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Chapter 28
Upper GI System Disorders
| Question | Answer |
|---|---|
| Anorexia Nervosa | A psychological disorder characterized by refusal to eat adequate quantities of food |
| Anorexia | General loss of appetite |
| Bulimia Nervosa | Psychological disorder characterized by consuming large quantities of food followed by purging to prevent weight gain |
| Purging | Vomiting , laxative use or excessive workout |
| What metabolic complications are we concerned of for individuals with bulimia nervosa? | Metabolic alkalosis |
| Underweight BMI | <18.5 |
| Normal Weight BMI | 18.5 - <25 |
| Overweight BMI | 25 - <30 |
| Obesity BMI | >30 |
| Cachexia | Severe malnutrition that results in skeleton like appearance |
| Wegovy | Semaglutide |
| Semaglutide | Wegovy |
| What kind of medication is Wegovy (Semaglutide) ? | A weight loss and diabetic control medication |
| When is Bariatric surgery considered? | - BMI > 40 -BMI >35 with one or more obesity related conditions |
| Restrictive Surgery | Surgery that removes part of the stomach |
| Ghrelin | Hunger hormone |
| How does restrictive surgery help individuals lose weight? | By removing a part of the stomach tissue it reduces the amount of ghrelin produced, decreasing a persons appetite |
| Malabsorptive Surgery | Re-routes food past the majority of the small intestines |
| How does malabsorptive surgery help individuals lose weight? | By bypassing a large part of the small intestine, it reduces the amount of calories and nutrients absorbed by the body |
| Combination Surgery (Roux-en-Y gastric bypass) | Limits stomach size and skips part of the small intestine |
| Why does dumping syndrome occur? | Food moves from the stomach into the small intestine faster because it is bypassing the pyloric sphincter and or the reduction in size of the stomach |
| Early Dumping Syndrome | Occurs 15-30 minutes after eating - A hyperosmolar food bolus pulls fluids from the blood stream into the intestines which can lead to hypotension |
| Signs and Symptoms of Early dumping syndrome | Weakness Dizziness Vertigo Diaphoresis Tachycardia Abdominal Cramp,ing Epigastric Fullness |
| Late Dumping Syndrome | Occurs 1-3 hours after a meal - Blood sugar crash that occurs from large amount of insulin being released to combat rapid glucose absorption |
| Signs and Symptoms of Late Dumping Syndrome | Weakness Shakiness Hunger Confusion Diaphoresis |
| Stomatitis | Generalized inflammation of the mucous membranes of the mouth |
| Causes of Stomatitis | Oral complications, nutritional deficiencies, smoking, alcohol, radiation therapy, certain medications |
| Symptoms of stomatitis | Halitosis Pain Swelling Aphthous Ulcers (Canker Sores) Thick ropy saliva |
| Dysphagia | Difficulty Swallowing |
| Who diagnosis's dysphagia | Speech therapist |
| Early sign of dyspahgia | Coughing or choking after eating or drinking Taking a long time to eat or drink |
| What nursing intervention should you put in place if you suspect someone to have dyspagia? | Requesting patient become NPO until evaluated by speech therapist |
| Symptoms of Cancer of the Oral cavity | R- Red U- Ulcerated L- lump E- Extending for more than 3 weeks |
| Barrett's Esophagus | A precancerous condition caused by GERD. -Replicating of cells being so frequent leaves individual more prone to mutations |
| Hiatal Hernia (Diaphragmatic Hernia) | Hernia of the stomach causing protrusion into the thoracic cavity |
| Symptoms of Hiatal Hernia | Typically asymptomatic but when signs do show they are: -Night coughing that causing you to wake up -Pressure fullness especially after eating -Gastric reflux -Indigestion -Belching -Regurgitation -Substernal/epigastric pain |
| What are PPI's | Proton Pump Inhibitor Drugs |
| What do Proton Pump Inhibitor Drugs do? | Reduces the amount of acid that's produced by the stomach |
| What is the suffix for PPI drugs? | -Zole |
| What do H2-Receptor Antagonist do? | Reduces stomach acid production by blocking histamine and the H2 receptors |
| What is the Suffix for H2 Receptor Antagonist Drugs | -Dine |
| What nursing management for post op esophagectomy? | Airway patency |
| Gastroesophageal Reflux Disease (GERD) | Lower esophageal sphincter weakens allowing reflux of stomach contents into the esophagus |
| What other areas can gastric secretion irritate? | Bronchoconstriction Asthma Symptoms |
| What are causes of Gastritis? | H. Pylori Long term use of NSAIDs Long term use of Steroids |
| What is H. Pylori? | Bacteria that infects the stomach lining |
| What complications can come from untreated H. Pylori infection | -Ulcers - GI Bleeding |
| What is Barretts Esophagus? | A precancerous condition caused by GERD |
| Why is Barret's Esophagus considered precancerous? | Cells are constantly healing themselves leaving one predisposed to mutations |
| What are Peptic Ulcers? | Erosion at the mucous lining of the stomach because gastric secretions start to digest their own organs |
| What is the difference between Peptic Ulcers and GERD? | -Peptic ulcers are close to the epigastric -Eating can improve symptoms because gastric secretions get absorbed into the food -Peptic Ulcers are better in the morning and get worse at night and before meals |
| What worsens symptoms of GERD? | -Highly acidic meals -Large meals -Spicy foods -Smoking -Alcohol -Carbonated drinks -Citrus |
| What is Gastritis? | Acute inflammation of the stomach' s mucous membrane lining |
| What should you look out for if Peptic Ulcers come from H. Pylori? | Infection can get into the blood steam quickly increasing risk of septic shock |
| What medications can aid with Gastritis? | -Antispasmodics - Antacids -H-2 Receptor antagonists -PPI's |
| Risk factors for Gastric Cancer | -Genetics -Diet high in smoked/salted/preserved foods -H. Pylori Infection - Pernicious anemia -Achlorhydria -Alcohol -Smoking |
| Pernicious Anemia | Blood disorder where the body not absorbing B12 |
| Achlorhydria | Absence of Hydrochloric acid |
| Varicies | Swollen blood vessels |
| Hematemesis | Vomiting of blood red blood |
| Signs and Symptoms of upper GI BLeed? | -Hematemesis -Black tarry stool -Metabolic alkalosis -Weakness -Faint -Nausea -Restlessness -Symptoms of Hypovolemic Shock |
| Hematochezia | Fresh blood in the stool |
| What is gastrointestinal decompression? | NG Tube inserted to remove fluids and gas from stomach or intestines |
| What is enteral nutrition? | Alternative methods of providing nutritional support |
| What is TPN? | Tube feeding given through central line to provide complete nutritional support |
| What should you monitor with TPN feeds? | - Blood Sugar - Infection risk |
| What Labs are you monitoring with enteral nutrition? | -BUN -Electrolytes -Glucose -Hematocrit -Albumin |
| What is PPN? | Supplemental nutrition that uses IV access |
Created by:
kyebula