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?