GI know this statements- Exam 3

Peptic ulcer disease diagnostic procedures

EGD which is an esophagogastroduodenoscopy

Peptic Ulcer Disease Medications

PPI

PPI does

suppress gastric acid by inhibiting enzymes that produces gastric acid

Peptic ulcer disease perforation or hemorrhage S/S

Excessive blood loss leading to Hypotension, Hypovolemia, Dizziness, RIGID ABDOMEN and PAIN,

Bowel Obstruction sounds

absent bowel sounds

Ulcerative colitis affects which lining

superficial layers of the large intestine

Ulcerative colitis lab values of hematocrit and hemoglobin

both decrease

Ulcerative colitis lab values for electrolytes

all decrease. K, Na, Mg, Ca, CLl

Gastroesophageal reflux disease (GERD) What do we need to rule out if there is this radiating type of pain in neck, jaw, back?

Myocardial Infarction or other Cardiac problems.

Gastroesophageal reflux disease (GERD) What other finding goes along with throat irritation?

Hoarseness or voice changes, chronic cough, difficulty swallowing. 

Gastroesophageal reflux disease (GERD) PPI

New-onset nausea, vomiting, abdominal pain, flatulence, gas, or constipation, headaches, mild dizziness, itching and mild rash. 

Gastroesophageal reflux disease (GERD) trigger foods

High-fat and Fried food, Acidic foods, spicy foods, minty/peppermit foods, Alcohol and Carbonated Beverages.

Gerd diet

maintain a soft diet for 1 week following procedure. Avoid foods that cause reflux (caffeinated beverage), avoid large meals, remain upright after eating

Gerd complications

Aspiration of gastric secretion

Peptic Ulcer Disease (PUD) diagnostic procedures

EGD, Gastrointestinal Diagnostic procedure, provides definitive diagnosis of peptic ulcer. Can be repeated to evaluate effectiveness of treatment

Gastroparesis manage for constipation

increase fluids and fiber, give meds as needed

Gastroparesis to relieve some of the pain

meds or ng tube

Diverticulitis exercise

regular exercise

Diverticulitis diet

Liquid or soft diet until it resolved in the active phase. The nonactive phase gives high fiber and staying hydrated.

Diverticulitis complications

 Blockage, bleeding, perforation 

Irritable Bowel Syndrome teaching with constipation

increase fiber, drink 2-3L, regular exercise, bowel training, limit foods that can worsen constipation, stool softeners

Irritable Bowel Syndrome diarrhea teaching

increase fluid, eat small fequent meals, bland foods, avoid food triggers

Irritable Bowel Syndrome diet modifications

eat regular meals, increase water, avoid caffeine and carbonation, high fat and freid foods, avoid gas and bloating foods

Irritable Bowel Syndrome prevent dehydration water levels

2-3L

Irritable Bowel Syndrome track of trigger foods

keep food dairy to tract reactions to certain foods

GERD foods to avoid

caffeine, peppermint, chocolate, nitrates, citrus fruits, alcohol

GERD labs

Calcium and magnesium monitor for long term PPI. Monitor B12 and iron due to malabsorption

PPI mechanism of action

irreversibly binding to and inhibiting the hydrogen potassium ATPase pump that resides on the luminal surface of parietal cells in the stomach lining which reduces stomach acid. 

H2 blockers mechanism of action

competitive antagonist to histamine. These medications bind to H2 receptors on stomach parietal cells to shut down the cAMP enzyme pathway that triggers acid secretion in the stomach. 

PPI side effect

Gi distrubances, constipation, diarrhea, N/V. Long term- kidney damage, impair absorption of micronutrients, increase risk for infection

Gerd complication

aspiration of gastric secretions

Ulcerative Colitis patho

inflammation affects the superficial mucosa and submucosa of the colon and rectum

Ulcerative Colitis  lab testing

CBC will show anemia and infection. Electrolytes should monitor for dehydration and imbalances form diarrhea

Hiatal Hernia  risk factor

obesity

Hiatal Hernia  expected findings

Heartburn

regurgitation of food or acid

sour taste in mouth

Dysphagia

Belching

Nausea

feeling of fullness after meals

chronic cough

Hoarseness

Chest and/or epigastric pain

Pouching of an Ileostomy

Client independently empties and changes pouch

Pouching of an Ileostomy client education

wash ahnds before and after ostomy care. empty when 1/3 to 1/2 full, avoid foods that cause blockage

Foods that cause blockage in Pouching of an Ileostomy

Nuts Popcorn Celery Corn Coconut. Also foods that increase/decrease gas., popcorn, celery, corn, and coconut.

Small Bowel Obstruction (SBO) expected findings

vomiting, diarrhea in small amounts means a partial obstruction

Small Bowel Obstruction (SBO) nursing care

maintain npo status

Diverticulitis

An inflamed pouch or sac in the

colon that is the result of stool becoming

trapped

Diverticulosis

wall of intestine becomes weak

forming diverticula (small sacs or pouches) in

the colon and food can become trapped

Diverticulitis diet

high fiber

Diverticulitis nursing care

liquid or soft diet until resolved and then high fiber diet

Diverticulitis client education

2L of water

Diverticulitis complications

peritonits which is rigid abd, fever, abd pain

Paralytic ileus patho

different than an obstruction

Paralytic ileus nursing care

maintain npo, monitor stool and flatus, fluid and electrolyte status, review all meds, ambulation

Paralytic ileus meds

NS, LR, prokinetics:prucalopride, erythromycin, neostigmine, and metoclopramide, TPN: if severe

Paralytic ileus therapeutic procedures

NPO

Paralytic ileus complications

bowel obstruction

bowel obstruction s/s

abd pain/distention, inability to pass gas or have a bowel movement, fever, constipation, vomiting, diarrhea

bowel obstruction interventions

NG tube, IV fluids, anti-emetics, NPO, surgery

bowel obstruction bowel sounds

high pitched and hyperactive above obstruction, hypoactive or absent below obstruction

Ileostomy Care ostomy function

produces expected output, amount, color, consistency, no evidence of bowel obstruction or leakage; should be bright pink or red, moist/shiny, gradually reduces in size post surgery, liquid stool;

What are some assessments and interventions to be considered related to mental or social emotional well-being? For a new ostomy of any kind, this is a huge change for the patient.  

Having a patient fill out a PHQ/GAD screening form, encourage support groups, take into account the patient's home life/past depression or anxiety diagnoses, and observe non-verbal cues of the patient regarding if the patient feels comfortable touching or looking at the stoma

Additionally, what would indicate that the client has accepted this change? Think of behaviors that might indicate acceptance.

Self care (the patient is looking, touching, and wanting to become more involved with the care), returning to "normal" life activities, comfortable clothing, open communication regarding their stoma

Ileostomy Care client education changing pouch

changing the pouching system, measuring the stoma periodically, ensuring the skin barrier fits snugly around the stoma to prevent leakage)

Ileostomy Care client education skin care

clean the stoma and surrounding skin, pat the skin dry thoroughly, avoid harsh soaps, lotions or oils

Ileostomy Care client education hydration

drinking plenty of fluids, monitor urine output

Ileostomy Care client education nutrition

ear regular, balanced meals, introduce new foods regularly

Ileostomy Care client education activity and lifestyle

gradually resume normal activities, wear comfortable clothing, carry extra ostomy supplies

Ileostomy Care client education psychosical adaption

express concerns regarding body image, participate in ostomy self-care to increase confidence

Ileostomy Care client education follow up

attend all follow up apt, monitor stoma size and color

Ileostomy Care abnormal findings

consist of pale/dusky/black/blue coloring, excessive bleeding, abnormal buldging/swelling, skin breakdown, high output

Colorectal Cancer foods to eat

healthy diet plant heavy diet in fiber, whole grains, lean proteins while minimizing red meats and alcohol

Colorectal Cancer foods to reduce

alcohol and tobacco

Colorectal Cancer risk factor

age, low intake of fruits/veg/fiber

Colorectal Cancer risk factors dieseases

IBD, crohns

Colorectal Cancer expected findings

rectal pain

Colorectal Cancer diagnositc procedures

EGD, Barium Swallow, CR, MRI, CEA (carcinoembryonic antigen), Colonoscopy the sedation used is Moderate Anesthetic Care sedation (twilight), Endorectal Ultrasound 

Colorectal Cancer stoma complications

know the proper assessment of a stoma; red to beefy red, moist and slightly raised

Gastritis risk factor

NSAID use, H. pylori infection

Gastritis meds of h2

reduces stomach acid

Gastritis meds of ppi

inhibit gastric secretion of acid

Peptic Ulcers risk factor

over age 60

Peptic Ulcers diagnostic procedures

Upper gi endoscopy

complications of upper gi endoscopy

Minor bleeding or perforation (worsening chest or abdominal pain, coffee ground looking emesis,), breathing/swallowing trouble, N/V

Peptic Ulcers meds

H2 and PPI

Peptic Ulcers procedures

partial gastrectomy (Billroth II (Gastrojejunostomy)

early dumping syndrome s/s

N/V, epigastric pain w/cramping, hyperactive bowel sounds, diarrhea

late dumping syndrome s/s

hypoglycemic symptoms: Pale, cool skin, anxiety, shakiness, irritability, hunger)

Peptic ulcer complications

perforation/peritonitis

perforation/peritonitis s/s

sudden/severe abdominal pain, rigid abdomen, N/V, abdominal distention, absent bowel sounds, hypotension