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NRS 3025 GI – Questions With Definite Solutions

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NRS 3025 GI – Questions With Definite Solutions

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NRS 3025 GI – Questions With Definite Solutions

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Terms in this set (172)


Esophageal disorders includes:
can affect any part of the upper esophageal (UES) and lower esophageal
esophagus (LES)

Disorders of the such as structural defects, inflammation, obstruction,
esophagus and cancer, can interfere with nutritional intake.

examples of esophageal also includes: gastroesophageal reflux disease
disorders (GERD), hiatal hernia, and esophageal varices.

gastric content and enzyme backflow into the
esophagus.
- Corrosive fluids irritate the esophageal tissue,
GERD
causing delay in their clearance.
- This further exposes esophageal tissue to the
acidic fluids, causing more irritation.

- diet and lifestyle changes - Followed by advancing
primary treatment of
to medication use (antacids, H2-receptor
GERD
antagonists, proton pump inhibitors) and surgery

leads to inflammation, breakdown, and long-term
Untreated GERD can.. complications, such as Barrett's esophagus or
adenocarcinoma of the esophagus.

- Maintain a weight below
-BMI of 30. Stop smoking.
- Limit or avoid alcohol and tobacco use.
Health Promotion and
-Eat a low-fat diet.
Disease Prevention of
- Avoid foods that lower the LES pressure.
GERD
-Avoid eating or drinking 2 hr before bed.
-Avoid tight-fitting clothes.
- Elevate the head of the bed 6 to 8 inches.

, include:
- Obesity
- Older age (delayed gastric emptying and
Risk factors of GERD
weakened LES tone)
- Sleep apnea
- Nasogastric tube

- Excessive ingestion of foods that relax the LES
include fatty and fried foods, chocolate, caffeinated
beverages (coffee), peppermint, spicy foods,
tomatoes, citrus fruits, and alcohol - Prolonged or
frequent abdominal distention Increased abdominal
pressure from obesity, pregnancy, bending at the
Contributing Factors of waist, ascites, or tight clothing at the waist
GERD - Medications that relax the LES - Increased gastric
acid caused by medications or stress
- Debilitation resulting in weakened LES tone
- Hiatal hernia
- Gastritis due to helicobacter pylori can increase
reflux
- Lying flat

- Report of dyspepsia (indigestion) after eating an
offending food or fluid, and regurgitation
- Radiating pain (neck, jaw, or back)
- Report of a feeling of having a heart attack.
- Pyrosis
- Odynophagia
- Pain that worsens with position (bending, straining,
laying down) and after eating and lasts 20 min to 2
Expected findings of
hr
GERD
- Throat irritation, hypersalivation, bitter taste in
mouth.
- Chronic GERD can lead to dysphagia.
- Pain is relieved (almost immediately) by drinking
water, sitting upright, or taking antacids.
- Dental caries
- Chest congestion and wheezing due to reflux
material entering the tracheobronchial tree

, Diagnostic procedures Includes: EGD, Esophageal pH monitoring, Barium
for GERD swallow,

- done under moderate sedation to observe for
tissue damage and to dilate strictures in the
esophagus.
- The esophageal lining should be pink but is often
Esophagogastroduoden
red with persistent GERD. Biopsies can be done to
oscopy (EGD)
determine if high-grade dysplasia (HGD) is present.
- EGD allows visualization of the esophagus,
revealing esophagitis or Barrett's epithelium
(premalignant cells).

Verify gag response has returned prior to providing
oral fluids or food following the procedure to
nursing actions for EGD reduce the risk for aspiration. Monitor client for
manifestations of esophageal perforation (fever,
pain, dyspnea, bleeding)

- A small catheter is placed through the nose and
into the distal esophagus, or a small capsule is
attached to the esophageal wall during endoscopy.
Esophageal pH pH readings are taken in relation to food, position,
monitoring and activity for 24 to 48 hr.
- Most accurate method of diagnosing GERD -
Especially helpful in diagnosis for clients who have
atypical manifestations

nursing actions for Instruct the client to keep a journal of foods and
esophageal pH beverages consumed, manifestations, and activity
monitoring during the 24-hr test period.

identifies a hiatal hernia, strictures, or structural
Barium swallow abnormalities, which would contribute to or cause
GERD.

Instruct the client to use cathartics to evacuate the
nursing actions of barium barium from the GI tract following the procedure.
swallow Failure to eliminate the barium places the client at
risk for fecal impaction

include: PPIs, antacids, Histamine 2 receptor
Medications for GERD
antagonists, Prokinetics

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