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85 Cards in this Set
- Front
- Back
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When does vomiting occur? |
If the GI tract is excited, irritated, or distended |
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What is a concern with vomiting & the older adult? |
Pulmonary aspiration is a concern for the elderly or patients who are unconscious because they lack the gag reflux |
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What are drugs that control nausea & vomiting? |
-antimuscarinics -antihistamines -phenothiazines |
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What is the patient at risk for if they have had severe or prolonged vomiting? |
-dehydration -acid base & electrolyte imbalances |
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What would we administer someone with dehydration/ |
-IV fluid therapy -glucose & electrolyte replacement untill oral intake is tolerated |
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What happens when a person is vomiting |
-closure of the pylorus -deep inspiration of the diaphram -closure of the pylorus -relaxation of the stomach & LES -contraction of abdominal muscles with increasing pressure |
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What can dehydration and water & electrolyte loss lead to? |
-circulatory failure (hypokalemia-->concerning) |
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S&S N&V |
-dehydration -water & electrolyte loss -metabolic acidosis -pallor -poor skin turgor -lethargic -dry mucous membranes -decreased output |
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Symptoms associated with vomiting? |
-diaphoresis -tachycardia -tachypnea |
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Who is most susceptible to oral infections? |
-patient who is immunosurpressed -ex: chemo patient -also people who are on oral corticosteroid treatment for asthma (candiasis) |
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What is the most common type or oral cancer? |
-squamous cell carcinoma |
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Common manifestations accompanied with oral cancer |
-leukoplakia -erythroplakia -ulcerations -soar that bleeds easily & doesnt heal -rough area felt with the tongue |
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Goals of a patient with oral carcinoma |
-patent airway -be able to communicate -adequate nutrition (promote would healing) -relief of pain & discomfort
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Most common site for oral cancer? |
Lower lip |
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Can we use an NG tube on someone who has nausea & vomiting |
Yes |
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Is leukoplakia cancerous or pre cancerous |
precancerous |
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Is erythroplakia cancerous or pre cancerous? |
-cancerous (red spots, red alert) |
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What symptoms may accompany oral cancer? |
-increased salivation -slurred speech -dysphagia -toothache/earache -foul breath -weight loss -self esteem-->disfiguring |
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What is GERD? |
reflux of acidic contents into the esophagous |
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Predisposing conditions associated with GERD |
-hiatal hernia -incompetent LES -decreased esophageal clearance -decreased gastric emptying |
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Complication of GERD |
-barretts esophagus (precancerous lesion) |
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Foods that decrease LES pressure |
-chocolat, tea, peppermint, coffee (AVOID) |
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Drug therapy for GERD |
-antacids -PPI -H2 receptors |
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Treatment of GERD- |
-lifestyle modification -medications -if these therapies dont work-->surgery |
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Sliding Hernia |
-part of the stomach slides through the hiatal opening, thoracic cavity
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paraesophageal hernia (rolling) |
-esophagus remains in the normal position, fundus & greater curvature of stomach roll up through the diaphragm |
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Predisposing factors to hiatal hernia |
-increased intrabdominal pressure -obesity -pregnancy -ascites -tumors -tight corsets -intense physical exertion -heavy lifting -forced recumbent position (bed rest) |
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Complications of hiatal hernia |
-GERD -hemorrhage -stenosis |
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S&S Gerd |
-heartburn -dysphagia |
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Drug therapy Hiatal Hernia |
-antacids -antisecretory agents -H2 blockers (idines) -PPI (azole) |
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What are the two main types of esophageal cancer? |
-squamous cell carcinoma -adenocarcinoma |
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What are two important risk factors for esophageal cancer? |
-excessive alcohol intake -smoking |
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S&S esophageal cancer |
-pain -dysphagia -weight loss
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Complications of esophageal cancer |
-hemorrhage (if tumour erodes into the aorta) -esophageal perforation with fistula -obstruction of esophagus -spread to lymph system |
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Treatment for esophageal cancer |
-surgery -chemo -radiation *poor prognosis |
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What is gastritis |
breakdown of the gastric mucosal layer |
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Drugs with irritating effects on the gastric mucosa/ |
-NSAIDs -aspirin -digitalis -corticosteroids |
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S&S acute gastritis |
-anorexia -N&V -epigastric tenderness -feeling of fullness |
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Normal hgb |
120-160 |
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NI-gastritis |
-antimetics & antacids -monitor vitals-->hemorrhage
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What drugs are a major cause of upper GI bleed? |
-NSAIDs -corticosteroids -aspirin |
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Immediate physical exam of a person with upper GI bleed |
-blood pressure -rate & character pulse -peripheral perfusion & cap refill -neck vein distention -monitor vitals every 15-30 mins` |
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What is the goal of endoscopic hemostasis |
stop the bleed |
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Nursing assessment-GI bleed |
-LOC -appearance of neck veins -skin color -cap refill -abdomen checked for distension, tenderness, peristalsis |
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Upper GI bleed-esophageal origin |
-tear in the mucosa near the esophagastric junction -mallory weiss tear |
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Upper GI bleed-stomay & duodenal origin |
-peptic ulcers -H pylori |
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Upper GI bleed-cushings ulcer |
-elevated intracranial pressure -when someone has a head injury |
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Upper GI bleed-curling ulcer |
-complication from severe burns, reduced plasma, systemic diseases |
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Melana |
-black tarry stools -from upper GI (slow bleed) |
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Drug therapy-Upper GI bleed |
-absolute alcohol or epinephrine -vasopressin -antacids -H2 receptors (idine) -PPI (azole) -ocreaotide |
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What is PUD? |
-erosion of GI mucosa from digestive action of HCl & pepsin |
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What organism is found in a majority of people with PUD? |
-h. pylori |
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What plays a role in gastric ulcer development? |
-alcohol -nicotine -drugs (aspirin, NSAIDs)
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3 major complications of PUD |
-hemorrhage -perforation -gastric outlet obstruction |
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Common procedure for diagnosing PUD |
-endoscopy |
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drug therapy for PUD |
-H2 blockers (idine) -PPI (azole) -antacids -anticholinergics -cytoprotective therapy -antibiotic-->H. pylori |
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Immediate manage of a person with a perforation |
-stop spillage of gastric contents into the peritoneum cavity & restore blood volume |
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PUD in the elderly |
-pain may not be their first symptom -may be gastric bleeding, decreased hematocrit |
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Diarhea |
-increase in stool frequency & volume -increase in loosness |
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Why does diarhea happen |
-alterations in GI motility -increase fluid secretion -decreased fluid absorption - |
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What are patients receiving antibiotics at risk for? |
C-diff |
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complication of chronic constipation |
hemorrhoids |
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What may we be concerned about if bowel sounds are missing in a quadrant? |
-bowel obstruction -paralytic ileus -acute peritonitis |
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IBS |
intermittent & recurrent abd pain associated with alteration in bowel function (diarhea/constipation) |
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IBS signs & symptoms |
-abd distention -excessive flatulence -bloating -urge to defecate -urgency -sensation of incomplete evacuation |
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Appendicitis |
-occlusion of the appendiceal lumen by fecalith (accumulated feces) |
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S&S appendicitis |
-periumbilical pain -anorexia -N&V -edema, venous engorg, invasion bacteria |
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Most commun symptom of peritonitis |
abdominal pain -rebound tenderness -muscular rigidity -spasm |
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Where is ulcerative colitis usually located? |
-rectum -colon |
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WHere does crohns disease occur? |
anywhere from the mouth to the anus -mostly in the terminal ileum & colon
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Primary symptoms of ulcerative colitis |
-bloody stools -abd pain |
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Primary symptoms of crohns |
-diarrhea -colicky abdominal pain -systemic symptoms (fever) |
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Common meds used to treat inflammatory bowel disease |
-aminosalicylates -antimicrobials -corticosteroids -immunosurpressants -biological therapy |
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Nursing Priorities during an acute episode of IBD |
-hemodynamic stability -pain control -fluid & electrolyte balance -nutritional support |
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Celiac disease |
-autoimmune disease characterized by damage to the small intestinal mucosa from the ingestion of wheat, barley, rye |
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Signs of Celiac disease |
-foul smelling diarhea -steahorea -flatulence -abdominal distention -symptoms of malnutrtion |
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Lactose Deficiency |
-lactase enzyme is absent |
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symptoms of lactose intolerance |
-bloating -flatulence -crampy abd pain -diarrhea |
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What is a mechanical obstruction? |
occlusion of the lumen of the intestinal tract |
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What is a non mechanical obstruction |
-may result from neuromuscular or vascular disorder |
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Most commun cause of a non-mechanical obstruction? |
paralytic ileus (lack of intestinal peristalsis) |
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What is the gold standard for colorectal cancer screening? |
-colonscopy |
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What does post op nursing care include after an ostomy surgery? |
-stoma assessment -appropriate pouching system
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What are colonstomy irrigations used for? |
-empty the colon in order to achieve a regular bowel pattern
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What should we observe a patient for whos underwent an ileostomy? |
-fluid & electrolyte imbalance (K, Na, fluid) |
