Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

z S15 HEHI 4 > adult gi > Flashcards

adult gi Flashcards

1
Q

gastroesophageal reflux disease

A

upper gastrointestinal disease caused by reflux of gi contents into esophagus; relaxation of lower esophageal sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

gastroesophageal reflux disease

A

relaxation of lower esophageal sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

gerd: causes

A
  • fatty foods, caffeinated bevs, chocolate, citrus, tomatoes
  • stress
  • body habitus
  • gastric anatomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

gerd: effects

A
  • esophageal stricture
  • esophagitis, erosion, ulceration
  • aspiration
  • barrett’s epithelium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

barrett’s epithelium

A

COLUMNAR epithelium instead of normal SQUAMOUS cell that develops in lower esophagus when healing from gerd (exposed to acid, pepsin)

considered premalignant, associated with increased risk of CANCER after prolonged disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

gerd: manifestations/dx

A

not much objective, rely on patient report: dyspepsia, regurgitation, dysphagia, odynogphagia

crackles (aspiration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

odynophagia

A

painful swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

barrett’s esophagus: interventions

A
  • esophagectomy

- ablative therapy: radiofrequency, photodynamic, cryotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

esophagectomy

A

remove esophagus, reanastemose stomach to what’s left of upper esophagus.

because stomach stretched and in the thoracic cavity, exposed to pressures from lungs. HIGH RISK OF ASPIRATION.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

hiatal hernia

A

protrusion of stomach through diaphragm

high risk for aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

hiatal hernia: effects

A

gerd, impaired esophageal emptying, volvulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

volvulus

A

obstruction of bowel caused by twisting of bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

hiatal hernia: manifestations

A

s: chest pain, breathlessness, worse when lying down
o: belching, dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hiatal hernia: eating habit modification

A

more frequent small meals closer together = easier to manage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

esophageal varices

A

dilation of esophageal and gastric veins
- high risk of bleeding, associated with cirrhosis (liver failure, blood backs up into portal veins then into mesoteric veins, then vessels in esophagus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hiatal hernia: nursing implications (3)

A
  • caution with ng tube placement
  • monitor vitals: slow downward trend (HR higher, BP lower)
  • hypovolemic shock, signs of bleeding in stools (extreme situation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

gastritis

A

inflammation of stomach lining!

- acute v chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

gastritis: causes

A
  • increased acid production
  • decreased protective mechanism
  • exposure to irritants (chemical ingestion, bleach)
  • meds/therapies (chemo, radiation)
  • h. pylori
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

gastritis: compromised protective mechanisms

A
  • mucus
  • bicarb (acids go wild)
  • blood flow
  • prostaglandins (pivotal in production of mucus & bicarb)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

pivotal in production of mucus, bicarb in stomach

A

prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

acute gastritis: effects

A

localized;

  • thickened, irritated rugae
  • mucosal necrosis in isolated area
  • edema, swelling

healing, regeneration usually within a few days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

chronic gastritis: effects

A

diffuse/generalized;

  • gastric atrophy
  • impaired absorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

gastritis: manifestations

A

s: anorexia, nausea, dyspepsia, cramping
o: epigastric pain, vomiting, hematemesis, melena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

dyspepsia

A

indigestion, heartburn following meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

hematemesis

A

blood vom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

peptic ulcer disease

A

impairment of gastric mucosal defenses so they no longer protect the epithelium from the effects of acid and pepsin;

localized tissue erosion in stomach or duodenum;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

melena

A

blood in stool: black tarry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

peptic ulcer disease

A

localized tissue erosion in stomach or duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

peptic ulcer disease: causes

A
  • h. pylori
  • stress (ICU patients 15%)
  • nsaid exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

peptic ulcer disease: effects

A
  • upper gi bleeding
  • coffee ground emesis
  • perforation
  • peritonitis
  • septic shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

coffee ground emesis sign of

A

peptic ulcer disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

melena, hematemesis sign of

A

gastritis

upper gi bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

pain left of midline with food sign of

A

gastric ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

pain right of midline 1.5 to 3 hours after food

A

duodenal ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

peptic ulcer disease: manifestations

A

s: sharp abdominal pain, dyspepsia
o: acute abdomen, pain left of midline with food (gastric ulcer), pain right of midline 1.5 to 3 hours after food (duodenal ulcer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

acute abdomen

A

firm, hard abdomen, severe pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

acute abdomen sign of

A

peritonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

pain left of midline with food sign of

A

gastric ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

pain right of midline 1.5 to 3 hours after food

A

duodenal ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

upper gi bleed

A

varying degrees of severity: can vary from trickle to massive, fulminant barfing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

upper gi bleed: effects

A
  • risk of hemodynamic instability
  • hypovolemia
  • anemia
  • hemodilution, f&e imbalances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

upper gi bleed: manifestations

A

s: minimal complaints -> abdominal pain, hematemesis, melena
o: vitals, presyncope, lethargy, hypoperfusion, hematemesis, melena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

presyncope

A

lightheadedness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

hypoperfusion

A

crummy capillary refill, weak pulses; cool/pale/clammy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

mallory-weiss tears

A

tear in mucosal lining of lower esophagus/upper stomach; occurs with longterm vomiting, coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

upper gi bleed: nursing implications

A
  • fluid replacement (revive circulating volume)
  • packed rbc transfusion (prevent hemodilution)
  • ngt placement to prevent mallory-weiss tears
  • meds, dx, surgery possible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

gastric cancer

A

often associated with chronic gastritis, h. pylori

  • tumor invasion to surrounding tissues
  • VERY FEW SYMPTOMS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

gastric cancer: manifestations

A

dyspepsia, abdominal/epigastric pain, back pain, weight loss, n/v

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

gastric cancer: interventions

A
  • radiation, chemo

- surgical resection (partial or total gastrectomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

dumping syndrome

A

rapid transit of nutrients through gi tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

mucoid stools sign of…

A

iritable bowel syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

dumping syndrome: management

A
  • numerous small meals
  • increased fiber (increased bulk = increased transit time)
  • limit sugars (irritant, speeds up motility)
  • cautious fluid intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

dumping syndrome: management

A
  • numerous small meals
  • increased fiber (increased bulk = increased transit time)
  • limit sugars (irritant, speeds up motility)
  • cautious fluid intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

irritable bowel syndrome

A

altered bowel motility: increased/decreased transit time

- unclear etiology: inflammatory, bacterial, genetic, stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

ibs: effects

A

diarrhea, constipation, abdominal pain, bloating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

ibs: manifestations

A

s: abdominal pain, mucoid stools, inconsistent bowel pattern
o: llq pain, observe stool variations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

mucoid stools sign of…

A

iritable bowel syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

hernia

A

intestinal protrusion through weakened muscle layer (abdominal wall, diaphragm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

reducible/irreducible hernia

A

can be placed back into abdominal cavity by gentle pressure

cannot be reduced/placed back into abdominal cavity: requires IMMEDIATE surgical evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

hernia: strangulation

A

blood supply to herniated segment of bowel is cut off by pressure from the hernial ring (band of muscle around the hernia) –> ischemia, obstruction of bowel loop –> can lead to necrosis, perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

hernia: incarceration

A

irreducible hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

hernia: effects

A
  • pain (not always), discomfort
  • ischemic bowel
  • sepsis
  • body image alteration
  • adl impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

hematochezia

A

blood in stool: via rectum, bright red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

occult blood

A

in stool but not readily apparent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

hernia: manifestations

A

s: pain, mass, nausea
o: v, abd tenderness, vitals variability, palpable mass, weakened muscle wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

hernia: nursing implications

A

core strengthening! supportive devices, minimize heavy lifting, weight management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

colorectal cancer

A

colon + rectum = large intestine; common

- often metastasizes to liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

colorectal cancer: initial presentation

A

polyp, 55% in rectum and sigmoid colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

colorectal cancer: associated with

A

hpv, smoking, alcohol, physical inactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

colorectal cancer: manifestations

A

s: rectal bleeding, abdominal pain, difficulty passing stool
o: hematochezia, anemia, occult blood, carcinoembryonic antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

hematochezia

A

blood in stool: via rectum, bright red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

occult blood

A

in stool but not readily apparent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

colostomy

A

surgical creation of opening between colon and surface of abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

high pitched/absent bowel sounds are a sign of…

A

bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

ascending colostomy

A

for right sided tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

descending colostomy

A

for left sided tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

sigmoid colostomy

A

for rectal tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

transverse (double-barrel) colostomy

A

often used in EMERGENCIES (intestinal obstruction, performation) because it can be created quickly.

TWO stomas: proximal (closest to small intestine) drains feces, distal drains mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

transverse (double-barrel) colostomy

A

often used in EMERGENCIES (intestinal obstruction, performation) because it can be created quickly.

TWO stomas: proximal (closest to small intestine) drains feces, distal drains mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

mechanical bowel obstruction

A

intussusception, volvulus, adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

maroon stools sign of

A

lower gi bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

visible blood clots in stools sign of

A

lower gi bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

nonmechanical bowel obstruction

A

ileus (can happen as a result of handling bowels during surgery, they are “paralyzed” temporarily)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

bowel obstruction: effects

A
  • fluid/electrolyte alterations
  • metabolic alkalosis
  • nutritional alterations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

bowel obstruction: manifestation

A

s: abdominal pain, nausea, no flatus/stool (diarrhea)
o: abdominal pain/distension, vomiting, high pitched/absent bowel sounds

86
Q

steatorrhea sign of

A

malabsorption syndromes

+ celiac disease in children

87
Q

high pitched/absent bowel sounds are a sign of…

A

bowel obstruction

88
Q

hemorrhoids

A

swollen/distended veins of anorectal region, increased intraabdominal pressure
- internal v external

89
Q

rebound tenderness sign of

A

peritonitis/appendicitis

90
Q

hemorrhoids: manifestations

A

s: rectal pain/itching, rectal bleeding/mucoid discharge
o: visible external, thrombosed hemorrhoid, bright red blood after wiping

91
Q

lower gi bleed

A

passage of blood directly into the large bowel

92
Q

rlq pain sign of

A

appendicitis

93
Q

llq pain sign of

A

irritable bowel syndrome

diverticulitis

94
Q

lower gi bleed: causes

A

diverticulitis, polyps, colitis (c diff), malignancy

95
Q

diverticula

A

sacs resulting from herniation of mucosa and submucosa of tubular organ into surrounding tissue

96
Q

lower gi bleed: manifestations

A

s: abdominal pain/cramps, passing of clots with bowel movements, frequent stools
o: hematochezia, maroon stools, visible blood clots

97
Q

maroon stools sign of

A

lower gi bleed

98
Q

visible blood clots in stools sign of

A

lower gi bleed

99
Q

malabsorption syndromes (+ types)

A

deterioration of colonic wall: thinning, flattening
- inability of appropriate nutritional absorption

deficiencies: bile salt, enzyme
bacteria (c diff), disruption of mucosal lining (ulcers, gastritis, etc)
altered lymphatic/vascular circulation
decreased gastric/intestinal surface (surgery or disease)

100
Q

minimal movement due to pain sign of

A

peritonitis

101
Q

malabsorption syndromes: assessment

A
  • chronic diarrhea, steatorrhea
  • bloating, flatus
  • anemia
  • edema
102
Q

malabsorption syndromes: assessment

A
  • chronic diarrhea, steatorrhea
  • bloating, flatus
  • anemia
  • edema
103
Q

steatorrhea sign of

A

malabsorption syndromes

+ celiac disease in children

104
Q

frequent loose stools sign of

A

gastroenteritis

105
Q

appendicitis

A

blockage of the lumen of the appendix

accumulation of secretions within the appendix leading to inflammation, gangrene, rupture

106
Q

appendicitis: effects

A
  • abscess
  • peritonitis (rebound tenderness)
  • perforation
  • sepsis
107
Q

tenesmus

A

sudden urges to defecate

108
Q

rebound tenderness sign of

A

peritonitis/appendicitis

109
Q

tenesmus sign of

A

ulcerative colitis

110
Q

blood & mucus in stool sign of

A

ulcerative colitis

111
Q

ileum

A

final section of small intestine

112
Q

appendicitis: assessment

A

s: nausea, anorexia, abdominal pain
o: vomiting, rlq pain, rebound > deep palpation, fetal position

113
Q

rlq pain sign of

A

appendicitis

114
Q

llq pain sign of

A

irritable bowel syndrome

115
Q

peritonitis

A

inflammation of the visceral/parietal layers of the abdominal cavity; usually bacterial

116
Q

perianal ulcers and fissures sign of

A

crohn’s disease

117
Q

severe diarrhea sign of

A

crohn’s disease

118
Q

peritonitis is usually due to…

A

bacterial infection

119
Q

peritonitis: effects

A
  • abscess formation
  • ascites
  • hypovolemia
  • decreased peristalsis
  • increased intraabdominal pressure
  • usually due to significant abdominal trauma
120
Q

ascites

A

accumulation of free fluid within the peritoneal cavity; increased hydrostatic pressure from portal hypertension causes this fluid to leak into the peritoneal cavity

121
Q

peritonitis: effects

A
  • abscess formation
  • ascites
  • hypovolemia
  • decreased peristalsis
  • increased intraabdominal pressure
  • usually due to significant abdominal trauma
122
Q

ascites

A

accumulation of free fluid within the peritoneal cavity; increased hydrostatic pressure from portal hypertension causes this fluid to leak into the peritoneal cavity

123
Q

peritonitis: manifestations

A

s: generalized abdominal pain, comfort through no movement
o: low grade fever, minimal movement, guarding, abdominal pain/tenderness

124
Q

minimal movement due to pain sign of

A

peritonitis

125
Q

gastroenteritis

A

inflammation of stomach and intestinal mucosa with frequent, watery stools

  • bacterial OR viral
  • self-limiting
126
Q

gastroenteritis: effects

A

secretions of fluid & electrolytes into bowel

increased gi motility

127
Q

gastroenteritis: manifestations

A

s: possible exposure/history, nausea, diarrhea, fatigue/malaise
o: vomiting, frequent loose stools

128
Q

frequent loose stools sign of

A

gastroenteritis

129
Q

ulcerative colitis

A

widespread inflammation, may be extensive. rectum and rectosigmoid colon

  • edematous mucosa
  • erosions, ulcers develop
130
Q

jaundice sign of

A

cirrhosis

131
Q

liver tenderness sign of

A

cirrhosis

132
Q

ulcerative colitis: effects

A
  • stools with blood & mucous
  • intraabdominal abscesses
  • tissue necrosis (lack of blood flow)
  • tenesmus
133
Q

tenesmus

A

sudden urges to defecate

134
Q

ulcerative colitis: manifestations

A

s: tenesmus, cramping
o: tachycardia/fever, distension

135
Q

itching due to bile salt accumulation in skin sign of

A

hepatitis

136
Q

tenesmus sign of

A

ulcerative colitis

137
Q

ulcerative colitis

A

chronic inflammatory process affecting mucosal lining of rectum/colon; widespread (sometimes extensive) inflammation

  • intestinal mucosa becomes hyperemic, edematous
  • erosions, ulcers, bleeds develop
138
Q

blood & mucus in stool sign of

A

ulcerative colitis

139
Q

llq pain sign of

A

irritable bowel syndrome

diverticulitis

140
Q

ulcerative colitis

A

chronic inflammatory process affecting mucosal lining of colon or rectum; widespread (sometimes extensive) inflammation

  • edematous mucosa
  • erosions, ulcers develop
141
Q

blood & mucus in loose stool sign of

A

ulcerative colitis

142
Q

crohn’s disease

A

inflammatory disease of small intestine (most often), colon, or both. can affect tract from mouth to anus but most commonly affects terminal ileum.

  • slowly progressive, unpredictable
  • frequent remission, exacerbation
  • transmural inflammation causes thickened bowel wall
143
Q

crohn’s disease: effects

A
  • fistula formation
  • bowel perforation
  • severe diarrhea
  • malabsorption
144
Q

crohn’s disease: assessment

A

s: weight loss, abdominal pain, diarrhea
o: distension, perianal ulcers/fissues

145
Q

dark foamy urine sign of

A

cholecystitis

146
Q

clay-colored feces sign of

A

cholecystitis

147
Q

perianal ulcers and fissures sign of

A

crohn’s disease

148
Q

severe diarrhea sign of

A

crohn’s disease

149
Q

diverticular disease

A

pouch-like herniations of mucosa

  • diverticulosis, diverticulitis
  • blockage is a concern (ex: nuts, seeds)
150
Q

diverticular disease: effects

A

perforation, intraabdominal abscess, peritonitis, lower gi bleed

151
Q

diverticulosis

A

presence of many abnormal pouchlike herniations (diverticula) in wall of intestine

152
Q

third spacing a sign of

A

pancreatitis

153
Q

if you give someone with pancreatitis something to eat…

A

it will stimulate their irritated pancreas, so don’t do that shit.

NOT EVEN ICE CHIPS OR SIPS YO

154
Q

diverticulitis

A

inflammation of one or more diverticula

155
Q

severe abdominal pain radiating to back and left side sign of

A

pancreatitis

156
Q

steatorrhea sign of

A

malabsorption syndromes
+ celiac disease in children

if + clay-colored feces, cholecystitis

157
Q

ascites

A

accumulation of free fluid within the peritoneal cavity; increased hydrostatic pressure from portal hypertension causes this fluid to leak into the peritoneal cavity

liver creates albumin for blood; in ascites liver unable to create as much

158
Q

diverticular disease

A

pouch-like herniations of mucosa, most commonly colon

  • diverticulosis, diverticulitis
  • blockage is a concern (ex: nuts, seeds)
159
Q

diverticulitis

A

inflammation of one or more diverticula

160
Q

cirrhosis

A

extensive, irreversible SCARRING of liver; response to chronic inflammation (due to: hep c, alcoholism, biliary obstruction aka scar tissue, hep b & d)

end stage!!!

161
Q

cirrhosis: effects

A
  • obstructed bile, blood flow
  • jaundice (can’t extract bilirubin from blood)
  • portal hypertension, esophageal varices, ascites
  • coagulation defects
  • hepatorenal syndrome
  • spontaneous bacterial peritonitis
  • hepatic encephalopathy
162
Q

hepatorenal syndrome

A

state of progressive oliguric renal failure associated with hepatic failure, resulting in functional impairment of kidneys with normal anatomic, morphologic features. poor prognosis for hepatic failure patient, often cause of death in patients with CIRRHOSIS

163
Q

hepatic encephalopathy

A

clinical disorder seen in hepatic failure, CIRRHOSIS; manifested by neurologic symptoms, characterized by altered level of consciousness, impaired thought process, neuromuscular disturbances; aka “hepatic coma” aka “portal-systemic encephalopathy”

164
Q

cirrhosis: manifestations

A

s: contributing fh, sh, pmh; anorexia, nausea, abdominal pain
o: distension, liver tenderness, jaundice/icteric, liver function panel

165
Q

jaundice sign of

A

cirrhosis

166
Q

liver tenderness sign of

A

cirrhosis

167
Q

hepatitis

A

catch all term for liver inflammation

- causes: viral, medication, toxin, non-hepatitis viruses

168
Q

hepatitis: effects

A

acute, chronic hepatitis; hepatocellular carcinoma

169
Q

hepatitis: manifestations

A

s: pmh, fh, sh; flulike sx, abdominal pain, n/v
o: lab findings (hep titers), abdominal pain, jaundice, itching (bile salts accumulate in skin)

170
Q

itching due to bile salt accumulation in skin sign of

A

hepatitis

171
Q

hepatitis: nursing implications

A

hand washing, food sanitation, cautious sexual practices, vaccination, clean needle programs

172
Q

cholecystitis

A

inflammation of gallbladder; acute v chronic

173
Q

cholecystitis: effects

A
  • necrosis
  • perforation
  • acute –> chronic
    • fibrous
    • dyskinetic
174
Q

acute cholecystitis types (2)

A

calculous (cholelithiasis), acalculous

175
Q

cholelithiaisis aka

A

aka calculous cholecystitis – ACUTE!
- chemical irritation, inflammation result from gallstones (cholelithiasis) that obstruct cystic duct, gallbladder neck, or common bile duct

176
Q

acalculous cholecystitis

A

inflammation NOT due to gallstones – ACUTE!

- typically associated with biliary stasis caused by any condition that affects regular filling/emptying of gallbladder

177
Q

chronic cholecystitis

A

results when repeated episodes of cystic duct obstruction cause chronic inflammation: gallbladder becomes fibrotic and contracted (decreased motility, deficient absorption)
- calculi almost always present

fibrous, dyskinetic

178
Q

cholecystitis: manifestations

A

s: pruritis, epigastric pain referred to right shoulder, intolerance of fatty foods
o: jaundice, clay-colored feces & steatorrhea, dark foamy urine

179
Q

dark foamy urine sign of

A

cholecystitis

180
Q

clay-colored feces sign of

A

cholecystitis

181
Q

cholecystitis: nursing implications

A 
surgical intervention (cholecystectomy, biliary drain)
- let infectious process decrease BEFORE doing surgery so infectious bile won't explode all over peritoneum resulting in peritonitis
182
Q

pancreatitis

A

inflammatory process of the pancreas
- premature activation of pancreatic enzymes; autodigestion (also of other internal organs)

POTENTIALLY LIFE THREATENING

183
Q

pancreatitis: effects

A
  • edema, inflammation, hemmorhage
  • necrosis, abscess formation
  • third spacing (LOTS)
  • endocrine, exocrine dysfunction
  • MODS, ARDS, shock
  • chronic pancreatitis, pseudocyst
184
Q

pancreatitis: effects

A
  • edema, inflammation, hemmorhage
  • necrosis, abscess formation
  • third spacing (LOTS)
  • endocrine (insulin), exocrine (enzymes) dysfunction
  • MODS, ARDS (pancreas sits under diaphragm!), shock
  • chronic pancreatitis, pseudocyst
185
Q

third spacing

A

fluid moves from vascular to interstitial space, resulting in shock

186
Q

third spacing a sign of

A

pancreatitis

187
Q

if you give someone with pancreatitis something to eat…

A

it will stimulate their irritated pancreas, so don’t do that shit.

NOT EVEN ICE CHIPS OR SIPS YO

188
Q

pancreatitis: manifestations

A

s: severe abdominal pain radiating to back and left side, n/v, pmh (significant etoh), sh
o: acute abdomen, lipase/amylase, decreased bowel sounds

189
Q

severe abdominal pain radiating to back and left side sign of

A

pancreatitis

190
Q

sphincter of oddi

A

muscular valve surrounding bile duct and pancreatic duct at beginning of duodenum; only opens in response to meal so juices can enter and mix with food

191
Q

pancreatitis: pain management considerations

A

morphine: can cause spasm of sphincter of oddi!
nsaid: platelet affect, so careful if hemmorhagic pancreatitis

dilaudid, fentanyl work great

192
Q

whipple procedure

A
  • aka pancreaticoduodenectomy; for pancreatic cancer

resection of: head of pancreas, full duodenum, portion of jejunum and stomach and gallbladder, then sewing dat shit back together (pancreas to jejunum, common bile duct to jejunum, stomach to jejunum). spleen may go byebye too.

193
Q

esophageal pH monitoring

A

for gerd - constant recording of pH of esophagus to dx reflux

194
Q

upper gi series

A

similar to barium swallow + fluoroscopy

195
Q

esophagogastroduodenoscopy

A

poke around to check squamus v columnar changes in esophagus, can also stick band around esophageal varices to make it necrose and fall off

196
Q

esophageal dilation

A

balloon opens lower esophageal sphincter to restore flow

  • risk rupture = emergent situation
197
Q

endoscopic ultrasound

A

allows provider to evaluate depth of tumor, presence of lymph node involvement = more accurate staging of disease

198
Q

endoscopic retrograde cholangiopancreatography (ercp)

A

visual, radiographic examination of liver, gallbladder, bile ducts, pancreas via endoscope + radiopaque dye to identify cause, location of obstruction

you can put stents in!

199
Q

capsule endoscopy

A

camera goes down the hatch and out the back door! find source of bleed in that tangled mess.

200
Q

hepatobiliary iminodiacetic acid (hida) scan

A

dye shows where bile leak is; shows path of tracer over time

201
Q

transjugular intrahepatic portosystemic shunt (tips)

A

non-surgical procedure: enter through jugular > SVC > IVC > hepatic vein to insert the bypass (sheath + stent + balloon) through the liver - alleviates symptoms of extreme cirrhosis; also controls long-term ascites, reduces variceal bleeding

LOTS of risks, so rare usage.

202
Q

transjugular intrahepatic portosystemic shunt (tips)

A

non-surgical procedure: enter through jugular > SVC > IVC > hepatic vein to insert the bypass through the liver - alleviates symptoms of extreme cirrhosis; also controls long-term ascites, reduces variceal bleeding

LOTS of risks, so rare usage.

203
Q

paracentesis

A

trocar catheter inserted into abdomen to drain ascitic fluid from peritoneal cavity; removal of all fluid could lead to hemodynamic collapse.

ps. body will create more fluid to fill up space again.

204
Q

positron emission tomography (pet)

A

injection of molecule tagged with isotope, which emits activity in form of positrons that are picked up by computer. highlights areas of active metabolism, specifically, cancer cells - more definitive than ct or mri

205
Q

computed tomography (ct) scan

A

x-ray images at many angles processed by computer to create horizontal levels (slices), results: cross sectional 3d pictures. iv contrast can be used to visualize bits on x-ray.

iodine/shellfish allergy = BIG NO NO (or premed)

206
Q

tagged red blood cell

A

finds bleeds that can’t be found in traditional fashion; results within 1 or 2 hours

207
Q

paracentesis

A

remove fluid if medically indicated; removal of all fluid could lead to hemodynamic collapse. however, body will also create more fluid to fill up space you are removing from.

208
Q

positron emission tomography (pet)

A

highlights areas of active metabolism, specifically, cancer cells - more definitive than ct or mri

209
Q

computed tomography (ct) scan

A

iv contrast used to visualize bits on x-ray;

iodine/shellfish allergy = BIG NO NO (or premed)

210
Q

magnetic resonance imaging (mri)

A

picks up densities using magnetic fields

high definition but longer to process, iv contrast can be given

211
Q

epigastric pain referred to right shoulder sign of

A

cholecystitis

z S15 HEHI 4 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions