| A | B |
|---|
| Antacids - Take when? | Give 1 hour after meals. Take with a full glass of water. |
| H2 Blockers - Take when? | Give with or before meals. |
| PPI’s - Take when? | Give before the first meal of the day. |
| H Pylori Triple Therapy | -cillin + -mycin + PPI (-azole) |
| Examples: Pepcid, Tagamet | Histamine 2 Blocker (H2 Blocker) |
| Examples: Omeprazole, pantoprazole, others ending in -prazole | Proton Pump Inhibitors (PPIs) |
| Rule of Admin for Multiple GI Meds Prescribed | Give them one hour apart from each other |
| Stops Nausea & Vomiting | Zofran (Ondansetron) Compazine/Promethazine |
| Stops Diarrhea | Lomotil or Imodium |
| Antidiarrheal Medications | Caution over use (r/t toxicity); watch for constipation |
| Slows/Inhibits/Stops Stomach Acid | Antacids, H2 Blockers, PPI’s |
| Sucralfate/Carafate | Protects mucosal lining of the stomach |
| Sucralfate/Carafate - Take when/how? | Give PO and take on an empty stomach. Do not give with Coumadin or Dilantin |
| Examples: Maalox, Tums, Milk of magnesia | Antacids |
| NSAIDs Teaching | Take with full glass of water or milk or with food. Avoid alcohol! |
| Hold NSAIDs how long before surgical procedures? | No less than 1 week |
| NSAIDs increase bleeding potential (why)? | Because they inhibit platelet aggregation |
| Corticosteroids | Mainstay Drug Tx IBD Exacerbations |
| Examples: Dexamethasone, cortisone, prednisone, -one | Corticosteroids |
| Corticosteroids Teaching | Take exactly as prescribed, gradually decrease use, never abruptly stop |
| What must be monitored taking a steroid? | Potassium level, glucose level, and I&O |
| Corticosteroids may cause symptoms of... | Cushing’s Syndrome |
| Corticosteroids will delay... | Wound Healing |
| Yes in PO for surgery should you still get the steroid | Yes, due to excess inflammation r/t surgery, stress, and illness. |
| UC signs, symptoms, complaints | Abdominal pain, bloody diarrhea (>20 stools/day), N&V, weight loss |
| UC appropriate diet | Low fiber, AVOID fiber, fatty/greasy foods to decrease diarrhea. Avoid alcohol and caffeine. Increase fluid intake. |
| UC Treatments | NPO, corticosteroids and or removal of colon and rectum (will need ileostomy) |
| Corticosteroid Caution | Avoid exposure to infection, live vaccines, immunizations |
| Duodenal Ulcer Pain | Occurs on empty stomach; subsides with food; feed a duodenal ulcer |
| Gastric Ulcer Pain | Occurs with meals or after eating; starve a gastric ulcer |
| PUD teaching | Avoid Smoking, Alcohol; Manage Stress |
| PUD Complications | Hemorrhage, Perforation, Peritonitis |
| PUD Peritonitis | Rigid, board-like abd, severe pain, decreased to hypo vowel sound! Get VS, check and/bs, Call Rapid! |
| Crohn’s location/characteristics | Anywhere from mouth to anus; cobblestone pattern |
| IBD Foods to AVOID | Dairy products and high fiber foods will increase diarrhea |
| Excess Diarrhea Electrolyte Concern? | Hypokalemia |
| Crohn’s Tx | Corticosteroids, NPO, stress Mgmt, surgery WILL NOT help |
| IBD Prognosis | Lifelong + unpredictable s&s; Crohn’s has no cure; sometimes surgery can cure UC |
| PUD 1st s&s | Is often serious GI bleeding |
| PUD vomit and still characteristics? | Vomit = coffee ground; Stool = Black Tarry (melena) |
| Bacteria that causes most PUD? | H pylori |
| H Pylori transmission | Poop to soup |
| How is bowel rest achieved? | NPO and of NG to suction (stomach decompression) |
| Excessive Diarrhea | Peri-anal skin integrity; gentle cleansing; mild soaps; protective ointment; no harsh temps or chemicals |
| IBD Monitor Labs | CBC/RBC/H&H; values will be lower with UC due to more blood loss |
| Guaiac | Test for Occult Blood |
| IBD Patient teaching | Monitor report bloody stools; Stress Mgmt |
| Gallbladder Risk Factors (some not all) | F’s: female, fluffy, forties, fertile, fatty foods familial; S = sedentary |
| Cholelithiasis S&S | 3-6 hrs post fatty meal or when pt lays down; Biliary colic r/t stone; tachycardia, diaphoresis, prostration, excruciating pain RUQ |
| Cholelithiasis Complication | Biliary Obstruction = Emergency |
| Biliary Obstruction S&S | pasty, clay colored stools |
| Biliary Obstruction not resolved may lead to | Bile Peritonitis |
| Cholecystitis labs | Leukocytes + fever |
| Cholecystitis and Cholelithiasis Priority | Pain Management (Opioids + NSAIDs) Infection Control, ABT prn, and fluid/electrolyte balance |
| Cholelithiasis Mainstay Tx | Cholecystectomy |
| Cholelithiasis conservative tx/meds | Cholesterol solvents (dissolve stones) |
| Anticholinergics | Decrease secretion and counteract smooth muscle spasms in the gut |
| Cholecystitis/Lithiasis N&V | NG Tube; gastric decompression |
| Examples: -diol; ursodiol, chenodiol | Cholesterol solvents (gall stones) |
