NR 324 Exam 3 Concepts to Review
1. Gastrectomy and Pernicious Anemia (Vit. B 12) Relationship
a. The patient with a total gastrectomy does not secrete intrinsic factor, which is needed
for cobalamin (vitamin B12) absorption
2. Endoscopy procedure-definition, nursing implications/complications
a. A temperature elevation may indicate that a perforation has occurred after an endoscopy
b. Endoscopy-> vomiting “coffee-ground”
3. UAP delegation
4. N/V causes and treatments
a. Nausea is associated with severe pain; it is likely that it is precipitated by stress and pain.
i. The best treatment will be to provide adequate pain medication before dressing changes
5. Advancing diet after NPO-clear, full, regular diet (foods included)
a. Clear cool liquids are usually the first foods started after a patient has been nauseated
6. Reducing Risk of Oral Cancer
a. Avoid use of cigarettes and smokeless tobacco.
7. GI Medications- PPI, H2 Blocker, Antacid, Antiemetics (mechanism of action,
indications, side effects, nursing implications)
a. Ranitidine (Zantac) is a histamine-2 (H2) receptor blocker,
i. Which decreases the secretion of gastric acid.
b. Aluminum hydroxide/magnesium hydroxide (Maalox)
i. The purpose for antacids is to increase gastric pH.
c. Antacids after meals and sucralfate 30 minutes before meals.
d. Esomeprazole (Nexium)->(GERD)->heartburn
i. Treats gastroesophageal reflux disease by decreasing stomach acid production.
1. Proton pump inhibitors decrease the rate of gastric acid secretion
8. Dietary teaching (GERD, IBD, Gastritis, PUD)
a. Eating late at night exacerbates GERD, and the nurse should plan to teach the patient to
avoid eating at bedtime.
b. (GERD)->Gelatin and fruit are low fat and will not decrease lower esophageal sphincter (LES)
pressure
1. Gastrectomy and Pernicious Anemia (Vit. B 12) Relationship
a. The patient with a total gastrectomy does not secrete intrinsic factor, which is needed
for cobalamin (vitamin B12) absorption
2. Endoscopy procedure-definition, nursing implications/complications
a. A temperature elevation may indicate that a perforation has occurred after an endoscopy
b. Endoscopy-> vomiting “coffee-ground”
3. UAP delegation
4. N/V causes and treatments
a. Nausea is associated with severe pain; it is likely that it is precipitated by stress and pain.
i. The best treatment will be to provide adequate pain medication before dressing changes
5. Advancing diet after NPO-clear, full, regular diet (foods included)
a. Clear cool liquids are usually the first foods started after a patient has been nauseated
6. Reducing Risk of Oral Cancer
a. Avoid use of cigarettes and smokeless tobacco.
7. GI Medications- PPI, H2 Blocker, Antacid, Antiemetics (mechanism of action,
indications, side effects, nursing implications)
a. Ranitidine (Zantac) is a histamine-2 (H2) receptor blocker,
i. Which decreases the secretion of gastric acid.
b. Aluminum hydroxide/magnesium hydroxide (Maalox)
i. The purpose for antacids is to increase gastric pH.
c. Antacids after meals and sucralfate 30 minutes before meals.
d. Esomeprazole (Nexium)->(GERD)->heartburn
i. Treats gastroesophageal reflux disease by decreasing stomach acid production.
1. Proton pump inhibitors decrease the rate of gastric acid secretion
8. Dietary teaching (GERD, IBD, Gastritis, PUD)
a. Eating late at night exacerbates GERD, and the nurse should plan to teach the patient to
avoid eating at bedtime.
b. (GERD)->Gelatin and fruit are low fat and will not decrease lower esophageal sphincter (LES)
pressure
