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GI MS 1
| Question | Answer |
|---|---|
| Acute gastritis | Rapid onset, caused by meds, ETOH, bile, acute illness, trauma |
| Chronic gastritis | Atrophy of gastric tissue, H. Pylori may lead to ulcers, associated with autoimmune disease, diet, meds, ETOH, smoking, chronic reflux |
| Erosive gastritis | Caused by local irritants (NSAIDs, ASA, steroids, alcohol) |
| Non-erosive | Caused by H. Pylori |
| Gastritis symptoms | N/V, abdominal bloating and pain, indigestion, burning feeling, loss of appetite. Melina, hematemesis, hematochezia or pernicious anemia, pain right after eating |
| Acute gastritis management | Refrain from food and alcohol, IV fluids, nasogastric intubation, metronidazole, Omeprazole, sucralfate, famotidine |
| Chronic gastritis management | Modify diet, promote rest, reduce stress, avoid alcohol and NSAIDs |
| Gastritis nursing management | Reduce anxiety, discourage caffeinated beverages, alcohol and smoking |
| Peptic ulcer manifestations | dull gnawing pain or burning in midepigastrium, heartburn and vomiting, pain 2-3 hours after eating or at night |
| Peptic ulcer risk factors | Excessive stomach acid secretion, diet, chronic NSAID use, alcohol, smoking, and familial tendency |
| Peptic ulcer diagnosis | Endoscopy (sedation), labs (CBC, serum amylase, liver enzymes, stool for occult blood, serum gastric, secretin stimulation), H. Pylori test, Upper GI with barium (contrast) |
| Esophagogastroduodenoscopy (EGD) | visualizes structures in upper GI system to check for gastritis or PUD, can obtain biopsies and tissue samples |
| Esophageal (barium swallow) | Patient swallows contrast medium to outline esophagus and upper GI tract, NPO for 8 hours prior, encourage fluids to pass barium, laxatives may be prescribed |
| Triple therapy (pud) | two antibiotics and a PPI |
| Quadruple therapy (pud) | two antibiotics and a PPI and bismuth |
| Gastric outlet obstruction/syndrome | Stomach fills and dilates causing discomfort and pain, projectile vomiting, treated with NGT decompression, PPI or H2, surgery or balloon dilation |
| Perforation | Lethal, GI contents spill into peritoneal cavity, rigid/board like abdomen, pain radiates to back and shoulders, shallow respirations, increased weak pulse |
| Perforation treatment | Notify HCP, frequent vitals, no oral or NG intake, IV fluids, pain management, antibiotics, prep for surgery (billroth) |
| Gastric surgery complications | Hemorrhage, dumping syndrome, postprandial hypoglycemia |
| Dumping syndrome | Lasts about 1 hour, weakness, sweating, palpitations, dizziness, cramping, borborygmi, defecation urge. |
| Dumping syndrome management | Eat high protein, high fat, low carbs, small meals, avoid drinking fluids with meals, lie down after eating |
| Mechanical obstruction | Obstruction from pressure on the intestinal wall |
| Functional / paralytic obstruction (ileus) | Intestinal musculature cannot propel contents along bowel, can be temporary as result of surgery or medications |
| Obstruction management | Decompression with NG tube, IV fluids, anti-emetics, analgesics, NPO, no laxatives, surgery may be necessary (open or laparoscopic) |
| Diverticulitis | Infection and inflammation of diverticula, increases with age and associated with low-fiber diet, diagnosis via colonoscopy |
| Diverticulitis manifestations | LLQ pain, N/V, fever, chills, tachycardia, abdominal distention |
| Acute diverticulitis management | NG tube, NPO, IV fluids, antibiotics, opioids, surgery for complications (colectomy with anastomosis or colostomy) |
| Milds diverticulitis management | Antibiotics, analgesics, antispasmodics, clear liquids, progress to low fiber… then advance to high fiber, low fat, avoid seeds, nuts and popcorn, no laxatives |
| Ulcerative colitis | LLQ pain, begins in rectum to colon, diarrhea w/mucus, pus, blood, high pitched bowel sounds, take daily weight |
| Crohn’s disease | RLQ pain, Cobblestone appearance of colon on CT; fistulas, fissures, abscesses, high pitched bowel sounds. Systemic - joint disorders, skin lesions, ocular disorders, oral ulcers, fever, take daily weight |
| IBD diagnosis | CBC, Serum electrolyte, albumin, Colonoscopy, erythrocyte sedimentation rate, C-reactive protein, upper/capsule endoascopy and abdominal CT (crohn’s) |
| IBD meds | Aminosalicylates (sulfasalazine), corticosteriods, antimicrobicals, immunomodulators, antiemetics, analgesics |
| IBD surgical therapy | Removal of a portion of colon, strictureplasty, repair of fistula or abscess drainage, total proctocolectomy with ileal pouch/anal anastomosis (IPAA), total proctocolectomy with permanent ileostomy |
| Peritonitis manifestations | Rigid, board-like abdomen, abd pain and distention, rebound tenderness, tachycardia, fever |
| Peritonitis management | Notify HCP, IV fluids, analgesics/antiemetics, NG tube - NPO, O2, intubation as needed, ANTIBIOTICS, hemodynamic support, surgery if needed. |
| Peritonitis | Caused by peritoneal dialysis, liver failure, inflammation, ischemia. Complication of ruptured diverticulum, UC, Crohn’s, ruptures appendix |
Created by:
Haydenmeh
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