Adult Gasto Flashcards
1
Q
Cullen’s sign
A
- discoloration of the abdomen and periumbilical area
- indicates pancreatitis
2
Q
Acute pancreatitis symptoms
A
- dehydration = n/v
- hypovolemia
- hyperglycemia
- hypocalcemia
- leukocytosis
- diagnose w amylase and lipase
3
Q
Pancreatitis treatment
A
- 0.9 fluid bolus
- monitor LOC
- NPO = TPN
- acute is very painful
- patient controlled analgesia
- fentanyl
- hydromorphone/morphine
4
Q
Necrotizing pancreatitis
A
- ecchymosis around the umbilicus
5
Q
Irrigating a nasogastric tube
A
draw 30 mL of irrigant into the syringe
6
Q
Colonoscopy should begin at age
A
45
7
Q
Dumping syndrome care
A
- dietary changes
- multiple, small means
- increase protein with each meal
- increase complex carbs
- whole grain, pasta, potatoes, rice
- gives body time to absorb before dumping
- lying down for 30 minutes after meals
- avoid drinking with meals
8
Q
Fecal impaction
A
- watery fecal material around the impacted mass, mimicking diarrhea (paradoxical diarrhea)
- abdomen appears distended and swollen
- stomach is hard to the touch
9
Q
Fecal impaction care
A
- enemas of tap water
- manual fragmentation (painful, may need sedation)
- increase fiber to 30 grams a day
10
Q
Acute perforated ulcer
A
- “board-like” rigidity of the abdominal wall
11
Q
4
complications following bariatric surgery (roux-en-y)
A
- venous thromboembolism
- early ambulation
- compression stocking
- anticoagulants
- dumping syndrome
- pneumonia
- infection
- follow strict diet after
- clear liquid for 1 week post
- no sugar or cafferine
12
Q
bariatric surgery care
A
- early ambulation
- compression devices
- prophylactic anticoagulant
- clear liquids
- multivitamin
- oxycodone
- stool softener
13
Q
Infectious mononucleosis (IM)
A
- causes splenomegaly
- fever
- cervical lymphadenopathy
- rash
- kissing disease
- standard precautions
14
Q
liver biopsy positioning
A
- During
- supine
- right arm abducted
- head turned to the left
- Post
- right side
- conscious
- avoid coughing/straining
- hold breathe*
- conscious with lidocaine for pain
15
Q
Appendicitis
A
- right lower quadrant pain
- can refer to left lower quadrant
- McBurney’s point / Psoas sign
- rebound tenderness
- leukocytosis (HIGH WBC)
- fever
- anorexia
- nausea and vomiting
16
Q
Appendicitis and suddenly feels better
A
- likely experienced a rupture of the appendix (perforated)
- emergency surgery
- abdominal pain worse with cough or movement
- relieved when bending right hip or knees
- progresses to peritonitis then sepsis
17
Q
Pain in pancreatitis
A
- severe
- begins mid-epigastrium and radiates to the back
18
Q
Pain in cholecystitis
A
- pain in the right upper quadrant
- can refer to the right shoulder and scapula
19
Q
Older adults at increased risk for malnutrition
A
live alone, especially widowed
20
Q
Order of abdominal assessment
A
- inspection
- auscultation
- percussion
- palpation
21
Q
Paralytic ileus
A
- abdominal distention
- nausea vomiting
- hypokalemia
- hiccups
- decreased bowel sounds
- NG tube helps to decompress
22
Q
NG tube
A
- decompress the stomach and relieve the pressure from the ileus
- causes hyponatremia and hypokalemia
- insert NOT during inspiration
- insert during swallowing of water
- wash bridge of nose with soap/water or alcohol to promote adherence of tape
- HOB 90 degrees
23
Q
Gastric residual volume (GRV)
A
- enteral nutrition should not be stopped for a GRV of less than 500 mL
- elevate HOB when feeding
24
Q
Hyperalimenation
A
- means TPN
- given through central IV line
- tubing with in-line filter
- change tubing every 24 hr
- check glucose every 4-6 hours
- do not abruptly stop
- TPN contains regular insulin
- can cause hypoglycemia
25
Q
Peptic ulcer disease
A
- mid-epigastric pain
- hematemesis
- gastric ulcer symtpoms
26
Q
Cirrhosis
A
- caused by A.B.C.D.
- Alcohol
- Hep B
- Hep C
- Diet
- risk for FLUID VOLUME EXCESS d/t PORTAL HYPERTENSION
- increased ammonia levels
- altered LOC
- give lactulose
27
Q
Melena
A
- black tarry stools
- gastrointestinal bleeding
28
Q
Abdominal surgery
A
- bowel sounds return within 48 hours
- use incentive spirometer
- if child have them blow bubbles
29
Q
Increase risk for gastric cancer
A
- chronic gastritis
- gastric ulcer
30
Q
Pernicious anemia
A
- inability of the body to utilize Vitamin B12.
- decrease in hemoglobin
- prescription for Vitamin B12, administered parenterally
- Cyanocobalamin = B12
- found in animal products (eggs, dairy, meat, fish)
- VEGAN DIET CAUSES THIS
- paresthesia
- glossitis (inflamed tongue)
- memory impairment
31
Q
Peritonitis
A
- caused by leakage or hole
- BURST APPENDIX
- slowing of peristalsis
- hyperactive bowl sounds
- pain, tenderness
- rigid abdominal muscles
- fever, nausea/vomiting
- HIGH WBC
- give antibiotics
- NG tube to decompress
- NOT TO FEED
- keep NPO
- feed through parental nutrition (IV)
32
Q
Crohn’s disease
A
- inflammation of GI tract
- extends from stomach to anus
- abdominal pain/cramps
- diarrhea
- loss of appetite = weight loss
- melena = bloody stools
- mouth ulcers
- fever and fatigue
33
Q
Irritable bowl syndrome (IBS)
A
- alternating between constipation and diarrhea
34
Q
Gastroenteritis
A
- clincial feature is diarrhea
- rapid peristalsis
- abdominal cramping
- hyperactive bowl sounds
- not present in gastroenteritis
- fever
- tachycardia
- tachypnea
- UNLESS DEHYDRATED
35
Q
Bowel obstruction
A
- abrupt onset stomach pain
- distended abdomen
- NO FEVER
- nausea and vomiting = DEHYDRATION
- fluid/electrolyte imbalance
- can lead to metabolic alkalosis
- fluid/electrolyte imbalance
- TREATMENT
- NPO
- establish vascular access
- rehydrate
- IV pain control
36
Q
Cirrhosis care
A
- give albumin to enhance oncotic pressure
- helps with ascites and edema
- perform bowl movements
- increased ammonia levels
- altered LOC
- give lactulose
