Assessment and diagnosis of GI disorders Flashcards
Gi system goes from..?
mouth to anus
peristalsis
propels food through the GI tract
accessory organs
liver
gallbladder
pancreas
bile ducts
vasculature
sympathetic effect on GI
Inhibitory
- Slows activity
- Constriction
- Decreased secretions and motility
Parasympathetic effect on GI
Stimulates
- Increases activity
- Increased peristalsis and GI secretions
Functions of the GI tract
Break down food for digestion
Absorb Nutrients
Eliminate undigested foodstuff or waste products
GI Assessment
Current state of health: N/V, diarrhea, constipation, pain, etc
Previous health: GI illnesses, ulcers, IBS GERD, Trauma
Medications: Food and drug allergies, !! NSAIDS, ASA, anti-HTN, laxatives!!
Emergency signals for GI system
- Progressive abd. pain sever and greater than 6 hrs
- Severe pain with guarding
- Blood in vomit
- Black tarry stool
- Tenderness/ rigidity (rebound tenderness)
Physical assesment
mouth, abdomen, liver, rectum, and anus
- IAPP
- 4 quadrant method
Diagnostics (labs for GI)
CBC, CMP, PT/PTT, Triglycerides, Liver function panel, amylase, Lipase
Stool tests
Stool test considerations
May require specific diet/ not take specific meds
Imaging Diagnostics for GI
Abdominal ultrasound
Upper GI Tract study
CT. MRI, PET scan
Upper GI endoscopy/ Lower GI endoscopy
Abdominal Ultrasound
low cost, immediate results
fast: 8-12 hrs pre procedure
upper GI tract study
contrast agent used (push fluids post op to prevent constipation/ obstruction)
- clear liquid diet and bowel prep
_ NPO midnight night before and hold PO meds
Lower GI tract studies
Need FULLY empty bowel
- Contrast used
- low residual diet 1-2 days prior, clear liquids evening before, NPO after midnight, cleansing enema until clear am of test.
who will we never do lower GI study on?
suspected bowel obstruction/ perforation
inflammatory disease
active GI bleed
CT, MRI, or PET scan
w/ or w/o contrast
- with contrast evaluate BUN and creatine
- increase fluids to protect kidneys
- Elderly at risk
Upper GI Endoscopy (prep)
NPO 6-8 hours pre-op
emergency- NG tube to suction stomach content
IV sedation for comfort
Post op Upper GI endoscopy
frequently check vitals
GAG REFELX RETURN (before anything oral)
Flatus
I&Os
Who do we not do lower GI endoscopy on?
Bowel Perforation
Endocarditis
Prosthetic valves
Lower GI endoscopy (Prep)
Laxatives & Enemas
Clear liquid day before
Fast morning of procedure
What considerations do you need to have for diabetics with Endoscopic procedures?
Adjust meds because of NPO blood sugars will be altered
