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Glossary of Gastrointestinal Disorders

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Created by redshorty03

Early stages of oral cancer signs and symptoms
Person may be asymptomatic but may also experience:
-Dysphagia
-Persistant pain in mouth, throat, teeth
-Tongue problems
-A thickening, lumpy feeling in the mouth, throat, or tongue
-Abnormal taste
-Persistant red or white lesions
-Unhealing mouth sores or increases in size or bleed easily
-Thickening of the cheek
-Voice changes
-Lump in the neck









Nursing interventions for the patient prior to and after esophagogastroduodenoscopy (EGD) exam
BEFORE:
-Contact doctor to see which medications should be discontinued before the EGD (such as aspirin and NSAIDs)
-NPO at least 6-12 hrs before to ensure that the upper intestinal tract will be empty
-Administer pain meds per doctors order
AFTER:
-Monitor patient until sedation wears off
-NPO until gag reflex returns
-






Nursing teaching for the medication NYSTATIN?
-Swish in the mouth then swallow the medication
-Take drug exactly as prescribed. Continue taking it for at least 48 hrs after symptoms subside.
-If you miss a dose, take dose asap and them resume regular dosing schedule
-Drug may cause nausea, vomiting, diarrhea, gastrointestinal distress, mouth irritation, itching or rash


Cause of esophageal reflux. What happens to the lower esophageal sphincter (LES)?
The LES weaken and lose tone making it unable to close completely after food enters the stomach, which allows acid from the stomach to back up into the esophagus.
Causes include:
-NSAIDs
-Calcium channel blockers, Anticholinergics, Beta blockers
-Diabetes
-Asthma
-Hiatal Hernia
-Peristalsis abnormalties






Dysphagia
difficulty swallowing
What can dysphagia lead to?
Increases the risk of choking and aspiration and may lead to malnutrition and dehydration
Esophageal Cancer
abnormal accumulation of cells that form a tumor in the esophagus. Symptoms include:
-Dysphagia
-weight loss
-angina
-fatigue
Typically causes no signs or symptoms in early stages




Ulcerative Colitis
a type of inflammatory bowel disease (IBD) that affects the large intestine (colon) and rectum. symptome include: abdominal pain, diarrhea, fever, melena, weight loss, gi bleeding, joint pain, nausea & vomiting
Daily dosage for Omeprazole (Prilosec)
Adult daily dosage: 20mg once daily for up to 4 weeks
Omeprazole (Prilosec)
Delayed release capsule for oral administration which blocks acid production in the stomach. Proton pump inhibitor used to treat acid-related stomach and throat problems such as GERD, ulcers, erosive esophagitis, or Zollinger-Ellison Syndrome to relieve heartburn, dysphagia, persistant cough, and trouble sleeping.
Whipple procedure
(pancreatoduodenectomy) most common operation performed for pancreatic cancer and used to teat other cancers such as small bowel cancer. Surgeons remove the head of the pancreas, most of the duodenum, and sometimes a portion of the stomach. The digestive tract is reconstructed after surgery.
Pancreatitis
an inflammation or infection of the pancreas. symptoms include:
-abdominal pain
-chills
-clammy skin
-fatty stools
-fever
-mild jaundice
-nausea/vomiting
-weakness
-weightloss








Dumping Syndrome
Most likely develops after gastrointestinal surgery. Rapid gastric emptying occurring when the undigested contents of the stomach are dumped into the small intestines too rapidly. Common symptoms include abdominal cramps, nausea and vomiting, diarrhea, bloating
Lab value that elevates when a person has pancreatitis
Serum amylase and serum lipase in the blood indicates pancreatitis. A CBC, liver function test, bilirubin level test may also be done.
Helicobacter pylori (H. pylori)
bacteria that only grows in the stomach and is responsible for most ulcers and many cases of stomach inflammation that can weaken the protective coating of the stomach allowing digestive juices to irritate the sensitive lining.
Barium Swallow
a test that may be used to determine the cause of painful swallowing, dysphagia, abdominal pain, hemoptysis, or unexplained weightloss. performed by drinking barium sulfate and an xray tracks its path through the digestive system. can detect: hiatal hernia, ulcers, tumors, polyps, disorders of swallowing, narrowing or irritation to the esophagus
CT Scan (computerized tomograhy)
combines a series of x-ray views taken from many different angles to produce cross-sectional images of tissues inside the body. Contrast material may be used (check for iodine or shellfish allergy). Metal objects will have to be removed cause they may interfere with image results.
Hiatal hernia
a part of the stomach pushed upward through the diaphragm. (The diaphragm normally has a small opening called the hiatus to allow the esophagus to pass through). symptoms include heartburn, belching, chest pain, nausea. can be caused when weakened muscles allow the stomach to bulge up through the diaphragm.
Management of hiatal hernia
-can be treated with antacids to neutralize stomach acid. -medications such as H-2 receptor blockers (cimetidie [tagamet hb], famotidine [Pepcid AC], nizatidine [Axid AR], or ranitidine [Zantac 75]) reduce acid production. Provides longer relief than antacids.
-Prevacid or Prilosec (lansoprazole or omeprazole respectively) help block acid production.
-may have surgery
-eat several small meals
-avoid foods that trigger heartburn such as chocolate, onions, spicy foods, citrus fruits, and tomato based foods
-sit up after you eat
-eat at least 3 hrs before bedtime
-elevate head of bed 6 inches
-reduce stress







Oral cancer lesions may metastasize to what other structures?
When oral cancer metastasizes, it usually travels through the lymphatic system by lymph to the nearby body parts such as the neck or lungs
Colonoscopy
an exam used to detect changes or abnormalties in the large intestine (colon) or rectum. a long flexible tube (colonoscope) is inserted into the rectum and a tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.
peristalsis
wave-like rhythmic contractions that propel material through the gastrointestinal tract
Enzymes secreted by the pancreas
-Amylase to digest starch to maltose
-Maltase to reduce maltose to monosaccharide glucose
-Lactase to split lactose into galactose and glucose
-Sucrase to reduce sucrose to fuctose and glucose
-Nuclease to split nucleic acids to nucleotides
-Enterokinase to activate trypsinogen to trypsin




Signs of bowel perforation and peritonitis
-guarding of the abdomen
-increased fever and chills
-pallor
-progressive abdominal distention and abdominal pain
-restlessness
-tachycardia and tachypnea




Paracentesis
transabdominal removal of fluid from the peritoneal cavity
BEFORE:
-have client void and empty bladder
-measure abdominal girth, weight, and baseline vitals
-client must be in an upright position on the edge of the bed with back supported and feet resting on stool
AFTER:
-monitor vital signs
-monitor I&O
-apply dry sterile dressing to insertion site
-measure abdominal girth and weight
-instruct pt to notify Dr. if notice urine in blood









Order for performing the abdominal assessment
-Inspect
-Auscultate
-Percuss
-Palpate


Vitamin B12
necessary for processing carbohydrates, proteins, and fats, and to help make all of the red blood cells in the body. Stored in the liver
Symptoms of Vitamin B12 deficiency
mouth irritation, brain damage, pernicious anemia
Pernicious anemia
a decrease in red blood cells that occurs when the body cannot properly absorb vitamin B12 from the gastrointestinal tract. A type of megaloblastic anemia.
Esophageal Varices
abnormally enlarged veins in the lower part of the esophagus. symptoms include vomiting blood; black, tarry or bloody stools; decreased urination from unusually low blood pressure; excessive thirst; lightheadedness; shock. caused by portal hypertension; cirrhosis
Antacids
neutralizes stomach acid
-Aluminum hydroxide gel (Alu-Cap, Alu-Tab, Amphojel, ALternaGel, Dialume)
-Aluminum hydroxide; magnesium hydroxide (Maalox oral suspension)
-Calcium carbonate (Mylanta, Tums)
-Magnesium hydroxide (Milk of Magnesia)
-Sodium bicarbonate preparation




Gastric Protectants
Suppresses secretion of gastric acid. Used to prevent gastric ulcers caused by long-term therapy with NSAIDs.
-Misoprostol (Cytotec)
-Sucralfate (Carafate)

Histamine 2 (H2)-Receptor Antagonists (Blockers)
Suppresses secretion of gastric acid to alleviate the symptoms of heartburn and assist in preventing complications of peptic ulcer disesase
-Cimetidine (Tagamet)
-Famotidine (Pepcid)
-Nizatidine (Axid)
-Ranitidine (Zantac)



Proton Pump Inhibitors
Suppresses gastric acid secretion. Used to treat active ulcer disease, erosive esophagititis, and pathological hypersecretory conditions
-Esomeprazole (Nexium)
-Lansoprazole (Prevacid)
-Omeprazole (Prilosec)
-Pantoprazole (Protonix)
-Rabeprazole (Aciphex)




Medication regimens to treat Helicobactor pylor infections
antibacterial agent alone is not effective for eradicating H. pylori becasue the bacterium readily becomes resistant to the agent. dual, triple, and quadruple therapy is used.
DUAL:
-Ranitidine bismuth citrate plus clarithromycin (Biaxin)
-Omeprazole plus clarithromycin
TRIPLE:
-Metronidazole (Flagyl), omeprazole, plus clarithromycin
-Amoxicillin (Amoxil), lansoprazole, plus clarithromycin
QUADRUPLE:
-colloidal bismuth subnitrate, tetracycline (Achromycin), metronidazole, plus omeprazole







Hepatitis A
formerly known as infectious hepatitis transmitted through fecal-oral route; person to person contact; parental; contaminated fruits, vegetables, or uncooked shellfish; contaminated water or milk; poorly washed utensils
Hepatitis B
trasmitted through blood or body fluid contact; infected blood products; infected saliva or semen; contaminated needles; sexual contact; parenteral; perinatal period (mother to baby). drug addicts, clients undergoing long-term hemodialysis, and health care personnel are at greatest risk
Hepatitis
inflammation of the liver caused by a virus, bacteria, or exposure to medications or hepatotoxins
Management for acute pancreatitis
maintain NPO status; hydrate with IV fluids as ordered; administer parenteral nutrition; administer meperidine hydrochloride (Demerol) as prescribed for pain (avoid morphine or codeine sulfate because they cause spasm of the sphincter of Oddi and increase pain); administer antacids; administer anticholinergics to decrease vagal stimulation, gastrointestinal motility, and inhip pancreatic enzyme secretion
Borborygmi
known as stomach growling, rumbling, or wambling but is the rumbling sound made by the movement of gas in the stomach and intestines
Salem sump
used to decompress the stomach. has two lumens: one for drainage and one for air (vent)called the blue pigtail. the drainage lumen is usually connected to low continuous suction. higher levels may be needed. plastic and disposable
Where should the blue pigtail (air vent on the salem sump) be placed?
open to environmental (atmospheric) air, which is drawn into the stomach to equalize the outside pressure with the pressure inside the stomach. This prevents the catheter tip from attaching to the gastric mucosa when the drainage lumen is attached to suction, limiting mucosal damage
Organs in RUQ of the abdomen
Liver, gallbladder, tail of pancreas, left kidney, & left adrenal gland
Organs in LUQ of abdomen
Stomach, spleen, head of the pancreas, left kidney and left adrenal gland
Organs in the RLQ of abdomen
Large/small intestines, right ovary (if female), appendix
[pain in this area caused from appendicitis, kidney stone, IBD, diverticulitis}
Organs of the LLQ of the abdomen
small/large intestine, descending colon, bladder
pin in this region caused from diverticulitis, appendicitis
melena
black, tarry , sticky, shiny feces with occult blood
Stomatitis
also known as canker sores. painful single or multiple ulcerations which appear as inflammation and erosion of the protective lining of the mouth. can result from infectoin, allergy, certain foods, vitamin deficiency, systemic disease, and irritants
Most important care for patients undergoing treatment for oral cancer
Assess and protect the patient’s airway function

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