Term
| What do stool studies evaluate? |
|
Definition
- Function and integrity of the GI tract
- Detect the presence of infections, protozoa, parasites, and blood in the stool |
|
|
Term
| What is the priority care after a patient has an upper endoscopy examination? |
|
Definition
| Check for the return of the gag reflex before offering fluid or food, to avoid aspiration |
|
|
Term
| What should you asses for in patients who have endoscopies? |
|
Definition
-Bleeding
-Fever
-Severe pain |
|
|
Term
| What should you check for in patients who have just had a colonoscopy? |
|
Definition
| Passage of flatus before allowing fluids or food |
|
|
Term
| Why does Gastroesophageal Reflux Disease (GERD) occur? |
|
Definition
| As a result of reflux, or backward flow, of gastrointestinal contents in to the esophagus |
|
|
Term
| What are symptoms of GERD? |
|
Definition
-Dyspepsia
-Belching
-Flatulence
-Difficult or painful swallowing |
|
|
Term
|
Definition
| Protrusion of a portion of the stomach through the esophageal hiatus of the diaphragm into the chest |
|
|
Term
| What are the symptoms of a hiatal hernia? |
|
Definition
| Most patients are asymptomatic, but some have daily symptoms similar to those with GERD |
|
|
Term
| What are some key points to remember when caring for patients with esophageal disorders? |
|
Definition
-Remain with dysphagic pt. during meals to prevent/assist with choking episodes
-Teach oral exercises and correct positioning aimed at improving swallowing
-Elevate head of bed by 6 in. when sleeping to prevent nighttime reflux
-Instruct patient to sleep in right side-lying position to minimize the effects of nighttime episodes of reflux |
|
|
Term
| What are the most common stomach disorders? |
|
Definition
-Gastritis
-Peptic ulcer disease
-Gastric cancer |
|
|
Term
|
Definition
| Inflammation of the gastric mucosa |
|
|
Term
| What can cause acute gastritis? |
|
Definition
| Inflammation of the gastric mucosa or submucosa after exposure to local irritants or other cause |
|
|
Term
| What is the most common bacterial cause of gastritis? |
|
Definition
|
|
Term
| What are the symptoms of acute gastritis? |
|
Definition
| Mild to severe epigastric discomfort, anorexia, cramping, nausea and vomiting, abdominal tenderness and bloating, hematemesis, or melena |
|
|
Term
| What are the symptoms of chronic gastritis? |
|
Definition
| Few symptoms unless ulceration occurs |
|
|
Term
| What is the gold standard diagnostic tool for gastritis? |
|
Definition
| Esophagogastroduodenoscopy via an endoscope with biopsy |
|
|
Term
| What is priority management for gastritis? |
|
Definition
-Supportive care for relieving symptoms (acute gastritis healing is spontaneous, usually occurring within a few days)
-Removing cause of discomfort |
|
|
Term
|
Definition
| Mucosal lesion of the stomach or duoenum |
|
|
Term
| What are 3 types of ulcers? |
|
Definition
-Gastric ulcers
-Duodenal ulcers
-Stress ulcers |
|
|
Term
| What causes peptic ulcer disease? |
|
Definition
| Results when mucosal defenses become impaired and no longer protect the epithelium from the effects of acid and pepsin |
|
|
Term
| What are the complications associated with peptic ulcer disease? |
|
Definition
-Hemorrhage
-Perforation
-Pyloric obstruction
-Intractable disease |
|
|
Term
| What are the signs of perforation of a peptic ulcer into the peritoneal cavity? |
|
Definition
| The patient has a rigid, boardlike abdomen accompanied by rebound tenderness |
|
|
Term
| What are the primary goals of drug therapy for peptic ulcers? |
|
Definition
1. Provide pain relief
2. Eliminate H. pylori infection
3. Heal ulcerations
4. Prevent recurrence |
|
|
Term
| What is important to know if a patient has an active GI bleed? |
|
Definition
| This is a life-threatening emergency and requires supportive therapy to prevent hypovolemic shock and possible death |
|
|
Term
| What are 3 general guidelines to keep in mind when caring for patients with stomach disorders? |
|
Definition
1. Identify patients at risk for gastritis and peptic ulcer disease, especially older adults who take large amounts of NSAIDs and those with H. Pylori
2. Teach patients with abnormal symptoms, such as abdominal tenderness, abdominal pain that is relieved by food or pain that becomes worse 3 hours after eating, dyspepsia, melena, and/or distention to consult with physician immediately
3. For patients who have undergone a gastrectomy, collaborate with dietitian and instruct the patient regarding diet changes to avoid distention and dumping syndrome |
|
|
Term
| What is Irritable Bowel Syndrome? |
|
Definition
| A functional GI disorder characterized by chronic or recurrent diarrhea, constipation, and/or abdominal pain and bloating |
|
|
Term
|
Definition
| List the characteristic symptoms, including abdominas pain relieved by defecation or falling asleep or associated with changes in stool frequency or consistency, abdominal distension, the sensation of incomplete evacuation of stool, and presence of mucus with stool passage |
|
|
Term
| Why would a patient with IBS have a hydrogen breath test? |
|
Definition
| When small intestinal bacterial overgrowth or malabsorption of nutrients is present, excess hydrogen is produced |
|
|
Term
| What are some interventions you need to implement for a patient with IBS? |
|
Definition
-Health teaching
-Drug therapy
-Stress management |
|
|
Term
| What patient education should be included for patients with IBS? |
|
Definition
-Teach patients to avoid GI stimulants, such as caffeine, alcohol, and milk and milk products
-Teach patients to manage stress |
|
|
Term
|
Definition
| A weakness or defect in the abdominal muscle wall through which a segment of the bowel or other abdominal structure protrudes |
|
|
Term
| What is the risk for a strangulated hernia? |
|
Definition
| Can cause ischemia and bowel obstruction, requiring immediate intervention |
|
|
Term
| What is an intestinal obstruction? |
|
Definition
| Common and serious disorder caused by a variety of conditions and is associated with significant morbidity |
|
|
Term
| What should you assess in a patient with a nasogastric tube? |
|
Definition
Check every 4 hours for:
-Proper placement
-Patency
-Output |
|
|
Term
|
Definition
| An acute inflammation which occurs when the lumen of the appendix is obstructed, leading to infection as bacteria invade the wall of the appendix |
|
|
Term
| What are the causes of appendicitis? |
|
Definition
-Fecaliths
-Malignant tumors
-Worms
-Other infections |
|
|
Term
| What is the difference between the risks for slow onset and rapid onset appendicitis? |
|
Definition
-An abscess may develop in slow onset
-A rapid process may result in peritonitis |
|
|
Term
| What are the complications of peritonitis? |
|
Definition
They are all serious, some examples are:
-Gangrene
-Perforation |
|
|
Term
| What lab tests would you look for in appendicitis? |
|
Definition
| WBCs "shift to the left," and if the elevation is greater than 20,000 it may indicate a perforated appendix |
|
|
Term
| What should you do with a patient admitted for suspected or known appendicitis? |
|
Definition
| Keep them NPO to prepare for the possibility of emergency surgery and to avoid making inflammation worse. Surgery is required ASAP. |
|
|
Term
|
Definition
| A life-threatening, acute inflammation of the visceral/parietal peritoneum and endothelial lining of the abdominal cavity |
|
|
Term
| What are the cardinal signs of peritonitis? |
|
Definition
-Abdominal pain
-Tenderness |
|
|
Term
|
Definition
| An increase in frequency and water content of stools or vomiting related to infection and inflammation of the mucous membranes of the stomach and intestinal tract, usually self-limiting unless complications occur |
|
|
Term
| What should you be concerned about with a patient with gastroenteritis? |
|
Definition
| Weakness and cardiac dysrhythmias may be the result of loss of potassium from diarrhea |
|
|
Term
| What is inflammatory bowel disease? |
|
Definition
| Usually refers to disorders of the GI tract with no known etiology, such as ulcerative colitis and Crohn's disease, but may be idiopathic |
|
|
Term
| What is ulcerative colitis? |
|
Definition
| Creates a widespread inflammation of the rectum and rectosigmoid colon, associated with periodic remissions and exacerbations |
|
|
Term
| What are the symptoms of ulcerative colitis? |
|
Definition
-Patient's stool typically contains blood and mucus
-Patient's report tenesmus
-An unpleasant and urgent sensation to defecate
-Lower abdominal colicky pain |
|
|
Term
| What should you instruct the patient about activity after treatment for ulcerative colitis? |
|
Definition
| Activity is generally restricted because rest can reduce intestinal activity, provide comfort and promote healing |
|
|
Term
| What is the most definitive test for diagnosing ulcerative colitis? |
|
Definition
|
|
Term
| What should you assess for in a patient with an ileostomy? |
|
Definition
| Coping strategies and identify support systems |
|
|
Term
|
Definition
| An inflammatory disease of the small intestine, the colon, or both. It is a slowly progressive, unpredictable, and a recurrent disease with involvement of multiple regions of the intestine with normal sections in-between |
|
|
Term
| What are the signs and symptoms of Crohn's disease? |
|
Definition
-Severe diarrhea
-Malabsorption of vital nutrients
-Anemia is common
-Fistulas are common with acute periods |
|
|
Term
|
Definition
| An abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect |
|
|
Term
| What are the complications of fistulas? |
|
Definition
-Systemic infections
-Skin problems
-Malnutrition
-Fluid and electrolyte imbalances |
|
|
Term
| What are the treatments of the patients with a fistula? |
|
Definition
-Includes nutrition and electrolyte therapy
-Skin care
-Prevention of infection |
|
|
Term
|
Definition
| Pouch-like herniations of the mucosa through the muscular wall of any portion of the gut, but most commonly in the colon |
|
|
Term
| What is the difference in the food a patient with diverticulosis should eat compared with a patient with diverticulitis? |
|
Definition
| Teach patients with diverticulosis to eat a high-fiber diet; diverticulitis requires a low-fiber diet, such as avoid nuts, foods with seeds, and GI stimulants |
|
|
Term
| What is the risk associated with diverticulitis? |
|
Definition
| Can result in rupture of the diverticulum with peritonitis, pelvic abscess, bowel obstruction, fistula, persistent fever or pain, uncontrolled bleeding |
|
|
Term
|
Definition
| An extensive irreversible scarring of the liver, usually caused by a chronic reaction to hepatic inflammation and necrosis |
|
|
Term
| What are the most common causes for cirrhosis? |
|
Definition
| Alcoholic liver disease and Hep C |
|
|
Term
| What are the risks associated with hepatic cell damage? |
|
Definition
| May lead to portal hypertension, ascites, bleeding esophageal varices, coagulation defects, jaundice, portal-systemic encephalopathy with hepatic coma, hepatorenal syndrome and spontaneous bacterial peritonitis |
|
|
Term
| What should the nurse make certain is done for a patient with cirrhosis and a GI bleed? |
|
Definition
| These patients should receive antibiotics on admission to the hospital |
|
|
Term
| How long does it take for hepatitis to be considered chronic? |
|
Definition
| When liver inflammation lasts longer than several months, usually defined as 6 months |
|
|
Term
| What puts people more at risk for gallstones? |
|
Definition
-If they are female
-Obesity
-Pregnancy
-Estrogen
-Birth control pills |
|
|
Term
| What pathologies could happen as a result of acute pancreatitis? |
|
Definition
| Severe, life-threatening complications sucha s jaundice from swelling of the head of the pancreas, calculi or pancreatic pseudocyst, transient hyperglycemia from release of glucagon, left lung pleural effusions, and total destruction of the pancreas leading to type 1 diabetes |
|
|
Term
| What would the nurse be concerned about in a patient with severe pain in the mid-epigastric area or left upper quadrant? |
|
Definition
|
|
Term
| What is the priority patient care for patients with acute pancreatitis? |
|
Definition
-Relieving symptoms
-Decreasing inflammation
-Anticipating or treating complications |
|
|
Term
| What is the focus of caring for a patient with chronic pancreatitis? |
|
Definition
-Manage pain
-Assist in maintaining a sufficient nutritional intake
-Prevent recurrence |
|
|
Term
| What is an alternative way to measure a patient's nutritional status if BMI is unavailable? |
|
Definition
| Measure patient's calf circumference |
|
|
Term
| What type of patients are likely to receive total enteral nutrition using a feeding tube? |
|
Definition
-Those can eat but cannot maintain adequate nutrition intake by oral intake of food alone
-Those who have permanent neuromuscular impairment and cannot swallow
-Critically ill patients |
|
|
Term
| What are some complications related to tube feeding? |
|
Definition
-Irritation
-Sinusitis
-Tissue erosion
-Pulmonary compromis |
|
|
Term
|
Definition
| A life-threatening metabolic complication that can occur when nutrition is restarted for a patient who is in a starvation state |
|
|
Term
| How often should a nurse check gastric residual volumes for a patient on tube feeding and why? |
|
Definition
| Every 4-6 hours or per agency policy, because overfeeding is a serious problem |
|
|
Term
| Who is a candidate for bariatric surgery? |
|
Definition
-Those who have repeated failure of nonsurgical intervention
-A BMI equal to or greater than 40
-Morbid Obesity |
|
|
Term
| What are indicators of malnutrition? |
|
Definition
-Weight loss of 5% in 30 days
-Weight loss of 10% in 6 months
-BMI <18 |
|
|
Term
|
Definition
| Vasomotor symptoms that occur as a result of rapid emptying of food into Small Intestine, occurs around 30 minutes after eating; often seen with Gastric Bypass |
|
|
Term
| Dumping syndrome symptoms and treatment |
|
Definition
Symptoms:
-Vertigo
-Tachycardia
-Syncope
-Sweating
-Pallor
-Palpitations
Treaments: Small meals, low CHO |
|
|
Term
| What are Small Intestine Bowel Obstruction S&S, Diagnostic findings, and medical management? |
|
Definition
S&S:
-Colicky severe abd pain, N&V
-Absence of stool or flatus
-Late sign: fecal vomiting
Dx:
-X-ray and CT show abnormal amount of air/fluid in intestine
MM:
-Decompression with NG tube and bowel rest
-If worsens and bowel at risk for ischemia, bowel resection |
|
|
Term
| What are the S&S and Diagnostics of Large Intestine Bowel Obstruction? |
|
Definition
S&S: (slower onset than SBO)
-Constipation
-Abd distension
-Eventually fecal vomiting
DX:
-Abd X-ray
-CT reveal a distended colon |
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|
