Exam 2 Chapter 23 Flashcards Preview

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1

inflammation of gastric/stomach mucosa

Gastritis
Acute or chronic

2

cause of acute gastritis

contaminated food
irritating foods (spicy)
overuse of ASA, NSAIDS
alcohol
bile reflux
radiation therapy

3

what are some SxS of acute gastritis

abd discomfort
anorexia
nausea
vomiting
headache
hiccuping
lassitude (fatigue)

4

Gastritis may be the first sign of systemic infection.
True or False

True

5

Chronic gastritis may be associated with which autoimmune disease?

Pernicious anemia

6

which medications can cause chronic gastritis

NSADs
Bisphosphonate (Fosamax, Actonel, Boniav)

7

causes of chronic gastritis

medications (NSAIDs, bisphosphonate)
ulcers
H.pylori
dietary factors
alcohol
smoking
reflux of pancreatic secretions and bile into the stomach

8

SxS of chronic gastritis

anorexia
nausea
vomiting
belching
heartburn after eating
sour test in mouth
Vitamin B12 deficiency

9

PUD

peptic ulcer disease
An excavation (hollowed out area) that forms in the mucosal wall of the stomach, pylorus, duodenum (first part of the small intestine)

10

An excavation (hollowed area) that forms in the mucosal wall of the stomach, pylorus, and duodenum?

Peptic ulcer disease (PUD)

11

Chronic gastric ulcers tend to occur where?

lesser curvature of the stomach, near the pylorus.

12

Amoxicillin (Amoxil)

bactericidal antibiotic that assists with eradicating H.pylori in the gastric mucosa.

May cause diarrhea
should not be used in patients allergic to penicillin

13

Clarithromycin (Biaxin)

Exerts bactericidal effects to eradicate H.pylori in gastric mucosa.

may cause GI upset, headache, altered taste.
many drug-drug interactions (eg. cisapride, colchicine, lovastatin, warfarin)

14

Metronidazole (Flagyl)

synthetic antibacterial and antiprotozoal that assists with eradicating H.pylori when administered with other antibiotics and PPIs.
should be given with meals to decease GI upsets.
may cause anorexia and metallic taste.
increases blood thinning effects of warfarin.
pts should avoid alcohol

15

Tetracycline

exerts bacteriostatic effects to eradicate H.pylori.
may cause photosensitivity; warn patient to use sunscreen.
may cause GI upset.
caution in pts with renal or hepatic impairment.
milk or dairy produces may reduce effectiveness.

16

Anti diarrhea
Bismuth subsalicylate (pepto-Bismol)

suppresses H.pylori in the gastric mucosa and assists with healing of mucosal ulcers.
Given concurrently with antibiotics.
SHOULD BE TAKING ON EMPTY STOMACH

17

Histmaine-2(H2) Receptor Antagonists

Cimetidine (Tagamet)
Famotidine (Pepcid)
Nizatidine (Axid)
Ranitidine (Zantac)
Roxatidine (Roxane)

18

Histmaine-2 (H2) antagonist

decrease amount of HCI produced by stomach by blocking action of histamine on histamine receptors or parietal cells in the stomach.

19

Cimetidine (Tagamet)

H2 Antagonists
least expensive
may cause confusion, agitation or coma in the elderly or those with renal or hepatic insufficiency.
long-term use may cause diarrhea, dizziness, gynecomastia.
Many drug-drug interactions (benxodiazepines, metoprolol, phenytoin, warfarin, amitriptyline, amiodarone)

20

Famotidine (Pepcid)

H2 receptor antagonist.
Best choice for critically ill patients because it is known to have the least risk of drug-drug interactions; does not alter liver metabolism.
Prolonged half-life in patients with renal insufficiency.
short-term relief for GERD.

21

which H2 receptor antagonist is the best choice for critically ill patients?

Famotidine (Pepcid)
it know to have the least drug-drug interactions.
does not alter liver metabolism

22

Nizatidine (Axid)

H2 receptor antagonist.
use for treatment of ulcers and GERD.
Prolonged half-life in patients with renal insufficiency.
May cause headache, dizziness, diarrhea, nausea/vomiting, GI upset, urticaria (hives).

23

Ranitidine (Zantac)

H2 receptor antagonists
prolonged half-life in patients with renal and hepatic insufficiency.
fewer side effects than cimetidine.
May cause headache, dizziness, CONSTIPATION, nausea/vomiting, or abdominal discomfort.

24

Roxatidine (Roxane)

H2 receptor antagonist.
prolonged half-life in patients with renal and hepatic insufficiency.
single bedtime dose in combination with PPI to reduce nocturnal acid reflux.
may cause headache, dizziness, CONSTIPATION, nausea/vomiting, or abd discomfort

25

Proton Pump Inhibitors of Gastric Acid (PPIs)

Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Omeprazole (Prilosec)
Pantoprazole (Protonix)
Rabeprazole (AcipHex)

26

What is the major action of PPIs

decreases gastric acid secretion by slowing the hydrogen-potassium adenosine triphosphatase (H, K ATPase) pump on the surface of the parietal cells of the stomach.

27

Esomeprazole (Nexium)

Used maily for Tx of duodenal ulcer disease and H.pylori infection.
A delayed release capsule that is to be swallowed whole and taken before meals.

28

which of the PPIs has drug-drug interactions with digoxin, iron, and warfarin?

Rabeprazole (AcipHex)
delayed-release tablet to be swallowed whole.
may cause abdominal pain, diarrhea, headache, nausea.

29

This type of PPI when given may cause hyperglycemia and abnormal liver function tests?

Pantoprazole (Protonix)
delayed-release capsule
should be swallowed whole
taken before meals.
may also cause headache, diarrhea, abd pain

30

Omeprazole (Prilosec)

PPI
delayed-release capsule.
should be swallowed whole.
taken before meals.
May cause diarrhea, nausea/vomiting CONSTIPATION, abd pain, headache or dizziness.