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GI QuestionsSmeltzer (Med-Surg)

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Which barium swallow would a doctor order for gastritis?
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Upper barium
You believe your patient has gastritis. Your first action is to?
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Make them NPO, or at least bland diet
T/F: Peptic ulcers are an erosion of the stomach wall
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True
Peptic ulcers are concerning because they increase the chance of stomach cancer. Why might this be?
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The malfunction of cells destroyed by the peptic ulcer will stimulate more cells
Doug is a middle aged man who arrives at your clinic complaining of mid-epigastric pain and heartburn that usually decreases with eating. He states that he does smoke and drink a lot of coffee. When asked about his meals, he says, "I'm always so busy I will quickly eat in the 5 minutes I have between meetings." You anticipate Doug has...
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A peptic ulcer. Risk factors include stress, rapid eating, caffeine, and smoking. Others include H. pylori and genetics.
A key diagnostic test for peptic ulcers (H. pylori) is: A) What is a VITAL nursing intervention for this test?
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Urea breath testing. Exhales for baseline, drinks carbon-enriched urea solution, then exhales again. If H pylori present, will have increase the co2 (breakdown of urea.) NPO status
What values would be important to monitor in patients with a peptic ulcer?
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H&H - any bleeding Occult blood/melena - any bleeding Dizziness, decreased BP, tachycardia, confusion - losing blood
Which ulcer will have pain 30-60 min after a meal, rarely occur at night, and worsen after food?
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Gastric ulcer
Which ulcer will have pain 1.5-3 HOURS after a meal, often occur at night, and be relived by food?
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Duodenal
Triple therapy is Tx for what?
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Peptic ulcer disease. On board will be antacids, antibiotics, and PPIs/h2 antagonists
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As a nurse, you anticipate providing education and encouragement about these two pertinent topics for patients with PUD.
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Eating small meals Smoking cessation
A priority for PUD is reducing and promoting?
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Pain/Nutrition
You have a nursing student shadowing you today. When you walk into a patient's room, you ask her to check the suction level for the patient's NG tube. She exclaims, "Why, it's continuous - it should never be continuous," and goes to turn it down. Your next action is: A) Applaud her. This could have been a grave error B) Explain to her this is a double lumen NG tube and can be hooked to continuous suction. Only single lumen must have intermittent. C) Stop her because you need to give medications first
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B
You had to quickly insert an NG tube for a patient who was vomiting. You then receive an order to start TPN for this patient. What should you do?
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*Get a CXR before feeding!*
You are a recent graduate and have just put in your first NG tube. You're not sure if it's in the lungs or not. How should you check?
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Put one end in water. If it's in the lungs, it'll bubble.
Nursing implications about patency and drainage are?
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Always check patency q 4 hrs, residual before feedings, and usual amount of drainage
What is dumping syndrome?
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A vasomotor response d/t rapid emptying of the stomach into the SI. This influx of hypertonic fluids drastically draws in fluid from the vessels, decreasing circulating volume. Typically occurs after surgery (Billroth II) because the reduced stomach is wacked out and cannot control amount and rate of chyme that enters the SI.
  
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