Gastroesophageal Reflux Disease (GERD) Quiz
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Questions and Answers

What is the primary goal of interprofessional and nursing care in bowel obstruction?

  • To treat underlying etiologies
  • To monitor for complications
  • To clear and reverse the obstruction (correct)
  • To alleviate symptoms

    • What is the name of the surgical procedure that involves wrapping and sewing the fundus around the esophagus below the diaphragm?

  • Herniorrhaphy
  • Fundoplication (correct)
  • Herniotomy
  • Gastropexy

    • What is the term for the assessment of stool using a chart?

  • Fecal Assessment Scale
  • Bristol Stool Scale (correct)
  • Gastrointestinal Assessment Tool
  • Stool Evaluation Chart

    • What is the name of the bacteria that is a common etiology of peptic ulcer disease?

    <p>H. Pylori</p> Signup and view all the answers

    What is the term for the paralysis of the intestinal muscles, leading to a lack of peristalsis?

    <p>Ileus</p> Signup and view all the answers

    What is the term for the surgical removal of a polyp or tumor?

    <p>Polyp removal</p> Signup and view all the answers

    What is the term for the inflammation of the peritoneum?

    <p>Peritonitis</p> Signup and view all the answers

    What is the term for the X-ray examination of the abdominal cavity?

    <p>Abdominal X-ray</p> Signup and view all the answers

    What is the term for the attachment of the stomach to the abdominal wall?

    <p>Gastropexy</p> Signup and view all the answers

    What is the term for the partial or complete blockage of the intestine?

    <p>Bowel obstruction</p> Signup and view all the answers

    Which of the following conditions is most likely to occur as a result of delayed emptying of the stomach?

    <p>Gastroesophageal reflux disease (GERD)</p> Signup and view all the answers

    What is the primary cause of angina-like chest pain in GERD?

    <p>Mucosal damage</p> Signup and view all the answers

    Which of the following is a risk factor for esophageal cancer?

    <p>Barrett's esophagus</p> Signup and view all the answers

    What is the primary difference in pain relief between duodenal ulcers and gastric ulcers?

    <p>Pain relief with food in duodenal ulcers</p> Signup and view all the answers

    What is the primary method of diagnosis for GERD?

    <p>Esophageal pH monitoring</p> Signup and view all the answers

    In irritable bowel syndrome, what is the most common symptom?

    <p>Abdominal bloating and distension</p> Signup and view all the answers

    What is the primary complication of hiatal hernia?

    <p>GERD</p> Signup and view all the answers

    What is the primary goal of nonsurgical management of ulcerative colitis?

    <p>Rest the bowel and control inflammation</p> Signup and view all the answers

    What is the primary etiology of hiatal hernia?

    <p>Structural: weakened muscle in the diaphragm and esophagogastric opening</p> Signup and view all the answers

    What is the most common complication of Crohn's disease?

    <p>Stricture development</p> Signup and view all the answers

    What is the term for something that is similar to, but not exactly the same as, another condition?

    <p>Anginal-“like”</p> Signup and view all the answers

    What is the primary difference between ulcerative colitis and Crohn's disease?

    <p>Depth of inflammation</p> Signup and view all the answers

    What is the primary nursing management for GERD?

    <p>All of the above</p> Signup and view all the answers

    What is the primary difference between sliding and paraesophageal hiatal hernias?

    <p>Location of the hernia</p> Signup and view all the answers

    What is the primary goal of surgical management of Crohn's disease?

    <p>To relieve symptoms</p> Signup and view all the answers

    What is the primary cause of diverticulitis?

    <p>Chronic low-fiber diet</p> Signup and view all the answers

    What is the primary complication of esophagitis?

    <p>Stricture formation</p> Signup and view all the answers

    What is the primary diagnostic test for liver disease?

    <p>Liver biopsy</p> Signup and view all the answers

    What is the primary symptom of irritable bowel syndrome?

    <p>Constipation or diarrhea</p> Signup and view all the answers

    What is the primary medication therapy for ulcerative colitis?

    <p>Corticosteroids</p> Signup and view all the answers

    What is the primary reason for the creation of alternative pathways in cirrhotic livers?

    <p>To facilitate adequate circulation to smaller venules</p> Signup and view all the answers

    What is the primary cause of jaundice in cirrhotic patients?

    <p>Inability of liver cells to convert bilirubin to bile</p> Signup and view all the answers

    What is the primary complication of esophageal varices?

    <p>Upper gastrointestinal bleeding</p> Signup and view all the answers

    What is the primary cause of ascites in cirrhotic patients?

    <p>Increased vascular permeability</p> Signup and view all the answers

    What is the primary cause of hepatic encephalopathy in cirrhotic patients?

    <p>Inability of the liver to detoxify ammonia</p> Signup and view all the answers

    What is the primary characteristic of fibrotic tissue in cirrhotic livers?

    <p>Inflammation and scarring of the liver tissue</p> Signup and view all the answers

    What is the primary cause of portal hypertension in cirrhotic patients?

    <p>Increased resistance to blood flow in the portal vein</p> Signup and view all the answers

    What is the primary complication of hepatorenal syndrome?

    <p>Renal failure</p> Signup and view all the answers

    What is the primary cause of anorexia in cirrhotic patients?

    <p>Altered metabolism of carbohydrates, fats, and proteins</p> Signup and view all the answers

    What is the primary cause of edema in cirrhotic patients?

    <p>Increased vascular permeability</p> Signup and view all the answers

    Study Notes

    Gastroesophageal Reflux Disease (GERD)

    • Chronic reflux of gastrointestinal contents into the esophagus
    • Causes:
      • Incompetent lower esophageal sphincter (LES)
      • Pyloric stenosis
      • Hiatal hernia
      • Delayed emptying
      • Motility problems
    • Clinical manifestations:
      • Heartburn
      • Substernal and retrosternal pain
      • Indigestion
      • Acid regurgitation
      • Esophageal irritation
      • Dysphagia
      • Angina-like chest pain
      • Respiratory problems

    Complications of GERD

    • Esophagitis
    • Esophageal scarring and strictures
    • Airway inflammation, aspiration, and scarring
    • Barrett's esophagus
      • Metaplasia of epithelials in the lower esophagus
      • Risk factor for esophageal cancer

    Diagnostic Tests for GERD

    • Endoscopy
    • Mucosal biopsy
    • Barium swallow (upper GI series)
    • Fluoroscopy/X-ray
    • Motility studies
    • Esophageal pH monitoring

    Interprofessional and Nursing Management of GERD

    • Diet: low-fat, high-fiber, high water concentration
    • Avoid foods that increase acid production
    • Stop smoking
    • Maintain a healthy weight
    • Avoid eating two hours before bedtime
    • Elevate the head of the bed (HOB)
    • Medications: antacids, H2 antagonists, and proton pump inhibitors (PPIs)

    Hiatal Hernia

    • Stomach herniation into the esophagus and diaphragm
    • 2 types: sliding and paraesophageal
    • Clinical manifestations:
      • Similar to GERD
    • Etiology and pathophysiology:
      • Structural: weakened muscle in the diaphragm and esophagogastric opening
      • Increased intra-abdominal pressure
    • Complications:
      • GERD
      • Esophagitis
      • Ulcers
      • Hemorrhage
      • Strangulation
      • Aspiration
    • Diagnostic studies:
      • Same as GERD
    • Nursing and interprofessional management:
      • Improve the cause of increased intra-abdominal pressure
      • Symptom management
      • Pain control
      • Stomach acid control
      • Surgical repair (herniotomy, herniorrhaphy, fundoplication, gastropexy)

    Bowel Obstructions

    • Clinical manifestations:
      • Nausea and vomiting
      • Pain (colicky or visceral)
      • Interruption in bowel habits
      • Abdominal distension
      • Changes in bowel sounds (BST)
    • Complications:
      • Atelectasis
      • Malnutrition
      • Hypovolemia
      • Rupture
      • Infection (peritonitis)
    • Types of bowel obstructions:
      • Functional (ileus)
      • Mechanical (simple)
      • Pyloric
      • Intestinal (more common in the small bowel)
    • Diagnostic studies:
      • Abdominal X-rays
      • CT scan
      • Contrast oral/enema
      • Sigmoidoscopy or colonoscopy
      • Blood tests (CBC, metabolic panel)

    Gastric Disorders

    • Typical clinical manifestations:
      • Nausea and vomiting
      • Pain
      • Hemorrhage
      • Anorexia
      • Weight loss
      • Flatus
    • Complications:
      • Neoplasm
      • Hypovolemia
      • Perforations
      • Obstruction

    Peptic Ulcers

    • Epigastric mucosal "craters"
    • Mucosal damage and increased presence of acid and/or pepsin
    • Common etiologies:
      • Stress
      • H. pylori
      • NSAIDs
    • MOA:
      • Inflammation
      • Cytokine damage
      • H. pylori toxins
    • Nursing considerations and interventions:
      • Manage pain
      • Control stomach acid
      • Prevent complications

    Inflammatory Disorders

    • Etiologies:
      • Increased immune sensitivities to intestinal flora
      • Epithelial dysfunction
      • Epigenetics
    • Most common: Crohn's disease and ulcerative colitis
    • Irritable bowel syndrome (IBS):
      • "Brain-gut" disorder
      • Increased incidence with stress, anxiety, and depression
      • Symptoms:
        • Abdominal bloating and distension
        • Pain
        • Increased flatus
        • Diarrhea or constipation
        • Nausea
      • Relieved with passing flatus and bowel movement, treat underlying etiologies (e.g., coping, diet, etc.)

    Ulcerative Colitis

    • Inflammation and ulceration of the mucosa and submucosa of the colon
    • Clinical manifestations:
      • Loose stools with blood and mucus
      • Malabsorption
      • Thickening/scarring of the colon wall
      • Other symptoms:
        • Hemorrhage
        • Strictures
        • Perforation
        • Toxic megacolon
        • Colonic dilation
    • Diagnostic tests:
      • CBC
      • Electrolytes
      • Serum protein levels
      • Stool cultures
      • Sigmoidoscopy and/or colonoscopy
      • Biopsy specimens
    • Nonsurgical management:
      • Rest the bowel
      • Control inflammation
      • Combat infection
      • Correct malnutrition
      • Stress management
      • Symptomatic relief
    • Medication therapy:
      • Corticosteroids
      • Antidiarrheal drugs
      • Antibiotics
    • Surgical management:
      • Colectomy (partial or total)
      • Pouch system
      • Total colectomy with a continent (Kock's) ileostomy
      • Total colectomy with ileoanal anastomosis (J pouch)

    Crohn's Disease

    • Idiopathic inflammatory disease
    • Affects the full thickness of the small intestine and/or the colon
    • Affects any part of the GI tract from the mouth to the anus
    • Complications:
      • Fat and/or gluten intolerance
      • Bowel wall thickening
      • Strictures and obstruction
      • Abscesses or fistulas
      • Malabsorption of vitamins and nutrients
    • Clinical manifestations:
      • Nonspecific complaints
      • Diarrhea (non-bloody)
      • Constipation
      • Abdominal pain
      • Fatigue
      • Fever
      • Weight loss
    • Diagnostic tests:
      • Laboratory studies
      • Endoscopy with biopsy
      • Upper GI barium studies
    • Nonsurgical management:
      • Nutrition
      • Medication therapy
      • Symptom management
      • Fluid and electrolyte therapy
      • Skin care
    • Surgical management:
      • Not curative
      • Small bowel resection and ileocecal resection
      • Stricturoplasty

    Diverticulitis

    • Diverticulosis: outpouchings in the intestinal walls (diverticula)
    • Diverticulitis: inflammation of diverticula
    • Cause: (believed) chronic low fiber diet
    • Risk factors:
      • Age
      • Gender
    • Clinical manifestations:
      • Intermittent left lower quadrant (LLQ) pain
      • Constipation
      • Diverticulitis:
        • Low-grade fever
        • Nausea
        • Abdominal pain
        • Constipation
        • Rectal bleeding
        • Abdominal distension
        • Rebound tenderness
      • Symptoms of diverticular perforation:
        • Tender mass in the rectal area
        • Hypotension
        • Dehydration

    Liver Disorders

    • Diagnostic tests for liver diseases:
      • Serum labs
      • Liver biopsy (gold standard)
      • Abdominal X-ray/CT scan
      • MRI
      • Ultrasound (US)
      • Endoscopic retrograde cholangiopancreatography (ERCP)
    • Liver disease (cirrhosis):
      • Regenerative properties decline and/or inhibited
      • Fibrotic tissue
      • Vascular restructuring and alternative pathways
      • Portal hypertension
    • Causes:
      • Alcohol
      • Hepatitis
      • Viral
      • Autoimmune
      • Drugs and toxins
      • Liver cancers
      • Biliary disease
      • Genetics
      • Nonalcoholic fatty liver
    • Clinical manifestations:
      • Early:
        • Anorexia
        • Dyspepsia
        • Increased flatulence
        • Nausea and vomiting
        • Change in bowel habits
        • RUQ and/or epigastric pain
        • Edema
        • Hepatic stretching
        • Fever
        • Weight loss
      • Later:
        • Jaundice
        • Peripheral edema and ascites
        • Pruritis
        • Skin lesions
        • GI bleed
        • Hepatic encephalopathy
        • Hepatorenal syndrome
        • Portal hypertension
    • Complications:
      • Portal hypertension
      • Ascites
      • Esophageal varices
      • Jaundice
      • Encephalopathy

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    Test your knowledge of Gastroesophageal Reflux Disease, its causes, clinical manifestations, and complications. Covering topics such as heartburn, indigestion, and esophageal irritation.

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