PNR 309 TEST 2 Vancouver Island University/ PNR 309
Final Exam With complete solu$on RATED A+ NEW
EDITION
Gastro-esophageal reflux disease (GERD) - Ans Any clinically significant symptoma c condi on
or histopathological altera on presumed to be secondary to reflux of gastric contents into the
lower esophagus.
What is onset for chronic thyroidi s and what causes this? - Ans O&en asymptoma c for a
long me. Caused by abnormal blood an bodies and WBC a)acking/damaging thyroid cells
Predisposing condi ons of GERD (4) - Ans 1. hiatal hernia
2. incompetent lower esophageal sphincter (LES)
3. decreased esophageal clearance from impaired esophageal mo lity
4. decreased gastric emptying
Complica ons of GERD - Ans Esophagi s (inflamma on of the esophagus),
Barre)'s esophagus (esophageal metaplasia),
respiratory complica ons,
aspira on pneumonia,
dental erosion.
Risk factors for Esophagi s - Ans hiatal hernia, chemical irrita on from lye, and physical
irritants such as smoking, cold or hot liquids, and excessive alcoholic intake. Trauma to the
esophagus may also produce inflamma on.
,Diagnosing GERD - Ans Endoscopy, barium swallow
GERD treatments - Ans lifestyle modifica ons,
nutri onal therapy,
drug therapy,
surgical/endoscopy therapy
What lifestyle modifica ons are suggested? - Ans smoking/alcohol cessa on (or at least
avoidance), avoid caffeine, lose weight if able (maintain healthy wt)
What nutri onal modifica ons? - Ans decrease high-fat foods, milk products, mints,
carbonated beverages, acidic foods/drinks
Drug therapy for GERD targets what? - Ans focused on improving LES func on, increasing
esophageal clearance, decreasing volume and acidity of reflux, and protec ng the esophageal
mucosa.
What drugs can treat GERD (give name, class)? - Ans H2R blockers - Pepsid, Zantac;
PPIs - Losec, Pantoloc, Prevacid;
Antacids - Gaviscon, maalox (mylanta);
Prokine c drugs - Metoclopramide
Following administra on of a dose of metoclopramide to the client, the nurse determines that
the medica on has been effec ve when which of the following is noted?
a) Decreased blood pressure
b) Absence of muscle tremors
,c) Relief of nausea and vomi ng
d) absence of diarrhea - Ans C
The nurse administered a dose of metoclopramide to a client and the client has symptoms of
nausea. The nurse would teach the client to report which of the following poten al adverse
effects?
a) Tremors
b) Cons pa on
c) Double vision
d) Numbness in the fingers and nose - Ans A - Extrapyramidal adverse effects, including
tremors and dyskinesias, may occur as a result of metoclopramide administra on.
The nurse is caring for a client with a diagnosis of diver culi s and a history of irritable bowel
disease and gastro-esophageal reflux disease (GERD) who has received a dose of Mylanta 30 mL
PO. The nurse would evaluate its effec veness by ques oning the client as to whether which of
the following symptoms has been resolved?
a) Diarrhea
b) Heartburn
c)cons pa on
d) Lower abdominal pain - Ans B
Hiatal hernia - Ans hernia on of a por on of the stomach into the esophagus through an
opening (hiatus) in the diaphragm.
Two types of Hiatus Hernia are: - Ans sliding and paraesophageal (rolling).
, Predisposing factors of hernia on - Ans increased intra- abdominal pressure (including obesity,
pregnancy, ascites, tumours, ght corsets),
intense physical exer on,
heavy li&ing on a con nual basis, increased age,
trauma,
poor nutri on,
prolonged bed rest.
**Occurs more o&en in women
Diagnosing a hiatal hernia - Ans xray, barium swallow, endoscopy
Complica ons with hiatal hernias - Ans hemorrhage,
stenosis of esophagus, regurgita on/aspira on,
ulcers in herniated por on of stomach,
strangula on of hernia.
H Hernia treatments: - Ans similar to GERD;
lifestyle modifica ons, elevate HOB, antacids/H2R blockers, surgical therapy (all varia ons of
fundoplica on)
Esophageal cancer - Ans rare malignant neoplasm of the esophagus, of which there are two
types: squamous cell carcinoma and adenocarcinoma
The nurse is caring for a client who is receiving chemotherapy and rings the call bell to report
an onset of nausea. The nurse should prepare a prn dose of which of the following prescribed
medica ons?
Final Exam With complete solu$on RATED A+ NEW
EDITION
Gastro-esophageal reflux disease (GERD) - Ans Any clinically significant symptoma c condi on
or histopathological altera on presumed to be secondary to reflux of gastric contents into the
lower esophagus.
What is onset for chronic thyroidi s and what causes this? - Ans O&en asymptoma c for a
long me. Caused by abnormal blood an bodies and WBC a)acking/damaging thyroid cells
Predisposing condi ons of GERD (4) - Ans 1. hiatal hernia
2. incompetent lower esophageal sphincter (LES)
3. decreased esophageal clearance from impaired esophageal mo lity
4. decreased gastric emptying
Complica ons of GERD - Ans Esophagi s (inflamma on of the esophagus),
Barre)'s esophagus (esophageal metaplasia),
respiratory complica ons,
aspira on pneumonia,
dental erosion.
Risk factors for Esophagi s - Ans hiatal hernia, chemical irrita on from lye, and physical
irritants such as smoking, cold or hot liquids, and excessive alcoholic intake. Trauma to the
esophagus may also produce inflamma on.
,Diagnosing GERD - Ans Endoscopy, barium swallow
GERD treatments - Ans lifestyle modifica ons,
nutri onal therapy,
drug therapy,
surgical/endoscopy therapy
What lifestyle modifica ons are suggested? - Ans smoking/alcohol cessa on (or at least
avoidance), avoid caffeine, lose weight if able (maintain healthy wt)
What nutri onal modifica ons? - Ans decrease high-fat foods, milk products, mints,
carbonated beverages, acidic foods/drinks
Drug therapy for GERD targets what? - Ans focused on improving LES func on, increasing
esophageal clearance, decreasing volume and acidity of reflux, and protec ng the esophageal
mucosa.
What drugs can treat GERD (give name, class)? - Ans H2R blockers - Pepsid, Zantac;
PPIs - Losec, Pantoloc, Prevacid;
Antacids - Gaviscon, maalox (mylanta);
Prokine c drugs - Metoclopramide
Following administra on of a dose of metoclopramide to the client, the nurse determines that
the medica on has been effec ve when which of the following is noted?
a) Decreased blood pressure
b) Absence of muscle tremors
,c) Relief of nausea and vomi ng
d) absence of diarrhea - Ans C
The nurse administered a dose of metoclopramide to a client and the client has symptoms of
nausea. The nurse would teach the client to report which of the following poten al adverse
effects?
a) Tremors
b) Cons pa on
c) Double vision
d) Numbness in the fingers and nose - Ans A - Extrapyramidal adverse effects, including
tremors and dyskinesias, may occur as a result of metoclopramide administra on.
The nurse is caring for a client with a diagnosis of diver culi s and a history of irritable bowel
disease and gastro-esophageal reflux disease (GERD) who has received a dose of Mylanta 30 mL
PO. The nurse would evaluate its effec veness by ques oning the client as to whether which of
the following symptoms has been resolved?
a) Diarrhea
b) Heartburn
c)cons pa on
d) Lower abdominal pain - Ans B
Hiatal hernia - Ans hernia on of a por on of the stomach into the esophagus through an
opening (hiatus) in the diaphragm.
Two types of Hiatus Hernia are: - Ans sliding and paraesophageal (rolling).
, Predisposing factors of hernia on - Ans increased intra- abdominal pressure (including obesity,
pregnancy, ascites, tumours, ght corsets),
intense physical exer on,
heavy li&ing on a con nual basis, increased age,
trauma,
poor nutri on,
prolonged bed rest.
**Occurs more o&en in women
Diagnosing a hiatal hernia - Ans xray, barium swallow, endoscopy
Complica ons with hiatal hernias - Ans hemorrhage,
stenosis of esophagus, regurgita on/aspira on,
ulcers in herniated por on of stomach,
strangula on of hernia.
H Hernia treatments: - Ans similar to GERD;
lifestyle modifica ons, elevate HOB, antacids/H2R blockers, surgical therapy (all varia ons of
fundoplica on)
Esophageal cancer - Ans rare malignant neoplasm of the esophagus, of which there are two
types: squamous cell carcinoma and adenocarcinoma
The nurse is caring for a client who is receiving chemotherapy and rings the call bell to report
an onset of nausea. The nurse should prepare a prn dose of which of the following prescribed
medica ons?
