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Care Of Adult 3 > Chapter 55 - Assessment Of GI System > Flashcards

Chapter 55 - Assessment Of GI System Flashcards

0
Q

6 steps of GI tract

A 
Ingestion
Mechanical digestion
Chemical digestion
Movements
Absorption
Elimination
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1
Q

3 functions of GI system

A

Digestion
Absorption
Metabolism

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2
Q

Deglutition

A

Swallowing, movement down esophagus

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3
Q

Peristalsis

A

Movement from stomach to small intestine, and small intestine to large intestine

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4
Q

Large intestine

A

Absorption of fluid, electrolytes, and endigestive products (waste)

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5
Q

Salivary amylase

A

Enzyme that breaks down carbohydrates

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6
Q

Upper esophageal sphincter

A

Closed at rest to prevent air from entering the esophagus

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7
Q

Lower esophageal sphincter

A

Closed at rest to prevent contents from the stomach from entering the esophagus

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8
Q

Pepsin

A

Breaks stuff down

“Chew your face off stuff”

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9
Q

Duodenum

A

Part of small intestine

Common bile duct, and pancreatic duct join to form Ampulla of Vater which terminates at the Sphincter of Oddi

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10
Q

Exocrine gland in pancreas

A

Amylase, Lipase, Trypsin, Chymotrypsin

Responsible for digestion carbohydrates, fats, protein

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11
Q

Liver function

A

Storage of minerals and vitamins (A, D, E, K, iron, and magnesium
Metabolism

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12
Q

Gall bladder

A

Collects, concentrates, and stores bile

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13
Q

Uvula

A

Prt of soft palate
Moves upward when you swallow
Prevents food from entering nasal pharynx

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14
Q

Rugae

A

Folds inside the stomach

Allows stomach to expand when you eat

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15
Q

2 kinds of mucous in the stomach

A
  • thick basic (high pH)= lines the stomach and protects it from the stomach acids
  • thin watery= provides the liquid needed to dissolve and mix the food (turns it to chyme)
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16
Q

Intrinsic factor

A

Body needs this to absorb vitamin B12

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17
Q

Gastrin is secreted in response to any of the following

A

Stomach distention,
Vagal stimulation,
presence of partially digested proteins,
hypercalcemia

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18
Q

Which intestine is very, very vascular?

A

Small intestine

19
Q

When a pt has acute diarrhea problems,

A

Think foreign travel. Have you traveled outside of the country lately?

20
Q

When a patient’s breath has a fruity odor,

A

Breath with a fruity odor is associated with diabetes

21
Q

When auscultating bowel sounds, what are bruits?

A

Swooshing noise

22
Q

Normal findings when auscultating bowel sounds

A

High pitch, irregular gurgles, every 5-15 seconds

23
Q

After a pt has abdominal surgery,

A

They will have absent bowel sounds for about 24 hours

24
Q

During an assessment, when should you palpate problem areas?

A

Last

25
Q

Blumberg’s sign

A
  • The abdominal wall is compressed slowly then rapidly released
  • Sudden pain with release is indicative of appendicitis
  • make pt NPO in preparation for surgery
26
Q

CBC tests for what in the GI tract?

A

Anemia, infection, changes in blood elements

27
Q

Prothrombin time (PT)

A

Dependent on vitamin K
Severe and/or chronic liver damage
Normal: 11.0-12.5

28
Q

High PT and INR and low albumin levels are indicative of:

A

Advanced cirrhosis

29
Q

Pancreatic enzymes

A

Amylase and lipase

30
Q

Ammonia

A

NH3
Hepatic function
Increased levels: hepatocellular injury (cirrhosis, fulminant hepatitis)

31
Q

Oncofetal antigens

A

Diagnose cancer and monitor treatment

32
Q

Carcinoembryonic antigen

A

One of the mainstays used to rule out/confirm colon cancer, stomach and or pancreatic cancer

Highest risk population: African-Americans and smokers

33
Q

Urine tests: amylase

A

Acute pancreatitis due to increased renal clearance
Remain high even after serum levels are normal
Helps with late diagnosis

34
Q

Urine tests: urobilinogen

A

Form of converted bilirubin excreted by the kidneys

Helpful with diagnosis of hepatic and biliary obstruction, as will be increased before jaundice is seen

35
Q

Stool tests

A

Blood:
-FOBT (uses a form of guild and can give false positives)
-FIT (better option)
-education: avoid raw vegetables and fruit, avoid red meat, anticoagulants should be stopped within 7days prior
Stool DNA:
-Detecting colon cancer
Stool cultures:
-more sensitive than assays, but take three days to get results
-test of choice

36
Q

CT

A

Used more often as they deliver more precise results
Allergies to iodine or shellfish
NPO four hours prior

37
Q

What teaching is involved after the patient has done using barium?

A

Push fluids, fluids, fluids

38
Q

Percutaneous transhepatic cholangiography (PCT)

A

X-ray of biliary system using contrast
Dye is delivered directly to biliary duct system via percutaneous needle
Rarely done today: jaundice and/or severe abdominal pain even after cholecystectomy

39
Q

Endoscopic retrograde cholangiopancreatography (ERCP)

A

A lot less complications
Visual and radiographic examination: liver, gallbladder, bile ducts, pancreas
Post procedure:
-vital signs every 15 minutes until stable
-NPO until gag reflex returns
-May take two days for symptoms to develop:
cholingitis (infection of the common bile duct), bleeding, perforation, sepsis, pancreatitis, fever, nausea, vomiting

40
Q

Esophagogastroduodenoscopy (EGD)

A

-Most common
-Visual exam of esophagus, stomach and duodenum
-NPO 6 to 8 hours prior to procedure
-Do not take with normal meds morning of test: Anticoagulants, NSAIDs, ASA
-IV sedation
-Sims position
Post procedure: NPO until return of gag reflex

41
Q

Colonoscopy

A

Hold blood thinners for 24 hours prior to test
Avoid red, orange, and purple liquids
NPO 4 to 6 hours prior to procedure
Must take all of the prep to ensure clean visualization of the colon
Give atropine to counteract Vagal stimulation
NPO until flatus resumes

42
Q

Ultrasonography

A

Painless, non-invasive, and requires no radiation or sedation
Must drink 1 to 2 L of water prior to test, as a full bladder is needed for proper visualization

43
Q

Liver spleen scan

A
  • IV injection of material that is primarily taken up by the liver
  • Evaluate liver and spleen for tumors and masses, organ size, location, and blood flow
  • Avoid use in pregnancy and breast-feeding mothers
  • Radionuclide is eliminated within 24 hours through urine (Handwashing, double flush with the lid down)
44
Q

Things to consider for radiation and chemo therapy treatment for oral cancer:

A

Dry mouth, mouth sores, taste changes (metal taste)

  • rinse mouth often with warm saline or sodium bicarbonate solution
  • patients often have impaired ability to soften and break down food

Care Of Adult 3 (1 decks)

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