Adult Health - Module 9 Flashcards
Lack of Peristalsis
Absent bowel sounds for 5 minutes in each quadrant
Sunken abdomen indicates
Malnutrition
Rebound tenderness indicates
Peritoneal irritation
RUQ pain indicates
Acute cholecystitis
Upper middle pain indicates
Acute pancreatitis
RLQ pain indicates
Acute appendicitis
LLQ pain indicates
Acute diverticulitis
GI Labs
CMP (Complete metabolic panel) CBC Liver Enzymes Pancreatic Enzymes Stool culture
CMP
Complete metabolic panel. Check K+, Na+, Mg+, BUN, Creatinine.
Liver Enzymes
AST, ALT, alkaline phosphatase
Pancreatic enzymes
Amylase/Lipase
Normal lab values for Liver Enzymes
AST: 0-35 units/L
ALT: 4-36 units/L
ALP: 30-120 units/L
Normal lab values for Pancreatic Enzymes
Amylase: 6.6-35.2 units/kg
Lipase: 0-160 units/L
Stool culture purpose
Assess blood, mucus, WBC, or parasites in feces.
Which disease is diagnosed with stool sample?
C-dif.
Upper GI diagnostic tests
Fluoroscopy and X-ray.
Interventions: Contrast Medium and patient should be NPO for 8 hours. Educate that stool may be white for 72 hours
Lower GI diagnostic tests
Fluoroscopy of colon and X-ray to find polyps, tumors, and lesions.
Interventions: Uses Contrast medium and administer laxatives/Barium enemas to clear the bowels. Elderly/Immobile do not tolerate this type of test well.
Abdominal Ultrasound
Identify size/configuration of organs, gallstones, and appendicitis.
Interventions: NPO for eight hours
CT scan
Combo of X-ray machines/diff depth exposure.
Interventions: Iodine sensitivity and educate patient that contrast will make them warm and feel like they peed their pants.
MRI
Noninvasive and uses radiofrequency and magnetic waves to detect metastasis, bleeding, and distinguish tumors.
Interventions: SCREEN FOR METAL. obtain screening form
Endoscopy tests
EGD/Colonoscopy. Patients receive MAC
EGD
Gives direct visualization of Esophagus Gastrium Duodenum (EGD).
Interventions: Signed consent, educate about anesthetic in throat/sedation to insert scope. After procedure, NPO until gag reflex returns and check vitals (sudden spike of temp indicates perforation which is LIFE THREATENING)
Colonoscopy
Direct visualization of the colon.
Interventions: Laxatives/enemas, NPO, and educate about sedation with scope inserted in rectum. After procedure, Check rectal bleeding, perforation, and vitals.
PUD
Peptic ulcer disease. Erosion of the mucosal surface and 80% are duodenal.
PUD causes
H. Pyloria and NSAIDs-induced injury
PUD assessment
Anxiety, tenderness, pain, N/V and possible bleeding
PUD diagnosis
Endoscopy. CBC, Liver enzymes (amylase), stool studies
PUD interventions
DO NOT TAKE ASPIRIN/NSAIDS
PUD meds
Analgesics, H2 receptors, Antacids, Sulcralfate (short term use to protect stomach lining), and antibiotics (ONLY if caused by H. pylori)
GERD symptoms
Dyspepsia, heartburn, hypersalivation, chest pain
GERD diagnosis
Barium swallow, endoscopy
GERD meds
Anti-ulcer, PPI/H2RA
GERD diet
Avoid fatty foods, chocolate, alcohol, mints, and citrus.
Nissen Fundoplication
Antireflux surgery in GERD to restructure the stomach. Uses fundus to wrap around.
Hiatal hernia
Distorted intrathoracic pressure causing reflex
Hiatal hernia diagnosis
Barium swalow, Upper GI X-ray (visualize lower esophagus). 90% are sliding hiatal hernias in which the stomach slides into the thoracic cavity.
Hiatal hernia symptoms
similiar to GERD. Heartburn, pain
Hiatal hernia meds
Antiulcer, PPI’s, H2RA, and antacids (to remove ulcers).
Hiatal hernia diet
Same as GERD. Avoid fatty foods, chocolate, alcohol, but adding on CAFFEINE.
Upper GI bleed symptoms
Hematemesis (vomiting blood/coffee ground), Hematochezia (bright red stool with unstable VS) and Melena (black, tarry, foul-smelling stool).
Upper GI bleed diagnosis
H/H not best indicator even though its bleeding. Instead, primary source is endoscopy occult blood stool testing, increased BUN (from blood digestion) CBC, PT/INR Serum electrolytes Liver Enzymes Type and Cross Match
Upper GI bleed interventions
IV/blood products for volume loss, NG tube to monitor. Monitor I/O, ECG, and mucous membrane assessment. AVOID ASPIRIN/NSAIDS
Rolling hernia
Fundus forms pocket/esophagus.
Mechanical vs Nonmechanical Obstruction
Mechanical: Occlusion of intestinal lumen (hernia/tumor)
Nonmechanical: Neuromuscular disorder (Paralytic illeus, peritonitis)
Antibiotic meds for Small bowel obstruction
Flagyl/Cipro
Small bowel obstruction Interventions
NPO, Ng tube to empty stomach, antibiotics (Flagyl/Cipro), Surgery, antiemetics, AMBULATION
