Nursing 122 - Exam 1 NEWEST VERSION 2026\LATEST UPDATE
WITH COMPLETE (51-100 QUESTIONS AND CORRECT DETAILED
ANSWERS \VERIFIED 100% GRADED A+\LATEST UPDATE
GERD - details A common comorbid disease is adult onset asthma
Esophageal motility or manometry. Barium swallow.
GERD Diagnostic Tests
Endoscopy. 24-hour pH monitoring
Avoid fatty foods, caffeine (cola, coffee, tea,
GERD - Diet chocolate), onions, tomato-based, and alcohol.
Frequent small meals. No snack 2-3 hours before bed.
Lose weight. Remain upright 1-2 hours after meals.
Avoid lifting, straining etc. No restrictive clothing. Do
GERD- Activity.
not sleep flat, elevated HOB 8- 12 inches. Stop
smoking
GERD Drugs Antacids. Histamine (H2) receptor antagonists. Proton pump
inhibitors.
No functional problems. Signs and symptoms mimic
Hiatal Hernia - sliding hernia GERD. Moves back and forth in response to changes in
position or abdominal pressure. The distal esophagus,
gastric junction and often part of the stomach
displace upward into the thorax
Hernia that is not usually reflux. Risk of volvulus,
Hiatal Hernias-
Paraesophageal hernias strangulation, and obstruction are high.
histal hernia - Diagnostic tests barium swallow. most found during GERD workup
Same as GERD. Surgery is necessary for paraesophageal
Hiatal Diet, Meds,
and Activity hernias due to the risk of serious complications-Nissen
Fundoplication.
May result from esophageal denervation. Signs and
Achalasia- Motility Disorders symptoms: Difficulty swallowing solids and liquids.
Chronic and progressive. dysphagia. Regurgitation of
swallowed food. Foul mouth odor. Classic "rat tail"
narrowing is observed on barium studies
, Obstruction may be so severe that little or no food may reach the
stomach.
Achalasia Treatments Conservative rx for mild disease with medication.
Medications: Anticholinergics Sublingual nitrates,
Calcium channel blockers, Botox injection into the LES,
None have been consistently valuable.
Esophageal dilatation is the main rx: Balloon dilatation is
Achalasia: treatment repeated as necessary
-Esophageal tearing is the primary concern.
Esophagomyotomy is the surgery -Done if 2-3
dilatations have failed
Small frequent meals
eaten slowly Change
Achalasia: diet
positions during eating
Risk for nocturnal
aspiration
Sleep with head elevated
Esophageal Carcinoma: Benign tumors usually
details
leiomyomas are rare.
Malignant tumors have a
high mortality rate.
Barrett's epithelium. 5
year survial rate 5-30%
Esophageal Cancer Risk Tobacco use, Alcohol
Factors: Squamous cell
use, Dietary nitrates,
carcinoma
Poor nutrition, Vitamin
deficiency, Mucosal
irritants, Ethnicity
(higher in African-
Americans), Sex (higher
in men)
Esophageal Cancer Risk Chronic GERD, Barrett's
Factors:
esophagus, Lack of
Adenocarcinoma
intake of fresh fruits and
vegetables, Ethnicity
(higher in Caucasians),
Sex (higher in men)
, usually asymptomatic. Progressive dysphagia (most
common). Usually not present until >90% obstructed
Esophageal Cancer Clinical diameter
Manifestations
Progresses from solids to liquids. Continuous, not
intermittent -Weight loss: up to 40 lb in 2-3 mos.
Odynophagia (painful swallowing). Persistent chest or
abdominal pain. Regurgitation, foul breath, hoarseness,
cough. Anorexia, nausea, vomiting
Esophageal Cancer: barium swallow, endoscopy.
diagnostic testing
Esophageal Cancer: chemotherapy
medications
Esophageal Cancer: esophageal dilation, radiation therapy. surgery.
treatments
Esophageal Cancer: diet maintain nutrition: TPN, tube feedings.
Other Esophageal Issues Diverticulum. Perforation. Foreign Bodies. Chemical Burns.
Barrett's Esophagus
Reflux causes changes in the lower esophagus lining
Barrett's Esophagus
and the cells are a precursor to cancer.
Acute Gastritis: Short-term inflammatory process in the stomach
acute gastritis can be Excess alcohol intake. Drug effects,Severe physical
caused by exposure to local stress, Trauma, ingestion of caustic substances,
irritants like. Radiation exposure, Bacterial contamination of food or
water.
Anorexia, Nausea, Vomiting, Abdominal Cramping,
Acute Gastritis: Clinical
Manifestations. Epigastric pain or heartburn, Painless GI bleeding:
Hematemesis, Melena.
Remove the causative agent. NPO then advance diet
Treatment of Acute Gastritis if severe case. Antacids. Histamine 2 (H2) receptor
antagonists, Proton pump inhibitors, Monitor for signs of
bleeding
Believed to be autoimmune. Involves all of the acid-
Chronic Gastritis; type A. secreting parietal cells of the fundus. Eventually may
cause pernicious anemia from loss of the intrinsic factor.
Usually no symptoms. Vitamin B12 is given if pernicious
anemia develops
, Most cases. Primarily caused by infection with
Chronic Gastritis: type B Helicobacter pylori. Usually acquired from
contaminated food and water. Can be confirmed by
histologic evaluation of a biopsy specimen
Vague complaint of epigastric pain relieved by food.
Chronic Gastritis: clincial
manifestations Anorexia, Nausea or vomiting, Intolerance of fatty and
spicy foods. Pernicious anemia.
chronic gastritis: diagnostic EGD with biopsy. Testing for H. pylori.
assessment
Stress the importance of not using OTC meds in addition to or
instead of those
prescribed. Stress importance of finishing entire
Treatment of Chronic Gastritis antibiotic course of treatment. Drug therapy-H2
antagonists, antacids, mucosal barrier fortifiers,
antisecretory agents,
prostaglandin analogues. Relapse is common with inadequate Rx.
Avoid known
precipitators (alcohol, foods, NSAIDS, caffeine, smoking
etc.). Stress management techniques
Mucosal lesion of the stomach or duodenum. Many
cases caused by H. pylori. Remainder caused by
Peptic Ulcer Disease NSAID use. Risk factors include:
Helicobacter pylori infection. Chronic use of NSAIDS.
Smoking. Age (>60). Race (more common in
African-Americans and extremely common in
Hispanics. More common in men
Episodic in nature lasting 30 min-2 hr. Epigastric
location near midline; may radiate around costal border
Duodenal Ulcer Pain
to back. Described as gnawing, burning, aching. Occurs
1-3 hr after meals and at night (12-3 am). Often
relieved by food or antacid-May have
weight gain.
Dull epigastric location near midline. May be relieved by
Gastric Ulcer Pain vomiting. Not usually
relieved by food or antacids. Pain occurs 30-60 minutes
after a meal, rarely at night. Hemorrhage more likely.
May have weight loss (food does not relieve
symptoms.
WITH COMPLETE (51-100 QUESTIONS AND CORRECT DETAILED
ANSWERS \VERIFIED 100% GRADED A+\LATEST UPDATE
GERD - details A common comorbid disease is adult onset asthma
Esophageal motility or manometry. Barium swallow.
GERD Diagnostic Tests
Endoscopy. 24-hour pH monitoring
Avoid fatty foods, caffeine (cola, coffee, tea,
GERD - Diet chocolate), onions, tomato-based, and alcohol.
Frequent small meals. No snack 2-3 hours before bed.
Lose weight. Remain upright 1-2 hours after meals.
Avoid lifting, straining etc. No restrictive clothing. Do
GERD- Activity.
not sleep flat, elevated HOB 8- 12 inches. Stop
smoking
GERD Drugs Antacids. Histamine (H2) receptor antagonists. Proton pump
inhibitors.
No functional problems. Signs and symptoms mimic
Hiatal Hernia - sliding hernia GERD. Moves back and forth in response to changes in
position or abdominal pressure. The distal esophagus,
gastric junction and often part of the stomach
displace upward into the thorax
Hernia that is not usually reflux. Risk of volvulus,
Hiatal Hernias-
Paraesophageal hernias strangulation, and obstruction are high.
histal hernia - Diagnostic tests barium swallow. most found during GERD workup
Same as GERD. Surgery is necessary for paraesophageal
Hiatal Diet, Meds,
and Activity hernias due to the risk of serious complications-Nissen
Fundoplication.
May result from esophageal denervation. Signs and
Achalasia- Motility Disorders symptoms: Difficulty swallowing solids and liquids.
Chronic and progressive. dysphagia. Regurgitation of
swallowed food. Foul mouth odor. Classic "rat tail"
narrowing is observed on barium studies
, Obstruction may be so severe that little or no food may reach the
stomach.
Achalasia Treatments Conservative rx for mild disease with medication.
Medications: Anticholinergics Sublingual nitrates,
Calcium channel blockers, Botox injection into the LES,
None have been consistently valuable.
Esophageal dilatation is the main rx: Balloon dilatation is
Achalasia: treatment repeated as necessary
-Esophageal tearing is the primary concern.
Esophagomyotomy is the surgery -Done if 2-3
dilatations have failed
Small frequent meals
eaten slowly Change
Achalasia: diet
positions during eating
Risk for nocturnal
aspiration
Sleep with head elevated
Esophageal Carcinoma: Benign tumors usually
details
leiomyomas are rare.
Malignant tumors have a
high mortality rate.
Barrett's epithelium. 5
year survial rate 5-30%
Esophageal Cancer Risk Tobacco use, Alcohol
Factors: Squamous cell
use, Dietary nitrates,
carcinoma
Poor nutrition, Vitamin
deficiency, Mucosal
irritants, Ethnicity
(higher in African-
Americans), Sex (higher
in men)
Esophageal Cancer Risk Chronic GERD, Barrett's
Factors:
esophagus, Lack of
Adenocarcinoma
intake of fresh fruits and
vegetables, Ethnicity
(higher in Caucasians),
Sex (higher in men)
, usually asymptomatic. Progressive dysphagia (most
common). Usually not present until >90% obstructed
Esophageal Cancer Clinical diameter
Manifestations
Progresses from solids to liquids. Continuous, not
intermittent -Weight loss: up to 40 lb in 2-3 mos.
Odynophagia (painful swallowing). Persistent chest or
abdominal pain. Regurgitation, foul breath, hoarseness,
cough. Anorexia, nausea, vomiting
Esophageal Cancer: barium swallow, endoscopy.
diagnostic testing
Esophageal Cancer: chemotherapy
medications
Esophageal Cancer: esophageal dilation, radiation therapy. surgery.
treatments
Esophageal Cancer: diet maintain nutrition: TPN, tube feedings.
Other Esophageal Issues Diverticulum. Perforation. Foreign Bodies. Chemical Burns.
Barrett's Esophagus
Reflux causes changes in the lower esophagus lining
Barrett's Esophagus
and the cells are a precursor to cancer.
Acute Gastritis: Short-term inflammatory process in the stomach
acute gastritis can be Excess alcohol intake. Drug effects,Severe physical
caused by exposure to local stress, Trauma, ingestion of caustic substances,
irritants like. Radiation exposure, Bacterial contamination of food or
water.
Anorexia, Nausea, Vomiting, Abdominal Cramping,
Acute Gastritis: Clinical
Manifestations. Epigastric pain or heartburn, Painless GI bleeding:
Hematemesis, Melena.
Remove the causative agent. NPO then advance diet
Treatment of Acute Gastritis if severe case. Antacids. Histamine 2 (H2) receptor
antagonists, Proton pump inhibitors, Monitor for signs of
bleeding
Believed to be autoimmune. Involves all of the acid-
Chronic Gastritis; type A. secreting parietal cells of the fundus. Eventually may
cause pernicious anemia from loss of the intrinsic factor.
Usually no symptoms. Vitamin B12 is given if pernicious
anemia develops
, Most cases. Primarily caused by infection with
Chronic Gastritis: type B Helicobacter pylori. Usually acquired from
contaminated food and water. Can be confirmed by
histologic evaluation of a biopsy specimen
Vague complaint of epigastric pain relieved by food.
Chronic Gastritis: clincial
manifestations Anorexia, Nausea or vomiting, Intolerance of fatty and
spicy foods. Pernicious anemia.
chronic gastritis: diagnostic EGD with biopsy. Testing for H. pylori.
assessment
Stress the importance of not using OTC meds in addition to or
instead of those
prescribed. Stress importance of finishing entire
Treatment of Chronic Gastritis antibiotic course of treatment. Drug therapy-H2
antagonists, antacids, mucosal barrier fortifiers,
antisecretory agents,
prostaglandin analogues. Relapse is common with inadequate Rx.
Avoid known
precipitators (alcohol, foods, NSAIDS, caffeine, smoking
etc.). Stress management techniques
Mucosal lesion of the stomach or duodenum. Many
cases caused by H. pylori. Remainder caused by
Peptic Ulcer Disease NSAID use. Risk factors include:
Helicobacter pylori infection. Chronic use of NSAIDS.
Smoking. Age (>60). Race (more common in
African-Americans and extremely common in
Hispanics. More common in men
Episodic in nature lasting 30 min-2 hr. Epigastric
location near midline; may radiate around costal border
Duodenal Ulcer Pain
to back. Described as gnawing, burning, aching. Occurs
1-3 hr after meals and at night (12-3 am). Often
relieved by food or antacid-May have
weight gain.
Dull epigastric location near midline. May be relieved by
Gastric Ulcer Pain vomiting. Not usually
relieved by food or antacids. Pain occurs 30-60 minutes
after a meal, rarely at night. Hemorrhage more likely.
May have weight loss (food does not relieve
symptoms.
