NUR 339 EXAM
- What is Peptic Ulcer Disease?
Answer upper GI disorder
ulcers formed in stomach, duodenum, and esophagus caused by mucosa exposed to gastric acid and pepsin
- What are the risk factors for Peptic Ulcer Disease? (11)
Answer stress, major trauma, severe medical illness, NSAID/aspirin ingestion, H. pylori infection of stomach, older adults >60, smoking, warfarin and corticosteroid use, family history, blood group O, caffeine intake
- What is the client teaching for Peptic Ulcer Disease? (3)
Answer eat a balanced diet, avoid alcohol and smoking, and do not take NSAIDs or aspirin
- What is the gastric mucosal barrier?
Answer tight junction of epithelial cells that prevent acid penetration to the mucosa
- Who are the priority clients for gastric ulcers (PUD)? (2)
Answer patients infected with
- pylori (more likely in smokers) and patients who ingest NSAIDs
- What is GERD?
Answer upper GI disorder called gastroesophageal reflux disease; caused by weak lower esophageal sphincter and increased intra-abdominal pres- sure leading to reflux of stomach contents into esophagus causing mucosal injury 1 / 3
- What is the client teaching for GERD? (6)
Answer avoid large meals, do not lie down after eating, avoid bending after meals, reduce weight, avoid aggravating foods, sleep with head elevated
- What is H. pylori?
Answer a gram negative bacterium infection associated with most of patients with PUD
- What is the client teaching for H. pylori? (3)
Answer more likely to occur in patients who smoke, occurs at any age and either sex, mostly chronic in nature
- What are the pain characteristics for a duodenal ulcer?
Answer most common 2-3 hours after eating and at night
- Which ulcer is more common?
Answer duodenal
- What is the pathophysiology of nausea? (3)
Answer stimulation of vomiting center in medulla oblongata -> stimulation of salivary center and pharyngeal, gastrointestinal, and abdominal muscle -> vomiting occurs
- What is irritable bowel syndrome? (3)
Answer lower GI disorder; associated with irregular GI motility, spastic contractions, and dysregulation of intestinal motor and sensory function
- What is the client teaching for irritable bowel syndrome? (6)
Answer 2 / 3
women are more affected than men, can be diarrhea or constipation predominant, should increase fiber, avoid aggravating foods, can keep a food diary, and reduce stress
- What are the two diseases associated with inflammatory bowel disease?-
Answer ulcerative colitis and Crohn's disease
- What is Crohn's disease? (3)
Answer lower GI disorder
Answer
affects any area in GI tract - ileum and submucosal of bowel most common,
granulomas and submucosal edema surrounded by normal tissue - skip lesions, bowel has poor absorption of nutrients
- What are the symptoms for Crohn's disease? (8)
Answer diarrhea, cramping in RLQ, weight loss, nutritional imbalances, low grade fever, fistulas, strictures/obstruction, abdominal abscesses
- What is ulcerative colitis? (5)
Answer lower GI disorder; affects colon & rectum only, continuous inflammation (no skip lesions), mucosal hemorrhage become necrotic and forms shallow ulcers leading to bleeding, bowel has poor nutrient absorption, varies in severity from mild (<4 diarrhea/day) to fulminant (> 10/day, toxicity)
- What is the client teaching for ulcerative colitis? (3)
- / 3
Answer fix nutritional deficien- cies, avoid aggravating foods and stress, surgical intervention is sometimes needed