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level: Level 1

Questions and Answers List

level questions: Level 1

QuestionAnswer
Drugs used for GI conditions, such as HEARTBURN, ACID INDIGESTION, GERD, and PEPTIC ULCERSAntacids-calcium carbonate/Tums. Antiulcer- sucralfate, PPI's- omepRAZOLE. Histamine Antagonists- Pepcid/ famotidine
Drugs used particularly for PROPHYLACTIC TREATMENT GI conditionsHistamine H2 Antagonists (famotidine/PEPCID)- "Prophylactic Pepcid"
Drugs used for GI conditions associated with H. PYLORIProton pump inhibitors (drugs that end in PRAZOLE, such as omeprazole and pantoprazole)- "Proton pumpazoles. Pylori"
Nursing Provisions following Percutaneous liver biopsyPatient 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
Tests used to identify stones and tumors in the gallbladder, but has been widely outdated by the gallbladder ultrasound. Requires use of oral DYE TABS and a FATTY TEST MEAL to view path of digested content. Patients should avoid smoking, eating, or chewing gum, AND ANYTHING THAT COULD EFFECT GASTRIC MOTILITYCholecystography/gram.
Test that has replaced cholecystography and requires patient to be NPO 6 hours prior. Usually requires ingestion of FATTY TEST DRINK. NO smoking, drinking through a straw, or anything that cause AIR TO FILL GI TRACTGallbladder ultrasound
Antiulcerative drug that should be given 1.5 hours before meals to form a protective layer over the GI tract before digestion of foodSucralfate
Antacid that creates a risk for hypercalcemia (should not be given to hypercalcemic patients)Calcium Carbonate/TUMS
Drugs used to treat nausea and vomitingAntiemetics (Dramamine and Meclizine also used for motion sickness), ZOFRAN
Drugs useful for patients with IRRITABLE BOWEL SYNDROME (IBS); slow hypermotility of GI tractAntispasmodics (Bentyl/dicyclomine)
Behind the ear PATCH that helps treat nausea and vomiting (anti-emetic), particularly in critically ill or end of life patients,Scopalamine
Extrapyramidal side-effects that should be monitored for in patients taking ReglanPseudo 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.
Considered safest laxative; usually a powder that must be mixed with water or juiceMetamucil
Laxatives that are commonly used for pre-op bowel prepPolyethylene glycol-electrolyte/GoLytely (most often used) and Magnesium Citrate (sometimes used)
Normal side-effects related to bowel-prep electrolyte solutionsSlight 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 diarrheaAntidiarrheals, 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 duodenumERCP (Endoscopic retrograde cholangiopancreatography)- this is a type of cholangiography that is used for visualization purposes.
Nursing Interventions Post Endoscopic procedures- particularly EDGMonitor 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 suctioningTo 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 GERDepigastric pain or discomfort (dyspepsia), BURNING of the throat/esophagus, and regurgitation. May also include trouble swallowing (dysphagia), and painful swallowing
Infection commonly associated with chronic gastritis and peptic ulcer diseaseH. pylori
Assessment findings commonly associated with gastritiseipgastric (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 gastritisavoidance 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
Risk factors for the development of Peptic ulcer diseaseH.PYLORI, smoking, stress, and NSAIDS (ibuprofen)
Assessment findings associated with peptic ulcer diseaseBURNING DISCOMFORT in upper abdomen (dyspepsia), Bloody emesis (hematemesis), dark tarry stools (melena), back pain
Medical treatment for peptic ulcer diseaseSclerotherapy (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 diseasePERFORATION 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 surgeryBleeding, blood clots, bowel obstruction, DUMPING SYNDROME, diarrhea, nausea, and vomiting.
Long term goals for bariatric surgeryResolution of chronic health problems, such as DM 2, sleep apnea, hypertension, and high cholesterol
Client and family teaching for gastric bypass surgery5-6 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 bleedingHematemesis (bloody vomit), melena (dark tarry stool)
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 ulcersUpper GI SERIES. barium swallow detects swallowing abnormalities and does not extend beyond visualization of esophagus
Location and purpose of cardiac sphincterBetween esophagus and stomach. Opens to allow digested content into the stomach.
Location and purpose of pyloric sphincterBetween stomach and duodenum. Opens for CHYME to leave the stomach and enter duodenum
GI structure that functions to absorb nutrients from CHYMESmall intestine (duodenum, jejunum, and ileum)
GI structure that receives waste and functions to absorbs water, some electrolytes, vitamin K, bile acidsLarge intestine
Liver functionsForms/releases BILE; processes vitamins, proteins, fats, carbs; stores glycogen; DRUG METABOLISM; forms ANTIBODIES & gamma-globulin
Common causes of GI tract perforationappendicitis, diverticulitis, PEPTIC ULCER, or ulcerative colitis
Common causes of gastritisH. PYLORI. overeating, alcohol abuse, meds (ASA, steroids), smoking
Treatment for gastric toxicityEMERGENCY: gastric lavage via gastric suctioning (irrigation and aspiration of stomach content) or activated charcoal
Treatment for gastritisBland food- liquid or soft diet. IV fluids, antiemetics. Antibiotics when H. Pylori is present.
Conditions commonly associated with H. Pylori bacterial infectionchronic gastritis and peptic ulcer disease
Risk factors for development Hiatal herniapregnancy, HEAVY LIFTING, weak diaphragm, OBESITY
Signs and Symptoms of hiatal herniaBELCHING, REGURGITATION, heartburn, throat irritation
Medical and surgical management of a hiatal herniaENDOSCOPIC stretching of the ESOPHAGUS
Condition Congenital or acquired esophageal wall weakness that causes food to become trapped in the esophagusEsophageal diverticulum/ Zenker’s diverticulum
Assessment findings of Zenker’s (esophageal diverticulum)BAD BREATH, dysphagia (difficulty swallowing), odynophagia (painful swallowing), belching, regurgitation, coughing
Usually caused by a weak lower esophageal sphincter resulting in regurgitation of stomach acid into the esophagus; Assessment findings include Heartburn, regurgitation, dysphagia, pain with swallowing, nausea, chest pain. ***Think issues with SWALLOWING."GERD
Function of Nasogastric salem sunction sumpDecompression (to remove gas or fluids from the stomach), particularly useful for PERITONITIS
Preparation for GI radiographyLiquid 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 prepYour prep is adequate if you're passing clear, yellow fluid without sediment.
Tests for H. Pylori infectionUREA BREATH test ( drink solution) or feces test.
Blood test that is useful to determine presence of GI bleedingCBC or complete blood count may indicate anemia associated with blood loss
Diagnostic procedure useful in determining bilirubin levelsUA
The primary causes of high bilirubin levelHepatic/Liver damage and biliary obstruction
Serum cholesterol levels greater than 200 may indicate....bile duct blockage and/ or PANCREATITIS, and/or hepatic disease
Triglyceride levels grater than 150 may indicate...pancreatitis
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 indicateHepatic diseases, biliary obstruction, or CHOLECYSTITIS,
Acid formed by the liver that activates pancreas to release digestive enzymes & alkaline fluid that neutralizes acidic contentBile
GI organ that stores bile after it is released from the liverGallbladder
Primary function of the gallbladderTo store bile
Primary functions of the PancreasAs 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 bileContains 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 GALLSTONESCholelithiasis
Most common complication of cholelithiasis; Acute or chronic inflammation of gallbladderCholecystitis
Gray/clay-colored stool =Gallbladder disease/lack up bile due to buildup in the gallbladder
Large bulky and pale colored stools may indicateundigested fat; float; oily (cystic fibrosis; gallbladder disease)
Both constipation and diarrhea may indicate...fecal impaction (normally caused by dehydration or immobility)
Condition marked by flatus, abdominal cramping, and Hyperactive bowel soundsTenesmus
bowel sounds associated with diarrhea or early bowel obstructionHyperactive bowel sounds
Signs and symptoms of constipationInfrequent BM, distended abdomen, hypoactive BS; rectal pain/bleeding-tears
IBS managementEat 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 infectionGastric suctioning for DECOMPRESSION via NG Tube insertion and SALEM SUMP. *Connect NG, SALEM SUMP, PERITONITIS."