NUR 2392 Multidimensional Care II / MDC 2 exam 1
questions & correct VERIFIED answers graded a 2024
Barret's esophagitis - Precancerous lesion associated with GERD
GERD s/s - indigestion, regurgitation, eructation, flatulence
GERD treatment - sit up 1hr after meal, balancing nutrition, antacid, proton pump
inhibitor
GI bleed - most often a result of gastroduodenal ulcer disease, esophagitis, and varices.
Can occur with overuse of (NSAIDs) and the use of alcohol and tobacco.
GI bleed s/s - rigid, hard abdomen(board-like)
decreased BP
coffee ground emesis
black tar stools
bloody stool
Peptic Ulcer Disease (PUD) - development of a circumscribed lesion (ulcer) in the
mucosal membrane of the lower esophagus, stomach, duodenum, or jejunum.
These lesions can be duodenal or gastric.
Gastric ulcers are a result of Helicobacter pylori.
Can occur in patients who consume a spicy diet, use tobacco, consume alcohol, and
overuse of (NSAIDs).
PUD diagnostics - Labs/Diagnostics- H pylori test, chest, abdomen x-ray, EGD, nuclear
med test if Gi bleed suspected
complications of peptic ulcer disease - hemorrhage, perforation, pyloric obstruction,
intractable disease
gastric cancer - malignant cell growth in the stomach.
Most commonly affected areas are the pylorus and antrum.
Prognosis is dependent on the stage of the disease. Can occur in patients who
consume a diet high in smoked and salted foods, positive family history, and use
tobacco.
gastric cancer risks - H. pylori, pernicious anemia, polyps, gastritis, achlorhydria; more
males than female over 50
, Gastric Cancer Treatment - Treatment- Radiation (local), chemo (systemic),
gastrectomy or subtotal (partial) gastrectomy
Diagnostic studies for upper GI - Barium swallow with fluoroscopy - allows visualization
of the esophagus in order to determine possible abnormalities.
Esophagastroduodenoscopy (EGD) or Upper GI endoscopy - allows direct visualization
of the esophagus to determine abnormalities.
Biopsy can also be obtained during the procedure.
Biopsy - removal of cells in order to determine the presence of malignancy.
Barium swallow with fluoroscopy - allows visualization of the esophagus in order to
determine possible abnormalities.
Esophagastroduodenoscopy (EGD) or Upper GI endoscopy - allows direct visualization
of the esophagus to determine abnormalities.
endoscopy - allows direct visualization of the esophagus to determine abnormalities.
Uncompensated - pH and one other value is abnormal
Partial compensation - pH, CO2, and HCO3 are all off
Full compensation - pH is normal
Acidosis - reduces the excitability of cardiovascular muscle, neurons, skeletal muscle,
and smooth muscle.
Alkalosis - increases the sensitivity of excitable tissues allowing them to
OVERRESPOND without stimulation
ABG considerations - - Assess cardiovascular w/ acidosis (cardiac arrest from
hyperkalemia)
- Assess neuro status
- Fall precautions
Bicarb HC03 - kidney compensation (slow and powerful)
Respiratory PaC02 - Respiratory compensation (fast but limited)
Metabolic acidosis causes - DKA, Starvation, diarrhea, kidney failure, dehydration, liver
failure, pancreatitis, heavy exercise, seizure activity, fever, hypoxia, ischemia,
ethanol/methanol intoxication
