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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher
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41 - Upper Gastrointestinal Problems

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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | Registered Nurse (RN) School Study Aid

41 - Upper Gastrointestinal Problems
18 Picmonics to Learn | 31 mins
Metabolic Alkalosis Assessment
Signs and Symptoms
Increased pH > 7.45
Increased HCO3 > 26
Excitable State
Arrhythmias
Paresthesias
Muscle Cramps
Muscle Weakness
Decreased Respiratory Effort
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1 min
Metabolic Acidosis Assessment
Characteristics
Decreased pH < 7.35
Decreased HCO3 < 22
Signs & Symptoms
Abdominal Pain
CNS Depression
Coma
Hypotension
Arrhythmias
Increased Respirations
Kussmaul Respirations
Flushed, Warm, Dry Skin
Muscle Weakness
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2 mins
Mallory-Weiss
Characteristics
Bleeding From Tears in Mucosa
Forceful Vomiting
Alcoholism
Eating Disorders (Bulimia)
Painful Hematemesis
Diagnosis
Endoscopy
Management
Observation
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2 mins
Promethazine (Phenergan)
Mechanism
Histamine H1 Receptor Antagonist
Weak Dopamine Antagonist
Indications
Nausea and Vomiting
Motion Sickness
Side Effects
Respiratory Depression
Sedation
Anticholinergic Effects
Extrapyramidal Symptoms
Considerations
Use Large Bore IV
Monitor for Tissue Necrosis
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2 mins
Chlorpromazine (Thorazine)
Mechanism
Low Potency Antipsychotic
Indications
Schizophrenia
Hiccups
Side Effects
Sedation
Weight Gain
Orthostatic Hypotension
Anticholinergic Effects
QT Prolongation
Neuroendocrine Effects
Caution in Seizure Patients
Corneal Deposits
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2 mins
Mumps (Parotitis)
Mechanism
Paramyxovirus
Signs and Symptoms
Fever
Headache
Earache
Orchitis
Pain and Swelling of Parotid Glands
Considerations
MMR Vaccination
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1 min
Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
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2 mins
Cimetidine and Famotidine (H2 Receptor Blockers)
-tidine Suffix
Mechanism
H2 Receptor Blocker
Indications
Suppress Gastric Acid Secretion
Side Effects (All)
Pneumonia
Side Effects - Cimetidine
Anti-androgen Effects
CNS Changes
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2 mins
Omeprazole (Prilosec)
"-prazole" Suffix
Indications
Zollinger-Ellison Syndrome
Gastritis
Peptic Ulcer
Gastroesophageal Reflux Disease (GERD)
Mechanism
Proton Pump Inhibitor (PPI)
Inhibit H+/K+/ATPase
Side Effects
Hip Fracture
Pneumonia
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2 mins
Dinoprostone and Misoprostol
Mechanism
Prostaglandins
Indications
Promote Cervical Ripening
Prevent GI Ulcers
Medical Abortion
Side Effects
Fetal Distress
Hyperstimulation of Uterus
Considerations
Vaginal Insertion
Give Before Induction of Labor
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2 mins
Sucralfate (Carafate)
Mechanism
Creates Protective Barrier
Indications
GI Ulcers
Side Effects
Constipation
Considerations
Require Acidic Environment
Give on Empty Stomach
Oral Suspension Available
May Decrease Absorption of Other Meds
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2 mins
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
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1 min
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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1 min
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
NSAIDs
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
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2 mins
Hypertrophic Pyloric Stenosis (HPS) Assessment
Mechanism
Hypertrophied Pylorus
Risk Factor
Macrolide Use
Assessment
3-6 Weeks of Age
Projectile Vomiting After Feeding
No Pain or Discomfort
Weight Loss
Dehydration
Hungry Baby
Olive Mass
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2 mins
Hypertrophic Pyloric Stenosis (HPS) Interventions
Treatment
Pyloromyotomy
Preoperative Care
Stabilize Fluid and Electrolyte Balance
Nasogastric Tube
Monitor Feeding
Postoperative Care
Start Formula or Breastfeeding Within 24 Hours
Feedings Every 4-6 hours
Full Feeding Within 2 days
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2 mins
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
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1 min
Tricyclic Antidepressants (TCAs)
Mechanism of Action
Inhibits Reuptake of Norepinephrine and Serotonin
Indications
Depression
Bipolar Disorder
Fibromyalgia
Side Effects
Sedation
Orthostatic Hypotension
Anticholinergic Effects
Cardiac Toxicity
Considerations
Delayed Effect
Do Not Stop Abruptly
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2 mins

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