Final MS II Review Subject to change
Gastrointestinal
1. Hiatal hernia-medical management
First you want to try antacids, small meals, no reclining 1 hour after
eating, raise HOB 6-12 inches
Avoid: eating 1 hour before bedtime, spicy foods, alcohol, caffeine,
and smoking
If symptomatic, surgery will be done when GERD, strangulation, or
obstruction is present. The procedure is called Fundoplication, which
the stomach fundus is wrapped around the lower part of the
esophagus (most common procedure done)
2. Peptic Ulcer- treatment purpose
Triple therapy: To cure H. pylori without recurrence
PPI or H2 receptor antagonist: to decrease resistance of the bacteria
3. Pernicious anemia- cause
Lack of intrinsic factor (vitamin B12), after some or all of the
stomach is removed
4. Ulcerative colitis- signs/symptoms, treatments
Common symptoms: Diarrhea with blood or pus, abdominal and
rectal pain, rectal bleeding, and fecal urgency with straining
Also: anorexia, weight loss, cramping, vomiting, fever, fatigue, and
severe dehydration associated with passing 5-10 or more liquid
stools/ day, anemia often develops as a result of rectal bleeding
Treatments: diet, lifestyle changes, medications, such as 5-
Aminosalicylates, Biologic Response Modifiers, Corticosteroids, Anti-
inflammatory Synthetic Corticosteroids, and Immunodilators and
surgery (if necessary), avoidance of offending foods
5. PN- what to monitor and what is it
Parenteral nutrition- which supplies complete nutrition via a central
or peripheral route. It is given to improve the patient’s nutritional
status, achieve weight gain or enhance the healing process
Monitor for signs and symptoms of infection, hyperglycemia, and
hypoglycemia
6. NG Tube –how to check placement and pH of gastric content
, Place stethoscope over the insertion to check placement by listening
for the swishing sound
aspirate gastric contents, and place on the paper to determine the
pH, then put gastric contents back into stomach
7. Metabolic alkalosis-causes
Prolonged vomiting and NG suction leading to electrolyte imbalance
8. GI Bleed – signs/symptoms
Varies by severity: Mild- slight weakness or diaphoresis
Severe- hypovolemic shock, weak pulse, chills, and palpitations,
melena, occult blood in stool, hematemesis
9. Nursing intervention for tube feedings
Checking PH of gastric content, residual, checking NG tube
placement with x-ray, check every 4 hours before giving med/food,
more than 150mL hold back from feeding, push residual back into
stomach, monitor for emesis or yellow fluid, head should be in high
fowlers, strictly NPO, flush after every medication & feeding, label
all feedings
10. Billroth II- nursing interventions
Parenteral feeding, re-introducing fat slowly in the diet, B12
injection for life, monitoring of NG tube for hemorrhage
11. Dumping syndrome- nursing interventions
Do not drink water with meal
Drink water 1hr before or after meal
Lie down 30-60mins after meal.
Eat in a reclined position
Eating small meals and avoiding simple sugars but eat complex carbs
Increase protein, fiber, complex carbs, and no simple sugars to diet
Accessory Organs
1. Hepatitis-signs/symptoms and causes
HAV: Ingestion of fecal contamination, raw shell fish
HBV: Hemodialysis, needle sharing, body fluids
Gastrointestinal
1. Hiatal hernia-medical management
First you want to try antacids, small meals, no reclining 1 hour after
eating, raise HOB 6-12 inches
Avoid: eating 1 hour before bedtime, spicy foods, alcohol, caffeine,
and smoking
If symptomatic, surgery will be done when GERD, strangulation, or
obstruction is present. The procedure is called Fundoplication, which
the stomach fundus is wrapped around the lower part of the
esophagus (most common procedure done)
2. Peptic Ulcer- treatment purpose
Triple therapy: To cure H. pylori without recurrence
PPI or H2 receptor antagonist: to decrease resistance of the bacteria
3. Pernicious anemia- cause
Lack of intrinsic factor (vitamin B12), after some or all of the
stomach is removed
4. Ulcerative colitis- signs/symptoms, treatments
Common symptoms: Diarrhea with blood or pus, abdominal and
rectal pain, rectal bleeding, and fecal urgency with straining
Also: anorexia, weight loss, cramping, vomiting, fever, fatigue, and
severe dehydration associated with passing 5-10 or more liquid
stools/ day, anemia often develops as a result of rectal bleeding
Treatments: diet, lifestyle changes, medications, such as 5-
Aminosalicylates, Biologic Response Modifiers, Corticosteroids, Anti-
inflammatory Synthetic Corticosteroids, and Immunodilators and
surgery (if necessary), avoidance of offending foods
5. PN- what to monitor and what is it
Parenteral nutrition- which supplies complete nutrition via a central
or peripheral route. It is given to improve the patient’s nutritional
status, achieve weight gain or enhance the healing process
Monitor for signs and symptoms of infection, hyperglycemia, and
hypoglycemia
6. NG Tube –how to check placement and pH of gastric content
, Place stethoscope over the insertion to check placement by listening
for the swishing sound
aspirate gastric contents, and place on the paper to determine the
pH, then put gastric contents back into stomach
7. Metabolic alkalosis-causes
Prolonged vomiting and NG suction leading to electrolyte imbalance
8. GI Bleed – signs/symptoms
Varies by severity: Mild- slight weakness or diaphoresis
Severe- hypovolemic shock, weak pulse, chills, and palpitations,
melena, occult blood in stool, hematemesis
9. Nursing intervention for tube feedings
Checking PH of gastric content, residual, checking NG tube
placement with x-ray, check every 4 hours before giving med/food,
more than 150mL hold back from feeding, push residual back into
stomach, monitor for emesis or yellow fluid, head should be in high
fowlers, strictly NPO, flush after every medication & feeding, label
all feedings
10. Billroth II- nursing interventions
Parenteral feeding, re-introducing fat slowly in the diet, B12
injection for life, monitoring of NG tube for hemorrhage
11. Dumping syndrome- nursing interventions
Do not drink water with meal
Drink water 1hr before or after meal
Lie down 30-60mins after meal.
Eat in a reclined position
Eating small meals and avoiding simple sugars but eat complex carbs
Increase protein, fiber, complex carbs, and no simple sugars to diet
Accessory Organs
1. Hepatitis-signs/symptoms and causes
HAV: Ingestion of fecal contamination, raw shell fish
HBV: Hemodialysis, needle sharing, body fluids
