Upper Gastrointestinal Problems

Study Guide

1. What side effects are shared between anticholinergics and antihistamines?

2. How would a prokinetic drug help nausea?

3. What is GERD? What are the manifestations? List complications. What is Barrett’s esophagus?

4. What is the recommended dosing schedule for antacids? Why?

5. What is the difference between the effects of H2 receptor blockers and cholinergic drugs? Name the drugs in each group. Which helps healing? What class of drugs is best to help healing?

6. Why would small frequent feedings help prevent esophageal reflux?

7. What advice would you give a patient with PUD about spicy foods?

8. Why would 6 inch blocks under the head of the bed help a patient with GERD or a hiatal hernia?

9. What is the relationship of pernicious anemia to chronic gastritis?

10. What diet and medications contribute to gastritis?

11. What are the elements of medical treatment for acute gastritis? When do you think the doctor would order an NG tube?

12. Define massive UGI hemorrhage. What change would you see in the hemoglobin? Answer: A massive upper GI bleed is a loss of more than 1500 ml or 25% of the intravascular volume. This would be represented by 3 gram reduction in hemoglobin.

13. What are the possible sources of UGI hemorrhage and what is the most common cause? Answer: chronic esophagitis, esophageal tear, esophageal varices, peptic ulcers account for more than 50%,

14. Why does a person with chronic gastritis need cobalamin?

15. Which antacids cause diarrhea?

16. Which antacid is best for healing an ulcer?

17. What is the difference in etiology and incidence of gastric and duodenal ulcers?

18. What is the role of histamine in the etiology of gastric ulcers?

19. What is the most common site for gastric ulcers?

20. What is a stress ulcer and how is it formed?

21. What is a perforated ulcer? How would you recognize it? Why are antibiotics parts of the treatment?

22. Why is endoscopy better than other methods of diagnosis? What is the nursing care following a gastroscopy? EGD? What is the advantage of a gastroscopy or EGD over GI x-rays?

23. What are the problems in identifying H pyori? How does it contribute to the development of an ulcer?

24. What is the role of the mucosal barrier in preventing a gastric ulcer?

25. How long does healing of a peptic ulcer take? When does the pain go away?

26. What is the advantage of H2 or proton pump inhibitors over antacids?

27. What are the side effects of anticholinergics?

28. Describe diet therapy for an ulcer.

29. What is the primary symptom of esophageal diverticuli? Of esophageal achalasia?

30. Distinguish between a sliding hiatal hernia and a rolling hiatal hernia. What are the primary symptoms?

31. What is the conservative management of a hiatal hernia?

32. Study the drugs in the objectives