Term
| Treatment/managment of PUD |
|
Definition
1- Rest
2- Smoking Cessation
3- Bland diet of 6 small meals
i.Avoid-
a.caffeine
b.spicy foods
c.carbonated beverages
d.Alcohol
e.chocolate |
|
|
Term
|
Definition
| Common site is above the upper esophageal spincter |
|
|
Term
| Aluminum/Magnesium hydroxide |
|
Definition
Prevents conversion of pepsinogen to pepsin
high does and grequency stimulate release of gastrin
hast he greatest noncompliance |
|
|
Term
| Amoxicillin/Clarithronycin/Omeprazole |
|
Definition
| used in patients with verified H.Pylori |
|
|
Term
Sucralfate (Carafate)
[PUD] |
|
Definition
| Covers/coats the ulcer, pretecting it from hydroxide mixture erosion |
|
|
Term
Omeprazole (Prilosec)
[PUD] |
|
Definition
| Decreases gastric acid secretion by blocking ATPase enzyme |
|
|
Term
|
Definition
Decreases all mucosal secreations; used with for PUD treatment to decrease HCL acid secreations and gastric motility
High incidence of side effcts and contraindications |
|
|
Term
|
Definition
Reduces HCL acid secretion by blocking action of histamine on H2 receptors
Lasts 12 hours
Lasts longer than antacids |
|
|
Term
| Misoprostol (Cytotec) mixture |
|
Definition
| Antisecretory effects in patients using antiprostiagladin drugs |
|
|
Term
|
Definition
| Often performed with a vagotomy to increase gastric emptying |
|
|
Term
|
Definition
| Severing of a parasympathetic nerve (Vagus) to decrease gastric secretion |
|
|
Term
|
Definition
| Removal of distal 2/3 of stomach with attachment to jejunum |
|
|
Term
|
Definition
| Removal of distal 2/3 of stomach with attachment to doudenum |
|
|
Term
Octreotide (Sandostatin)
[Esophageal Varices] |
|
Definition
| Used to decrease bleeding and decrease gastric acid secretions |
|
|
Term
|
Definition
| Inflammation of esophagus from irritants or gastric reflux |
|
|
Term
|
Definition
| Narrowing of the esophagus from scarring |
|
|
Term
|
Definition
| Absence of peristatlsis of lower 2/3 of esophagus with nonrelaxing LES |
|
|
Term
|
Definition
| Precancerous esophageal metaplasia associated with GERD |
|
|
Term
|
Definition
| Generates ammonia, effecting the mucosal layer in the stomach; the HCL then causes ulcers |
|
|
Term
| ASA and NSAIDS - effect of causing PUD |
|
Definition
| inhibits synthesis of mucus and prostaglandins |
|
|
Term
| Corticosteroids - effect on PUD patients |
|
Definition
| decreases the rate of mucousal cell turnover |
|
|
Term
|
Definition
|
|
Term
| Severe physiologic stress - formation of PUD |
|
Definition
| Ischemia of gastric mucosa |
|
|
Term
| Nicotine- causation of PUD |
|
Definition
| Decreases pancreatic bicarbinate secretion; effects the Bicarb buffer system |
|
|
Term
| Where is the vomiting center located? |
|
Definition
|
|
Term
| Where are the sympathetic afferent receptors for vomiting located? |
|
Definition
GI tract
Kidneys
Bladder
Heart
Uterus |
|
|
Term
| Where are the vagal afferents located |
|
Definition
|
|
Term
| Before vomiting, the parasympathetic nervous system - |
|
Definition
| Relaxes LES, increases GI motility, increases salivation |
|
|
Term
| Before vomiting the sympathetic nervous system- |
|
Definition
produces tachycardia
tachypnea
diaphoresis |
|
|
Term
| Sympathetic afferents respond to - |
|
Definition
inflammation
menstration
obstruction
spasms
stretch
distention |
|
|
Term
Vagal afferents respond to
|
|
Definition
Distention and gas
inflammation
irritation
ischemia |
|
|
Term
|
Definition
Chemical stimuli of drugs, toxins and labyrinth stimulation
Triggers of emotition, stress, unpleasant sights, odors, pain
Once CTZ is stimulated it sends stimuli to vomiting center |
|
|
Term
|
Definition
Treat underlying cause
careful Pt history
precipitating factors
description of contents
associated symptoms |
|
|
Term
| Vomiting can cause what metabolic complication? |
|
Definition
|
|
Term
| Possible lab findings from N/V? |
|
Definition
Altered F/E
Abnormal upper GI endoscopy
Abnormal Abdominal XR |
|
|
Term
| Past health history questions regarding N/V? |
|
Definition
Gi disorders
Chronic indigetsion
Food allergies
Pregnancy
Infection
CNS disorders
Recent travel
Bulimia
F/E disorders
Cardio disorders
Renal disease |
|
|
Term
| What important info regarding meds is asked of a patient with N/V? |
|
Definition
Use of antiemetics
digitalis
opiods
ferrous sulfate
ASA
aminophylline
alcohol
antibiotics
general anesthesia
chemotherapy |
|
|
Term
|
Definition
Lethargy
Sunken eyes
pallor
dry mucous membranes
poor skin turgor
amount of emesis/frequency/character/content/color
decreased urinary output
|
|
|
Term
| Nursing interventions for N/V |
|
Definition
IV therapy - F/E replacement
NPO - rests gut
Fluids - Clear diet, warm tea and carbonated fluids @room temp
Diet - Hi carb, low fat; eat slow and small
Position -prevent aspiration
Meds - antiemetics, antipsychotics, antihistamines, prokinetitcs |
|
|
Term
Meds for N/V
(Antiemetics/Antipsychotics) |
|
Definition
Compazine
Thorazine
Trilafon
Sparine
Stelazine |
|
|
Term
Meds for N/V
(Antihistamines) |
|
Definition
Phenergan
Bucladin-S
Marezine
Dramamine
Vistaril
Antivert
Bonine
(Main drug names end in Zine
|
|
|
Term
Meds for N/V
(Prokinetics) |
|
Definition
|
|
Term
| Common side effects of N/V meds? |
|
Definition
Dry mouth
Low B/P
Sedative effects
GI disturbances
Constipation |
|
|
Term
| Metabolic crisis that triggers the CTZ and N/V? |
|
Definition
Uremia
Hyperthyroidsm
DKA
HTN crisis |
|
|
Term
| Position to prevent aspiration |
|
Definition
|
|
Term
|
Definition
| Herniation of a portion of the stomach into the esophagus thru an opening in the diaphragm |
|
|
Term
| Two types of hiatal hernias |
|
Definition
Sliding - junction fo the somach and esophagus is above the hiatus of the diaphram
Rolling - esophageal juntion remains in the normal position |
|
|
Term
|
Definition
Same s/s as GERD
Severe burning when Pt bends over
asymptomatic regurgitation
nocturnal heartburn |
|
|
Term
| Diagnostics for hiatal hernia |
|
Definition
|
|
Term
| Complications of hiatal hernia |
|
Definition
Erosion
Stenosis
Ulcerations
Strangulation of hernia
Regurgitation
Tracheal aspiration
Dysphagia
Nocturnal dyspnea |
|
|
Term
| Treatment for hiatal hernia |
|
Definition
Avoid consticting garments
Avoid lifting and straining
Do not eat in bed
Avoid caffeine/chocolate/irritating foods
Eliminate alcohol and smoking
Elevate HOB 4-6 inches
Weight loss
Use of antacids |
|
|
Term
Meds for Hiatal Hernia
(Antacids) |
|
Definition
|
|
Term
Meds for Hiatal Hernia
(Antisecretory agents:H2 receptor blockers) |
|
Definition
Tagamet
Pepcid
Axid
Zantac |
|
|
Term
Meds for hiatal hernia
(Antisecretory agents: PPI) |
|
Definition
Nexium
Prevacid
Prilosec
Protonix
Aciphex |
|
|
Term
|
Definition
| inflammation of the gastric mucousa |
|
|
Term
Causes of gastritis
(drugs) |
|
Definition
ASA
Corticosteroids
NSAIDS |
|
|
Term
Causes of gastritis
(Diet) |
|
Definition
|
|
Term
Causes of gastritis
(Microorganisms) |
|
Definition
H.Pylori
Salmonella
Staphylococcus |
|
|
Term
Causes of gastritis
(Environmental factors) |
|
Definition
|
|
Term
Causes of gastritis
(Patho conditions) |
|
Definition
Burns
hiatal hernia
Stress
Reflux
Uremia(renal failure)
Sepsis
shock |
|
|
Term
Causes of gastritis
(Procedural causes) |
|
Definition
|
|
Term
|
Definition
Malaise
Anorexia
Headache
Epigastric discomfort
Cramping
N/V
Painless GI bleed
Hematemesis
S/S of Shock - esp. if hemorrhaging |
|
|
Term
| Diagnostitics for Gastritis |
|
Definition
Stool for occult blood
CBC
Endoscopic exam
Biopsy
Gastric analysis
Serum Labs |
|
|
Term
| Treatment for acute gastritis |
|
Definition
mild - antacids, antiemetics, liquid diet
severe - NPO, IVs |
|
|
Term
| Complications from gastritis |
|
Definition
Hemorrhage
Perforation
Peritonitis |
|
|
Term
| Three types of chronic gastritis |
|
Definition
Autoimmune (AI) - high risk of gastric cancer
Diffuse antral - involves antrum and H.pylori
Multifocal- diffuse thru stomach and H.pylori |
|
|
Term
| Triple drug therapy for H.pylori |
|
Definition
PPI - Tritec
Amoxicillin
Biaxin
7 DAY TREATMENT |
|
|
Term
| Dual drug therapy for H.pylori |
|
Definition
PPI-Tritec
Biaxin
7 DAY THERAPY |
|
|
Term
| Quad.Therapy for H.pylori |
|
Definition
PPI
Bismuth
Tetracycline
Flagyl
14 DAY THERAPY |
|
|
Term
|
Definition
-usually none, but when present similar to acute
-progressive loss of acid secreting cells and loss of intrinsic factor |
|
|
Term
| Treatment of chronic gastritis |
|
Definition
Eliminate underlying cause
stop smoking
medical supervision
prevent anemia
medication therapy |
|
|
Term
| Patients at risk for upper GI bleed |
|
Definition
Prolonged extensive surgical procedure
renal failure
intracranial disorder
burn patients
major trauma |
|
|
Term
| Classification of PUD ulcers |
|
Definition
Acute
Chronic
Gastric
Duodenal |
|
|
Term
|
Definition
mucosa
submucosa
muscularis
serosa |
|
|
Term
|
Definition
superficial
little inflammation
responds well to treatment |
|
|
Term
|
Definition
Extends thru the muscularis to submucosa
heals slow
varying amounts of scarring |
|
|
Term
|
Definition
pyrosis 1/2-1hr PC
Pain with food digestion
Hematemesis
Old peeps |
|
|
Term
|
Definition
Intermittent dull, burning aching hunger type pain 2-4 PC
Food relieves s/s
Melena present |
|
|
Term
|
Definition
Hemorrhage
perforation
gastric outlet obstruction |
|
|
Term
Meds for Pud
Antisecretory H2 blockers |
|
Definition
Cimetidine (Tagmet)
Famotidine (Pepcid)
Nizatidine (Axid)
Ranitidine (Zantac)
-ends with tidine |
|
|
Term
|
Definition
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Omeprazole (Prilosec)
Pantoprazole (Protonix)
Rabeprazole (Aciphex)
-ends with prazole |
|
|
Term
|
Definition
Basaljel
Amphojel
Phosphojel
Tums
Rolaids
Maalox
Mylanta
-commercial or ends with jel |
|
|
Term
Meds for Pud
Tricyclic antidepressants |
|
Definition
Imipramine (Tofranil)
Doxepin (Sinequan) |
|
|
Term
|
Definition
| Severing/removal of vagus nerve; usually performed with a gastrectomy |
|
|
Term
|
Definition
| surgical enlargement of pyloric sphincter to facilitate easy passage of contents from stomach |
|
|
Term
|
Definition
Dumping syndrome
Postprandial hypoglycemia
Bile reflux gastritis |
|
|
