ADULT EXAM 2 Flashcards
Which hernia has a symptom of heartburn?
Sliding
Two types of Hernias:
Sliding and Paraesophageal
Sliding hernias occur when..
the upper stomach and GI junction are displaced upward and slide out of the thorax.
S/S: heartburn, difficulty swallowing, weakness, trauma, tight pants
Complications of hernias:
hemorrhage, obstruction and strangulation
What diagnostic test would you do for Hernias?
barium swallow, xray, CT
most common reason for PUD
h. pylori
Diagnostics for PUD:
endoscopy to confirm ulcer
CBC
Medical Management for PUD: Dietary modifications:
avoid extreme temp foods, avoid alcohol and caffeine, eat 3 regular meals a day.
Complications of PUD
Hemorrage: vomiting bright red or coffee groups, tachycardia, test stools
Bariatric surgery dietary restriction
sugar free clear liquids for 48 hours, drink 30 ml every 15 minutes, no Ng tube needed.
Can have 600-800 calories a day.
Dumping syndrome:
unpleasant set of vasomotor and GI symptoms. Eat first, drink Later.
S/S of dumping syndrom
fullness, weakness, cramping, diaphoresis, diarrhea.
can occur 10 to 90 minutes after eating.
Dietary guidelines for bariatric patients
smaller more frequent meals–1cup
low carb intake
eat only foods high in nutrients (peanut butter, fish, beans, cheese, chicken)
patient complains of midepigastric pain, dull and gnawing pain, burping (esp when stomach is empty), diarrhea, bleeding, etc.
PUD (duodenal)
Meds for PUD
PPI, bismuth salts, antibiotics
H2 and PPIs are used to treat ulcers not associated with
H pylori
how many meals should a person with PUD eat
3 meals a day
It is important for those with bariatric surgery to get what type of injections
B12 and iron
Bariatric surgery patients should drink water
30 minutes after or before a meal but never with a meal to prevent dumping syndrome
bariatric patients should be positioned in..
low fowlers
lab findings of someone with appendicitis
elevated WBC, neutrophils
why is it important to do a pregnancy test for someone with suspected appendicitis
could be ectopic pregnancy
should also rule out UTI
What diagnostic test is number one in determining appendicitis
X RAY
CT SCAN-when diagnosis is uncertain
complication of appendicitis is..
peritonitis, abscess and portal pyleophlebitis
someone with appendicitis position the patient..
HIGH FOWLERS–> makes patient comfortable by increasing peristalsis, reduces tension on incision and abdominal organs
When should the patient follow up with an appointment after appendix removal
5-7 days
patients after appendix surgery should avoid heavy lifting for..
2-4weeks
lift no more than 10lbs (gallon on milk)
LLQ pain is prevalent in..
diverticulitis
complications of diverticulitis
peritonitis or abcsess and septicemia
what is contraindicated in patients with diverticulosis
barium enema
what is contraindicated with patients with diverticulitis
colonoscopy
In lab values, what might be elevated in patients with dierticulitis
ESR and WBC
dietary management for patients with diverticulitis
clear liquids initially; rest bowels, high fiber, low fat, decrease pressure and increased stool volume
what pharmacological interventions can you give to someone with diverticulitis
broad spectrum antibiotics, antispasmotics, bulk forming laxatives
if stool is blood or pusy when it can mean the patient has
diverticulitis
If patient has a rigid abdomen, elevated ESP, elevated WBC, increased temp, tachycardia and hypotension the patient may have
severe case of diverticulitis
Patient complains of pain in RLQ with diarrhea that is unrelieved by defecation and complains of cramping after eating..
crohns disease
This shows a string sign..
Crohns disease
Can have an elevated ESR, WBC and albumin will be decreased with H&H decreased as well. Shows bowel wall thickening and/or fistula formation
Crohns disease
Complications of people with crohns
intestinal obstruction and perianal disease
patient complains of LLQ pain and an inclination to defecate
Ulcerative colitis
patient has pus and mucous in their stool
ulcerative colitis
Patients with ulcerative colitis may have hypo or hypercalcemia
hypo
major complication of ulcerative colitis
Toxic mega Colon
Which ostomy do we see most often with perforated diverticulitis
Sigmoid
Which ostomy puts out more enzymes since it is closer to the stomach?
ileostomy
For a postop ostomy patient, how long should IV fluids be administered for?
4-5 days
patient complains of epigastric pain after a heavy meal/ binge drinking and has a rigid or boardlike abdomen
acute pancreatitis with peritonitis
cullen sign
bruising around umbillicus
grey-turners sign
bruising around the flank
amylase and lipase levels are increased in
acute pancreatitis
pancreatitis nutritional status
npo or send home on low fat high protein diet for 4-6 weeks
check blood sugars every45-6 hours
how many carbs should diabetic have..
45-60
give how much insulin for every 15 gram of carbs
1 unit
