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6 Cards in this Set

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esophagitis
Assessment
1. heartburn 30-60 min. after meal
2. pain worsens when lying down
Implementation
1. frequent, small meals
2. elevate head of bed 5 - 10 inches
3. no meals 3 hours prior to bedtime
4. avoid irritant food
Medications
1. antacids for occasional heartburn
2. cimetidine to reduce gastric acid secretion
Hital hernia
Assessment
1. often asymptomatic
2. heartburn
3. regurgitation of food
4. diagnosis : chest X-ray or barium swallow
Implementation
1. if asymptomatic - no treatment necessary
2. small frequent meals
3. elevate head of bed to reduce acid reflux
4. avoid activities that increase abdominal pressure
Esophageal varices
liver cirrhosis -> elevated portal vein pressure -> esophageal varilces
Assessment
1. history of alcohol abuse (liver cirrhosis)
2. hematemesis(vomiting blood)
3. melena (black, tarry stools)
signs of shock if bleeding is severe
Implementation
1. watch for hemorrhage, hypotension, sighs of shock
2. Monitor vital sighs if acute bleeding
3. Watch for sighs of hepatic encephalopathy
4. assist with Sengstaken tube
Sengstaken tube
1. monitor bleeding in gastric drainage
2. watch for sighs of asphyxiation
3. watch for tube displacement
Gastritis
Assessment
1. nausea, anorexia
2. sour taste in mouth
3. belching
4. cramping, pain
Implementation
1. watch for signs of GI bleeding (coffee-ground vomit)
2. CBC if suspected pernicious anemia
Medications
1. antacids
2. antihistamines (to reduce acid secretion)
antibiotics (to eradicate H. pylori)
treatment : monthly, lifelong IM injections of vit. B12
Peptic ulcer disease
1. gastric ulcer->normal or decreased acid production;decrease mucosal resistance; chronic NSAID use
2. duodenal ulcer->increase acid production;H.pylori;pain typically relieved by meals
Assessment
1. gnawing, burning epigastric pain
2. vomiting
GI bleeding->anemia
diagnosis - upper GI series or endoscopy/test for presence of Helicobacter pylori
Implementation
1. watch for sighs of bleeding - "coffee-ground8und" vomit tarry stools
2. avoid irritating food
3. avoid cigarette smoking
4. avoid aspirin, NSAID and steroids
Medications
1. antihistamines
2. antibiotics to eradicate H.pylori