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62 Cards in this Set

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dyspepsia, regurgitation , cough, hoarseness, hypersalivation, difficulty swallowing and painful swallowing along with chest pain are all manifestations of what esophageal problem?
GERD
Medication management for GERD includes:
antacids
histamine receptors
__________inhibitors
prokinetic
protein pump inhibitors
these are two types of _______:
sliding
rolling
hiatal
the _________intestines have enzymes that break down food farther
small
the _______ intestine is responsible for reabsorption of water, vitamins and minerals
large
Need good _____ supply for stimulation of movement of smooth muscle
nerve
THe blood supply originates in the ____ and then branches out throughout entire GI system
Aorta
Overuse of OTC, NSAID's and laxatives especially by the elderly may precipate chronic ____ problems
GI
______ produces bile salts that help to break down food
Liver
_________ stores bile
gallbladder
__________ contibutes bicarb, insulin and glucagon to the digestive process.
pancreas
in the ______ client- structural changes such as compromised immune system and/or GI changes can bring on GI problems
aging
in the aging client will see:
poor dentition, ______ circulation in the gums
decreased
In the aging client- will see ________ salivary secretion- difficulty breaking down food which makes them prone to choking and aspiration along with decreased taste
decreased
decreased motility due to loss of __________ and elasticity (things don't flow through as well) things get dry and hard.
at risk for constipation.
intestinal wall strength
At risk for ___________ due to:
impaction
obstruction
diverticulosis
constipation
constipation in the elderly is usually due to low _____ in the diet
fiber
decreased secretion of _____- problems with absorption of vitamin K and the fat soluble vitamins. May see anemia, need calcium to help absorb the vitamin K.
HCL
In the elderly will see decreased ____ production
Bile
This test is used to evaluate the esophagus, gastric and duodenal area
Upper GI
This test post procedure you want to make sure the you check the gag reflex before starting the patient back on liquids and food. make sure the patient can swallow by giving sips.
endoscopy
With this test- prep takes usually 24 hours, you need to clean out the intestines so that you can visualize the large intestine to confirm the diagnoses and symptoms.
colonscopy
This test ________,the patient drinks liquid that helps to visualize stuctures with x-ray. Verifies and confirms symptoms. encourage fluids after test
Barium swallow
This test is used to visualize the lower GI
Barium enema
With suspected bleeding and Complete blood count will be ordered to look at the ____ and ____.
Hgb and Hct
_________antigen- tumor marker, glucoprotein increased levels indicate prescence of colo-rectal cancer.
Carcinoembryonic
With a _____ diet you will decrease irritating foods, less fat foods and less spicy foods
Bland
Low _____ diet when the patient has difficulty with digesting fats
Low fat
_____ restricted diet when sensitivity to certain substances as in celiac disease.
Glutten
____ Nutrition- direct delivery of nutrients into GI system.
short term- nasogastric
Long term- gastrostomy
Enteral
Nursing consideration with Enteral Nutrition:
Patient _______
monitor for complications
comfort measures
pt and family instructions
Safety
________nutrition- pts who have nonfunctional GI tracts, comatose or cannot take enteral feedings
Parenteral
Short term Enteral feedings _________
nasogastric
Long term enteral feedings:
_________
Gastrostomy
hyperalimentation is a type of _______:
blood and electrolyte analysis is done prior to starting this type of nutrition so that you have a set of baseline values
TPN
Total parenteral nutrition
TPN is administered IV by __________.
Lipids come in little white bottles and TPN in big bags with yellow liquid
central venous line
Nursing considerations with TPN:
good vascular assess, central line is ____ and good dressing changes
patent
Nursing considerations with TPN:
daily weights because of increased calories
I and O
daily serum _____, electroyltes, blood glucose, liver enzymes, renal function
asepsis
Iv antibiotics- may be via their central line, check compatibility especially with lipids
protein
Problems with the oral cavity consists of the teech- being able to chew food, free of ________, sores.
Look at mucosa (upper and lower palate) tongue, gums
infection
Complications of the mouth:
________- common, like a canker sore. inflammation of the mucosa. painful bleeding at risk for infection
Stomatitis
Complication of the mouth:
_________ stomatitis- herpes, infections, vitamin deficiency
primary
Complications of the mouth:
_______ stomatits- related to virus, bacteria in immunocompromised patient
secondary
With a hepatic lesion the drug of choice is __________-
acyclovir
Complications of the mouth-
________- fungal infection, white plaque lesions on tongue, palate, pharynx. If wiped away- underlying surface is red and sore (thrush) treat with nystatin, soft bristled brush and good oral care along with warm saline rinses
Candidiasis
Management of candidiasis (thrush) is with __________, soft bristled toothbrush, good oral care and warm saline rinses
nystantin
Complications of the mouth:
Cancer/Tumor - management and risk factors very painful condition, psychosocial issues involved. airway issues. look for thick white attached patches called ________________ (usually on lips, tongue) highly malignant.
Leukoplakia
Complications of the mouth-
_________- a red lesion usually found on the tongue, palate and floor of the mouth. high degree of malignancy
Erythoplakia
Types of tumors:
__________ most common type. progresses very slowly. early symptoms are red, raised eroded areas, sore painful, burn, may see some cervical node enlargement
squamous cell
Types of tumors:
_________- due to sun exposure, lips most common site. asystematic, may be raised bump on lip that doesn't go away
Basal cell carcinoma
Interventions for tumors :
good oral care
radiation
chemotherapy
Make sure airway is clear, risk for _________.
aspiration
Surgical interventions- minor removal of small area of large area needs radical surgery. May need gastostomy tube or ___________.
tracheotomy
Disorders of the esophagus- _______at risk for cancer, neoplastic disorders, trauma.
esophagus
Early symptoms of disorders of the ___________ include: dysphagia (difficulty swallowing), regurgitation (c/o heartburn, food coming back up)
esophagus
_________- more severe, where there's a problem with the lower esophageal sphincter (LES).
sphincter is not preventing gastric secretion from coming back up the esophagus.
not common, seen more in younger group. problems with swallowing with progressive painful swallowing, decreased weight, and c/o chest pain
achalasia
__________- backward flow of GI contents into esophagus. hurts, no difficulty with swallowing like seen in achalasia. (achalasia is hard to swallow)
GERD
Gastroesophageal reflux disease
Most important management with GERD is ______.
diet
with management of GERD- you want to select meds that will decrease______ secretions or reduce
acid
management of GERD includes use of:
_______
histamine receptor antagonists
GI stimulants
proton pump inhibitor
antacids
Mangement of GERD- nutrition- small frequent feedings, no carbonated beverages, no food ____ hours before bedtime, elevate HOB, eat slow and chew food well. Eliminate foods that decrease sphincter pressure.
3 hours
Foods that decrease sphincter pressure include:
_______
chocolate
alcohol
caffeine
Surgical management for GERD includes the ____ procedure- wrap part of the stomach (fundus) around esophagus and make a new valve, only used if meds and nutrition interventions fail
Nissen
Lifestyle management for GERD includes:
sleeping with the HOB elevated, decrease caffeine intake, decrease weight and stop smoking along with avoiding _________clothing
restrictive