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48 Cards in this Set

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Define digestion
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
Functions to digestion
break down food particles
absorb into the bloodstream
eliminate undigested/unabsorbed food
MOUTH
process of digestion begins
saliva contains the enzyme ptyalin which begins the digestion of starches and lubricates food
Problems of mouth
stomatitis
mouth ulcers
herpes/candida
ESOPHAGUS
peristalsis moves food bolus to stomach
GASTRIC
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
What are the 2 types of cells involved with digesiton
partial cell-found in the gastric mucosa secrete HCL and intrinsic factor
Chief cells-synthesis and secrete pepsinogen
Assessment of UGI status
History;pain, indigestion, sysphasia, n/v, food intolerences
psych factors-smk,etoh,stress,meds
what are the two symptoms of upper GI problems
indigestion
discomfort with eating
LABS
CBC/CEA
LFT
trigylcerides
guiac
Diagnostic
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
Gastric Aspiration
NG tube(can test aspirate)
Gastric acid stimulation
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
pH probe
NG tube tip above the esophageal sphincter, outer part gnerallye attached to recording device
DX reflux
TX dilation
REFLUX
TX-dilation, IV abx, NG tube, surgery depends on cause
HIATAL HERNIA
define
opening in diaphragm, upper stomach moves through the diaphragm into lwr esophagus
3 types
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
HIATAL HERNIA
etiology
unknown
HIATAL HERNIA
Related factors
due to exerction/coughing/straining/increase intra abdominal pressure/over weight/injury
HIATAL HERNIA
symptoms
mimic heart attack, common >50, smks,over weight
HIATAL HERNIA
diagnosis
upper GI
CT scan
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
GERD
define
symptom
incompetent lwr esophageal sphincter
most common symptom HEARTBURN
GERD
Treatment
symptomatically
meds; antacids, h2 receptor antagonist (zantac) prokeninetics (reglan)proton pump inhibitors(protonix)
Surgery in severe cases
SYMPTOMS specic to GI status
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
Nursing diagnosis
pain, acute
pain, chronic
nutritional imbalance
impaired swallowing
risk for aspiration
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
USES OF NG TUBE
decompression
lavage
dx og GI disorders,ulcers or motility disorders
med administration
nutritional support
treatments
Enteral feedings
4 types
commercially prepared
modular
disease specific
elemental formulas
Complication of NG feeding
Dumping syndrome-rapid gastric emptying of undigested food
aspiration
dehydration
azotemia (excessive urea in the blood
PUD
define/etiology
caused by h.pylori, which neutilizes acid
promotes ulcer development thru weakening of stomach mucosa
PUD
dx of h pylori
blood, breatth, stool or tissue test.
most common way is blood test
how are Peptic ulcers classified?
according to location
gastric
duodenal
esophageal
What type is the most common
duodenal ulcers
Predisposing factors for PUD
familial
blood type O
smk
etoh
meds
diet habits
PUD
symptoms
pain(dull mid epigastric, burning, gnawing)occurs after meal and more food relieves
black tarry stool
PUD
DX
labs
endoscopy
UGI
PUD
Treatment
stress reduction
smk cess
dietary modifications
medications
PUD
Complications
hemorrhage-most common
scleral therapy
perforation
obstructions
what is ZES
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
Stress ulcers
occurs after a physiologically stressful event(trauma, sepsis etc..)
ischemia leads to casoconstrictive action that disrupts gastric mucosa
asymptomatic unless vomiting blood, stool changes
PROTON PUMP INHIBITORS
suppress final step in gastric acid production
stops mechanism that pumps acid into stomach
PROTONIX< PRILOSEC
H2 RECEPTOR ANTAGonsist
block the action inhibiting gastci acid secretion, prevent the production of acid within the parietal cells
TAGAMENT
ANTICHOLINERGICS
decre gastic secretions and decrease spasms of sm muscle
monitor for tachycardia and urinary retention
BELLADONNA
CYTOPROTECTIVE AGENTS
stengthen mucosal lining against attacks of acid secretions
PEPTO BISMAL
ANTACIDS
neutrilize acids in stomach MAALOX, MYLANTA(mg agents-produce lax effects
AMPHOJEL aluminum agent produce constipation
some containg lots of NA
some are combo
DRUGS THAT SHOULD NOT BE GIVEN WITH ANTACIDS
digonxin, tetracycline, dilantin, depakote
How long does it take for most ulcers to heal
6-8wks