Chapter 57

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created 7 years ago by NHeck
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updated 7 years ago by NHeck
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College: Fourth year
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1

What are way you could prevent Gastritis?

Eat a well balanced diet
Avoid drinking excessive amounts of alcoholic beverages
Use caution in taking large does of asprin, NSAIDs, and corticosteroids
Avoide excessive intake of caffeine-containing beverages, such as coffee and tea
Be sure that foods and water are safe, to avoid contamination
Manage stress levels using complementary alternative therapy such as relaxation
Stop smoking
Protect yourself against toxic substances n the workplace such as lead and nickel
seek medical treatment if symptoms of GERD

2

What are the key features of acute Gastritis?

Rapid onset of epigastric pain or discomfort
Nausea and vomiting
Hematemesis (vomiting blood)
Gastric hemorrhage
dyspepsia
anorexia

3

What are the key features of chronic Gastritis?

Vague report of epigastric pain that is relieved by food
anorexia
nausea and vomiting
Intolerance of fatty and spicy foods
pernicious anemia

4

What is the purpose of a mucosal barrier fortifier?

Binds with bile acids and pepsin to protect stomach mucosa
Ex: Sucralfate
Give 1 hr before and 2 hr after meals and at bedtime
Do not give within 30 min of giving antacids or other drugs

5

What is the purpose of Prostaglandin Analogs?

Decreases gastric secretions and enhances resistance to mucosal injury when patient is taking NSAIDS
take with food
Avoid magnesium-containing antacids because both can cause diarrhea
ex: Misoprostol

6

What antimicrobial treats H. Pylori?

Clarithromycin (Biaxin) an gram negative bacterium implicated in the development of peptic ulcer disease (PUD)

7

What are key features of upper GI bleeding?

Bright red or coffee-ground vomitus (hematemesis)
Tarry stools or frank (bright red) blood in stools
Melena (occult blood-older adults)
Decreased BP
Increased weak and thready pulse
Decreased H&H
Vertigo
Acute confusion (older adults)
Dizziness, syncope

8

What is the main feature of a duodenal ulcer?

high gastric acid secretion

9

Where do gastric ulcers usually occur?

They develop in the antrum of the stomach near acid-secreting mucosa

10

What is Zollinger-Ellison Syndrome?

It is a rare disease that is manifested by upper GI tract ulceration, increased gastric acid secretion and one or more duodenal or pancreatic tumors called gastrinomas-2/3 of the time malignant

11

What are the key features of GERD?

Dyspepsia
Regurgitation (may lead to aspiration or bronchitis)
Coughing, horsesness or wheezing at night
Water brath (hypersalivation)
Dysphagia
Odynophagia (painful swallowing)
Epigastric pain
belching
flatulence
Nausea
Pyrosis (retrosternal burning)
Globus (feeling of something in back of throat)
Pharyngitis
Dental carries-late

12

What is the purpose of antacids?

Increase Ph of gastric contents by deactivating pepsin
ex: Mylanta, Maalox

13

What is the purpose of Histamine Recpetor Antagonists?

Decrease gastric secretions by blocking histamine receptors in parietal cells
ex: Rantidine, Famotidine,Nizatidine

14

What is a hiatal hernia?

protrusion of the stomach through the esophageal hiatus of the diaphram into the chest

15

What is the most important role of the nurse in caring for a patient with a hiatal hernia?

health teaching

16

What care should the nurse perform post Laparoscopic Nissen Fundoplication surgery (FNP)?

Pt is at risk for bleeding an infection so the nurse's priority is to observe for these complications and to provide health teaching

17

What is the highest priority for patients having an esophagectomy?

Respiratory care- patients on mechanical ventilation for first 16-24 hrs

18

What are the major interventions for controlling symptoms related to diverticula?

Nutrition therapy and positioning

19

What symptoms will the patient report who has esophageal diverticula?

dysphagia, regurgitation, nocturnal cough, and halitosis.

20

What is the pt who has esophageal diverticula at risk for?

perforation