleviate symptoms of GERD?
C
Which of the following is a goal in treatment for gastroesophageal reflux disease? a) repairing the sphincter b) relaxing the sphincter c) decreasing esophageal irritation d) increasing pepsin production
Barrett's esophagus
A major complication of GERD that occurs when the cells in the epithelial tissue of the esophagus are damaged by chronic acid exposure.
ABCE
A nurse is teaching patients with gastroesophageal reflux disease (GERD) about foods to avoid. Which foods would the nurse include in the teaching? (Select all that apply.) A) Chocolate B) Decaffeinated coffee C) Citrus fruits D) Peppermint E) Tomato sauce
Fluid
A patient presenting with s/s of shock needs immediate attention. The patient needs to have __________ pushes via two IVs STAT.
LNF
Abbreviation for Nissan Fundoplication
Manometry
An important diagnostic test for GERD involving determining pressure at the lower esophageal sphincter (LES).
pH testing
An important diagnostic test for GERD involving testing acidity in esophagus to determine if stomach contents are present. Can confirm a diagnosis via a 48 hour test.
EGD (esophagogastroduodenoscopy)
An important diagnostic test for GERD involving visualization of the esophageal mucosa.
Cancerous
Barrett's esophagus can eventually become _______________.
Intestine
Barrett's esophagus causes the esophageal Cells to change from normal to cells more like that of the ________________.
A
Circular muscles that act as valves to control food passage are: a) sphincters. b) gingivitis. c) esophagitis. d) strictures.
Risk for bleeding, Pain
What are the top two priority nursing diagnoses for patients with PUD?
D
Dietary management of peptic ulcer disease includes a) consuming a bland diet. b) drinking milk frequently. c) eating frequent snacks. d) avoiding alcohol and coffee.
Laparoscopically
Fundoplication is typically performed _______________________.
Cardiac
GERD can often be mistaken for ____________ pain.
Prostaglandin
Gastritis is caused by the ____________________ protective barrier in the stomach becoming breached, allowing HCl acid to injure the stomach lining.
Good diet, reduces stress
How can one reduce chances of getting gastritis?
10-14 days
How long will a patient be on PPI triple therapy to treat PUD?
Shock
If a patient has both tachycardia and hypotension, what is the concern?
Fetal, pain, rigid
If an ulcer has perforated, the patient may present as lying in the __________ lying position, have severe ________, and a __________ abdomen.
Hemorrhage, cancer
Long term inflammation of the stomach lining can cause risks for ____________________ (acute) or ___________ (chronic)
Anticholinergics, antacids, H2 Blockers, PPIs, Pepsin inhibitors, Prostaglandin E1 Analogue
Name all the GI medications you can think of
H. pylori
What bacteria is often a major cause of Peptic Ulcer Disease (PUD)?
A,B,C,D
The nurse has taught a patient about lifestyle modifications for gastroesophageal reflux disease (GERD). What statements by the patient indicate good understanding of the teaching? (Select all that apply.) A) I just joined a gym, so I hope that helps me lose weight." B) "I sure hate to give up my coffee, but I guess I have to." C) "I will eat three small meals and three small snacks a day." D) "Sitting upright and not lying down after meals will help." E) "Smoking a pipe is not a problem and I don't have to stop."
gastroesophageal reflux disease (GERD)
backflow of contents of the stomach into the esophagus, often resulting from abnormal function of the lower esophageal sphincter, causing burning pain in the esophagus
Dysphagia
difficulty swallowing
Gastritis
inflammation of the stomach or lining of the stomach
Longer
pH testing in the most definitive test for GERD, however it is not used as much as other tests because it takes ____________ amounts of time.
hiatal hernia
protrusion of a part of the stomach upward through the opening in the diaphragm, can cause GERD as well as symptoms similar to GERD.
Volvulus
twisting (or strangulation) of the bowel on itself, causing obstruction
A
A patient is scheduled to have a fundoplication. What statement by the patient indicates a need to review preoperative teaching? A) "After the operation, I can eat anything I want." B) "I will have to eat smaller, more frequent meals." C) "I will take stool softeners for several weeks." D) "This surgery may not control my symptoms."
Gas
Post op care for fundoplication (LNF) includes avoiding carbonated beverages and _______ producing foods.
Peptic Ulcer Disease (PUD)
sore on the mucous membrane of the stomach, duodenum, or any other part of the gastrointestinal system exposed to gastric juices; commonly caused by infection with Helicobacter pylori bacteria
Fundoplication
surgical procedure to treat gastroesophageal reflux disorder that tightens the lower esophageal sphincter by wrapping the gastric fundus around the lower esophagus and suturing it into place
Soft
Post op care for fundoplication (LNF) includes eating a _______ diet for a week. Patient should avoid difficult to swallow foods.
Breathing
Post op care for fundoplication (LNF) includes incentive spirometry and deep _______________.
Dysphagia
Post op care for fundoplication (LNF) includes observe early feedings; _________________ is common after the procedure.
Month
Post op care for fundoplication (LNF) includes remain on acid reflux medications for 1 _________ post op.
Hypovolemic shock
The priority when taking care of a patient with a GI bleed is to prevent ___________________ __________.
Acute
Type of gastritis that is erosive and caused commonly by stress ulcers.
B
The nurse is caring for a patient with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the patient's abdomen is tense and rigid. What action takes priority? A) Administer the prescribed pain medication. B) Notify the health care provider immediately. C) Percuss all four abdominal quadrants. D) Take and document a set of vital signs.
Probable, Account, Screen, Speech
To assess for dysphagia in a patient, think PASS; P: Is it ______________ the patient has swallowing difficulty? A: ____________ for previous swallowing problems S: ____________ for signs and symptoms S: Obtain a ___________ pathologist referral
2-3
To prevent reflux, patients with GERD should not eat ___-___ hours before bed.
HOB
To prevent reflux, patients with GERD should raise the _______ when sleeping.
B
Which of the following is a potential complication of peptic ulcer disease (PUD)? a) heartburn b) perforation c) inflammatory bowel disease d) gastritis
B
Which of the following is a sign that a person might have dysphagia? a) persistent dry mouth b) frequent throat clearing c) inflammation of the mucous membranes d) gastroesophageal reflux
Chronic
Is the following a symptom of acute or chronic gastritis?: Slow onset, vague description of pain relieved by food.
Chronic
Is the following a symptom of acute or chronic gastritis?: Treating the condition by trying to determine and treat the cause.
Acute
Is the following a symptom of acute or chronic gastritis?: Treating the conditions by primarily treating the symptoms.
C
A patient has gastroesophageal reflux disease (GERD). The provider prescribes a proton pump inhibitor. About what medication would the nurse anticipate teaching the patient? A) Famotidine B) Magnesium hydroxide (Maalox) C) Omeprazole (Prilosec) D) Ranitidine (Zantac)
Both
Is the following a symptom of acute or chronic gastritis?: Anorexia
Acute
Is the following a symptom of acute or chronic gastritis?: Dyspepsia
Acute
Is the following a symptom of acute or chronic gastritis?: Gastric hemorrhage
Acute
Is the following a symptom of acute or chronic gastritis?: Hematemesis or Melena
Chronic
Is the following a symptom of acute or chronic gastritis?: Intolerance of fatty or spicy foods
Both
Is the following a symptom of acute or chronic gastritis?: Nausea and Vomiting
Chronic
Is the following a symptom of acute or chronic gastritis?: Pernicious Anemia
Acute
Is the following a symptom of acute or chronic gastritis?: Rapid onset of epicgastric pain
ABCE
The student nurse studying stomach disorders learns that the risk factors for acute gastritis include which of the following? (Select all that apply.) A) Alcohol B) Caffeine C) corticosteroids D) Fruit juice E) Nonsteroidal anti-inflammatory medications (NSAIDs)
Sphincter, pressure
The two causes of GERD are... 1.) excessive relaxation of the lower esophageal _____________, leading to backflow of stomach contents into the esophagus 2.) increased gastric distention leading to increased ______________ in the stomach against the lower esophageal sphincter.
1-2
To prevent reflux, patients with GERD should sit upright for ___-___ hours after eating a meal.
Chronic
Type of gastritis that is patchy, diffuse, and causes inflammation.
Antacids, histamine Blockers, PPIs
What 3 main med classes are used for GERD treatment?
A,B,C,D
The nurse is aware that which factors are related to the development of gastroesophageal reflux disease (GERD)? (Select all that apply.) A) Delayed gastric emptying B) Eating large meals C) Hiatal hernia D) obesity E) Viral infections
Hemorrhage, perforation, obstruction
What are the most common complications of PUD?
GERD, hiatal hernia
What conditions can fundoplication treat?
Dehydration
What is the biggest risk/complication of acute gastritis?