Blood in the stool is more common with ulcerative colitis or crohn's disease?
ulcerative colitis
What role do fat emulsions play in TPN?
Supplemental calories; Help control hyperglycemia (fat slows digestion of sugars)
Which surgery can cure ulcerative colitis?
Prolectectomy: removal of entire rectum and colon
What diagnosis are these procedures used for: Vagal Blocking; Intragastric Balloon Therapy
Bariatric Procedures
H-Pylori is a cause of PUD. True or False
True
You patient has a BMI of 29. Are they considered obese?
No, BMI 30+ is obese; they are considered overweight
Why would a patient need a J-tube vs a g-tube?
Stomach motility issues; excessive N/V (J tube bypasses the stomach)
Which type of ulcer is more likely to cause pain during the night?
Duodenal
Which type of ulcer is likely to cause pain right after eating?
Gastric Ulcer
Severe symptoms related to ulcerative colitis are most commonly treated with _____.
corticosteroids
Your patient is having excessive diarrhea from cryptosporidium (parasite). You can expect the provider to order imodium to help treat the diarrhea. True or False
False- we want to get that parasite out of the system; not keep it in
Patients with PUD are advised to use OTC ibuprofen as needed for pain. True or False
False- ibuprofen is bad
What is the most common test for Crohn's disease?
CT
A patient should be monitored for anemia if they have ulcerative colitis or Crohn's disease. True or False
True: UC can cause anemia from GI bleed; Crohn's anemia can occur from malnutrition
Spicy foods can cause peptic ulcers. True or False
False- does not cause ulcers; CAN aggravate an already formed ulcer
Where is pain most common with Crohn's disease?
RLQ
Prior to prescribing these meds as a treatment for your patient, which labs need to be checked for each? Tums? MOM?
Tums: Calcium; MOM: Magnesium
Bisacodyl is a stool softener. True or False?
False- it is a laxative
What can worsen GERD symptoms?
Smoking, Chocolate, Coffee, Fatty Foods, Alcohol, Large Meals, Eating Too Close to Bedtime, Ibuprofen/Aspirin
H2 receptor antagonists are part of the treatment plan for H-Pylori. True or false
False- PPI or Bismuth Salts
It is recommended to take H2 receptor blockers and antacids together at the same time to increase effectiveness of both medications. True or False
False- do not take together- antacids decrease absorption of H2RA; H2RA at night; antacids 1-3 hours before meals
Your patient is receiving tube feeding through an NG tube. How often and with ___ mL should the tube be flushed?
30mL every 4 hours
Where is pain most common with ulcerative colitis?
LLQ
Your patient is receiving TPN. How often should blood sugar checks be done?
Every 6 hours.
How do proton pump inhibitors work?
Inhibit the stomach's H+/K+ ATPase proton pump; Most potent inhibitors of acid production
What is a common symptom that can occur about 1 day after laparoscopic surgeries?
Pain to the shoulder/scapular area. Gas used in the surgery to "bloat" open the abdomen. Encourage ambulation.
Define Constipation.
Less than 3 BM/week; Hard, dry, small, difficult to pass stool
Your patient is admitted with appendicitis and will have surgery today. An enema should be given preop to help clear out stool prior to surgery. True or False?
False: Enema/laxative= increase risk for bowel perforation
Barrett Esophagus is considered "pre-cancer". True or False
True: Barretts is cell changes- precursor to esophageal adenocarcinoma
Which disease can have a symptoms of increased abdominal pain after eating: Crohn's or Ulcerative Colitis
Crohn's Disease
What are risk factors for GERD?
Overweight/Obesity, Pregnancy, Delayed Emptying of Stomach, Diseases of Connective Tissue
Patients taking Orlistat (Alli) should supplement their diet with what vitamins?
DEAK (fat soluble); Orlistat prevents absorption of fat soluble vitamins
Which ethnicity of adult males have a highest prevalence of obesity?
Hispanic men
When should a daily dose of H2 Receptor Antagonists be taken?
Evening (basal acid)
Eating small meals can help manage symptoms of both GERD and PUD. True or False?
False: Helps with GERD. Does not affect PUD.
You are caring for patient that just experienced cholecystitis. What diet is best?
Right after attack: Low Fat Liquids (can include protein powder in skim milk)
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