EXAM 1 - GI AND BLADDER CANCER Flashcards
What are some other s/s to assess for in malabsorption syndrome?
- Unintentional weight loss
- Bloating & flatus (carbohydrate malabsorption)
- Decreased libido
- Easy bruising (purpura)
- Anemia
- Bone pain
- Edema
Where does gastric cancer usually begin?
in the glands of the stomach mucosa
At what age range should you get screened for colorectal cancer?
45-75
inflammation occurring without gallstones
Acalculous cholecystitis
Surgery to remove the tumor and a small portion of the bladder
segmental cystectomy, sometimes called partial
cystectomy
what prep is required for flexible sigmoidoscopy
fasting and cleansing of colon with laxative.
Which test has dietary/medication restrictions in regards to FIT/FOBT
FOBT
How do you manage nutrition in malnourished clients?
- Dietician calculates nutrients required daily and plans diet
- Provide nutrient rich and high calorie foods
Symptoms for Cholelithiasis?
a. Episodic or vague upper abdominal pain that can radiate to the right shoulder
b. Pain triggered by high-fat or high-volume meal
c. Sudden Pain – Biliary Colic (Possible sepsis in Acute Cholecystitis)
d. Positive Murphy’s sign
e. N/V
f. Dyspepsia
g. Eructation (belch)
h. Flatulence
i. Feeling of abdominal fullness
j. Rebound tenderness
k. Fever
l. Jaundice, clay colored stools, dark urine, steatorrhea
Most bladder cancers are cancer that begins in cells that normally make up the inner lining of the bladder known as?
transitional cell carcinomas
Other types are (squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids)
Nonsurgical interventions for obesity?
a. Diet Programs/Lifestyle changes (Nutritionally Balanced Diets)
b. Nutrition Therapy
c. Behavioral Management
Assessment for obesity?
- History
- Physical
- Psychosocial
Which adjacent organs may experience direct invasion as a result of gastric cancer?
Liver, pancreas, transverse colon
A condition that can develop after surgery to remove all or part of the stomach or after surgery
to bypass the stomach to help lose weight
Dumping syndrome
Types of bariatric surgeries?
a. Adjustable Gastric Band (Lap Band)
b. Duodenal Switch (DS)
c. Roux-en-Y Gastric Bypass (RNY)
d. Vertical Sleeve Gastrectomy (Gastric Sleeve)
Nonsurgical management for colorectal cancer?
Radiation therapy, drug therapy
an operation to remove the entire bladder, as well as
surrounding lymph nodes
radical cystectomy
Advanced gastric cancer symptoms?
- Progressive weight loss
- Nausea
- V omiting
- Weakness
- Fatigue
- Anemia
a common presentation of a stone in the cystic duct or common bile duct of the biliary tree.
biliary colic
Assessment for malnutrition?
- History
- Physical
- Psychosocial
- Laboratory Assessment
Drugs for pain management in cholelithiasis?
- NSAIDS
- ACETAMINOPHEN
- NARCOTICS
- ANTIEMETICS
Noninvasive procedure used to detect altered DNA in stool and identify precancer polyps. If positive, colonoscopy required.
SDNA test - stool dna test - a colon cancer screening method
Cancer at this stage occurs in the bladder’s inner lining but hasn’t invaded the muscular bladder wall
Stage 1 bladder cancer
Non invasive test that uses CT to create 2-D/3-D images to view inside of colon and detect polyps. Follow up colonoscopy required if anything suspicious is found. How often does this need to be done?
CT colonography - colon cancer screening method. Every five years.
Risk factors for Cholelithiasis
Five F’s
- Female
- Fertile (pregnancy)
- Fat
- Fourty and above
- Fair - Caucasian, Native, Mexican
The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of?
chronic irritation and inflammation
Surgical treatment for cholelithiasis?
Cholecystectomy
- laparscopic (lap chole)
- traditional f
S/S for dumping syndrome post op bariatric surgery?
Tachycardia, nausea, diarrhea, and abdominal cramping
Post op measures for bariatric surgeries
a. Abdominal binder
b. Semi Fowler’s position or use BiPAP or CPAP at night
c. O2 Saturation
d. Compression stockings and prophylactic anticoagulant
e. Assess skin
f. Out of bed on day of surgery
g. Turning every 2 hours
h. Measure and record abdominal girth
i. Six small feedings and fluids
j. S/S of Dumping Syndrome
What prep is required for CT colonography
fasting and cleansing of colon with laxative.
Assessment for colorectal cancer?
i. Assessment
ii. History
iii. Physical
iv. Psychosocial
v. Laboratory/Diagnostic Assessment
often the first major sign – PRIMARY SYMPTOM of bladder cancer?
painless hematuria
Invasive procedure that allows doctor to check in colon for cancer and polyps with flexible tube w/ attached camera. How often does this need to be done?
Colonoscopy - Every 10 years.
In colorectal cancer where do most tumors arise from?
From glandular tissues called adenocarcinomas and from polyps
Greatest risk factor for gastric cancer?
Infection with H. Pylori
Treatments for bladder cancer
i. Biological therapy (Immunotherapy)
1. An immune-stimulating bacterium
2. Bacille Calmette-Guerin (BCG) is a bacterium used in tuberculosis vaccines
ii. Chemotherapy
iii. Radiation therapy
Early symptoms of dumping syndrome?
a. Feeling bloated or too full after eating
b. Nausea/vomiting
c. Abdominal cramps
d. Diarrhea
e. Flushing
f. Dizziness, lightheadedness
g. Hyperglycemia
h. Vertigo
i. Tachycardia
j. Syncope
k. Diaphoresis
l. Pallor
m. Palpitations
n. Desire to lie down
How long after eating does dumping syndrome occur?
15-30 minutes
invasive test where LOWER part of rectum and colon are viewed with a flexible lighted tube with small video camera on the end. how often?
flexible sigmoidoscopy —every 3 to 5 years
How does colorectal cancer spread?
through blood or lymph
At this stage, cancer has invaded the bladder wall but is still confined to the bladder
Stage 2 bladder cancer
Etiology & Risk Factors for colorectal cancer?
i. The exact cause of colorectal cancer is not known
ii. Diet
iii. Tobacco/smoking
iv. Heavy alcohol use
v. Hereditary cancer syndromes or a family history of colorectal cancer
a precancerous polyp is referred to as?
severe dysplasia
What do major complications of obesity effect?
CV and respiratory systems
one or more of these abnormalities may be present in malabsorption syndrome.
- Bile Salt Deficiencies
- Enzyme Deficiencies
- Presence of bacteria
- Disruption of the mucosal lining of the Small Intestine
- Altered lymphatic and vascular circulation
- Decrease in the gastric or intestinal surface area
process of chronic inflammation of the gastric mucosa of the stomach, leading to a loss of gastric glandular cells and their eventual replacement by intestinal and fibrous tissues
atrophic gastritis - precancerous condition
chemical irritation and inflammation of the gallbladder that results from Gallstones that obstruct the cystic duct (most common), gallbladder neck, or common bile duct
Calculous cholecystitis
Who is most at risk for poor nutrition?
Older adults
Drug treatment for malnutrition?
MV, Zinc, And iron prep for anemia
small, hard deposits that can form in the gallbladder, a sac-like organ that lies under the liver in the
upper right side of the abdomen
gallstones
what labs may you see with cholelithiasis?
- Elevated WBC
- Alkaline phosphatase and bilirubin elevated
- AST and ALT elevated when common bile duct stones are present.
A maneuver during a physical examination as part of the abdominal examination; it is useful for differentiating pain in the RUQ
murphys sign
Discharge teaching for Bariatric surgery?
- Nutrition
- Drug Therapy
- Wound Care
- Activity Level
- S/S to Report
- Follow Care
- Continuing Education
diagnostic tests for cholelithiasis?
- ultrasound of RUQ
- Endoscopic ultrasound
interferes with the ability to absorb nutrients and results in generalized flattening of the mucosa of the small intestines
malabsorption syndrome
At this stage cancer cells may have spread to the lymph nodes and other organs, such as your lungs, bones or liver
Stage 4 bladder cancer
often used to remove bladder cancers that are confined to the inner layers of the bladder
Transurethral resection (TUR) (surgery to remove tumor)
Non-surgical management for gastric cancer?
- Radiation
- Chemotherapy
- Combination Therapy
Etiology and risk factors for gastric cancer?
i. H. Pylori
ii. Pernious Anemia
iii. Gastric Polyps
iv. Achlorhydria
v. Foods
vi. Alcohol
vii. Smoking
viii. Atrophic Gastritis – precancerous condition
Non-surgical treatment for cholelithiasis?
- avoid fatty foods
- Pain management
- IV antibiotics depending on cause
what is are two classic symptoms of malabsorption syndrome?
- Diarrhea
* Steatorrhea (fatty stools)
what prep is required for a colonoscopy?
fasting and cleansing of colon with laxative.
occurs when your stomach empties its contents too quickly into your intestine (duodenum). For many people, this condition is managed with dietary changes.
Dumping syndrome
Total enteral nutrition methods for malnutrition?
- NG tube
- Gastrotomy -PEG tube
- Jejunostomy
Surgical management for obesity?
a. Bariatrics
b. Laparoscopic Adjustable Gastric Band (LAGB)
c. Gastric Bypass Surgery
Early gastric cancer symptoms?
- Asymptomatic
- Heartburn
- Abdominal discomfort
- Epigastric or back pain
formation of gallstones
Cholelithiasis
What other organs/systems decrease in function with malnutrition?
- liver
- heart
- lungs
- Gi tract
- immune system
What are some drug therapies used for malabsorption syndrome?
- Antibiotics – bacterial overgrowth
- Antidiarrheal agents
- Anticholinergics (slows motility)
- IVFs
How does the Bacillus Calmette Guerin therapy help treat bladder cancer?
Immunotherapy causes the body’s own immune system to attack the cancer cells. BCG is the most common for treating early-stage bladder cancer. It’s used to help keep the cancer from growing and to help keep it from coming back
Barium sulfate suspension is injected with air into rectum via flexible tube and xrays are taken?
Double contrast barium enema
- Refers to an excess amount of body when compared with lean body mass
- One of the leading causes of preventable deaths in the US, and has become a national crisis
Obesity
Late symptoms of dumping syndrome?
a. Dizziness
b. Lightheadedness
c. Palpitations
d. Diaphoresis
e. Confusion
f. Hunger
g. Irritability
h. Release of excessive amounts of insulin
occurs as protein synthesis of the liver decreases
Hypoproteinemia
The cancer cells have spread through the bladder wall to surrounding tissue; they may also have spread to the prostate in men or to the uterus or vagina in women
Stage 3 bladder cancer
characterized by the inability of the body to properly utilize vitamin B12
pernicious anemia
A non invasive procedure Designed to detect occult blood (not seen with eye) in stool. If positive, colonoscopy may be required to determine source of bleeding. How often?
Fecal occult blood test/Fecal immunochemical test - colon cancer screening method. Every year.
How do gastric cancers spread?
through gastric wall and to the lymph nodes
Risk factors for bladder cancer?
i. Smoking
ii. Increasing age
iii. Caucasian
iv. Male
v. Exposure to certain chemicals
vi. Previous cancer treatment
vii. Chronic Bladder Inflammation
viii. Family history
Operative procedures for colorectal cancer?
- colon resection
- colectomy
- Adominoperineal resection (AP RESECTION)
What restrictions is the patient on for dumping syndrome?
No fluids with meal and no High carbs (bread/potatoes)
a system of urinary drainage which a surgeon creates using the small intestine after removing the bladder. To do this, the surgeon takes a short segment of the small intestine and places it at an opening he has made on the surface of the abdomen to create a mouth, or stoma
ileal conduit
Interventions for malabsorption syndrome?
i. Avoidance of substances that aggravate malabsorption and supplementation of nutrients
ii. Nutrition management
iii. Nutritional supplements
iv. Drug therapy
v. Skin care for patients with chronic diarrhea
inflammation of the gallbladder
cholecystitis
Diagnostic tests for bladder cancer?
- Routine UA of hematuria
- Cystoscopy
- Biopsy
- Urine cytology
- Imaging tests
describe patho of malnutrition?
protein catabolism exceeds protein intake and synthesis, resulting in negative nitrogen
balance, weight loss, decreased muscle mass, and weakness
absence of hydrochloric acid in the gastric secretions.
achlorhydria
Where is the T-Tube located?
Common Bile duct
When is a T-Tube usually placed?
Cholecystectomy
Which position is best for a client with a T-Tube
Semi-Fowlers
A drainage amount of _____ or more within a 24 hour period is abnormal and the physician should be notified.
500 cc
Characteristics of pain with Cholecystitis?
- RUQ
- RADIATES TO RIGHT SHOULDER AND BACK
- INCREASES WITH DEEP BREATH
