MS45-Nursing Care Upper GI Disorders – Flashcards
Unlock all answers in this set
Unlock answersquestion
nausea
answer
the subjective feeling of the urge to vomit
question
priority to prevent aspiration
answer
protection of the airway and the use of suction
question
Nursing diagnosis r/t vomiting & nausea
answer
nausea r/t various causes, risk for aspiration and deficient fluid volume
question
anorexia
answer
lack of appetite
question
anorexia nervosa
answer
eating disorder affecting 12-18 yo
question
Early s/s of anorexia nervosa
answer
severe weight loss, low self-esteem, compulsive dieting, and altered body image.
question
bulimia nervosa
answer
compulsive eating w/self-induced vomiting
question
Nursing Diagnosis for pt. w/eating disorder
answer
Imbalanced Nutrition Disturbed Body Image
question
Obesity
answer
caloric intake that exceeds energy expenditure
question
morbid obesity
answer
BMI above 40
question
gastroplasty
answer
reducing the size of the stomach with laproscopic adjustable gastric banding and vertical banded
question
Complications of gastric restrictive surgeries
answer
erosion of the gastric tissue surrounding the band breakdown of the staple line leaking of the stomach secretions into the abdomen
question
postoperative care for gastric surgeries
answer
liquids to pureed foods, and finally at 6 weeks regular foods as tolerated
question
oral care
answer
very important throughout life, linked to cardiac health.
question
stomatitis
answer
inflammation of the oral cavity
question
aphthous stomatitis
answer
cold sores or fever blisters (canker sores and herpes simplex virus I
question
oral cancer
answer
common in those who drink alcohol or use any form of tobacco. highest incidence is in the pharynx
question
s/s of oral cancer
answer
the pt. may report difficulty swallowing, chewing or speaking
question
NC for oral cancer
answer
referrals for cessation, teaching on tracheostomy after surgery if placed,
question
#1 concern postoperatively after oral cancer surgery
answer
airway patency, then communication & nutritional needs
question
esophageal cancer
answer
r/t to alcohol and tobacco use.
question
s/s of esophageal cancer
answer
difficulty swallowing, feeling of fullness, pain in chest area after eating, foul breath, regurgitation of foods if there is an obstruction. The appearance of these s/s is the late stages of this type of cancer
question
diagnostic tests for esophageal cancer
answer
EGD(esophagogastroduodenoscopy) and biopsy
question
Therapeuatic measures for esophageal cancer
answer
radiation, chemo, and surgery. esophagectomy, esophagogastrostomy, esophagoenterostomy
question
esophagectomy
answer
esophageal resection
question
esophagogastrostomy
answer
resection of the esophagus and anastomosis to the remaining part of the stomach
question
esophagoenterostomy
answer
section of colon to replace the esophagus
question
ND for esophageal cancer
answer
Pain r/t to tumor Risk for deficient fluid volume Imbalance nutrition
question
hiatal hernia
answer
condition in which lower part of the esophagus and stomach slides up through the hiatus of the diaphragm into the thorax. GERD
question
s/s of hiatal hernia
answer
may not produce any discomfort or require treatment. A large hernia can cause pain, heartburn, a feeling of fullness or reflux
question
diagnostic tests for hiatal hernia
answer
x-rays and fluoroscopy
question
therapeutic measures for hiatal hernia
answer
antacids, eating small meals and not reclining for 1 H after meals
question
GERD
answer
condition in which gastric secretions reflux into the esophagus
question
s/s of GERD
answer
heartbuen, regurgitation, dysphagia and bleeding. aspiration is a concern and scar tissue can develop from the inflammation
question
diagnostic tests for GERD
answer
barium swallow, esophaoscopy
question
Therapeutic measures for GERD
answer
Lifestyle changes elevate bed 4-6" histamine receptor antagaonist (acid reducers)
question
Barrett's esophagus
answer
a precancerous condition
question
ND for GERD
answer
Acute pain
question
Mallory-Weiss tear
answer
a longitudinal tear in the mucous membrane of the esophagus at the stomach junction (gastric cardia) Occur from a sudden powerful or prolonged force due to coughing, vomiting, seizures, prolapse of the stomach into the esophagus or CPR.
question
s/s of MWT
answer
bright red bloody emesis or tarry stools
question
Diagnostic test for MWT
answer
EGD. Hmg and Hmt checked
question
Therapeutic Measures for MWT
answer
usually self heal
question
NC for MWT
answer
avoidance of alcohol
question
Esophageal Varices
answer
dilated blood vessels in the esophagus. Their rupture can precipitate a life-threatening event
question
Gastritis
answer
inflammation of the stomach mucosa. acute or chronic
question
s/s of gastritis
answer
abdominal pain, nausea and anorexia
question
Therapeutic measures for gastritis
answer
bland diet
question
Type B gastritis
answer
most common. Helicobacter pylori bacterial infection
question
PUD-peptic ulcer disease
answer
caused by H pylori duodenal ulcers are more common than gastric ulcers
question
Therapeutic measures for PUD
answer
Santac, bland diet or foods that cause discomfort.
question
H2 receptor blocking agents
answer
cimetidine (Tagamet)
question
Ulcers-medical emergency
answer
perforated ulcer and usually requires surgical intervention
question
ND for PUD
answer
Acute pain Risk for injury
question
gastric bleeding causes
answer
ulcer perforation tumors gastric surgery or other conditions
question
Blood loss
answer
can be hidden (occult) obsevable vomited blood black tarry stools
question
s/s of gastric bleeding
answer
mild--weakness or diaphoresis severe--hypovolemic shock
question
s/s of hypovolemic shock
answer
hypotension, weak, thready pulse, chills, palpitations, and diaphoresis
question
therapeutic measure for gastric bleeding
answer
NG tube assesses rate of bleeding, decompress the stomach, monitor the pH and administer saline lavage if ordered. O2 therapy may b needed if there is a lot of blood loss
question
ND for gastric bleeding
answer
Deficient fluid volume
question
gastric cancer
answer
H. pylori infecction plays a role in gastric cancer development
question
s/s gastric cancer
answer
indigestion, anorexia, pain relieved by antacids, weight loss, n/v. anemia and occult blood loss
question
Diagnostic tests for gastric cancer
answer
x-ray, gastroscopy, gastric fluid analysis, serum gastrin levels
question
Therapeutic Measures for gastric cancer
answer
surgical removal is only to releive the symptoms This cancer metastasizes. chemo and radiation is not very effective
question
gastroduodenostomy
answer
distal portion of stomach removed and remainder is surgically attached to the duodenum
question
gastrojejunostomy
answer
larger amount of distal stomach removed and the rest is attached to the proximal jejunum
question
total gastrectomy
answer
total removal of stomach for extensive gastric cancer. the esophagus is attached to the jejunum
question
what is to be done when the G tube is removed
answer
it cuts the vagus nerve and need to notify RN or physician
question
data process for pt. having gastric surgery
answer
identify pts. fears and concerns and provide knowledge of postoperative care and discharge instructions
question
Post operative care
answer
VS, respiratory status, atelectasis or pneumonia can develop because of guarding and shallow breathing. Monitor the NG tube drainage report and excessive amts. of bleeding or drainage to physician
question
ND for gastric surgery
answer
Acute pain Fear r/t to body image changes, treatment and life threatening illness
question
dumping syndrome
answer
rapid entry of food into the jejunum w/o proper mixing of food with digestive juices
question
dumping syndrome s/s
answer
occur 5-30 minutes after eating and include dizziness, nausea, diarrhea, a feeling of fullness, tachycardia, fainting, sweating, and abdominal cramping
question
Pernicious anemia
answer
Vitamin b 12 deficiency and is required to prevent when gastric surgery is done
