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44 Cards in this Set
- Front
- Back
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What areas of the body can be involved if there is a diagnosis of Peptic ulcer?
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1. Esophagus
2. Stomach 3. Duodenum |
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What are the possible causes of damage resulting in ulcers?
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1. Increase contact with HCL acid
2. Increase contact with Pepsin 3. decrease mucosal resistance 4. Helicobacter pylori |
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What % of gastric and duodenal ulcers are caused by H. pylori?
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75% of gastric and 95% of duodenol
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What are the common SxS of peptic ulcers?
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Hemoptysis or Melena
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What is Melena?
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Blood in the stool
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If a person is considered a hypersecreter, what SxS will they have?
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Pain at night and hyperactive bowel sounds
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What are the common causes of ulcers?
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1. Stres
2. Smoking 3. Medications: ASA and NSAIDs 4. H. Pylori |
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What are the nursing assessments relating to Uclers?
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1. Pain
2. GI Hx 3. N/V 4. Night pains 5. Hematoemesis 6. Melena 7. Hyperperistalsis |
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What are the nursing diagnosis associated with Ulcers?
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1. Alt in comfort: pain
2. Alt in nutrition < body req. 3. Knowledge defecit |
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What is the preparation for an Upper GI series?
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1. NPO
2. 16 oz of chalky, liquid 3. Assume various position |
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What is used to conduct an Upper GI Series?
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radio opaque drink and then have a series of pictures and xrays down
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What must be done prior to an esophagogastroduodenoscopy (gastroscopy)?
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1. NPO
2. Consent 3. Monitor VS and O2 sat 4. IV sedation |
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What must be checked before a pt eats following a gastroscopy?
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Have gag and swallowing reflex
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List the nursing interventions for a pt with an ulcer.
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1. Assess for bleeding, perforation, obstruction
2. Check WBC, BUN 3. Diet 4. Rest 5. Stress reduction 6. No ASA, no NSAIDs 7. meds |
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Why do BUN levels rise for pts with ulcers?
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because digesting blood increases the urea levels
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What is the best sign that a patient has suffered a perforation from an ulcer?
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Board-like abdomen because of bleeding into the vacity
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List the 6 classes of drugs used to Tx ulcers.
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1. Antacids
2. Cytroprotective 3. Antipasmodic 4. Histamine 2 Antags 5. PPIs 6. H.Pylori agents |
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What is an example of a cytroprotective?
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Carafate: ulcer adherent given 1 hour prior to meals
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What is an example of an antispasmotic and what is its function?
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Banthine: used to prevent spasms: anticholingeric. Decreases HCL production and gastric mobility
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What is the number 1 choice drug for ulcers?
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PPI's: stop or prevent pumping of gastric juice itself
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List the common H2 atagonist drugs.
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Tagamet and Zantac
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What class of drugs do Prilosec and Prevacid fall under?
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PPIs
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What is a Bilroth I?
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Gastroduodenostomy
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What is a Bilroth II?
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gastrojejunostomy
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What is a vagotomy?
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removal of the branch of the vagus nerve that stimulates the GI tract
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What is the term for a total removal of the stomach?
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Gastrectomy
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Which post surgical tubing must be connected to only intermittent suction>
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Levine pump
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Describe a Salem sump.
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Runs parallel to center tube and allows air to enter the tube. Can be used with continuous suction
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Why must post op gastrectomy patients be given B12?
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They may develop pernicious anemia due to a loss of intrinsic factor
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When a person develop dumping syndrome why can they become hypoglycemic?
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Have a rapid vasomotro response to fluid in the GI tract. Get a quick spike of hyperglycemia and rapid insulin release leading to hypo.
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What is an example of a hypertonic food? What are hypotonic foods?
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Hyper: simple sugars
hypo: high protein and complex carbs |
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Describe Dumping Syndrome.
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1. Food hypertonic
2. Fluid enters the small bowel 3. Drop in volume of intravascular space 4. Vasomotor response 5. Glucose absorbed 6. Hyperglycemia 7. Rapid release of insulin 8. hypoglycemia |
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What are the early symptoms of colon cancer?
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There are none
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List the late symptoms of colon cancer.
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1. Melena
2. Pain 3. Change in bowel habits 4. Anemia 5. Anorexia/weight loss. |
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What are some ways to avoid dumping syndrome>?
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1. Eat protein and complex carbs
2. small frequent meals 3. avoid fluid with meals 4. Lay down for 30 mins after eating |
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What is the 3rd most common cause of cancer in men and women?
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Colon Cancer
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What test can be done to detect colon cancer? When should they be done?
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1. Rectal exam: yearly
2. Sigmoidoscopy: q5years 3. Colonoscopy: q 10 years 4. Lower GI series: barium enema 5. Cat scan, MRI, Ultrasound |
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What is the protocol for pre- colonoscopy ?
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1-2 days before the test have a low residue diet
-day before: drink clear fluids, NPO 8 hours prior and laxative regimen |
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What is the most common Tx for colon cancer?
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Surgery
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What drugs ca be used to reduce the flora of the GI tract preoperatively for colon cancer surgery?
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aminoglycosides
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What is the #1 post operative colonostomy nurisng goal?
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Help the patient cope with the ostomy: must get them to look at it.
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How long after placement of the ostomy does it begin to function?
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3-6 days
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What are some complications of an ostomy?
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1. Skin breakdown
2. paralytic ileus 3. bowel obstruction 4. peritonitis 5. wound infection atelectasis, pneumonia 6. pain |
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What type of ostomy encourages a low residue diet?
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Ileostomy
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