Term
|
Definition
Duration: several hours to a few days
Causes: ingestion of food with disease-causing microorganisms; dietary indiscretions; overuse of aspirin/NSAIDs; excessive ETOH use; bile reflux or radiation therapy.
Side Effect: Scarring can occur. |
|
|
Term
|
Definition
Duration: prolonged inflammation
Cause: Often due to benign or malignant uclers, H. pylori, autoimmune disorders AND diet, smoking, prolonged ETOH use, or large quantities of caffeine. |
|
|
Term
|
Definition
Abdominal discomfort
Anorexia
N/V
Headache
Hiccupping |
|
|
Term
| Chronic Gastritis Symptoms |
|
Definition
Anorexia
N/V
Belching
Heartburn after eating
Sour taste in mouth
Vitamin B12 deficiency
Hematemesis |
|
|
Term
| Gastritis Diagnostic Testing Procedures |
|
Definition
Upper GI series
EGD with biopsy
Serologic testing for H. pylori antibodies
Breath test for H. pylori |
|
|
Term
|
Definition
Hemorrhagic gastritis: hematemesis, tachycardia, hypotension.
Pernicious anemia
Ulcers
Gastric cancer |
|
|
Term
| Gastritis: Medical Management of Symptoms |
|
Definition
*Avoid irritating foods, fluids and other substances such as spicy and highly-seasoned foods, caffeine, ETOH, and nicotine until symptoms subside.
*Treat H. pylori (if present)
* Protect stomach mucosa: Cytotec or Carafate (sucralfate)
* Treat symptoms: medications
* Promote rest
* Reduce stress |
|
|
Term
|
Definition
Amoxil - amoxicillin
"Quadruple therapy"
Biaxin - clarithromycin
Prilosec/Nexium - PPI
Flagyl - metronidazole
Pepto Bismal - bismuth subsalicylate |
|
|
Term
| Gastritis: Drugs to treat symptoms |
|
Definition
H2 blockers
PPIs
Antacids
Phenothiazines
Anticholinergics |
|
|
Term
| H2 Blockers (H2 receptor antagonists) |
|
Definition
ZAPT
Z - Zantac
A - Axid
P - Pepcid
T - Tagamet |
|
|
Term
|
Definition
NAPPP
N - Nexium
A - Aciphex
P - Previcid
P - Prilosec
P - Protonix |
|
|
Term
| Gastric Protectants (Mucosal Barrier Protectants) |
|
Definition
CC
Cytotec - misoprostol
Carafate - sucralfate |
|
|
Term
|
Definition
GGRAMMA Tums (Think "Grandma is always eating tums."
G - Gaviscon
G - Gelusil
R - Riopan
A - Aludrox
M - Maalox
M - Mylanta
A - Amphojel
T - Tums |
|
|
Term
| Duodenal Ulcers: Characteristics |
|
Definition
*Age of onset: 30-60
*Gastric acid and pepsin secretions are increased
*Pain 2-3 hours after eating: burning, gnawing
*Pain may awaken patient during the night
*Melena is more common than hematemesis
*Pain is often relieved by eating food
*More common in men
*Malignancy is rare
*Pain is in epigastric region |
|
|
Term
|
Definition
| Antrum or junction of fundus and pylorus |
|
|
Term
| Duodenal Ulcers: Location |
|
Definition
| Located 1/4 - 1" from pylorus |
|
|
Term
| Gastric Ulcers: Characteristics |
|
Definition
*More severe than the other type of ulcer
*Normal or hyposecretion of gastric acid
*50 yrs. or older at onset
*Pain occurs 30-60 minutes after eating (may be relieved by vomiting)
*Food ingestion accentuates the pain
*Hematemesis is more common than melena
* Greater risk of malignancy (10%)
* Pain is in epigastric region |
|
|
Term
| Duodenal Ulcers: Risk Factors |
|
Definition
Infection with H. pylori
ETOH intake
Smoking
Stress
Caffeine
Aspirin use
Corticosteroids
NSAIDs |
|
|
Term
| Gastric Ulcers: Risk Factors |
|
Definition
Infection with H. pylori
ETOH intake
Smoking
Stress
Caffeine
Aspirin use
Corticosteroids
History of gastritis
Family history of gastric ulcers |
|
|
Term
|
Definition
* Initiated by physiologically stressful situations
* Usually gastric in origin
*!st sign: often hemorrhagic |
|
|
Term
| Peptic Ulcer: Interventions |
|
Definition
*Small frequent bland feedings during the active phase
*H2 receptor antagonists or PPIs to decrease gastric acid secretion
*Antacids to neutralize gastric secretions
*Anticholinergics to reduce gastric motility
*Mucosal barrier protectants 1 hour before meals
*Prostaglandins for protective and anti-secretory actions |
|
|
Term
| Peptic Ulcer: Client Education |
|
Definition
*Avoid consuming: alcohol, caffeine, chocolate
*Milk can be irritating
*Avoid smoking
*Avoid aspirin and NSAIDs
*Obtain adequate rest
*Reduce stress |
|
|
Term
| Peptic Ulcer: Complications |
|
Definition
HOPP
Hemorrhage
Obstruction - ulcers can lead to scar tissue
Perforation
Peritonitis |
|
|
Term
| Peptic Ulcer: Surgical Treatment |
|
Definition
Total gastrectomy
Vagotomy
Gastric resection
Billroth I
Billroth II
Pyloroplasty |
|
|
Term
|
Definition
| Removal of the stomach with attachment of the esophagus to the jejunum or duodenum |
|
|
Term
|
Definition
| Surgical division of the vagus nerve to eliminate the vagal impulses that stimulate hydrochloric acid secretion in the stomach. |
|
|
Term
| Gastric resection (Antrectomy) |
|
Definition
| Removal of the lower half of the stomach and usually includes a vagotomy. |
|
|
Term
|
Definition
| Partial gastrectomy with the remaining segment anastomosed to the duodenum. |
|
|
Term
|
Definition
| Partial gastrectomy with the remaining segment anastomosed to the jejunum. |
|
|
Term
|
Definition
| Enlargement of the pylorus to prevent or decrease pyloric obstruction thereby enhancing gastric emptying. |
|
|
Term
|
Definition
| Rapid emptying of the gastric contents into the small intestine that occurs following gastric resection. |
|
|
Term
| Dumping Syndrome: Pathophysiology |
|
Definition
*Hypertonic, undigested food bolus rapidly enters duodenum or jejunum
*Water is pulled into the lumen of the intestine by the hyperosmolar character of the chyme.
*This results in decreased blood volume and intestinal dilation
*Peristalsis is stimulated and intestinal motility is increased
*Entry of hyperosmolar chyme into jejunum also causes a rapid rise in blood glucose.
*This rise stimulates an excessive amount of insulin
*The excess insulin leads to hypoglycemic conditions 2-3 post eating. |
|
|
Term
| Dumping Syndrome: Symptoms |
|
Definition
Tachycardia/palpitations
Orthostatic hypotension, dizziness, weakness
Flushing
Diaphoresis
Nausea/Vomiting
Epigastric pain
Abdominal cramping and feeling of fullness
Borborygmus
Diarrhea |
|
|
Term
| Dumping Syndrome: Dietary Considerations |
|
Definition
HP/HF/LC
High protein
Hight fat
Low carb
AVOID: Salt, Sugar, Milk (esp. avoid concentrated sweets) |
|
|
Term
| Dumping Syndrome: Client Education |
|
Definition
Eat small meals
Avoid consuming fluids with meals.
[Take fluids ONE hour before or ONE hour after meals.]
Post-meal position: Either lie down or low Fowler's (30 degrees or less)
Use anti-spasmodics: Bentyl |
|
|
Term
| POTENTIAL COMPLICATION: Hemorrhage r/t peptic ulcer surgery |
|
Definition
Monitor VS for S/S of shock
*Low BP
*Diaphoresis
*Rapid, but weak, pulse
*Change in level of consciousness
Insert peripheral IV line
Monitor 02 sat and administer O2 as needed
Insert NG tube as ordered
Insert urinary catheter (as ordered) and monitor output
Place client in LEFT LATERAL RECUMBENT position
Administer Vasopressin as ordered (increase BP)
Administer blood products as ordered (Hg<8, client will probably receive blood) |
|
|
Term
| POTENTIAL COMPLICATION: Perforation and Penetration r/t peptic ulcer surgery |
|
Definition
Monitor for S/S of perforation
*Sudden, severe, upper abdominal pain not handled by analgesia (not even morphine will help with this pain!)
*Vomiting
* Tender, rigid abdomen
* Shock symptoms
Administer antibiotics as ordered
Monitor labs: WBC and H/H |
|
|
Term
| POTENTIAL COMPLICATION: Pyloric Obstruction r/t peptic ulcer surgery |
|
Definition
Monitor bowel sounds.
*If decreased or absent, let someone know!
Monitor for constipation
Insert NG tube as ordered to decompress the stomach
Administer IV fluids as ordered to prevent hypovolemia
Monitor electrolytes: K+ could be low from vomiting |
|
|
Term
| Post-operative Nursing Care for Peptic Ulcer Surgery |
|
Definition
*Monitor VS
* Semi-Fowler's position for comfort and promotion of drainage
*Monitor NG suction and assess drainage: color, amount
*Don't reinsert NG tube if it dislodges, call MD
*Incentive spirometer: coughing and deep breathing
*Relieve pain: before it gets severe. Give oral meds 1 hour prior to morning activity (IV, 30 minutes prior), anticipate the pain. |
|
|
Term
| Client Education: Discharge Teaching r/t Peptic Ulcer Surgery |
|
Definition
Gradual increase of food intake
Daily monitoring of weight
Keep incision clean and dry
May use splinting or an abdominal binder for support
S/S to report to MD
*Spike in temp.
*Incision becomes red or swollen
*Increase in pain |
|
|
Term
| Gastric Cancer: Risk Factors |
|
Definition
Diet
Chronic gastritis
Gastric ulcers
Pernicious anemia
Presence of H. pylori
Heredity |
|
|
Term
| Gastric Cancer: Late Clinical Manifestations |
|
Definition
Dyspepsia or indigestion
N/V, anorexia
Significant weight loss (30-40 pounds in a month)
Constipation
Abdominal pain
Anemia |
|
|
Term
| Gastric Cancer: Diagnostic Tests |
|
Definition
Upper GI series
EGD - "Gold Standard" test
CT scan
Bone scan - to look for metastasis |
|
|
Term
| Gastric Cancer: Common Treatment Options |
|
Definition
Surgery
Chemotherapy
Radiation therapy |
|
|
