GI
What is GERD and what symptoms accompany it?
Gastroesophageal reflux disease
Relaxation of the lower esophageal sphincter, allowing stomach contents to regurgitate into the esophagus
Heartburn; retrosternal burning sensation
Eructation
What is the primary cause of gastric ulcers and the related treatment?
H. pylori infection
Antibiotic treatment
PPIs (Omeprazole)
What is the most common cause of hypothyroidism?
Hashimoto’s disease, an autoimmune disorder causing death of thyroid hormone producing cells
What is an HbA1c measuring?
Average blood glucose levels over the past approximately 3 months/90 days
Stimulates release of thyroid hormone from the thyroid gland
What is Thyroid-stimulating hormone (TSH)?
What is the difference between diverticulosis and diverticulitis?
Diverticulosis is the presence of diverticula; diverticulitis is inflammation/infection of those diverticula
In diverticulosis, high fiber diets are beneficial
In diverticulitis flare ups, a low fiber diet and avoidance of seeds should be implemented
What is a hernia?
How are hernias diagnosed?
Where internal organs or tissues bulge through an inappropriate opening
Diagnosed via:
Barium swallow
EGD
CT scan
What is hyperthyroidism? Common signs/symptoms, treatments?
Excessive secretion of thyroid hormones from the thyroid gland
Results in increased overall metabolism
Most commonly caused by Graves disease; autoimmune
S/S: Exophthalmos, weight loss, tachycardia, diaphoresis
Tx: Surgical remove of thyroid gland, radioactive iodine therapy
What is hypoglycemia? Signs/symptoms?
Blood glucose <70mg/dL
Sweating, confusion, irritability, dizziness
Used in Grave's disease, this medication lowers thyroid hormone levels and is usually a temporary solution prior to thyroidectomy
What is Propylthiouracil (PTU)?
What causes appendicitis?
Obstruction of the opening of the appendix
Tumors, fecaliths, parasitic infection
What are some contrasting symptoms in gastric ulcers vs duodenal ulcers?
Gastric ulcers - Pain soon after consuming a meal
Duodenal ulcers - Pain 2-3 hours after consuming a meal
What is the function of levothyroxine and what should patients know about it?
Replaces thyroid hormone
Typically is a lifelong treatment
Take on empty stomach, same time daily (typically early morning)
Monitor TSH levels
What is glucagon and when is it used?
A hormone that raises blood glucose by stimulating release of stored glucose in the liver
As a medication, it is delivered as a subcutaneous or intramuscular injection
Used to raise blood sugar in severe hypoglycemia when the patient cannot safely ingest oral carbohydrate
A ring-shaped muscle just before the opening to the stomach that opens to let food pass into the stomach and closes to keep it there.
What is the lower esophageal sphincter (LES)?
What is Nissen fundoplication?
Surgical procedure where the upper portion of the stomach is wrapped around the lower portion of the esophagus
This reinforces the LES area and reduces gastric content reflux
What is a strangulated hernia?
A complication of an incarcerated (irreducible) hernia that causes reduction in oxygen supply due to reduced blood flow.
Strangulated hernias required urgent surgical intervention to limit/prevent tissue necrosis.
What is Cushing's disease? Common signs/symptoms?
Excess of adrenal hormones, often caused by tumors or side effect of other medications
S/S:
Moon face
Buffalo hump
Truncal obesity
Increased hair
Hypertension
What type of exams should diabetic patients regularly have performed?
Eye exams
Foot exams
Kidney function tests (microalbumin)
HbA1c
When a hernia and its contents can be pushed back into their normal anatomical space
What is a reducible hernia?
What are some teaching points related to GERD?
Avoid eating about three hours before bedtime
Encourage smoking cessation, avoidance of alcohol (r/t relaxation of LES)
Avoid excessive bending at the waist, straining with bowel movements (r/t increased intra-abdominal pressure)
What are some teaching points for patients diagnosed with peptic ulcer diease?
Avoid NSAIDs, aspirin
Avoid acidic, spicy, oily foods
Avoid caffeinated beverages
What are nursing interventions for a patient experiencing an Addisonian crisis?
Fluid administration (correct dehydration, raise BP, correct electrolyte imbalances)
IV corticosteroids
Medications to treat hyperkalemia
What is metabolic syndrome?
A cluster of conditions that increase risk for diabetes, heart disease, and stroke:
Hypertension
Abdominal obesity
Hyperlipidemia
Hyperglycemia
The condition where the motor activity of the bowel is impaired, not associated with a mechanical cause
What is paralytic ileus?