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365 Exam 2
365 CH Upper GI
| Term | Definition |
|---|---|
| nausea | feeling of discomfort in the epigastrium with a conscious desire to vomit |
| vomiting | forceful ejection of partially digested food and secretions from the upper GI tract |
| vomiting action | closure of the glottis, contraction of the diaphragm, closure of the pylorus, relaxation of the stomach, contraction of abdominal muscles |
| sympathetic response to vomiting | tachycardia, tachypnea, diaphoresis |
| parasympathetic response to vomiting | relaxation of lower stomach, increase gastric motility, increase salivation |
| manifestations of nausea and vomiting | anorexia, dehydration, electrolyte imbalances, plasma loss, metabolic alkalosis, weight loss |
| metabolic alkalosis in nausea and vomiting | occurs due to loss of hydrochloric acid and stomach acid; respiratory will try and compensate |
| assess emesis | partially digested food can indicate obstruction or delayed emptying; hematemesis |
| antiemetic common for post op | ondansetron; zofran; serotonin blocker |
| promethazine IV or injection | blocks dopamine receptors that trigger nausea and vomiting; is not given subcutaneously |
| extravasation | leaking can cause damage to tissues |
| metoclompramide (reglan) | inhibits action of dopamine; increase gastric motility and emptying |
| acute care of nausea and vomiting | NPO, Iv fluids, NGT suction, aspiration precautions |
| GERD | reflux of acid into the esophagus; causes esophageal irritation leads to metaplasia of cells |
| GERD manifestations | heartburn (pyrosis), dyspepsia (pain in upper abdomen), regurgitation, respiratory symptoms |
| long term consequences of GERD | possible esophageal cancer, adult asthma, dental caries |
| lifestyle changes for GERD | excess weight puts more pressure pushing on the stomach; pregnant women; eat 4 - 6 small meals, do not eat before bed |
| foods that worsen GERD | chocolate, alcohol, fatty and fried foods, caffeine, carbonation |
| proton pump inhibitors | decrease acid, allow cells to repair; PRAZOLE |
| histamine receptor blockers | block the H2 receptor of acid producing parietal cells; IDINE |
| antacids | used for GERD, combination with prokinetic drugs |
| fundoplication | fundus of stomach is wrapped around esophagus |
| LINX reflux management system | magnets are used to strengthen the LES, cannot have an MRI |
| hiatal hernia | part of the stomach herniates into the esophagus through the diaphragm |
| sliding hiatal hernia | can slide through the diaphragm and back down |
| rolling hiatal hernia | paraesophageal; popped up through diaphragm and stays; pouch could burst and cut off circulation (MED EMERG) |
| hiatal hernia symptoms | fullness, breathlessness after eating |
| hiatal hernia complications | esophagitis, hemorrhage from erosion, stenosis of esophagus, strangulated hernia |
| gastritis | inflammation of the gastric mucosa; eventual thinning and atrophy leads to loss of intrinsic factor |
| intrinsic factor | B12 absorption, deficiency leads to pernicious anemia |
| gastritis diagnosis | history of alcohol use, CBC indicates anemia |
| manifestations of gastritis | anorexia, nausea and vomiting, epigastric tenderness, full feeling |
| antibiotics for H pylori gastritis | amoxicilin |
| peptic ulcer disease | erosion of the GI mucosa by gastric acids |
| acute peptic ulcer | superficial erosion, short duration |
| chronic peptic ulcer disease | long duration, erodes to muscular wall, occurs intermittently |
| stress ulcers | after acute medical crisis or trauma, patient is NPO, after burns and head injury; cause bleeding |
| gastric peptic ulcer | epigastric pain occurs 1 - 2 hours after a meal, burning or gaseous, food worsens |
| duodenal peptic ulcer | mid epigastric pain 2 - 5 hours after a meal, burning or cramping like, well nourished, food relieves; excess acid |
| gastric sampling | endoscope, diagnosis for peptic ulcer |
| urea breath testing | confirms H pylori in peptic ulcer disease |
| EGD | diagnosis testing for peptic ulcer |
| hemorrhage peptic ulcer complication | drop in H&H; increase HR, decrease BP, blood in aspirate, flush NGT with saline to prevent obstruction |
| perforation peptic ulcer complication | ulcer has opened, gastric contents leak into cavity; sudden, severe pain, rigid abdomen, shallow, fast respirations, absent bowel sounds |
| perforation treatment | stop spillage, vital signs every 15 minutes, NGT for gastric decompression; replace lost volume with LR or PRBCs, ECG monitor |
| gastric outlet obstruction peptic ulcer complication | results from edema, pylorospasm or scar tissue formations, pain worsens when stomach is full; constipation dehydration and anorexia, abdominal distension |
| GI bleeding | bleeding from the upper GI tract due to erosive gastritis, PUD, esophageal varices |
| coffee ground emesis blood in the GI tract | lower, slower bleed; blood has been sitting in the stomach long enough for acid to change its color |
| melena blood in GI tract | black in color, blood has gone through digestive tract, in the stool |
| bright red blood per rectum GI bleed | above stomach, high in GI tract |
| diagnostic of GI bleed | endoscopy within 24 hours; can cauterize to stop the bleed |
| angiography | place a catheter in femoral artery to gastric or mesenteric artery until bleeding is discovered |
| BUN diagnostic for GI bleed | increased with protein breakdown with significant bleeding |
Created by:
ahommel
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