Term 2: module 4: Upper GI system
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Term 2: module 4: Upper GI system - Marcador
Term 2: module 4: Upper GI system - Detalles
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| Drugs used for GI conditions, such as HEARTBURN, ACID INDIGESTION, GERD, and PEPTIC ULCERS | Antacids-calcium carbonate/Tums. Antiulcer- sucralfate, PPI's- omepRAZOLE. Histamine Antagonists- Pepcid/ famotidine |
| Drugs used particularly for PROPHYLACTIC TREATMENT GI conditions | Histamine H2 Antagonists (famotidine/PEPCID)- "Prophylactic Pepcid" |
| Drugs used for GI conditions associated with H. PYLORI | Proton pump inhibitors (drugs that end in PRAZOLE, such as omeprazole and pantoprazole)- "Proton pumpazoles. Pylori" |
| Nursing Provisions following Percutaneous liver biopsy | Patient to remain on right side (for pressure) and remain bedfast for 8-12 hours following procedure. Monitor for bleeding, swelling, and hematoma. Monitor BREATH SOUNDS. Report diminished sounds immediately |
| Nursing considerations for a Hemoccult Test (stool samples that identifies GI bleeds) | Blue ring around sample is positive for GI bleed. AVOID REDMEAT, HORSERADISH, tomatoes, beets, and cantaloupe which could cause a false positive result. AVOID VITAMIN C could cause a false negative result. Patients should AVOID ASA and NSAIDS 3 days prior to test (could cause bleeding). Samples should be COLLECTED ON 3 SEPERATE DAYS |
| Antacid that creates a risk for hypercalcemia (should not be given to hypercalcemic patients) | Calcium Carbonate/TUMS |
| Drugs used to treat nausea and vomiting | Antiemetics (Dramamine and Meclizine also used for motion sickness), ZOFRAN |
| Drugs useful for patients with IRRITABLE BOWEL SYNDROME (IBS); slow hypermotility of GI tract | Antispasmodics (Bentyl/dicyclomine) |
| Extrapyramidal side-effects that should be monitored for in patients taking Reglan | Pseudo parkinsonism (such as a shuffled gait, tremors, and stooped posture), Tardive dyskinesia ( basically weird facial movements and gestures). Patient may also be restless or have muscle spasm. |
| Laxatives that are commonly used for pre-op bowel prep | Polyethylene glycol-electrolyte/GoLytely (most often used) and Magnesium Citrate (sometimes used) |
| Normal side-effects related to bowel-prep electrolyte solutions | Slight chills, nausea, and abdominal cramping |
| Abnormal reactions to bowl-prep electrolyte solution that prompt a phone call to the Dr. | Continuous or severe vomiting and severe abdominal pain |
| Drugs that slow GI peristalsis and decrease/stops diarrhea | Antidiarrheals, such as Pepto and Imodium. Lomotil is a controlled antidiarrheal and has a more harsh effect |
| An extended version of an Esophagogastroduodenoscopy (EGD); also visualizes the pancreas and biliary ducts in addition to esophagus, stomach, and duodenum | ERCP (Endoscopic retrograde cholangiopancreatography)- this is a type of cholangiography that is used for visualization purposes. |
| Nursing Interventions Post Endoscopic procedures- particularly EDG | Monitor for return of GAG REFLUX (these tests include throat numbing spray), dyspnea, DYSPHAGIA (difficulty swallowing), pain with swallowing. ANYTHING THAT HAS TO DO WITH SWALLOWING. |
| Indications for gastric suctioning | To obtain specimen, to remove gas and toxic fluids from stomach or intestines (especially with abdominal distension), to EMPTY THE STOMACH BEFORE EMERGENCY SURGERY or after poisoning, to maintain a GI suture line |
| Symptoms commonly associated with GERD | Epigastric pain or discomfort (dyspepsia), BURNING of the throat/esophagus, and regurgitation. May also include trouble swallowing (dysphagia), and painful swallowing |
| Condition that leads to ulcer development | Prolonged gastric hyperacidity or mucus reduction |
| Assessment findings commonly associated with gastritis | Eipgastric (stomach/duodenum) fullness, pressure, pain, anorexia, nausea, and vomiting; Upper GI bleed may also be indicated by blood in emesis or dark tarry stools. |
| Treatment of chronic gastritis | Avoidance of alcohol and NSAIDS, and irritating substances such as spicy food and caffeine. Bland foods. Drug therapy (antacids, Histamine Antagonists, Proton pump inhibitors) |
| Disease marked by loss of tissue in the GI tract due to acid irritation of abdominal wall. | Peptic ulcer disease |
| A common complication of gastritis (especially chronic) | Development of ulcers |
| Risk factors for the development of Peptic ulcer disease | H.PYLORI, smoking, stress, and NSAIDS (ibuprofen) |
| Assessment findings associated with peptic ulcer disease | BURNING DISCOMFORT in upper abdomen (dyspepsia), Bloody emesis (hematemesis), dark tarry stools (melena), back pain |
| Single greatest risk factor for development of peptic ulcer disease | H.Pylori infection |
| Medical treatment for peptic ulcer disease | Sclerotherapy (for bleeding ulcers), Gastric intubation (if obstruction results) medications (proton pump inhibitors, antacids, H2 antagonists. SUCRALFATE (medication that forms a seal over the ulcer and protects from irritation). ANTIBIOTICS FOR H. PYLORI. Bland foods. ELIMINATE POPCORN, NUTS, SMALL FRESH FRUIT, caffeine, chocolate, alcohol, and smoking. |
| Serious complications of Peptic Ulcer disease | PERFORATION that can also cause hemorrhage and sepsis (when gastric acid seeps into peritoneum due to complete penetration of stomach). Inhibits production of intrinsic factor (causing malabsorption of vitamin B). Obstruction (which necessitates gastric intubation) |
| Treatment for refractory ulcers (persistent and chronic ulcers), which are commonly malignant. | Gastronomy (total removal of stomach), which requires life long B12 supplement because intrinsic factor, which is necessary for absorption is no longer produced. |
| Postoperative risks for bariatric surgery | Bleeding, blood clots, bowel obstruction, DUMPING SYNDROME, diarrhea, nausea, and vomiting. |
| Long term goals for bariatric surgery | Resolution of chronic health problems, such as DM 2, sleep apnea, hypertension, and high cholesterol |
| Client and family teaching for gastric bypass surgery | 5-6 small meals daily; Include protein, fat, and complex carbs. Chew food slowly and take time to eat. Withhold fluids with meals. avoid tough, fibrous, and overcooked meats. Don't overeat. Avoid liquid calories, such as soda and juice. |
| Signs of upper GI bleeding | Hematemesis (bloody vomit), melena (dark tarry stool) |
| Condition that may be caused by ineffective esophageal sphincter | GERD (reflux disease) |
| Fluoroscopic examination of esophagus, stomach, and upper small intestine (duodenum) to evaluate GI symptoms; utilizes BARIUM contrast; may detect abnormalities such as hiatal hernias, diverticula, strictures and ulcers | Upper GI SERIES. barium swallow detects swallowing abnormalities and does not extend beyond visualization of esophagus |
| Location and purpose of cardiac sphincter | Between esophagus and stomach. Opens to allow digested content into the stomach. |
| Location and purpose of pyloric sphincter | Between stomach and duodenum. Opens for CHYME to leave the stomach and enter duodenum |
| GI structure that functions to absorb nutrients from CHYME | Small intestine (duodenum, jejunum, and ileum) |
| GI structure that receives waste and functions to absorbs water, some electrolytes, vitamin K, bile acids | Large intestine |
| Liver functions | Forms/releases BILE; processes vitamins, proteins, fats, carbs; stores glycogen; DRUG METABOLISM; forms ANTIBODIES & gamma-globulin |
| Condition usually caused by PERFORATION OF GI tract | Peritonitis (infection and inflammation of the peritoneum/ abdominal wall) |
| Common causes of GI tract perforation | Appendicitis, diverticulitis, PEPTIC ULCER, or ulcerative colitis |
| Common causes of gastritis | H. PYLORI. overeating, alcohol abuse, meds (ASA, steroids), smoking |
| Treatment for gastric toxicity | EMERGENCY: gastric lavage via gastric suctioning (irrigation and aspiration of stomach content) or activated charcoal |
| Treatment for gastritis | Bland food- liquid or soft diet. IV fluids, antiemetics. Antibiotics when H. Pylori is present. |
| Conditions commonly associated with H. Pylori bacterial infection | Chronic gastritis and peptic ulcer disease |
| Risk factors for development Hiatal hernia | Pregnancy, HEAVY LIFTING, weak diaphragm, OBESITY |
| Signs and Symptoms of hiatal hernia | BELCHING, REGURGITATION, heartburn, throat irritation |
| Medical and surgical management of a hiatal hernia | ENDOSCOPIC stretching of the ESOPHAGUS |
| Condition Congenital or acquired esophageal wall weakness that causes food to become trapped in the esophagus | Esophageal diverticulum/ Zenker’s diverticulum |
| Assessment findings of Zenker’s (esophageal diverticulum) | BAD BREATH, dysphagia (difficulty swallowing), odynophagia (painful swallowing), belching, regurgitation, coughing |
| Function of Nasogastric salem sunction sump | Decompression (to remove gas or fluids from the stomach), particularly useful for PERITONITIS |
| Preparation for GI radiography | Liquid diets for several days before the procedure, and using enemas or cathartic drinks the day before and/or the morning of the procedure. |
| Indicates successful GI bowel prep | Your prep is adequate if you're passing clear, yellow fluid without sediment. |
| Diets for several days before the procedure, and using enemas or cathartic drinks the day before and/or the morning of the procedure. | Diets for several days before the procedure, and using enemas or cathartic drinks the day before and/or the morning of the procedure. |
| Tests for H. Pylori infection | UREA BREATH test ( drink solution) or feces test. |
| Blood test that is useful to determine presence of GI bleeding | CBC or complete blood count may indicate anemia associated with blood loss |
| The primary causes of high bilirubin level | Hepatic/Liver damage and biliary obstruction |
| Serum cholesterol levels greater than 200 may indicate.... | Bile duct blockage and/ or PANCREATITIS, and/or hepatic disease |
| Elevated ALT levels (greater than 40 u/L in males and 35/L in females) and elevated AST levels ( greater than 20 units/L for men and 36 units/L in women) may indicate | Hepatic diseases, biliary obstruction, or CHOLECYSTITIS, |
| Causes gallbladder to contract | Contraction triggered by food/especially FAT |
| Primary function of the gallbladder | To store bile |
| Primary functions of the Pancreas | As an Endocrine organ: produces hormones, INSULIN and glucagon Exocrine organ: produces protein-, fat-, and carbohydrate-digesting enzymes. Releases ALKALINE fluid to help neutralize acidic content |
| Function of bile | Contains fat-digesting enzymes (flows from gallbladder to duodenum) when food (especially fats) enters GI system. |
| Condition caused by the build up of cholesterol and calcium in the gallbladder, resulting in formation of GALLSTONES | Cholelithiasis |
| Most common complication of cholelithiasis; Acute or chronic inflammation of gallbladder | Cholecystitis |
| Gray/clay-colored stool = | Gallbladder disease/lack up bile due to buildup in the gallbladder |
| Large bulky and pale colored stools may indicate | Undigested fat; float; oily (cystic fibrosis; gallbladder disease) |
| Both constipation and diarrhea may indicate... | Fecal impaction (normally caused by dehydration or immobility) |
| Bowel sounds associated with diarrhea or early bowel obstruction | Hyperactive bowel sounds |
| Signs and symptoms of constipation | Infrequent BM, distended abdomen, hypoactive BS; rectal pain/bleeding-tears |
| IBS management | Eat small frequent meals at regular intervals Eliminate alcohol Stop smoking |
| Medical treatment for peritonitis (condition often caused by perforation, ulcer, or anything that could cause a defect in the abdominal lining). Leads to spilling of acidic content and bacteria into peritoneum, resulting in inflammation and infection | Gastric suctioning for DECOMPRESSION via NG Tube insertion and SALEM SUMP. *Connect NG, SALEM SUMP, PERITONITIS." |