Med-Surg cards on complications in the upper GI tract for nursing
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| Occurs as a result of backflow of gastric and duodenal contents into esophagus. | GERD
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| Characterized by symptoms of heart burn and epigastric pain. | GERD
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| Gerd involves inappropriate relaxation of the LES or UES? | LES
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| Which of these are common s/s of GERD? Incontinence, dyspepsia, hyposalivation, odynophagia, acute chough, N/V. | Dyspepsia, odynophagia, N/V. Hypersalivation is common, as well as Chronic cough.
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| The nurse knows that which of these procedures will not be performed if GERD is suspected. 24-hr ambulatory pH monitoring, EGD, bronchoscopy, or esophageal manometry? | Bronchoscopy
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| What is a priority nsg dx for a person with GERD? | Acute pain
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| Fiber should be avoided in pts with GERD. T or F? | False. High fiber is recommened.
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| A pt complains of GERD exacerbations frequently. He also claims he eats a decent sized dinner before bed each night. How should the nurse respond? | Try not eating or drinking two hours before bed. Try to have dinner a couple of hours earlier.
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| Which of these foods should a person have for a snack if they have GERD? Cheese, chocolate cake and coffee, candy cain, applesauce? | Applesauce
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| What happens to thoe LES with age? | Tone decreases
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| Gastric emptying is sped up or delayed? | Delayed
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| Should the nurse caring for a client with GERD be concerned if there is occult blood or crackles in the lung? | Yes. GI bleed and aspiration pneumonia are serious side effects of GERD.
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| The nurse that which of these pathologic condition can exacerbate GERD? CHF, Asthma, Anaphylaxis, Crohn's disease? | Asthma
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| What disorder is known as a malignant change in the epithelium of the esophagus r/t GERD? | Barrett's esophagus
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| Which of these is not a risk factor or condition r/t PUD? H. pylori, NSAID use, hyposecretory states, or stress? | Hyposecretory state. PUD generally causes a HYPERsecretory state.
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| Which of these is a test the nurse would not expect to be performed when testing for PUD? EGD, Barium enema, H. pylori test, occult blood? | Barium enema. The other three would be performed is PUD is suspected.
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| Dyspepsia is a common sign of PUD and GERD. T or F? | True
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| What s/s in addition to dyspepsia does a person with PUD experience? | Abdominal tenderness and bloating
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| Sharp midepigastric pain occuring 30 to 60 min after a meal. Gastric or Duodenal? | Gastric
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| Hematemesis is more common than melena. Gastric or duodenal? | Gastric
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| Buring midepigastric pain 1.5 to 3 hrs after a meal and during the night. Gastric or Duodenal? | Duodenal
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| Melena is more common than hematemesis. Gastric or Duodenal? | Duodenal
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| Pain is often relieved by the ingestion of food. Gastric or Duodenanl? | Duodenal
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| What is a potential complication of PUD? (r/t bleeding) | Intravascular depletion and shock
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| Which of the following is not an appropriate intervention for PUD? Admin saline lavage via NG tube, decrease caffeine, admin blood, dec. stress? | Decrease caffeine. Though a dec. in caffeine can help with other GI disorder, it is not specific to PUD.
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| Is insertion of an IV necessary for a person with advanced PUD? (think bleeding) | Yes. Admin of fluids and blood for hypovolemic state
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| Which labs should be monitored for a pt experiencing hypovolemia r/t PUD? (general, not specific labs) | Elytes
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| Do pts with PUD need special considerations when standing up and ambulating? | Yes. Fluid loss leads to orthostatic hypotension
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| Partial gastrectomy with remaining segment anastomosed to the jejunum. AKA gastrojejunostomy. | Billroth II procedure
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| Which position should a pt post-gastric surgery be place in? Fowlers, Semi-fowlers, low-fowlers, or high fowler's. | Semi-Fowlers
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| Nurse does not need to notify the provider before repositioning or irrigating an NG tube. T or F? | False
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| This is a complication r/t gastric surgery which causes rapid emptying of gastric contents inton SI and vasomotor symptoms. | Dumping Syndrome
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| In dumping syndrome, a(hypertonic or hypotonic) food bolus draws fluid into the SI. | Hypertonic
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| Which of these are signs of dumping syndrome? Syncope, pain in lower abdomen, pallor, palpitations, GI bleed, dyspepsia, headache? | Syncope, pallor, palpitations, headache
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| N/V, dizziness, tachycardia, and palpitations are early or late signs of dumping syndrome? | Early. 30 min after meals
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| Rapid emptying is a sign of early or late dumping syndrome? | Early. 30 min after meals
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| Hunger, dizziness, diaphroeses, tachycardida, shakes, anxiety, and confusion are early or late signs of dumping syndrome? | Late. at least 90 min after meal
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| Excessive insulin is a sign of early or late dumping syndrome? | Late. at least 90 min after a meal
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| Which position should a pt with dumping syndrome be placed in? Fowler's, high fowler's, supine, or prone? | Supine
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