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Chapter 50
Unit 7: Nursing care of clients with gastrointestinal disorders
| Question | Answer |
|---|---|
| Acute and Chronic gastritis (Pg. 559) | Inflammation of the lining of the stomach acute: sudden onset, short duration, bleeding if severe chronic; slow onset, may result in pernicious anemia *ulcers can be formed |
| Risks; infection, meds, drinks, reflux, age | H.pylori, etc. fam hx, NSAIDs/corticosteroids excessive alcohol use, smoking, caffeine, stress bile reflux disease autoimmune disorders older age radiation |
| S/S of gastritis: dys__, pain, appetite/wt, abdominal, vomit like? | dyspepsia, general abdominal discomfort/indigestion -upper abdominal pain, increase/decrease w/ eating -nausea, low appetite, bloating (wt loss) -hematemesis |
| S/S of erosive gastritis: | Black, tarry stools; coffee-ground emesis -acute abdominal pain |
| Labs; CBC serum & stool antigen C 13 urea breath test | CBC- anemia? bleeding? -->others testing for H.pylori |
| What is anemia in women and in men? | Women; hgb <12, rbc <4.2 Men; hgb<14, rbc <4.7 |
| How do you dx gastritis? | Upper endoscopy (through mouth into esophagus, stomach, duodenum) |
| Upper endoscopy: NPO? Anesthetic? perforation? | NPO 6-8 hrs before -local anesthetic sprayed into back of throat -perforation is a risk |
| Medications you can give? | H2 antagonists(dine's), antacids (hydroxides), PPI's (zoles) -prostaglandins, anti-ulcer/mucosal barriers, antibiotics |
| Surgery? | Prescribed when ulcerations or significant bleeding - |
| Surgery: Vagotomy | nerve fibers only responsible for gastric production -laproscopically common |
| surgery: Pyloroplasty | usually done at the same time as the vagotomy |
| Surgery: Partial gastrectomy | Removal of the involved portion of the stomach |
| Methods for stopping gastric bleeding: | Insert a NG tube for gastric lavage (irrigate w/ NS or water to stop active gastric bleeding) |
| Complications to gastritis; gastric bleeding, outlet obstruction, dehydration, pernicious anemia, dumping syndrome --> why pernicious anemia? | Chronic gastritis may damage the parietal cells. leads to a reduced production of intrinsic factor= (necessary to absorption of vitamin b12) -insufficient vit b12 can lead to pernicious anemia |
| Pernicious anemia you need monthly ___? | Injections of vit b12 |
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mary.scott260!
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