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1. Examination of the upper GI tract under fluoroscopy after
the client drinks barium sulfate
2. NPO after midnight the day of the test A laxative may be
prescribed Instruct client to increase oral fluid intake to help
pass the barium Monitor stools for the passage of barium (chalky
white stools) because barium can cause a bowel obstruction
3. A fluoroscopic and radiographic examination of the large
intestine is performed after rectal instillation of barium
sulfate
4. A low-residue diet is given for 1 to 2 days before the test
A clear liquid diet and laxative are given the evening before the
test NPO after midnight the day of the test Cleansing enemas on the
morning of the test
5. Instruct client to increase oral fluid intake to help pass
the barium Administer a mild laxative as prescribed to facilitate
emptying of the barium Monitor stools for the passage of barium
Notify the physician if a bowel movement does not occur within 2
days
6. Requires the passage of a nasogastric tube into the stomach
to aspirate gastric contents for the analysis of acidity,
appearance, and volume; the entire gastric contents are aspirated,
and then specimens are collected every 15 minutes for 1 hour
7. Fasting for 8 to 12 hours is required before the test
Tobacco and chewing gum are avoided 6 hours before the test Client
may resume normal activities after Refrigerate gastric samples if
not tested within 4 hours
8. Also known as esophagogastroduodenoscopy Following sedation,
an endoscope is passed down the esophagus to view the gastric wall,
sphincters, and duodenum; tissue specimens can be obtained
9. The client must be NPO for 6 to 12 hours before the test A
local anesthetic (spray or gargle) is administered along with
medication that provides conscious sedation and relieves anxiety,
such as IV midazolam (Versed), just before the scope is
inserted
10. Atropine sulfate may be administered to reduce secretions
Client is positioned on the left side to facilitate saliva drainage
and to provide easy access of the endoscope Airway patency is
monitored during the test and pulse oximetry is used to monitor
oxygen saturation
11. Client must be NPO after the procedure until gag reflex
returns Monitor for pain, bleeding, unusual difficulty swallowing,
elevated temperature Maintain bed rest for the sedated client until
alert
12. Requires the use of a rigid scope to examine the anal canal
Client is placed in the knee-chest or left lateral position
13. Require the use of a flexible scope to examine the rectum
and sigmoid colon The client is placed on the left side with the
right leg bent and placed anteriorly
14. Enemas are given before the procedure until the returns are
clear Monitor for rectal bleeding and signs of perforation and
peritonitis
15. The lining of the large intestine is visually examined;
biopsies can be performed Performed with the client lying on the
left side with the knees drawn up to the chest; position may be
changed during the test to facilitate passing of the scope
16. A clear liquid diet is started on the day before the test
Consult the physician regarding medications that must be withheld
before the test Client is NPO after midnight on the day of the
test
17. Midazolam (Versed) is administered intravenously to provide
sedation Provide bed rest until alert Monitor for signs of bowel
perforation and peritonitis Instruct the client to report any
bleeding
18. Examination of the hepatobiliary system is performed via a
flexible endoscope inserted into the esophagus to the descending
duodenum Multiple positions are required during the procedure to
pass the endoscope
19. Client is NPO for several hours before the procedure
Sedation is administered before the procedure Monitor vital signs
Monitor for the return of the gag reflex
20. Transabdominal removal of fluid from the peritoneal cavity
for analysis
21. Have client void before the start of the procedure to empty
the bladder and to move the bladder out of the way of the
paracentesis needle Measure abdominal girth, weight, and baseline
vital signs Fowlers position is used for the client confined to
bed
22. Monitor vital signs Measure fluid collected, describe and
record Label fluid samples and send to the laboratory for analysis
Apply a dry sterile dressing to the insertion site; monitor site
for bleeding
23. Measure abdominal girth and weight Monitor for hematuria
Instruct the client to notify the physician if the urine becomes
bloody, pink, or red
24. A needle is inserted through the abdominal wall to the
liver to obtain a tissue sample for biopsy and microscopic
examination
25. Assess results of coagulation tests Administer a sedative
as prescribed Position client supine or left lateral to expose the
right side of the abdomen Assess vital signs
26. Asses biopsy site for bleeding Monitor for peritonitis
Maintain bed rest for several hours Place the client on the right
side with a pillow after the procedure Instruct the client to avoid
coughing and straining as well as heavy lifting for 1 week
27. Detects the presence of Helicobacter pylori, the bacteria
that cause peptic ulcer disease The client consumes a capsule of
carbon-labeled urea and provides a breath sample10 to 20 minutes
later
28. Is the backflow of gastric and duodenal contents into the
esophagus The reflux is caused by an incompetent lower esophageal
sphincter, pyloric stenosis, or motility disorder
29. Pyrosis Dyspepsia Regurgitation Pain and difficulty with
swallowing Hypersalivation
30. Instruct the client to avoid factors that decrease lower
esophageal sphincter pressure or cause esophageal irritation
Instruct the client to eat a low-fat, high fiber diet Instruct
client to avoid anticholinergics Instruct client to avoid caffeine,
tobacco, and carbonated beverages
31. Instruct client to avoid eating and drinking 2 hours before
bed time, and wearing tight clothes Elevate the head of the bed on
a 6 to 8 inch blocks Instruct the client regarding prescribed
medications, such as antacids, H2- receptor antagonists, or proton
pump inhibitors
32. Inflammation of the stomach or gastric mucosa Caused by
ingestion of food contaminated with disease causing microorganisms
or food that is too irritating, or too highly seasoned, the overuse
of aspirin and NSAIDS, excessive alcohol intake, smoking, or
reflux
34. Anorexia, nausea,and vomiting Belching Heartburn after
eating chronic Sour taste in the mouth Vitamin B12 deficiency
35. Food and fluids may be withheld until symptoms subside;
afterward, ice chips can be given followed by clear fluids, and
then solid food Monitor for signs of hemorrhagic gastritis such as
hematemesis, tachycardia and hypotension
36. Instruct client to avoid irritating foods, fluids and other
substances, such as spicy and highly seasoned foods, caffeine,
alcohol, and nicotine
37. Is an ulceration in the mucosal wall of the stomach,
pylorus duodenum, or esophagus in portions accessible to gastric
secretions May be referred to as gastric, duodenal, esophageal,
depending on its location The most common are gastric and duodenal
ulcers
38. Antral region and Pyloric region lesser curvature Peak age
50-60 Peak age 30-45 years old years old Normal to Increased acid
decreased acid secretion secretion Melena Hematemesis
39. H. pylori (60-80%) H. pylori (100%) Food-pain pattern
Pain-food-relief pattern Weight loss is No weight loss common
Gnawing sharp pain Burning pain occurs in or left of the in the
midepigastric midepigastric region area 1 to 3 hours 30 6o minutes
after after a meal and meal during the night
40. Monitor vital signs and for signs of bleeding Administer
small, frequent bland feedings during the active phase Administer
H2 antagonist as prescribed to decrease the secretion of gastric
acid Administer antacids as prescribed to neutralize gastric
seretions
41. Administer anticholinergics as prescribed to reduce gastric
motility Administer mucosal barrier protectants as prescribed 1
hour before each meal Inform client to avoid consuming alcohol and
substances that contain caffeine or chocolate Avoid aspirin or
NSAIDs
42. Avoid smoking Obtain adequate rest and reduce stress
43. Total Gastrectomy removal of the stomach with attachment of
the esophagus to the jejunum or duodenum Billroth 1 partial
gastrectomy, with the remaining segment anastomosed to the
duodenum
44. Billroth 2 Partial gastrectomy with the remaining segment
anastomosed to the jejunum Pyloroplasty enlargement of the pylorus
to prevent or decrease pyloric obstruction, thereby enhancing
gastric emptying
45. Monitor vital signs Place in a Fowlers position for comfort
and to promote drainage Monitor intake and output Administer fluids
and electrolytes as prescribed
46. Assess bowel sounds Monitor nasogastric suction as
prescribed Do not irrigate or remove the nasogastric tube; assist
physivian in irrigation and removal Maintain NPO status as
prescribed for 1 to 3 days until peristalsis occurs
47. Progress the diet from NPO to sips of clear water to six
small bland meals a day, as prescribed when bowel sounds return
Monitor for postoperative complications of hemorrhage, dumping
syndrome, diarrhea, hypoglycemia, and vitamin B12 deficiency
48. The rapid emptying of the gastric contents into the small
intestine that occurs following gastric resection Symptoms
occurring 30 minutes after eating Nausea and vomiting
49. Feelings of abdominal fullness and abdominal cramping
Diarrhea Palpitations and tachycardia Perspiration Weakness and
dizziness Borborygmi
50. Eat a high-protein, low carbohydrate diet Eat small meals
and avoid consuming fluids with meals Lie down after meals Take
antispasmodic as prescribed to delay gastric emptying
51. An inflammatory disease that can occur at anywhere in the
GI tract but most often affects the terminal ileum and leads to
thickening and scarring, a narrowed lumen, ulcerations, and
abscesses Characterized by remissions and exacerbations
52. Fever Cramp-like and colicky pain after meals Diarrhea,
which may contain pus and mucus Abdominal distention Anorexia,
nausea, and vomiting
53. Weight loss Anemia Dehydration Electrolyte imbalances
54. Restrict clients activity to reduce intestinal activity
Monitor bowel sounds and for abdominal tenderness and cramping
Monitor stools, noting color, consistency and the presence of
blood
55. Instruct client to avoid gas-forming foods, milk products,
nuts, raw fruits and vegetables, pepper, alcohol, and caffeine
containing products Instruct the client to avoid smoking
56. Inflammation of the gallbladder that may occur as an acute
or chronic process Acute inflammation is associated with
cholelithiasis Chronic cholecytitis results when inefficient bile
emptying and gallbladder muscle wall disease cause fibrotic and
contracted gallbladder
57. Acalculous cholecystitis occurs in the absence of
gallstones and is caused by bacterial invasion via the lymphatic or
vascular system
58. Nausea and vomiting Inidgestion Belching Flatulence
Epigastric pain that radiates to the scapula 2 to 4 hours after
eating fatty foods and may persist for 4 to 6 hours
59. Pain localized in the right upper quadrant Guarding,
rigidity, and rebound tenderness Mass palpated in the right upper
quadrant Murphys sign
60. Elevated temperature Tachycardia Signs of dehydration
Jaundice Dark orange and foamy urine Steatorrhea and clay-colored
feces
61. Maintain NPO status during nausea and vomiting episodes
Maintain nasogastric decompression as prescribed for severe
vomiting Administer antiemetics as prescribed Administer analgesics
as prescribed (morphine sulfate and codeine sulfate are
avoided)
62. Administer antispasmodics as prescribed to relax smooth
muscles Instruct the client with chronic cholecystitis to eat
small, low-fat meals Instruct the client to avoid gas forming foods
Prepare the client for surgical interventions
63. Cholecystectomy is the removal of the gallbladder
Choledocholithotomy requires incision into the common bile duct to
remove the stone Surgical procedures may be performed by
laparoscopy
64. Monitor for respiratory complications caused by pain at the
incisional site Encourage coughing and deep breathing Encourage
early ambulation Instruct the client about splinting the abdomen to
prevent discomfort during coughing
65. Administer antiemetics as prescribed for nausea and
vomiting Administer analgesics as prescribed for pain relief
Maintain NPO status and nasogastric tube suction as prescribed
Advance diet from clear liquids to solids when prescribed as
tolerated by the client
66. Maintain and monitor drainage from the T tube, if
present
67. A T tube is placed after surgical exploration of the common
bile duct. The tube preserves patency of the duct and ensures
drainage of bile until edema resolves and bile is effectively
draining into the duodenum] A gravity drainage bag is attached to
the t tube to collect the drainage
68. Position the client in a semi-Fowlers position to
facilitate drainage Monitor the amount, color, consistency, and
odor of the drainage Report sudden increases in bile output to the
physician Monitor for inflammation and protect the skin from
irritation
69. Keep the drainage system below the level of the gallbladder
Monitor for foul odor and purulent drainage and report its presence
to the physician Avoid irrigation, aspiration, or clamping of the T
tube without a physicians order
70. Inflammation of the pancreas appears to be caused by a
process called autodigestion Commonly associated with excessive
alcohol consupmtion
71. Abdominal pain (midepigastric or left upper quadrant) with
radiation to the back Pain aggravated by a fatty meal or alcohol
Abdominal tenderness and guarding
72. Nausea and vomiting Weight loss Cullens signs Turners sign
Absent or decreased bowel sounds
73. Elevated WBC, glucose, and bilirubin Elevated serum lipase
and amylase levels
74. Maintain NPO status and maintain hydration with IV fluids
as prescribed Administer parenteral nutrition for severe
nutritional depletion Administer supplemental preparations and
vitamins and minerals to increase caloric intake if prescribed
75. Maintain nasogastric tube to decrease gastric distention
and suppress pancreatic secretion Administer meperidine
hydrochloride as prescribed for pain Administer antacids as
prescribed Administer H2 receptor antagonists as prescribed
76. Administer anticholinergics as prescribed Instruct the
client in the importance of avoiding alcohol Instruct the client in
the importance of follow-up visits with the physician Instruct the
client to notify the physician if acute abdominal pain, jaundice,
clay- colored stools, or dark colored urine develops
77. Continual inflammation and destruction of the pancreas,
with scar tissue replacing pancreatic tissue The acinar, or
enzyme-producing cells of the pancreas ulcerate in response to
inflammation
78. Abdominal pain and tenderness Left upper quadrant mass
Steatorrhea and foul-smelling stools that may increase in volume
Weight loss Muscle wasting Jaundice
79. Instruct client to limit fat and protein intake Instruct
the client to avoid heavy meals Instruct the client about the
importance of avoiding alcohol Provide supplemental
preparations
80. Administer pancreatic enzymes as prescribed Administer
insulin and oral hypoglycemic agents as prescribed Instruct the
client in the importance of follow-up visits
81. Also known as gluten enteropathy or celiac sprue
Intolerance to gluten, the protein component of wheat, barley, rye,
and oats Results in the accumulation of the amino acid glutamine,
which is toxic to intestinal mucosal cells
82. Intestinal villi atrophy occurs, which affects absorption
of ingested nutrients
85. Maintain a gluten-free diet, substituting corn and rice as
grain sources Instruct parents and child about lifelong elimination
of gluten sources such as wheat, rye, oats, and barley Administer
mineral and vitamin supplements
86. Teach client about a gluten-free diet and about reading
food labels carefully for hidden sources of gluten
87. React with gastric acid to produce neutral salts or salts
of low acidity Inactivate pepsin and enhance mucosal protection but
do not coat the ulcer crater Taken 1 t0 3 hours after each
meal
88. Should be chewed thoroughly and followed with a glass of
milk or water Aluminum hydroxide preprations Calcium carbonate
(Tums) Magnesium hydroxide preparations Sodium bicarbonate
89. Misoprostol (Cytotec) Suppresses secretion of gastric acid
Promotes secretion of bicarbonate and cytoprotective mucus
Sucralfate (Carafate) Creates a protective barrier against acid and
pepsin
90. Cimetidine (Tagamet) Food reduces rate of absorption
Ranitidine (Zantac) Not affected by food Famotidine (Pepcid) Not
affected by food
92. To control vomiting and motion sickness Monitor for
drowsiness and protect the client from injury Ondansetron (Zofran),
Metoclopramide (Reglan), Promethazine hydrochoride (Phenergan)