Gastroparesis and Related Disorders Quiz

Promoting Health in Patients with GI Disorders

• Correlate clinical manifestations with the pathophysiology of selected gastrointestinal disorders.
• Discuss medical and nursing management of selected gastrointestinal disorders.
• Develop a teaching plan for a patient with gastrointestinal disorders.
• Discuss potential diagnostic procedures for patients with gastrointestinal disorders.

Oral Candidiasis

• Fungal yeast infection.
• Raised, bright white patches or coatings on the tongue and inside of the cheeks.
• Irritation, redness, and mouth pain.
• Erythema when white patches are removed.
• Burning sensation, change in taste, or oral bleeding.
• Risk factors include age (65 years old or older, or very young), weakened immune systems, corticosteroid use, antibiotics, tobacco use, dentures.
• Treatment: antifungal medication.

GERD

• Regurgitation of gastric contents into the esophagus.
• Causes changes to the esophagus lining.
• Symptoms include burning, irritation, and chest pain.
• Potential causes include esophageal motility, lower esophageal sphincter function, delayed gastric emptying.
• Risk factors include obesity, smoking, stress, diet, age (50+), low socioeconomic status, lying down after eating, hiatal hernia, pregnancy, stress, and medications.
• Potential complications include Barrett's esophagus, strictures, and esophageal adenocarcinoma.
• Manifestations include heartburn, regurgitation, epigastric pain, sour taste, dysphagia, odynophagia, belching, and nausea/vomiting.

GERD Management

• Diagnosis through history and physical examination, potentially cardiac workup, esophagogastric pH monitoring, and esophageal endoscopic procedures.
• Treatment includes lifestyle modifications (e.g., medication, lifestyle modifications), including proton pump inhibitors, H2 receptor antagonists, and OTC antacids.
• Symptom and complication management includes surgical interventions such as esophageal dilation, Nissen fundoplication, and gastric bypass.
• Interventions include vital signs, physical assessment, stress reduction, weight loss strategies, diet and exercise, avoiding tight-fitting clothes, smoking cessation, finishing meals at least 2 hours prior to bedtime, avoiding lying down after eating, and raising the head of the bed.

GERD Surgeries

• EGD: flexible endoscope examination of the esophagus, stomach, and part of the small intestine to diagnose problems and take biopsy samples.
• Patient is sedated during EGD procedure.
• NPO (nothing by mouth) for 6-8 hours before EGD.

NCLEX Questions (Gastroesophageal Reflux Disease)

• Identify substances to avoid in GERD patients (coffee, chocolate, fried chicken, scrambled eggs, etc).
• Prioritise client care following esophagogastroduodenoscopy (monitoring for temperature, heartburn, sore throat, gag reflex).
• Know different medication classes (e.g., proton pump inhibitors, H2 receptor antagonists).
• Know about over-the-counter antacids (their function).

NCLEX Question (Hiatal Hernia)

• Avoid lying recumbent after eating.
• Consume small, frequent bland meals.
• Take H2 receptor antagonists.
• Raise the head of the bed on blocks (to prevent reflux).

Gastroparesis

• Chronic illness that causes delayed or absent emptying of the stomach.
• Potential causes include damage to the vagus nerve, pacemaker cells of the stomach, long-term poorly controlled diabetes mellitus, surgery, or other autoimmune, connective tissue diseases, stroke (CVA), or Parkinson's disease.
• Manifestations of gastroparesis include early satiety, nausea, vomiting (recurring), abdominal pain, bloating, acid reflux, decreased energy levels, and lack of appetite.

Gastroparesis Management

• Diagnostic tests include esophageal gastroscopy, gastric emptying tests.
• Treatment may include medications like metoclopramide (Reglan) and erythromycin, which stimulate muscles in the stomach.

Metoclopramide

• Class: dopamine receptor antagonist.
• Action: assists in stimulation of GI tract muscles to move food and liquids.
• Use: delayed gastric motility, nausea/vomiting.
• Adverse effects: drowsiness, agitation, extrapyramidal effects, and potentially tardive dyskinesia.
• Teaching points include taking with a full glass of water, taking on an empty stomach, and not taking medications for more than 12 weeks.

Erythromycin

• A motilin agonist that enhances gastric motility and improves gastric emptying.
• Use in delayed gastric motility and infection treatments.
• Side effects may include nausea, vomiting, abdominal pain, diarrhea, tachycardia, skin rash, and tiredness.
• QT prolongation is a possible side effect.

Ondansetron and Prochlorperazine

• Antiemetics that block serotonin action, used for nausea and vomiting.
• Side effects include headache, lightheadedness, blurry vision, tiredness, constipation, and prolonged QT interval.

Gastritis

• Inflammation of the gastric mucosa.
• Causes include exposure to gastric irritants (aspirin, NSAIDs, alcohol, spicy/fried food).
• Manifestations may include epigastric pain, nausea, vomiting, weight loss, decreased appetite, fullness, bloating, belching and bleeding (rare).
• Management involves diagnosis, including endoscopy with biopsy, urea breath tests, CBC, stool samples.
• Treatment may involve diet modifications, medication (e.g., proton pump inhibitors and H2 receptor antagonists), and potentially antibiotics (for H. pylori).

Gastritis Complications

• Possible complications include peptic ulcers, gastric cancer, vitamin B12 deficiency, bleeding, anemia, perforation, dehydration or nutritional deficits.
• H. Pylori is a possible cause of gastritis.

Peptic Ulcer Disease

• Open sores in the inner lining of the stomach or duodenum.
• Etiology potentially due to H. pylori, NSAIDs, corticosteroids, or other medications.
• Manifestations include weight loss, decreased appetite, abdominal pain (burning or gnawing), nausea, vomiting, bloating, early satiety.
• Complications include hemorrhage, perforation, obstruction, shock, infection, and nutrient deficiencies.
• Diagnosis through EGD procedure, H. pylori testing, and potentially medication such as proton pump inhibitors.
• Management includes interventions like vital signs, physical assessment, monitoring CBC values, diet modifications, and limiting medications.

Celiac Disease

• Autoimmune disorder triggered by gluten.
• Damages the small intestine lining.
• Potential causes include a reaction to gluten, or ingestion of gluten -containing proteins.
• Symptoms/manifestations include diarrhea, fatigue, weight loss, bloating, increased flatulence, and anemia.

Test your knowledge on gastroparesis, hiatal hernia, and peptic ulcers with this comprehensive quiz. Learn about common symptoms, dietary recommendations, and management strategies for these gastrointestinal conditions. Ideal for nursing students and healthcare professionals looking to enhance their understanding of these topics.