smoking, salicylates intakeNursing Intervention:a. Relaxation techniquesb. Eliminate caffeine, cigarette smoking, alcohol intake and spicy foodsc. High fat, high carbohydrateMedical Treatment: Antacids - avoid administration within 1-2 hr of otheroral meds- frequent administration – ac, pc,
40Nurse Licensure Examination Review HandoutsLocation of UlcerPain:BleedingMalignancy:HypersecretionPylorusoExperienced 2-3 hrs after mealoIngestion of FOODRELIEVES PAINMelena is more common than hematemesisNot possibleNormal to hyposecretionLesser curvatureoExperienced ½ to 1 hour after mealoIngestion of FOOD DOES NOT RELIEVE PAINHematemesis is more common than melenaPossiblehsH2 Antagonists- with meals/pcAnticholinergicsProstaglandin Analogs - **misoprostol** & ACID PUMP INHIBITORS - **inhibits the enzyme thatproduces gastric acid H Pylori – MetronidazoleOmeprazoleTetraycline/ClarithromycinCytoprotective – binds with diseased tissue and provides a protective barrier to acidSurgical Treatment1. Vagotomy2. Gastric Resection- Gastroduodenostomy; GastrojejunostomyGASTRIC CANCERIncidence:f.Common in men than womeng.History or presence of Pernicious Anemiah.Often develops with the occurrence of atrophic gastritisi.Low-socio economic status; live in urban areaj.Exposure to radiation or trace metals in soilCause: Helicobacter Pylori
41Nurse Licensure Examination Review HandoutsClinical Manifestations:Diagnosis: GIT x-ray, gastroscopyTreatment: Chemotherapy, radiation therapy, gastric resection Nursing Intervention: Same as with patient’s with ulcer, emotional support, pre and post-operative health teaching3.2. Disorders of the Large and Small BowelVIRAL AND BACTERIAL GASTROENTERITIS/ DYSENTERYGastroenteritis-Inflammation of stomach and intestine usually the small bowel.S/S:abdominal cramps, diarrhea, vomiting, fever, severe fluid and electrolyte loss, mild to severe temperatureCause: ViralDysentery-Inflammation in the colon S/S:severe bloody diarrhea and abdominal cramping, severe fluid and electrolyte loss, mild to severe temperatureCause:Bacterial ( E.coli nd/or shigella, salmonella, Clostriduum difficile from antibiotics)Risk Factors:oPoor food handlingoPoor sanitary conditionsoOvercrowdingoFood remaining on high temperature making organisms incubate and colonize easily.Management:oReplace fluid loss
42Nurse Licensure Examination Review HandoutsoAnti-infective Agent (e.g. Metronidazole spec for amoebiasis, Bactrim)Nursing Intervention:oMeasure intake and outputoAdminister medicationsoReplace fluidsAPPENDICITISoInflammation of the vermiform appendixIncidence: Common between 20-30 yrs. oldCause:Fecalith (stone or calculus in the appendix) .-> Kinking of the appendixFibrous condition in the bowel wall-> Bowel adhesionS/S: Pain starts in the epigastriium the shifts to the the right lower quadrant
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