Podcast
Questions and Answers
A patient with esophageal varices is actively bleeding. Which medication would be MOST appropriate to administer?
A patient with esophageal varices is actively bleeding. Which medication would be MOST appropriate to administer?
- Ranitidine (H2 Blocker)
- Omeprazole (PPI)
- IV Octreotide (antidiarrheal/splanchnic vasoconstriction) (correct)
- Psyllium
Which of the following instructions should a nurse include when educating a patient with gastritis on lifestyle modifications to manage their condition?
Which of the following instructions should a nurse include when educating a patient with gastritis on lifestyle modifications to manage their condition?
- Limit physical activity to avoid exacerbating symptoms.
- Take NSAIDs as needed for pain relief.
- Notify your primary care provider if your stools appear dark. (correct)
- Consume caffeine and alcohol in moderation to reduce gastric acid production.
A patient is admitted with suspected appendicitis. The patient reports migrating pain in the right lower quadrant (RLQ). What intervention should the nurse avoid?
A patient is admitted with suspected appendicitis. The patient reports migrating pain in the right lower quadrant (RLQ). What intervention should the nurse avoid?
- Applying a warm compress to the abdomen (correct)
- Administering antibiotics as prescribed
- Administering prescribed antipyretics
- Administering intravenous fluids
A patient with diverticulitis is being discharged. Which of the following dietary instructions should the nurse include in the discharge teaching plan?
A patient with diverticulitis is being discharged. Which of the following dietary instructions should the nurse include in the discharge teaching plan?
A patient with Irritable Bowel Syndrome (IBS) is prescribed dicyclomine. Which of the following instructions should the nurse include when educating the patient about this medication?
A patient with Irritable Bowel Syndrome (IBS) is prescribed dicyclomine. Which of the following instructions should the nurse include when educating the patient about this medication?
A patient with an intestinal obstruction suddenly develops a fever and tachycardia. Which complication should the nurse suspect?
A patient with an intestinal obstruction suddenly develops a fever and tachycardia. Which complication should the nurse suspect?
A patient with celiac disease is having a consultation. Which of the following foods should the nurse educate the patient to avoid?
A patient with celiac disease is having a consultation. Which of the following foods should the nurse educate the patient to avoid?
A patient post-gastrectomy is experiencing dumping syndrome. Which dietary modification should the nurse recommend to help manage the symptoms?
A patient post-gastrectomy is experiencing dumping syndrome. Which dietary modification should the nurse recommend to help manage the symptoms?
A patient with short-bowel syndrome is at risk for malabsorption of nutrients. Which intervention is MOST important for the nurse to implement?
A patient with short-bowel syndrome is at risk for malabsorption of nutrients. Which intervention is MOST important for the nurse to implement?
A patient with GERD is prescribed Omeprazole for long-term management. What potential adverse effect should the nurse monitor for?
A patient with GERD is prescribed Omeprazole for long-term management. What potential adverse effect should the nurse monitor for?
A patient is diagnosed with a hiatal hernia. Which assessment finding would indicate a life-threatening complication?
A patient is diagnosed with a hiatal hernia. Which assessment finding would indicate a life-threatening complication?
A patient presents with stomatitis secondary to chemotherapy. Which intervention is MOST appropriate for managing this condition?
A patient presents with stomatitis secondary to chemotherapy. Which intervention is MOST appropriate for managing this condition?
A patient is diagnosed with ulcerative colitis. Why are they at an increased risk for colon cancer?
A patient is diagnosed with ulcerative colitis. Why are they at an increased risk for colon cancer?
Which assessment finding in a patient with Crohn’s disease indicates a complication requiring immediate intervention?
Which assessment finding in a patient with Crohn’s disease indicates a complication requiring immediate intervention?
Which is a serious complication related to ulcerative colitis?
Which is a serious complication related to ulcerative colitis?
Which intervention is crucial for a patient diagnosed with antibiotic-associated enterocolitis (C. Diff)?
Which intervention is crucial for a patient diagnosed with antibiotic-associated enterocolitis (C. Diff)?
A patient is suspected of having peptic ulcer disease. What finding in the patient's emesis is MOST concerning and indicates a need to notify the primary care provider?
A patient is suspected of having peptic ulcer disease. What finding in the patient's emesis is MOST concerning and indicates a need to notify the primary care provider?
A patient waiting for an appendectomy has a sudden cessation of abdominal pain. What complication should the nurse suspect?
A patient waiting for an appendectomy has a sudden cessation of abdominal pain. What complication should the nurse suspect?
A patient with an intestinal obstruction is receiving an NG tube to low intermittent suction. What nursing intervention is essential for this patient?
A patient with an intestinal obstruction is receiving an NG tube to low intermittent suction. What nursing intervention is essential for this patient?
Which statement accurately describes the pathophysiology of ulcerative colitis?
Which statement accurately describes the pathophysiology of ulcerative colitis?
Why are clients with Crohn's Disease at high risk for malnutrition?
Why are clients with Crohn's Disease at high risk for malnutrition?
A patient with a peptic ulcer is experiencing heart flutters 30 minutes after eating. What complication is MOST likely occurring?
A patient with a peptic ulcer is experiencing heart flutters 30 minutes after eating. What complication is MOST likely occurring?
What is the difference between mechanical and functional intestinal obstructions?
What is the difference between mechanical and functional intestinal obstructions?
A patient with esophageal varices vomits a large amount of blood and develops melena. What condition should the nurse suspect, and what vital sign change would be expected?
A patient with esophageal varices vomits a large amount of blood and develops melena. What condition should the nurse suspect, and what vital sign change would be expected?
A patient with a history of GERD is scheduled for an EGD. What finding would suggest the development of Barrett's esophagus?
A patient with a history of GERD is scheduled for an EGD. What finding would suggest the development of Barrett's esophagus?
A patient has been experiencing postprandial discomfort. What GI disorder does this suggest?
A patient has been experiencing postprandial discomfort. What GI disorder does this suggest?
The provider has ordered a barium swallow study for a patient. This test is MOST likely used to diagnose which GI disorder?
The provider has ordered a barium swallow study for a patient. This test is MOST likely used to diagnose which GI disorder?
A client with gluten intolerance consumes a product with gluten in it. What change is MOST likely to occur in the small intestine?
A client with gluten intolerance consumes a product with gluten in it. What change is MOST likely to occur in the small intestine?
A client has a history of peptic ulcer disease. They have been experiencing severe stomach pain, hematemesis, and signs of shock. What is the MOST likely reason the client is expereincing signs of shock?
A client has a history of peptic ulcer disease. They have been experiencing severe stomach pain, hematemesis, and signs of shock. What is the MOST likely reason the client is expereincing signs of shock?
Which diagnostic test is MOST useful in differentiating ulcerative colitis from Crohn's disease?
Which diagnostic test is MOST useful in differentiating ulcerative colitis from Crohn's disease?
A nurse is caring for a patient recently diagnosed with short bowel syndrome. What is the MOST appropriate nursing intervention to support the patient's nutritional needs?
A nurse is caring for a patient recently diagnosed with short bowel syndrome. What is the MOST appropriate nursing intervention to support the patient's nutritional needs?
A client with GERD reports persistent heartburn despite taking omeprazole as prescribed. What additional instruction should the nurse provide?
A client with GERD reports persistent heartburn despite taking omeprazole as prescribed. What additional instruction should the nurse provide?
A patient with diverticulitis experiences a sudden increase in abdominal pain, fever, chills, and signs of peritonitis. What is the MOST appropriate intervention?
A patient with diverticulitis experiences a sudden increase in abdominal pain, fever, chills, and signs of peritonitis. What is the MOST appropriate intervention?
A patient is admitted with severe diarrhea, abdominal pain, and a fever. A stool sample tests positive for Clostridium difficile (C. diff). Besides antibiotics, what is the MOST important intervention?
A patient is admitted with severe diarrhea, abdominal pain, and a fever. A stool sample tests positive for Clostridium difficile (C. diff). Besides antibiotics, what is the MOST important intervention?
You're providing discharge instructions for a patient with Celiac's disease. What snacks can they have?
You're providing discharge instructions for a patient with Celiac's disease. What snacks can they have?
A nurse is educating a client with ulcerative colitis on dietary modifications during a flare-up. What dietary recommendation is MOST appropriate?
A nurse is educating a client with ulcerative colitis on dietary modifications during a flare-up. What dietary recommendation is MOST appropriate?
A 50-year-old client presents to the emergency department with severe abdominal pain, distension, and inability to pass stool. Nurse suspects the client is experiencing a complete intestinal obstruction because they have these symptoms. What nursing intervention should the nurse implement FIRST?
A 50-year-old client presents to the emergency department with severe abdominal pain, distension, and inability to pass stool. Nurse suspects the client is experiencing a complete intestinal obstruction because they have these symptoms. What nursing intervention should the nurse implement FIRST?
A nurse is caring for a client following a partial gastrectomy. The client reports symptoms of dumping syndrome, including dizziness, palpitations, and diarrhea, approximately 30 minutes after eating. What dietary modification should the nurse recommend?
A nurse is caring for a client following a partial gastrectomy. The client reports symptoms of dumping syndrome, including dizziness, palpitations, and diarrhea, approximately 30 minutes after eating. What dietary modification should the nurse recommend?
What would be the BEST choice of food for a client diagnosed with diverticulosis?
What would be the BEST choice of food for a client diagnosed with diverticulosis?
Flashcards
Stomatitis
Stomatitis
Ulcerations of the oral mucosa, often seen in chemo patients. Can be caused by bacteria or virus (HSV).
GERD
GERD
Inefficient closure of the lower esophageal sphincter, leading to regurgitation of gastric acid/food.
Omeprazole
Omeprazole
PPI, long-term use concern for bone fracture/ hip and diarrhea/ headache.
Hiatal Hernia
Hiatal Hernia
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Esophageal Varices
Esophageal Varices
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Gastritis
Gastritis
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Gastroenteritis
Gastroenteritis
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Peptic Ulcer Disease
Peptic Ulcer Disease
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EGD Procedure
EGD Procedure
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Ulcerative Colitis
Ulcerative Colitis
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Toxic Megacolon
Toxic Megacolon
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Crohn’s Disease
Crohn’s Disease
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Enterocolitis (C. Diff)
Enterocolitis (C. Diff)
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Appendicitis
Appendicitis
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Diverticulosis
Diverticulosis
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Diverticulitis
Diverticulitis
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Irritable Bowel Syndrome
Irritable Bowel Syndrome
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Intestinal Obstruction
Intestinal Obstruction
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Celiac Disease
Celiac Disease
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Dumping Syndrome
Dumping Syndrome
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Short-bowel Syndrome
Short-bowel Syndrome
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Study Notes
- GI disorders involve various conditions affecting the digestive tract, each with unique causes, symptoms, and treatments.
Stomatitis
- Idiopathic ulcerations occur in the oral mucosa, commonly seen in chemotherapy patients, those undergoing radiation therapy, and individuals with autoimmune disorders.
- Bacterial or viral infections, such as HSV, can cause this condition.
- Clinical manifestations include pain and ulcers.
- Management involves monitoring swallowing and chewing abilities; patients unable to eat may require an NGT or PICC for TPN.
- Magic Mouthwash may be prescribed for symptomatic relief.
Gastroesophageal Reflux Disease (GERD)
- An inefficient lower esophageal sphincter causes regurgitation of gastric acid and food.
- Risk factors include restrictive clothing, weight gain, smoking, pregnancy, caffeine, alcohol, and fatty foods.
- Clinical manifestations include heartburn, chest pain, dysphagia, and Barrett’s esophagus.
- Treatment options include Omeprazole (a PPI) and Ranitidine (an H2 blocker).
- Long-term use of Omeprazole may lead to concerns about bone fracture/hip fracture along with diarrhea/headache.
- Lifestyle modifications include smoking cessation, reduced alcohol consumption, a low-fat diet, and weight loss.
Hiatal Hernia
- Idiopathic loosening of the muscular band around the esophagus and diaphragmatic junction causes part of the fundus to be above the diaphragm.
- Clinical manifestations include dysphagia, GERD symptoms, belching, and regurgitation.
- Incarceration, or strangulation, is a life-threatening complication.
- Diagnosis includes a barium swallow study and EGD.
- Treatment involves surgery and dietary restrictions.
Esophageal Varices
- Enlarged veins in the esophagus result from portal hypertension.
- Variceal bleeding leads to hematemesis (vomiting blood), melena (dark tarry stool), anemia, and potentially hemorrhagic shock.
- IV Octreotide is administered as a medication (antidiarrheal/splanchnic vasoconstriction).
Gastritis
- Inflammation of the stomach lining can result from aspirin, alcohol, irritation, and H. Pylori infection.
- Clinical manifestations range from asymptomatic to N/V and postprandial discomfort (during/after meals).
- Management involves avoiding NSAIDs and ASA for pain.
- Education includes promoting physical activity for stress reduction, avoiding alcohol and caffeine, and advising patients to notify their PCP if stool is dark.
Gastroenteritis
- Acute inflammation affects the stomach and small intestine.
- Clinical manifestations include diarrhea, pain, N/V, fever, malaise, and abdominal discomfort.
- Treatment is similar to managing a stomach bug, involving IVF and bowel rest.
Peptic Ulcer Disease
- Stomach acid damages the lining of the digestive tract, specifically the epithelial mucosal barrier, in the duodenal or gastric area.
- Clinical manifestations include pain, burning, nausea, and dyspepsia when the stomach is empty.
- Hematemesis indicates GI bleeding and is concerning.
- Patients should notify their PCP if there is coffee ground emesis or NGT drainage.
- EGD procedure involves an endoscope views the upper gastric wall and stomach
- Patients should notify PCP if they experience heart flutters 30 minutes after eating, which may indicate dysrhythmia.
Ulcerative Colitis
- Inflammatory Bowel Disease (IBD) affects the colon only.
- Inflammation starts at the base of the crypts of Lieberkühn, leading to abscess formation and exudative diarrhea.
- Patients are at risk for colon cancer.
- Toxic megacolon is a serious complication involving swelling and inflammation of the colon, potentially leading to rupture.
- Clinical manifestations include abdominal pain, bloody diarrhea, and rectal bleeding.
- Management involves a low-fiber, high-protein, high-calorie diet.
- Medications include corticosteroids, immunomodulators, and antibiotics.
- Labs to monitor: CBC (for bleeding), Stool (occult blood), and Albumin (decreased).
Crohn’s Disease
- IBD affects the entire GI tract, leading to a cobblestone-like appearance.
- Ulcers, fissures, fistulas, and abscesses may be present.
- Clinical manifestations include malnutrition (anemia/malaise), toxic megacolon, diarrhea (less severe than UC), abdomen pain, skin conditions, arthritis, and fever.
- Treatment includes corticosteroids, antibiotics, and TPN.
- Monitor labs such as elevated WBC, elevated ESR, and complications linked to abnormal electrolytes (decreased K).
Enterocolitis (Antibiotic-Associated Colitis / Pseudomembranous colitis)
- Also known as C. Diff, the large intestine is exposed to bacterial toxins, resulting in inflammation and mucosal necrosis.
- Clinical manifestations include elevated WBC, fever, abdomen pain, sepsis, and perfuse watery, foul-smelling diarrhea.
- Use precautions.
- Antibiotics may be used.
Appendicitis
- Inflammation of the vermiform appendix results from obstruction caused by a hard mass of feces.
- Clinical manifestations include fever, diarrhea, nausea, and migrating pain at McBurney’s point (RLQ).
- Nursing considerations include maintaining hydration, educating the patient about going to the ER, and treating fever with antipyretics.
- Treatment involves an appendectomy via surgical care.
- Avoid laxatives.
- Antibiotics, IVF, Opioids, and antipyretics may be administered.
Diverticulosis / Diverticulitis
- Diverticulosis involves the creation of polyps in the intestinal tract, leading to constipation, related to primarily low fiber intake and high pressure within the intestine.
- Diverticulitis occurs when something gets stuck in the polyp, resulting in inflammation, infection, and potential rupture.
- Clinical manifestations include LLQ pain, fever, elevated WBC, constipation/diarrhea, and complications such as sepsis, obstruction, and perforation.
- Treatment includes antibiotics, laxatives, and fiber.
- Prevention education involves drinking 8 glasses of water daily, increasing intake of soft, cooked vegetables, avoiding nuts, corn, and seeds, and taking psyllium daily to increase bulk/fiber and prevent constipation.
Irritable Bowel Syndrome
- A non-inflammatory condition where the patient exhibits constipation or diarrhea (or a combination).
- Idiopathic with no identifiable pathological process.
- Clinical manifestations include constipation, diarrhea, nausea, and mucous in stool.
- Abdominal pain is relieved with defecation.
- Medication treatment includes antidiarrheals, fiber (psyllium), dicyclomine (antispasmodic), antibiotics, and probiotics.
- Monitor diet for triggers, sleep, encourage exercise, avoid fluid with meals, and employ stress control.
Intestinal Obstruction
- Impacted feces or blockage (partial or complete) can occur in the small or large bowel.
- Mechanical obstruction results from scar tissue (seen with hernia, tumor, inflammation, intussusception, stricture, and impaction).
- Functional obstruction results from loss of propulsive ability (ileus, occurring after surgery).
- Clinical manifestations include abdominal distention, abdomen pain, fever, increased bowel sounds initially, then absent bowel sounds.
- Large bowel obstruction leads to lower abdominal cramps.
- Stop tube feeding/PO feed with obstruction, bowel rest, infuse IVF to help break up hard stool.
- An NG tube should be placed to low intermittent suction.
- Measure abdominal girth.
- Prepare the patient for surgery if not responding to treatment.
- High fever with tachycardia and constipation indicates concern for obstruction.
Celiac Disease
- Intolerance of gluten is triggered by gliadin in genetically predisposed persons.
- Intestinal villi atrophy leads to malabsorption.
- More prevalent in females than males.
- Clinical manifestations include weight loss, malnutrition, diarrhea/constipation, joint pain, and tooth enamel loss.
- Education focuses on avoiding triggering foods (gluten).
Dumping Syndrome
- Rapid gastric emptying into the small intestine causes malabsorption around 30 minutes after eating.
- Glucose absorption prompts insulin secretion, while other nutrients are "dumped," leading to hypoglycemia within 1-3 hours.
- Clinical manifestations include abdomen pain, diarrhea, hypovolemia (fluid shifting from blood to the intestine), and hypoglycemia 1 to 3 hours after eating.
- No fluid with meals, and no high carbs.
- Monitor and treat hypoglycemia as indicated.
Short-Bowel Syndrome
- Severe diarrhea causes malabsorption of nutrients (H2O, electrolytes, protein, fats, carbs, vitamins, and minerals) due to surgical removal of parts of the small intestine.
- Clinical manifestations depend on the location of the intestine removed.
- Monitor nutritional deficits due to malabsorption from removal of parts of the small intestine.
- Parenteral nutrition may be necessary.
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