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48 Cards in this Set
- Front
- Back
Define digestion
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process by which food and drink are broken down into small parts so the body can use them to build and nourish cells and provide energy
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Functions to digestion
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break down food particles
absorb into the bloodstream eliminate undigested/unabsorbed food |
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MOUTH
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process of digestion begins
saliva contains the enzyme ptyalin which begins the digestion of starches and lubricates food |
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Problems of mouth
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stomatitis
mouth ulcers herpes/candida |
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ESOPHAGUS
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peristalsis moves food bolus to stomach
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GASTRIC
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secretions breakdown food into more absorbable components and aid in destructiojn of most ingested bacteria
gastric mucose secretes HCL acid, pepsin and intrinsic factor food mixes with stomach acid=chyme peristaltic wabves in the stomach move the chyme towards the pylorous and into duodeum |
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What are the 2 types of cells involved with digesiton
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partial cell-found in the gastric mucosa secrete HCL and intrinsic factor
Chief cells-synthesis and secrete pepsinogen |
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Assessment of UGI status
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History;pain, indigestion, sysphasia, n/v, food intolerences
psych factors-smk,etoh,stress,meds |
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what are the two symptoms of upper GI problems
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indigestion
discomfort with eating |
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LABS
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CBC/CEA
LFT trigylcerides guiac |
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Diagnostic
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abd ultrasound-NPO prior
MRI/CT upper GI/Barium swallow-contrast agent digested dx ulcers, varicies and tumors edoscopic-NPO, sedated, invasive, therapeutic to tx GI sticture spray to numb gag refles-assess gag before resume food/drink |
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Gastric Aspiration
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NG tube(can test aspirate)
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Gastric acid stimulation
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give a histamine SQ, NPO 4-6h before, stimulate the secretion of gastric acid, specimens are collected q 10-15m DX pernicious anemia, malignancy and ulcer disease
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pH probe
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NG tube tip above the esophageal sphincter, outer part gnerallye attached to recording device
DX reflux TX dilation |
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REFLUX
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TX-dilation, IV abx, NG tube, surgery depends on cause
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HIATAL HERNIA
define |
opening in diaphragm, upper stomach moves through the diaphragm into lwr esophagus
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3 types
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Axial/sliding- most common. happens sporadically happens when the pt lies down(herniation slides up)
Paraesophageal-continuous, more severe. Part of the stomach pushes up thru diaphragm end up next to esophageal junctions-CAN CAUSE stranglation and cut of blood supply MIXED- combo of the two |
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HIATAL HERNIA
etiology |
unknown
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HIATAL HERNIA
Related factors |
due to exerction/coughing/straining/increase intra abdominal pressure/over weight/injury
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HIATAL HERNIA
symptoms |
mimic heart attack, common >50, smks,over weight
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HIATAL HERNIA
diagnosis |
upper GI
CT scan |
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HIATAL HERNIA
Treatment |
severe symptoms-rq surgery
tx of choice for raesophageal lap surg-after surg no diet restrictions, resume activity in wk, avoid heavy lifting for 3 mo |
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GERD
define symptom |
incompetent lwr esophageal sphincter
most common symptom HEARTBURN |
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GERD
Treatment |
symptomatically
meds; antacids, h2 receptor antagonist (zantac) prokeninetics (reglan)proton pump inhibitors(protonix) Surgery in severe cases |
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SYMPTOMS specic to GI status
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pain, vomiting;type, location, occur any time, correlatio with food, eating relieve or worsen symptoms
anorexia, dyspepsia(vague feeling of discomfort after eating Odynophagia(pain with swallowing) Pyrosis-feeling of heart burn hematemesis-vomiting blood flatulence steatorrhea diarrhea constipation |
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Nursing diagnosis
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pain, acute
pain, chronic nutritional imbalance impaired swallowing risk for aspiration |
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ACHALASIS
define s/s dx tx |
motor disorder of distal eso. movement lost at distal part of peristalsis
s/s difficulty swallowing, regurge, vomiting dx-barium swallow tx-augmentin |
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USES OF NG TUBE
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decompression
lavage dx og GI disorders,ulcers or motility disorders med administration nutritional support treatments |
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Enteral feedings
4 types |
commercially prepared
modular disease specific elemental formulas |
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Complication of NG feeding
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Dumping syndrome-rapid gastric emptying of undigested food
aspiration dehydration azotemia (excessive urea in the blood |
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PUD
define/etiology |
caused by h.pylori, which neutilizes acid
promotes ulcer development thru weakening of stomach mucosa |
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PUD
dx of h pylori |
blood, breatth, stool or tissue test.
most common way is blood test |
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how are Peptic ulcers classified?
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according to location
gastric duodenal esophageal |
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What type is the most common
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duodenal ulcers
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Predisposing factors for PUD
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familial
blood type O smk etoh meds diet habits |
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PUD
symptoms |
pain(dull mid epigastric, burning, gnawing)occurs after meal and more food relieves
black tarry stool |
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PUD
DX |
labs
endoscopy UGI |
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PUD
Treatment |
stress reduction
smk cess dietary modifications medications |
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PUD
Complications |
hemorrhage-most common
scleral therapy perforation obstructions |
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what is ZES
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severe form of PUD where a tumor produces excessive amts of gastrin
Diarrhea predominant symptoms results in multiple ulcers TX-proton pump inhib, h2 recp |
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Stress ulcers
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occurs after a physiologically stressful event(trauma, sepsis etc..)
ischemia leads to casoconstrictive action that disrupts gastric mucosa asymptomatic unless vomiting blood, stool changes |
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PROTON PUMP INHIBITORS
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suppress final step in gastric acid production
stops mechanism that pumps acid into stomach PROTONIX< PRILOSEC |
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H2 RECEPTOR ANTAGonsist
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block the action inhibiting gastci acid secretion, prevent the production of acid within the parietal cells
TAGAMENT |
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ANTICHOLINERGICS
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decre gastic secretions and decrease spasms of sm muscle
monitor for tachycardia and urinary retention BELLADONNA |
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CYTOPROTECTIVE AGENTS
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stengthen mucosal lining against attacks of acid secretions
PEPTO BISMAL |
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ANTACIDS
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neutrilize acids in stomach MAALOX, MYLANTA(mg agents-produce lax effects
AMPHOJEL aluminum agent produce constipation some containg lots of NA some are combo |
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DRUGS THAT SHOULD NOT BE GIVEN WITH ANTACIDS
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digonxin, tetracycline, dilantin, depakote
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How long does it take for most ulcers to heal
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6-8wks
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