ANATOMY AND PATHOPHYSIOLOGY
A gut hormone that regulates appetite by inhibiting leptin
What is Ghrelin
The nurse is caring for a client diagnosed with GERD writes the client problem of "behavior modification." Which intervention should be included for this problem?
1. Teach the client to sleep with a wedge pillow under the head.
2. Encourage the client to decrease the amount of smoking.
3. Instruct the client to take over-the-counter medication for relief of pain.
4. Discuss the need to attend Alcoholics Anonymous to quit drinking.
1. Teach the client to sleep with a wedge pillow under the head.
The stem does not indicate the client smokes or consumes alcohol.
Name some signs and symptoms of GERD
What are
1. Heartburn
2. Chest pain
3. Dyspepsia
4. Regurgitation
5. Wheezing or coughing
Common medications used to treat obesity
What are
1. GLP-1 (Liraglutide, Semaglutide, Tirzepatide)
2. Phentermine/Topirimate
3. Orlisat
4. Bupropion/Naltrexone
What are
1. CBC (anemia)
2. Barium contrast study
3. EGD
The three components of the small intestine
What is Duodenum, Jejunum, Ileum
Which statement made by the client indicates to the nurse the client may be experiencing GERD?
1. "My chest hurts when I walk up the stairs in my home."
2. "I take antacid tablets with me anywhere I go."
3. My spouse tells me I snore very loudly at night."
4. "I drink six to seven soft drinks every day."
2. "I take antacid tablets with me anywhere I go."
What is one of the primary factors causing GERD?
What is lower esophageal sphincter dysfunction
Common medications to treat peptic ulcers
What are
1. Misoprostol
2. Sucralfate
3. Antacids
4. H2 receptor blockers (Ranitidine, Cimetidine, Famotidine)
5. Proton pump inhibitors (Pantoprazole, Esomeprazole, Omeprazole)
Common complications of a peptic ulcer
What are
1. GI bleeding
2. Perforation
3. Obstruction
The part of the brain that regulates appetite
What is the hypothalamus
Which assessment data supports the client's diagnosis of gastric ulcer to the nurse?
1. Presence of blood in the client's stool for the past month
2. Reports of a burning sensation moving like a wave.
3. Sharp pain in the upper abdomen after eating a heavy meal.
4. Reports of epigastric pain shortly after ingesting food.
4. Reports of epigastric pain shortly after ingesting food.
What are important things to teach your patient regarding the management of GERD?
What are
○Avoid triggers
○Elevate the HOB to 30 degrees or higher
○Should avoid lying supine for 2 to 3 hours after a meal
○Stop smoking
○Avoid stress
○Avoid eating within 3 hours of bedtime
○Implement measures to reduce weight if applicable
○Eat small, frequent meals
○Avoid alcohol and caffeinated beverages
What is a contraindication to the administration of misoprostol?
What is pregnancy
What will you teach your patient about managing a peptic ulcer?
What are
1. Stop NSAID and aspirin use
2. Stop smoking
3. Adequate rest
4. Restrict alcohol
5. Diet
6. Report s/s of acute bleeding to physician
The back diffusion of HCl acid into the gastric mucosa results in cellular destruction and inflammation. What can this lead to?
What is a peptic ulcer
The nurse is caring for a client diagnosed with rule out peptic ulcer disease. Which test confirms this diagnosis?
1. Esophagogastroduodenoscopy (EGD)
2. Magnetic resonance imaging (MRI)
3. Occult blood test
4. Gastric acid stimulation test
1. Esophagogastroduodenoscopy (EGD)
Common causes of GERD
What are
1. NSAIDs
2. Potassium
3. Obesity
4. Diet
5. Alcohol and caffeine
6. Eating large meals or eating late at night
What are adverse effects of metoclopramide?
What are delayed gastric motility, drowsiness, EPS
What are indications that someone has an upper GI bleed?
What are
1. Melena
2. Hematemesis
3. Anemia
A stomach ulcer penetrates the serosal surface with spillage of either gastric or duodenal contents into the peritoneal cavity. What is this called?
What is perforation
The client with a history of peptic ulcer disease is admitted into the ICU with frank gastric bleeding. Which priority intervention should the nurse implement?
1. Maintain a strict record of intake and output
2. Insert a nasogastric (NG) tube and begin saline lavage.
3. Assist the client with keeping a detailed calorie count.
4. Provide a quiet environment to promote rest.
2. Insert a nasogastric (NG) tube and begin saline lavage.
This removes blood and may slow the bleed
Common procedure performed to diagnose GERD
What is an esophagogastroduodenoscopy (EGD)?
When should NSAIDs be avoided?
What are peptic ulcer history or current diagnosis, GERD, renal failure, salicylate hypersensitivity
What is the difference in symptoms between a gastric ulcer and a duodenal ulcer?
What is
Gastric ulcer: Symptoms occur 1-2 hours after meals, Food worsens the pain
Duodenal ulcer: Symptoms occur 2-5 hours after meals, Empty stomach worsens the pain