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Med Surg > Chapter 38 / 39: Assessment of Digestive and GI function > Flashcards

Chapter 38 / 39: Assessment of Digestive and GI function Flashcards

1
Q

Digestions begins with ________ where food is broken down into small particles that can be swallowed and mixed with _____________ ________

A

chewing
digestive enzymes

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2
Q

Absorption is a MAJOR function of the ______ intestine — vitamins and minerals are absorbed, accomplished by _________ transport and _________ across intestinal walls into the circulation

A

small
active
diffusion

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3
Q

elimination is the phase of the digestive process that occurs after digestion and absorption when _______ products are eliminated from the body

A

waste

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4
Q

salivary amylase breaks down :
Pepsin breaks down:
intrinsic factor is needed to absorb _____
lipase breaks down:
trypsin breaks down :
Bile breaks down :

A

startches
protein
b12
fat
protein
fat

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5
Q

Chyme is broken down ________ and __________ acid

A

food
stomach

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6
Q

emulsification is the breakdown of ____

A

fat

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7
Q

peristalsis is the constriction of ________ muscles that promotes wavelike movement to push stomach contents _________

A

stomach
forward

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8
Q

Key parts of the GI system assessment

A

Health Hx
-pain, indigestion, gas, N/V, diarrhea, constipation, previous GI disease

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9
Q

What is included in the physical assessment of the GI system

A

Oral cavity
- lips, gums, tongue
Abdominal assessment (4 quad method) IAPP

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10
Q

Diagnostic studies and tests for GI
stool tests : ________ blood test (must be obtained on __x on different days to confirm blood occult)
Breath tests : __ ________ testing
________ and ________ tract study
GI ________ study
Endoscopic procedures
CBC
Coag studies ( to look for ________)
Culture

A

occult ,3
H. Pylori
Upper and Lower
motility
bleeding

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11
Q

Parotitis is the inflammation of the ________ gland. is the most ________ inflammation condition of salivary glands

A

parotid
common

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12
Q

what are some symptoms of parotitis?

A

Fever
chills
systemic signs of infection

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13
Q

what is the medical management of parotitis?
* adequate _____________/_______ intake
* good _______ care
* ______packs
* Stop meds that decrease ____________ (steroids, anti-inflammatory)

A

nutritional/ fluid
oral
cold
salivation

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14
Q

Sialasentitis is the inflammation of the ___________ glands - may be caused by:
* Dehydration
* ___________ therapy
* Stress
* Malnutrition
* salivary gland _________
* Improper _______ hygiene

A

salivary
radiation
calculi
oral

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15
Q

what are some signs and symptoms of sialadenitis

A

pain
swelling
purulent drainage

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16
Q

how do you treat/manage sialadentitis?

A

massage
hydration
warm compress
sialagogues ( anything that stimulates salivation)

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17
Q

Sialolithiasis are salivary _________ (stones)

A

calculi

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18
Q

What are the symptoms of salivary stones?

A

local sudden pain —relieved by gush of saliva

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19
Q

How are salivary stones managed/treated?

A

Sialendscopy ( standard treatment)
Lithotripsy

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20
Q

Neoplasms are salivary _________/________

A

tumors/growths

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21
Q

what are some risk factors of neoplasms?
* ___________ to the head and neck
* __________ age
* exposure to specific ____________ in the work environment

A

radiation
increased
carcinogens

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22
Q

how are neoplasms treated/managed?

A

radiation
chemo
surgery

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23
Q

What are some risk factors for oral cancer?

A

tobacco use
HPV infection
Alcohol
HX of head/neck cancer

24
Q

what are early manifestations of oral cancer?

A

often few/no symptoms
painless mass/sore that doesn’t heal

25
Q

Any lesion present for more than 2 weeks or does not heal should be examined and biopsied (TRUE OR FALSE)

A

True

26
Q

what are some late manifestations of oral cancer?

A

complaints of soreness
difficulty swallowing, chewing, speaking

27
Q

what are the treatments/Management for oral cancer?

A

surgical resection (removal)
Radiation therapy (localized)
Chemo (systemic)

28
Q

_______ neck dissection is used the ________ - it removes lymph nodes, sternocleidomastoid muscle, internal jugular vein, spinal accessory nerve

A

radical
most

29
Q

_________ neck dissection removes structures such as lymph nodes and tumor

A

modified

30
Q

some pre-op care for neck dissections include :
* assess _________ prep and _________
* make sure pt _____________ procedure and what they should _______ afterwards

A

physical and knowledge
understands, expect

31
Q

some post-op care for neck dissection includes :
* assess for _____________ related to :
* airway and breathing
* infection
* Hemorrhage
* Other : _______ injury , ______ leak

A

complications
nerve, chyle

32
Q

Nursing interventions for Neck dissection
* maintain _________ clearance
* ________ position
* deep __________
* assess and manage _____
*Maintain adequate ___________

A

airway
fowler
breathing
pain
nutrition

33
Q

a _______ ________ is where the opening in the diaphragm through which the esophagus passes becomes enlarged, and part of the upper stomach moves up into the portion of the thorax

A

hiatal hernia

34
Q

___________ and _______________ are the two main types of hiatal hernias

A

sliding and paraesophageal

35
Q

sliding hiatal hernias occur when the upper _________ and the _________________ junction are displaced upward and slide in and out of the thorax

A

stomach
gastroesophageal
*** most common type

36
Q

A paraesophageal hernia occurs when all or part of the stomach pushed through the __________ beside the ___________

A

diaphragm
esophagus

37
Q

what are some signs and symptoms of sliding hiatal hernias?

A

heartburn
reflux
chest pain
**dysphagia
belching
**pyrosis
**regurgitation
** many pts are asymptomatic

38
Q

what are some common signs and symptoms of paraesophageal hiatal hernias?

A

**hemorrhage
**obstruction
**volvulus
**strangulation feeling
fullness after eating
chest pain

39
Q

what are some risk factors of hiatal hernias
high intake of _______ foods
_________ or ___________ right before bed

A

fatty
eating or drinking

40
Q

management for hiatal hernias includes :
*frequent small _______
* pt is advised to not _______ for 1 hour after eating to prevent reflux/ movement of hernia
* PPIs : reduce ______ ____ by inhibiting cellular pump or gastric parietal cells necessary for gastric and acid secretion ( omeprazole , Panprozol )
* Antacids : _________ excess acid and increases LES pressure (TUMs, Pepcid) ** take 1-2 hours before eating

A

meals
recline
gastric acid
Neutralizes

41
Q

GERD is a fairly common disorder marked by the backflow of _______ or duodenal contents into the esophagus

A

gastric

42
Q

GERD may occur because of an incompetent lower esophageal ___________, pyloric _______, hiatal _______, or ________ disorder

A

Sphincter
stenosis
hernia
motility

43
Q

common risk factors of GERD:
* _________ use
*__________ drinking
* _________ consumption
* increased ________
*sleep ____
* ________ age
* _________ infection w helicobacter pylori

A

tobacco
caffeine
alcohol
weight
apnea
increased
gastric

44
Q

clinical manifestation of GERD include
* heartburn (may ________)
* ___________ at midline
*_______salivatio n (can mimic heart attack )
* Nocturnal - cough, wheeze, SOB, ______ sleep patterns

A

radiate
dyspepsia
hyper
disturbed

45
Q

how do you treat/manage GERD?
* avoid esophageal _________
*lifestyle modifications — (_________, ______ ______)
* ________ HOB 30 degrees, assess lung sounds, prevent aspiration
*Nutritional diet - low ____ diet
Avoid caffeine, peppermint or spearmint, beer, milk, carbonated beverages
* Meds: PPIs and H2 receptors

A

irritants
smoking, losing weight
elevate

46
Q

complications of GERD are:
* aspiration
esophagitis
** Barrett’s esophagus : ____________ cell _________

A

reversible, changes

47
Q

what are some risk factors of esophageal cancer?

A

GERD
BE
nutritional deficiency
tobacco use
alcohol use

48
Q

what are some clinical manifestations of esophageal cancer? ** feeling that food is not ___________ _________ or sensation of ________ ___ _________
* sore throat or __________
*Dysphagia
* Weight ______
* Choking and/or _____________

A

passing through, mass in throat
hoarseness
gain
regurgitation

49
Q

what is some pre-op care for esophageal cancer? *______ calorie and _____ protein diet
* IV fluids _________/ chemotherapy
* Meticulous ______ care

A

high, high
radiation
oral

50
Q

what is some post-op care for esophageal cancer? HOB elevated ___ degrees
_____ - no manipulation by RN; monitor for arrhythmias
When able to eat, diet as tolerated; risk for ___________ syndrome

A

30
NGT
Dumping

51
Q

Delivering nutrition enterally is done to meet ___________ requirements when oral intake is inadequate or not possible, but GI tract is functioning

A

nutritional

52
Q

what are some of the advantages of delivering nutrition enterally?
* _____ and ______ effective
* Preserve GI ___________
* Preserve _______ sequence of intestinal and hepatic metabolism
* Maintain fat _____________ and lipoprotein synthesis
* Maintain __________ insulin and glucagon ratios

A

safe and cost
integrity
normal
metabolism
normal

53
Q

what are some of the most common complications of enteral nutrition ?

A

Overfeeding
reseeding syndrome
aspiration pneumonia
constipation
Diarrhea

54
Q

reasons for tube feeding:
* pt cannot __________
* something in the ________ tract (mouth , throat ) needs to be bypassed

A

swallow
upper

55
Q

What are some reasons to have a g tube or j-tube?

A

difficulty swallowing
difficulty digesting food
removal of part of the GI

Med Surg (20 decks)

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