Nurs 128 Gi

Front 1

dyspepsia, regurgitation , cough, hoarseness, hypersalivation, difficulty swallowing and painful swallowing along with chest pain are all manifestations of what esophageal problem?

Back 1

GERD

Front 2

Medication management for GERD includes:
antacids
histamine receptors
__________inhibitors
prokinetic

Back 2

protein pump inhibitors

Front 3

these are two types of _______:
sliding
rolling

Back 3

hiatal

Front 4

the _________intestines have enzymes that break down food farther

Back 4

small

Front 5

the _______ intestine is responsible for reabsorption of water, vitamins and minerals

Back 5

large

Front 6

Need good _____ supply for stimulation of movement of smooth muscle

Back 6

nerve

Front 7

THe blood supply originates in the ____ and then branches out throughout entire GI system

Back 7

Aorta

Front 8

Overuse of OTC, NSAID's and laxatives especially by the elderly may precipate chronic ____ problems

Back 8

GI

Front 9

______ produces bile salts that help to break down food

Back 9

Liver

Front 10

_________ stores bile

Back 10

gallbladder

Front 11

__________ contibutes bicarb, insulin and glucagon to the digestive process.

Back 11

pancreas

Front 12

in the ______ client- structural changes such as compromised immune system and/or GI changes can bring on GI problems

Back 12

aging

Front 13

in the aging client will see:
poor dentition, ______ circulation in the gums

Back 13

decreased

Front 14

In the aging client- will see ________ salivary secretion- difficulty breaking down food which makes them prone to choking and aspiration along with decreased taste

Back 14

decreased

Front 15

decreased motility due to loss of __________ and elasticity (things don't flow through as well) things get dry and hard.
at risk for constipation.

Back 15

intestinal wall strength

Front 16

At risk for ___________ due to:
impaction
obstruction
diverticulosis

Back 16

constipation

Front 17

constipation in the elderly is usually due to low _____ in the diet

Back 17

fiber

Front 18

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.

Back 18

HCL

Front 19

In the elderly will see decreased ____ production

Back 19

Bile

Front 20

This test is used to evaluate the esophagus, gastric and duodenal area

Back 20

Upper GI

Front 21

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.

Back 21

endoscopy

Front 22

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.

Back 22

colonscopy

Front 23

This test ________,the patient drinks liquid that helps to visualize stuctures with x-ray. Verifies and confirms symptoms. encourage fluids after test

Back 23

Barium swallow

Front 24

This test is used to visualize the lower GI

Back 24

Barium enema

Front 25

With suspected bleeding and Complete blood count will be ordered to look at the ____ and ____.

Back 25

Hgb and Hct

Front 26

_________antigen- tumor marker, glucoprotein increased levels indicate prescence of colo-rectal cancer.

Back 26

Carcinoembryonic

Front 27

With a _____ diet you will decrease irritating foods, less fat foods and less spicy foods

Back 27

Bland

Front 28

Low _____ diet when the patient has difficulty with digesting fats

Back 28

Low fat

Front 29

_____ restricted diet when sensitivity to certain substances as in celiac disease.

Back 29

Glutten

Front 30

____ Nutrition- direct delivery of nutrients into GI system.
short term- nasogastric
Long term- gastrostomy

Back 30

Enteral

Front 31

Nursing consideration with Enteral Nutrition:
Patient _______
monitor for complications
comfort measures
pt and family instructions

Back 31

Safety

Front 32

________nutrition- pts who have nonfunctional GI tracts, comatose or cannot take enteral feedings

Back 32

Parenteral

Front 33

Short term Enteral feedings _________

Back 33

nasogastric

Front 34

Long term enteral feedings:
_________

Back 34

Gastrostomy

Front 35

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

Back 35

TPN
Total parenteral nutrition

Front 36

TPN is administered IV by __________.
Lipids come in little white bottles and TPN in big bags with yellow liquid

Back 36

central venous line

Front 37

Nursing considerations with TPN:
good vascular assess, central line is ____ and good dressing changes

Back 37

patent

Front 38

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

Back 38

protein

Front 39

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

Back 39

infection

Front 40

Complications of the mouth:
________- common, like a canker sore. inflammation of the mucosa. painful bleeding at risk for infection

Back 40

Stomatitis

Front 41

Complication of the mouth:
_________ stomatitis- herpes, infections, vitamin deficiency

Back 41

primary

Front 42

Complications of the mouth:
_______ stomatits- related to virus, bacteria in immunocompromised patient

Back 42

secondary

Front 43

With a hepatic lesion the drug of choice is __________-

Back 43

acyclovir

Front 44

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

Back 44

Candidiasis

Front 45

Management of candidiasis (thrush) is with __________, soft bristled toothbrush, good oral care and warm saline rinses

Back 45

nystantin

Front 46

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.

Back 46

Leukoplakia

Front 47

Complications of the mouth-
_________- a red lesion usually found on the tongue, palate and floor of the mouth. high degree of malignancy

Back 47

Erythoplakia

Front 48

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

Back 48

squamous cell

Front 49

Types of tumors:
_________- due to sun exposure, lips most common site. asystematic, may be raised bump on lip that doesn't go away

Back 49

Basal cell carcinoma

Front 50

Interventions for tumors :
good oral care
radiation
chemotherapy
Make sure airway is clear, risk for _________.

Back 50

aspiration

Front 51

Surgical interventions- minor removal of small area of large area needs radical surgery. May need gastostomy tube or ___________.

Back 51

tracheotomy

Front 52

Disorders of the esophagus- _______at risk for cancer, neoplastic disorders, trauma.

Back 52

esophagus

Front 53

Early symptoms of disorders of the ___________ include: dysphagia (difficulty swallowing), regurgitation (c/o heartburn, food coming back up)

Back 53

esophagus

Front 54

_________- 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

Back 54

achalasia

Front 55

__________- backward flow of GI contents into esophagus. hurts, no difficulty with swallowing like seen in achalasia. (achalasia is hard to swallow)

Back 55

GERD
Gastroesophageal reflux disease

Front 56

Most important management with GERD is ______.

Back 56

diet

Front 57

with management of GERD- you want to select meds that will decrease______ secretions or reduce

Back 57

acid

Front 58

management of GERD includes use of:
_______
histamine receptor antagonists
GI stimulants
proton pump inhibitor

Back 58

antacids

Front 59

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.

Back 59

3 hours

Front 60

Foods that decrease sphincter pressure include:
_______
chocolate
alcohol

Back 60

caffeine

Front 61

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

Back 61

Nissen

Front 62

Lifestyle management for GERD includes:
sleeping with the HOB elevated, decrease caffeine intake, decrease weight and stop smoking along with avoiding _________clothing

Back 62

restrictive