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Questions and Answers
Which cells secrete hydrochloric acid?
What is the primary function of surface epithelium cells in the stomach?
Secrete mucus for protection
What condition is characterized by the backward flow of stomach acid into the esophagus?
Antacids are used to treat diarrhea.
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What should patients be cautious about when taking antacids if they have kidney disease?
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The mechanism of H2-receptor antagonists is to block the action of ____.
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What is the mechanism of action for proton pump inhibitors?
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What are common indications for mucosal protectants like Sucralfate?
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Probiotics should not be recommended as part of nonpharmacological interventions for diarrhea.
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What is a serious risk associated with severe diarrhea?
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Study Notes
Pathophysiology of the Stomach
- The stomach contains several cell types, each with specific functions.
- Parietal cells secrete hydrochloric acid (HCl) and intrinsic factor, crucial for vitamin B12 absorption.
- Chief cells release pepsinogen, converted to pepsin for protein digestion.
- Surface epithelium cells secrete mucus for protection.
- Enteroendocrine cells, including G cells, produce substances like gastrin, which regulates stomach functions.
Acid-Related Disorders
- These result from imbalances in acid production and secretion.
- Common examples include gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD).
Nursing Considerations for Hyperacidity Medications
- Assess patient's abdomen regularly, document bowel patterns, and monitor for drug interactions, side effects, and potential vitamin B12 deficiency.
- Implement treatment plans using appropriate drug dosages and administration routes.
- Evaluate symptom improvement and report any worsening or lack of improvement to the provider.
Antacids
- Used to treat heartburn, acid indigestion, and upset stomach.
- They neutralize gastric acidity, elevate stomach pH, and inactivate pepsin.
- Common examples include calcium carbonate.
- Administration considerations vary based on formulation (tablets, chewable, liquid) and require caution in patients with kidney disease.
- Patient teaching should emphasize appropriate use, especially for chewable and liquid forms.
H2-Receptor Antagonists
- Famotidine is an example of an H2-receptor antagonist.
- It's used for GERD, peptic ulcers, erosive esophagitis, and hypersecretory conditions.
- It works by blocking histamine's action, thereby reducing acid production.
- Administration considerations include timing (15-60 minutes before potential triggers), dosage adjustments for liver and kidney disease, and proper use of oral suspensions.
- Patient teaching should emphasize shaking oral suspensions, staying hydrated, and maintaining a high-fiber diet.
Proton Pump Inhibitors
- Pantoprazole is a proton pump inhibitor.
- Commonly used for GERD, excessive stomach acid, and Zollinger-Ellison syndrome.
- It inhibits the hydrogen/potassium ATPase pump, significantly reducing acid secretion.
- Administration options include oral, nasogastric tube, and intravenous routes.
- Granules may be mixed with applesauce or apple juice for easier administration.
- Patient teaching should involve reporting any worsening or lack of improvement, and discouraging alcohol, NSAIDs, and irritating foods.
Mucosal Protectant
- Sucralfate is a mucosal protectant.
- It's used for treating ulcers.
- It acts by locally covering and protecting ulcer sites.
- Administration considerations take into account individual preferences, empty stomach administration, and cautious use in chronic renal failure.
- Patient teaching should emphasize reporting any worsening or lack of improvement.
Antiflatulent
- Simethicone is an antiflatulent.
- It's used to relieve gas discomfort.
- It alters the elasticity of gas bubbles, facilitating expulsion.
- Usual administration involves taking it four times a day.
- Liquid drops should be shaken before administering.
- Patient teaching should educate on additional measures for gas expulsion.
Antidiarrheals
- Diarrhea can be caused by a variety of factors including:
- Bacteria
- Viruses
- Parasites
- Medications
- Food intolerances
- Diseases
- Severe diarrhea poses a threat of dehydration due to water and electrolyte loss.
Nursing Considerations for Antidiarrheal Medications
- Assess the patient's abdomen, bowel movement frequency, stool characteristics, and monitor for skin breakdown.
- Prioritize monitoring for dehydration, especially in vulnerable populations.
- Implement safe use of antidiarrheal medications, cautioning against exceeding over-the-counter (OTC) dosages.
- Advocate for the use of probiotics.
- Nonpharmacological interventions, like fluid replacement and soft foods, are also important.
- Evaluate the effectiveness of the treatment.
- Notify the provider if symptoms persist after 48 hours.
- Monitor for adverse effects, such as increased bleeding or abnormal heart rhythms.
Adsorbents
- Bismuth subsalicylate is an example of an adsorbent.
- It coats the gastrointestinal tract and binds causative bacteria and toxins, reducing fluid flow.
- Administration considerations include avoiding use in patients with salicylate allergy, ulcers, bleeding, or black stool.
- Patient teaching should include taking it as directed, being aware of color changes, and discontinuing use if tinnitus occurs.
Antimotility Agents
- Anticholinergics, such as hyoscyamine, inhibit propulsive GI motility and decrease gastric acid secretion.
- Contraindications include glaucoma and myasthenia gravis.
- Patient teaching should inform patients about potential dizziness, drowsiness, and dry mouth.
- Encourage oral hygiene to alleviate dry mouth.
- Opioid-like medications, such as loperamide, work by decreasing fluid flow and slowing bowel movements.
- Administration considerations involve monitoring for side effects and QT prolongation.
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Description
This quiz covers the pathophysiology of the stomach, focusing on the various cell types and their functions. It also addresses acid-related disorders such as GERD and peptic ulcer disease, along with nursing considerations for managing hyperacidity medications. Test your understanding of gastrointestinal health and nursing implications.
