chapter 33 upper GI disorders

<p>Maintaining a clean environment as well as oral care, daily weights, iv fluids, ng tube /Zofran, reglan, Phenergan (D)</p> Signup and view all the answers

<p>electrolytes, Potassium levels, hemogloblin and hematocrit thicker more concentrated, also due to loss of hydrochloric acid patients may develop metabolic alkalosis(PH will be elevated) (A)</p> Signup and view all the answers

<p>Due to loss of stomach hydrochloric acid (A)</p> Signup and view all the answers

<p>Bleeding in the stomach(digestive blood), if given IV fluid monitor for fluid overload and also dependent patients should be turned to side to prevent aspiration (D)</p> Signup and view all the answers

<p>Hyperthyroidism (D)</p> Signup and view all the answers

<p>Females aged 12 to 18, males make up less than 10 percent (C)</p> Signup and view all the answers

<p>Restoration of nutritional health (C)</p> Signup and view all the answers

<p>Decreased potassium (D)</p> Signup and view all the answers

<p>Encouraging the patient to exercise regularly (A)</p> Signup and view all the answers

<p>Less than 10% (D)</p> Signup and view all the answers

<p>Medications, treatments, stress, emotional problems, infections, females with low self-esteem are at high risk, patients often have a phobia of gaining weight (C)</p> Signup and view all the answers

<p>Lanugo (D)</p> Signup and view all the answers

<p>Monitoring the rate of tube feeding or IV fluid administration,Monitoring vital signs, EKG, and lab values,Assessing that the patient has access to preferred foods, Accurate documentation or intake and output are important. (A)</p> Signup and view all the answers

<p>Early treatment results in a better prognosis. (C)</p> Signup and view all the answers

<p>Hyperthyroidism (D)</p> Signup and view all the answers

<p>Lanugo (D)</p> Signup and view all the answers

<p>Restoration of nutritional health, all of them above (C)</p> Signup and view all the answers

<p>Cognitive Behavioral Therapy (B)</p> Signup and view all the answers

<p>Results in poor nutritional health  Body tries to conserve energy  Pulse and blood pressure fall  Heart and kidney failure  Osteoporosis  Muscle loss  Vitamin and electrolyte imbalance  Diabetes  Constipation  Amenorrhea  Lanugo  Cardiac arrhythmias (D)</p> Signup and view all the answers

<p>\compulsive eating and self induced throwing up known as binging and purging (C)</p> Signup and view all the answers

<p>Heart failure, dysrhythmias, and death (B)</p> Signup and view all the answers

<p>Staining of the teeth, enamel erosion (A)</p> Signup and view all the answers

<p>BMI over 40 (D)</p> Signup and view all the answers

<p>Gallbladder disease, heart disease, hypertension, sleep apnea, type 2 diabetes, atherosclerosis (C)</p> Signup and view all the answers

<p>Education on healthy diet and exercise, caloric restriction (C)</p> Signup and view all the answers

<p>Atherosclerosis (C)</p> Signup and view all the answers

<p>Energy balance, Educate patient to:  Decrease stress  Change concepts about food  Encourage joining support group (C)</p> Signup and view all the answers

<p>'Binging and purging' in Bulimia Nervosa avoids weight gain. (B)</p> Signup and view all the answers

<p>Laxatives (D)</p> Signup and view all the answers

<p>BMI over 40 with life-threatening obesity-related diseases or BMI 35-40 with life threatning obesity (A)</p> Signup and view all the answers

<p>To limit food intake an inflatable band is placed around the upper portion of the stomach. A small sack is made to limit the amount of food that the patient eats. This procedure can be reversed (B)</p> Signup and view all the answers

<p>To decrease hormone that produces hunger (B)</p> Signup and view all the answers

<p>reduces size of stomach and the small intestine Creates a small thumb-sized gastric pouch (A)</p> Signup and view all the answers

<p>Protein, vitamin, and mineral deficiencies, Vomiting due to overeating  Bloating  Heartburn  Staple disruption  Obstruction  Dumping syndrome  Protein, vitamin, and mineral deficiencies  Lifelong supplements are often required  Compliance can be an issue  Band slippage  Intestinal Leakage (D)</p> Signup and view all the answers

<p>Patients will be started on a clear liquid diet. This is because of the small pouch that has been created.  Only a small amount of fluid at a time is allowed (30 ml).  The diet is increased to full liquids and pureed foods.  Patient should be able to tolerate the appropriate amount of regular foods at about 6 weeks post surgery.  Diet is very important! If not will likely have GI upset  Patients usually can not eat and drink at the same time due to the small gastric pouch that has been created. (C)</p> Signup and view all the answers

<p>To monitor for complications and skin changes wait 1 year to have skin removed (B)</p> Signup and view all the answers

<p>Complications in respiratory and cardiac diseases (B)</p> Signup and view all the answers

<p>Nystatin oral swish and swallow medication (A)</p> Signup and view all the answers

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

<p>EGD, barium swallow tests and biopsy (C)</p> Signup and view all the answers

<p>Heartburn, pain, feeling of fullness, or reflux (B)</p> Signup and view all the answers

<p>Small meals and avoiding reclining after eating, rasie HOB, avoid alcohol, smoking cessation (B)</p> Signup and view all the answers

<p>Nutritional needs, fluid intake, swallowing as appropriate, monitor PN nutrition, airway and breathing and pain management (A)</p> Signup and view all the answers

<p>Strangulation or obstruction (A)</p> Signup and view all the answers

<p>Alcohol use and tobacco (D)</p> Signup and view all the answers

<p>Progressive dysphasia, a feeling of fullness, pain in the chest after eating, foul breath (A)</p> Signup and view all the answers

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

<p>Monitoring IV nutrition and fluids (C)</p> Signup and view all the answers

<p>Candidiasis (thrush) (D)</p> Signup and view all the answers

<p>Difficulty swallowing or speaking, Leukoplakia  Painless or tender ulcers  Oral sore that won’t heal  Swollen cervical lymph nodes  Oral cancer is usually diagnosed with a biopsy. (A)</p> Signup and view all the answers

<p>Treated with radiation, chemotherapy, surgery or a combination of these treatmentsEsophageal resection  Esophagogastrostomy  Esophageal dilation or stent placement for inoperable tumors (A)</p> Signup and view all the answers

<p>Respiratory and cardiac diseases, Some dependent patients may be unable to complete the task of oral care for themselves.  Changes that are associated with aging and disease can result in inflammation and infection (B)</p> Signup and view all the answers

<p>Nutritional needs, airway management, pain management, and education stop alcohol and tobacco use (A)</p> Signup and view all the answers

<p>Both alcohol and tobacco use (D)</p> Signup and view all the answers

<p>To remove cancerous lymph nodes (B)</p> Signup and view all the answers

<p>It is usually found in the pharynx (B)</p> Signup and view all the answers

<p>Stopping alcohol and tobacco use (A)</p> Signup and view all the answers

<p>They irreversibly block the H+/K+ ATPase enzyme or gastric proton pump found in parietal cells (B)</p> Signup and view all the answers

<p>Sudden, powerful, or prolonged vomiting or coughing, a longitudinal tear in the mucous membrane of the esophagus and stomach junction (C)</p> Signup and view all the answers

<p>They are dilated blood vessels in the esophagus that develop from portal hypertension (C)</p> Signup and view all the answers

<p>Beta blockers such as propranolol and nadolol (B)</p> Signup and view all the answers

<p>Weight loss, smoking cessation, avoiding alcohol, chocolate, fatty foods, and caffeinated sodas (D)</p> Signup and view all the answers

<p>They neutralize stomach acid (B)</p> Signup and view all the answers

<p>75% (D)</p> Signup and view all the answers

<p>Conservative management with proton pump inhibitors and antiemetic medications, blood transfusions, or endoscopy (D)</p> Signup and view all the answers

<p>They compete with histamine for H2 receptors on parietal cells, depressing production of hydrochloric acid (C)</p> Signup and view all the answers

<p>Endoscopic variceal ligation using rubber bands (A)</p> Signup and view all the answers

<p>Hiatal hernias disrupt the anti-reflux barrier formed by the lower esophageal sphincter, allowing gastric contents to reflux into the esophagus. (B)</p> Signup and view all the answers

<p>barium swallow, esophagoscopy, and pH monitoring of the esophagus (B)</p> Signup and view all the answers

<p>Consuming large, infrequent meals (A)</p> Signup and view all the answers

<p>Fundoplication where the fundus folds down and sown into esophegeal sphincter (C)</p> Signup and view all the answers

<p>esophagitis leading to Barrett's esophagus (A)</p> Signup and view all the answers

<p>Respiratory complications: Asthma, aspiration pneumonia, bronchospasm, laryngospasm, chronic bronchitis (C)</p> Signup and view all the answers

<p>Hiatal hernia (B)</p> Signup and view all the answers

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

<p>Dysphagia (difficulty swallowing) (B)</p> Signup and view all the answers

<p>Peritonitis (C)</p> Signup and view all the answers

<p>Type A gastritis Patients are usually asymptomatic  These patients do not produce adequate amounts of intrinsic factor from the stomach cells. This results in difficulty absorbing vitamin B12. The result of this is pernicious anemia (C)</p> Signup and view all the answers

<p>Asymptomatic (D)</p> Signup and view all the answers

<p>include antacids, antiemetics, and histamine receptor antagonists. (A)</p> Signup and view all the answers

<p>Pernicious anemia (A)</p> Signup and view all the answers

<p>Diarrhea starting in 5 to 6 hours, all of them basically (B)</p> Signup and view all the answers

<p>Bland diet and removing irritating substances Occurs when the productive mucous membrane is broken down. This allows for auto digestion to occur.  Stomach is no longer protected from pepsin and hydrochloric acid.  Complications:  Inflammation results in edema and possible hemorrhage.  With severe gastritis, mucosa can become gangrenous and perforate leading to peritonitis  Scarring may also occur (B)</p> Signup and view all the answers

<p>Restoring blood flow to the GI tract and using prophylactic medications (D)</p> Signup and view all the answers

<p>schemia and damage to the mucosa occur which can lead to acid created ulcerations. Life threatening bleeding can be the result of this (A)</p> Signup and view all the answers

<p>alcohol, spicy foods, microorganisms, medications, stress, and, smoking, (D)</p> Signup and view all the answers

<p>Nausea and vomiting, poor appetite, heartburn after eating, belching, a sour taste (A)</p> Signup and view all the answers

<p>Exercising regularly (A)</p> Signup and view all the answers

<p>Location in the stomach, type b is lower end of stomach, type A is fundus of stomach, and stress gastritis (D)</p> Signup and view all the answers

<p>Intermittent sharp pain (C)</p> Signup and view all the answers

<p>Initiating IV fluids and monitoring vital signs, Discomfort&amp;pain poor nutrition and bad sleep can lead to peptic ulcers, Antiobiotic, amoldine, fumodine (C)</p> Signup and view all the answers

<p>Colonoscopy (B)</p> Signup and view all the answers

<p>Higher likelihood of recurrent ulcers, A perforated ulcer is a medical emergency and usually requires emergent surgical intervention.  Gastroduodenal contents are spilled into the abdominal cavity and result in an inflammation known as peritonitis.  Can lead to septicemia and hypovolemic shock (D)</p> Signup and view all the answers

<p>14 days (D)</p> Signup and view all the answers

<p>Monitoring for signs of septicemia and hypovolemic shock (B)</p> Signup and view all the answers

<p>Duodenal ulcers often have relief after meals (A)</p> Signup and view all the answers

<p>Development of peritonitis (D)</p> Signup and view all the answers

<p>H.pylori infection (C)</p> Signup and view all the answers

<p>Duodenum (B)</p> Signup and view all the answers

<p>Erosion occurs due to increase of the activity of hydrochloric acid and pepsin (C)</p> Signup and view all the answers

<p>Duodenal ulcers are less common than gastric ulcers. (D)</p> Signup and view all the answers

<p>Stomach pain and indigestion (C)</p> Signup and view all the answers

<p>Inadequate mucus production for tissue protection (D)</p> Signup and view all the answers

<p>Peptic ulcers (D)</p> Signup and view all the answers

<p>Hematemesis (B)</p> Signup and view all the answers

<p>HYPOVOLEMIC SHOCK-Weak, thready pulse, hypovolemic shock:  Hypotension  Tachycardia  Tachypnea  Chills  Palpitations  Weak, thready pulse (A)</p> Signup and view all the answers

<p>Nothing by mouth (D)</p> Signup and view all the answers

<p>Melena (D)</p> Signup and view all the answers

<p>Insertion of urinary catheter,placement of an NG tube, oxygen therapy, and medications as appropriate. (A)</p> Signup and view all the answers

<p>Peptic ulcers (B)</p> Signup and view all the answers

<p>Coffee grounds like appearance (C)</p> Signup and view all the answers

<p>Metastasis to other organs (C)</p> Signup and view all the answers

<p>H.pylori infection (B)</p> Signup and view all the answers

<p>Distal portion of the stomach is removed. The remainder of the stomach is attached surgically to the duodenum (C)</p> Signup and view all the answers

<p>Endoscopy (B)</p> Signup and view all the answers

<p>include pain management and assessment of the incision. monitor vital signs and maintain NG tube as ordered by the provider (D)</p> Signup and view all the answers

<p>Non-specific signs and symptoms (C)</p> Signup and view all the answers

<p>Surgical removal of the cancer (C)</p> Signup and view all the answers

<p>Consuming smoked fish or meats (B)</p> Signup and view all the answers

<p>Billroth I procedure (A)</p> Signup and view all the answers

<p>Dumping syndrome due to rapid emptying of food into the jejunum (B)</p> Signup and view all the answers

<p>Dumping syndrome symptoms (A)</p> Signup and view all the answers

<p>Low-residue diet (B)</p> Signup and view all the answers

<p>Monitoring electrolyte levels (D)</p> Signup and view all the answers

<p>Total gastrectomy involves the complete removal of the stomach and attachment of the esophagus to the jejunum. (D)</p> Signup and view all the answers

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

<p>To relieve symptoms caused by the metastatic cancer. (C)</p> Signup and view all the answers

<p>Monitoring the color of the mucous membranes is unnecessary. (D)</p> Signup and view all the answers

<p>Roux-en-Y gastric bypass, which alters the stomach and small intestine. (D)</p> Signup and view all the answers

<p>Rapid entry of food into the jejunum and improper mixing with digestive juices (C)</p> Signup and view all the answers

<p>dizziness, tachycardia, fainting, sweating, nausea, diarrhea, and abdominal cramping (D)</p> Signup and view all the answers

<p>Small, frequent meals high in protein and low in fat, sugar, and carbohydrates (D)</p> Signup and view all the answers

<p>cold skin, increased pulse, decreased temperature and blood pressure. The patient may also have a change in LOC. The patient may also exhibit hematemesis.  The patient may return from the OR with an NG tube in place. Monitor the amount and character of the drainage.  Monitor the wound dressings for bleeding (A)</p> Signup and view all the answers

<p>Encouraging increased fluid intake (C)</p> Signup and view all the answers

<p>Rapid entry of food into the jejunum leads to fluid imbalances (A)</p> Signup and view all the answers

<p>taught to eat small frequent meals. meals should be high in protein, low in fat, low sugar, and low carbohydrate (A)</p> Signup and view all the answers

<p>Hypovolemic shock (D)</p> Signup and view all the answers

<p>Tachycardia (D)</p> Signup and view all the answers

<p>High-protein, low-fat, low-sugar, low-carbohydrate meals (D)</p> Signup and view all the answers

<p>Vitamin B12 (C)</p> Signup and view all the answers

<p>Pyloric obstruction due to scar tissue or edema (B)</p> Signup and view all the answers

<p>Pernicious anemia (B)</p> Signup and view all the answers

<p>Steatorrhea (C)</p> Signup and view all the answers

<p>Small, frequent meals with limited fluid intake during meals (C)</p> Signup and view all the answers

<p>Vitamin B12 deficiency, The release of the extra insulin can result in the symptoms of hypoglycemia about 2 hours after the episode (C)</p> Signup and view all the answers