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Med Surg 2 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Subjective data for GI assessment

A

demographics, PMH, PSH, family hx, nutrition hx, socioeconomic status, chief complaint

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2
Q

Age related changes to GI

A

decreased peristalsis, loss of teeth, diminished salivary flow, decreased gastric motility, risk for dysphagia

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3
Q

diagnostic study that illuminates inside GI system

A

barium swallow

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4
Q

inflammation of oral cavity

A

stomatitits

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5
Q

How can you treat stomatitis

A

soft toothbrush, foam swabs, no alcohol rinses, warm saline, no hot foods, soft bland diet

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6
Q

What do you do with Nystatin?

A

swish drug around mouth before swallowing

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7
Q

inflammation of salivary gland

A

acute sialadenitis

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8
Q

reduces acid secretion in stomach by binding irreversibly to the enzyme H+. Inhibits final pathway involved in acid secretion– before meals

A

proton pump inhibitors

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9
Q

decrease gastric acid secretion– give with meals

A

H2 blockers

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10
Q

deactivating pepsin - can be given before or after meals

A

antacids

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11
Q

surgical management of GERD

A

nissen fundoplication

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12
Q

occurs from long standing untreated GERD

A

Barretts esophagus

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13
Q

Risk factors for esophageal cancer

A

obesity, smoking, untreated GERD, pickled foods, alcohol intake

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14
Q

What meds can cause gastritis?

A

steroids, aspirin, NSAIDS

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15
Q

rapid onset, N/V, hematemesis, dyspepsia, anorexia

A

acute gastritis

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16
Q

vague epigastric pain that is relieved by food- b12 deficiency

A

chronic gastritis

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17
Q

impaired mucosal barrier

A

peptic ulcers

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18
Q

gnawing sharp pain, bloody emesis, food ingestion makes pain worse

A

gastric ulcer

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19
Q

bloody stool, dull burning pain, relieved by eating food

A

duodenal ulcer

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20
Q

sudden severe pain, referred shoulder pain

A

perforation

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21
Q

unpleasant symptoms - when fluid and food move rapidly into the small intestines before proper absorption

A

dumping syndrome

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22
Q

prevention of dumping syndrome

A

frequent small meals, high fat high protein, love carb, no milk, avoid alcohol

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23
Q

what drugs can cause GI bleeding?

A

nsaids, naproxen

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24
Q

s/s of GI bleeding

A

coffee ground vomitus, occult blood, decreased BP

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25
Q

What is important to do after a barium enema?

A

drink lots of water- stools will be chalky white

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26
Q

endoscopic view of large bowel starting at age 50

A

colonoscopy

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27
Q

protrusion through a weak abdominal wall

A

hernia

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28
Q

peritoneum sac formation

A

indirect inguinal

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29
Q

weak point in abdominal wall

A

direct inguinal hernia

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30
Q

protrusion through the femoral ring

A

femoral hernia

31
Q

can be congenital or acquired

A

umbilical hernia

32
Q

inadequate healing of the incision

A

incisional hernia

33
Q

s/s include: abdominal distention, nausea and vomiting, pain , fever, tachycardia

A

strangulated hernia

34
Q

swollen or distended veins in the anorectal region

A

hemorrhoids

35
Q

what can trigger hemorrhoids

A

constipation, obesity, weight lifting, strenuous exercise, decreased fluid intake

36
Q

hemorrhoid management

A

stool softener, exercise, sitz bath/ warm compresses, topical anesthetics

37
Q

obstruction with compromised blood flow

A

strangulated obstruction

38
Q

non mechanical obstruction: s/s - distention, absent peristalsis

A

paralytic ileus

39
Q

intermittment colicky pain

A

mechanical obstruction

40
Q

constant pain

A

nonmechanical

41
Q

bowel blockage

A

mechanical obstruction

42
Q

obstruction with compromised blood flow

A

strangulated obstruction

43
Q

s/s of strangulated intestinal obstruction

A

fever, tachycardia, pain, rigid abdomen

44
Q

Labs for intestinal obstruction

A

WBC ^

H and H ^, BUN ^ = dehydration

45
Q

what setting will the NGT be on for intestinal obstruction

A

low intermittent suction

46
Q

risk factors for CRC

A

50+, smoking, polyps, genetics, family history of cancer, alcohol, diet

47
Q

how often is a colonoscopy recommended?

A

every 10 years

48
Q

how often is a barium enema recommended?

A

every 5 years

49
Q

how often is fecal occult blood testing recommended?

A

every year

50
Q

s/s of CRC

A

fatigue, full abdomen, vague pain, unintentional weight loss, bloody stool, CEA +

51
Q

solid formation of stool

A

sigmoid/ descending colostomy

52
Q

diarrhea, constipation, mucous in stool, belching, gas, bloated

A

IBS

53
Q

interventions for IBS

A

increase fiber, fluids, chew slowly, stress reduction

54
Q

what is a risk with appendicitis?

A

peritonitis–> sepsis

55
Q

cramping pain, anorexia, rebound tenderness, N/V, RLQ pain, relief when hip or knee is bent is emergency

A

appendicitis

56
Q

What lab is drawn to show appendicitis

A

elevated WBC with shift to the left

57
Q

point of rebound tenderness

A

McBurneys point

58
Q

when you palpate LLQ the pain is felt on the RLQ

A

Rovsings sign

59
Q

inflammation of lining of abdominal cavity

A

peritonitis

60
Q

What are the risks for peritonitis

A

sepsis, respiratory difficulty, poor kidney perfusion

61
Q

classic sign of peritonitis

A

rigid boardlike abdomen, distended, n/v, decreased bowel sounds, fever, tachycardia, dehydration

62
Q

treatment for peritonitis

A

oxygen, NPO, abx, infection control, IV fluids

63
Q

abx associated diarrhea

A

c-diff

64
Q

treatment for c-diff

A

abx, contact precautions, skin care, fluids, vs, electrolytes

65
Q

intestinal mucosa becomes hyperemic, edematous and reddened- remissions and exacerbations

A

ulcerative colitis

66
Q

s/s: lower abdominal colicky pain, bloody and mucousy stool, tenesmus

A

ulcerative colitis

67
Q

chronic inflammatory disease

A

Crohns disease

68
Q

s/s: diarrhea, abdominal pain, and low grade fever, steatorrhea, anemia

A

Crohns disease

69
Q

complications of Crohns

A

hemorrhage, malnourishment, fistula formation

70
Q

how often do you change the tubing for TPN?

A

every 24 hours

71
Q

pouchlike herniations

A

diverticula

72
Q

abnormal pouchlike herniations

A

diverticulosis

73
Q

inflammation or infection of diverticula

A

acute diverticulitis

74
Q

usually has no symptoms

A

diverticulosis

Med Surg 2 (3 decks)

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