Chapter 48 Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Question | Answer |
Esophagus (Pg. 538) -what kind of muscle -where does it start/end -sphincters | -Smooth muscle tube -Throat to the stomach -UES and the LES (prevent reflux of food & fluids into the mouth or esophagus |
Esophageal disorders: (2) | GERD & Esophageal varices |
GERD (Pg.538) Characterized by.. | Gastroesophageal reflux disease -gastric content & enzyme back flow into the esophagus -irritate esophageal tissue (delay in clearance & acidic exposure) |
Primary tx of GERD: | Diet & lifestyle changes, advancing to med use & surgery |
3 types of meds used to tx GERD | Antacids, h2 receptor antagonists, PPI |
Risks to GERD: wt, age, sleep, tubes | obesity, older age (delayed gastric emptying & weak LES), sleep apnea, NG tube (open sphincter) |
Contributing factors to GERD: -what kind of food relax the LES.. | Fatty & fried foods, chocolate, caffeine, peppermint, spicy foods, tomatoes, citrus fruits & alcohol |
Other contributing factors to GERD: | overeating, pregnancy, obesity, bending at waist, ascites, tight waist clothing -stress, hiatal hernia, lying flat |
What kind of meds relax the LES: | theophylline, nitrates, ccb, anticholinergics, dizepam (valium) -NSAIDs (increase gastric acid) |
S/S: -pain type & worsens with | dyspepsia, regurgitation, wave-like pain and may radiate, pain worsens w/ position, pain after eating |
S/S of GERD; throat irritation causing.. | chronic cough & laryngitis |
S/S GERD; -salivation, taste in mouth -chest pain -gas & burping -how is pain relieved | -Hypersalivation, bitter taste in mouth -chest pain caused by esophageal spasm -increased gas & eructation -pain relieved by sitting up, drinking water or taking antacids |
How are s/s of GERD considered dx? | Occur 4-5x/week on a consistent basis |
DX procedures for GERD: EGD Nursing action post | Esophagogastroduodenoscopy; moderate sedation, observes tissue damage -Verify gag reflex has returned |
DX procedures for GERD: 24-hr ambulatory esophageal pH monitoring -nursing actions | * most accurate method to dx!! Small catheter is placed through nose into E & pH readings are recorded in relation to food, position & activity -nursing: keep journal of foods & fluids consumed, & activity |
DX procedures for GERD: Esophageal manometry | Records lower esophageal sphincter pressure -keep a diary as well |
DX procedures for GERD: Barium swallow test to identify a ____ | Hiatal hernia; could cause GERD |
Medications for GERD: Antacids -med contraindication | Aluminum hydroxide (Mylanta); neutralizes excess acid -contra to levothyroxine |
When is acid secretion the highest? | 1-3 hrs after eating & at bedtime |
When should a client take an Antacid? | When acid secretion is the highest -1 hr before or after other meds are given |
H2 receptor antagonists (Pg. 540) onset & duration compared to antacids | Ranitidine (Zantac), famotidine (pepcid) & nizatidine (Axid) -Reduce secretion of acid -longer onset than antacids but longer duration |
When should client's take H2 receptor antagonists? | With meals & at bedtime |
nizatidine (Axid) should not be mixed with what? | Vegetable-based juices |
Proton pump inhibitors (PPI's) | Pantapraxole (protonix), omeprazole (prilosec), esomeprazole (Nexium), lansoprazole (prevacid) -reduces gastric acid by inhibiting the cellular pump necessary for gastric acid secretion |
PPI sustained release capsules | can open and sprinkle into applesauce, food, etc. |
Prokinetics: | Metoclopramide hydrochloride (Reglan) -Increases motility of the esophagus & stomach |
GERD therapeautic procedures: -stretta procedure | Uses radio frequency energy w endoscope to reduce vagus nerve activity on LES (tightens/contracts it) |
Surgical interventions: GERD Fundoplication | Fundus of stomach is wrapped around & behind the esophagus through a laproscope to create a physical barrier |
Diet client education for GERD: -avoid ___ meals, remain ___ after eating, avoid eating before ___ | large meals, upright, bedtime |
Lifestyle education for GERD: clothing, wt, bed, which side to sleep on | avoid tight clothing around abdomen, lose wt if obese, elevate HOB 6-8in w/ blocks (pillows not recommended), sleep on right side |
Complications of GERD | Aspiration & barrett's epithelium and esophageal adenocarcinoma |
Reflux of gastric fluids leads to _____ | Esophagitis.. can lead to premalignant epithelial tissue (barrett's) or malignant |
Esophageal varices -What are they? | Swollen, fragile blood vessels in the esophagus -can hemmorhage |
Esophageal varices risk factors? | Portal htn, alcoholic cirrhosis, viral hepatits, older age |
S/S of varices: | May be asymp until start to bleed; hematemesis and melena -triggering by valsalva, lifting heavy objects, sneezing/coughing, alcohol .. hypotension, tachycardia if bleeding |
Varices labs: | LFTs, H&H |
Varices dx: | Endoscopy |
Meds for Varices: | Non-selective BB & vasocontrictors |
Nonselective BB Propranolol (inderal) | Decrease HR & consequently reduce hepatic venous pressure -prophylactically |
Vasoconstrictors IV terlipressin (synthetic vasopressin) & natural somatostatin | increases portal inflow -not given w CAD |
Created by:
mary.scott260!
Popular Nursing sets