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M/S 2 > Exam 5 - GI > Flashcards

Exam 5 - GI Flashcards

1
Q

Chrons disease is aka

A

regional enteritis

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2
Q

what part of the GI tract can be affected by Chrons

A

from the mouth to the anus

usually affects terminal ileum and ascending colon

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3
Q

2 types of chrons

A

subacute
chronic

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4
Q

chrons will have what type of appearance

A

cobblestone

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5
Q

Chrons s/sx

A

persistent diarrhea
liquid, soft stools
intestinal obstruction
RLQ pains, spasms
palpable RLQ mass
weight loss, malnutrition
anemia

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6
Q

T or F. Blood in stools r/t chrons is usually mild

A

True

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7
Q

Chrons complications

A

abscess
fistula to other organs
repeated bowel resection
F/E imbalance
malnutrition
malabsorption

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8
Q

chronic inflammatory bowel disorder

A

ulcerative colitis

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9
Q

what parts of the GI tract are affected with UC

A

mucosa, submucosa of colon and rectum ONLY

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10
Q

2 types of UC

A

chronic intermittent colitis (recurrent UC)
fulminant colitis (entire colon)

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11
Q

s/sx of UC

A

diarrhea
blood + mucous in stools
nocturnal diarrhea
rectal inflammation
LLQ cramping relieved by defecation
fatigue, anorexia, weakness
pallor, fever
anemia
tachycardia

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12
Q

complications r/t UC

A

hemorrhage
mega colon
dehydration
color perforation (board like abdomen)
increase colorectal cancer

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13
Q

inflammation extends inhibiting ability for contraction (colonic distention)

A

mega colon

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14
Q

s/sx of mega colon

A

fever
abdominal pain
distention
fatigue
vomiting

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15
Q

what will an MD want you to do if the pt is vomiting and has mega colon

A

NGT

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16
Q

when would surgery be performed with mega colon if decompression has not yet occured

A

after 72 hour

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17
Q

IBD diet

A

low residue
eliminate milk, milk products
< 2G fiber daily
avoid raw veggies

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18
Q

review Chrons and UC meds - slide 20-22

A

review Chrons and UC - slide 20-22

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19
Q

leading cause of surgery in Chrons

A

bowel obstruction

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20
Q

normal output first 24 hours after colostomy

A

1500-1800 mL

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21
Q

ileostomy postop care/education

A

drainage will be clear
Kegel exercises
perianal skin care

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22
Q

is the pancreas an endocrine or exocrine gland

A

both

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23
Q

pancreas endocrine function

A

insulin production

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24
Q

pancreas exocrine function

A

digestion; amylase, lipase, trypsin

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25
Q

2 types of pancreatitis

A

acute
chronic

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26
Q

acute pancreatitis can be ___ or ___

A

mild; severe

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27
Q

mild pancreatitis

A

self-limiting (acutely ill)
edema, inflammation of pancreas only
minimal organ dysfunction
return to normal in 6 months

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28
Q

severe pancreatitis

A

widespread damage, hemorrhage
necroisis/abscess
organ failure
death

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29
Q

pancreatitis risk factors

A

alcohol*
gallstones*
thiazides*
smoking
trauma
PUD
hypertriglyceridemia

*most common

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30
Q

what can cause acute pancreatitis turn into chronic

A

alcohol abuse

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31
Q

Turner’s sign

A

bruising in flank

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32
Q

Cullen’s sign

A

bruising around umilicus

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33
Q

acute pancreatitis s/sx

A

acute, continuous abdominal pain
–can radiate to back
N/V
abdominal distention, rigid
decrease bowel sounds, crackles
tachycardia
hypotension
mild confusion
fever, cold, clammy skin
mild jaundice (within 24 hours)
Turner’s sign (3-6 days after onset)
Cullen’s sign (3-6 days after onset)

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34
Q

severe acute pancreatitis s/sx

A

rigid, board like abdomen
ecchymosis
hypotension
tetany
shock

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35
Q

___ is shifted from the blood into the ___ space during pancreatitis

A

calcium; intracellular

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36
Q

normal amylase level

A

30-170

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37
Q

how soon will amylase rise and fall with acute pancreatitis

A

rise: 2-12 hours
fall: 3-4 days

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38
Q

normal lipase levels

A

14-280

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39
Q

how long will lipase levels remain elevated with acute pancreatitis

A

7-14 days

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40
Q

will WBC be elevated or depleted with acute pancreatitis

A

elevated

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41
Q

with calcium be elevated or depleted with acute pancreatitis

A

depleted

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42
Q

only method to remove gallstone

A

ERCP

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43
Q

how long can a person be NPO

A

no longer than 3-5 days

44
Q

acute pancreatitis treatment

A

aggressive hydration
assess pain (morphine, dilaudid)
IV abx
antiemetics
H2 blockers
antipyretics
cholecystectomy (after acute phase is over)

45
Q

acute pancreatitis nursing care

A

NPO
NGT
IVF/TPN
low fat diet
no alcohol, smoking
oral care
health promotion
bedrest, quiet environment
no food in room
daily weight
I&O
O2 SAT
positioning

46
Q

PANCREAS re: nursing interventions

A

P ain (morphine, dilaudid)
A ntispasmodic drugs (decrease motility)
N PO, NGT
C alcium replacement
R eplace F/E
E ndocrine and enzymes
A bx with fever
S terioids for acute attack

47
Q

acute pancreatitis PO diet

A

low fat
high carb
small frequent meals
no caffeine, alcohol, smoking

48
Q

when measuring abdominal girth, where to do you mark the measuring tape

A

upper and lower part

49
Q

causes of chronic pancreatitis

A

alcoholism
gallstones
trauma
smoking
autoimmune disease (lupus, cystic fibrosis)

50
Q

chronic pancreatitis pain characteristics

A

severe pain in upper abdominal, back
reoccurring bouts
sometimes unrelieved by pain meds
nagging discomfort between bouts
can have decreased pain as destruction occurs

51
Q

steatorrhea

A

fatty stools
foul smelling
frothy, loose

52
Q

how to Dx chronic pancreatitis

A

ERCP
MRI, CT, US
GTT
amylase
steatorrhea

53
Q

chronic pancreatitis management

A

prevent, manage attacks
pain control
manage exocrine, endocrine insufficiency

54
Q

nonpharm pain management for chronic pancreatitis

A

yoga
antioxidants
avoid alcohol, heavy meals, irritating foods

55
Q

meds for pancreatic enzyme replacement

A

pancrease
zenpep
creon
viokace

56
Q

fat soluble vitamins to be replaced

A

A, D, E, K

57
Q

pancreatic enzyme replacement education

A

take with food
do not crush or open capsule
dosing for meals, snacks
monitor BM for effectiveness

58
Q

6 types of hepatitis

A

A, B, C, D, E, G

59
Q

which race has the highest incidence of hepatitis C

A

African Americans

60
Q

Hepatitis A is transmitted via which route

A

fecal-oral

poor sanitation
contaminated water
uncooked seafood

61
Q

how soon is hepatitis A seen in feces before symptoms

A

2 weeks+

62
Q

T or F. You have immunity after having hepatitis A

A

True

63
Q

How is hepatitis B transmitted

A

blood
saliva
vaginal secretions
percutaneously

64
Q

hepatitis is a ___ virus

A

DNA

65
Q

how long can hepatitis B live on a dry surface

A

7 days

66
Q

populations at risk for hepatitis B

A

healthcare workers
hemodialysis pts
blood transfusions
male homosexual, bisexual
heterosexual with many partners
IV drug users
close contact with a Hep B carrier

67
Q

where is hepatitis B an endemic

A

Artic
Africa
China
SE Asia
Amazon

68
Q

how many antigens does the hepatitis B structure have

A

3

surface (HBsAg)
core (HBcAg)
E (HBeAg)

69
Q

where does hepatitis B replicate

A

the liver

70
Q

how long does it take to see hepatitis B antigens in serum

A

6 months

this is a chronic disease

71
Q

hepatitis C is a ___ virus

A

RNA

72
Q

how is hepatitis C commonly transmitted in the US

A

IV drug use

73
Q

hepatitis C risk factors

A

high risk sexual behavior
hemodialysis
occupational exposure
perinatal transmission

74
Q

is there a vaccine against hepatitis C

A

No

75
Q

those with the highest incidence of hepatitis D

A

Mediterranean
Middle Eastern
South America

76
Q

Hepatitis D has a high risk for developing what other form of hepatitis

A

hepatitis C

77
Q

T or F. Hepatitis D has a sudden, severe onset.

A

True

78
Q

Where is hepatitis E most common?

A

India
Africa
Asia
Central America

79
Q

hepatitis E route of transmission

A

fecal-oral

drinking contaminated water

80
Q

what is present with hepatitis E

A

jaundice

81
Q

how is hepatitis G transmitted

A

through blood

only found in those who have received contaminated blood transfusions

82
Q

hepatitis G is what kind of virus

A

RNA

83
Q

T or F. liver cells can regenerate with time if no complications occur.

A

True

the liver will resume normal appearance and function

84
Q

antigen-antibody complexes have a ___ effect

A

systemic

85
Q

antigen-antibody complex s/sx

A

rash
angioedema
arthritis
malaise
fever
glomerulonephritis
vasculitis
cryoglobulinemia (proteins in the blood clump together)

86
Q

what can trigger antigen-antibody complex effects

A

cold weather - can lead to organ damage

87
Q

how long does the acute phase last?

A

1-4 months

88
Q

s/sx during the acute phase

A

malaise
anorexia
fatigue
N/V
abdominal discomfort
HA
low-grade fever

flu like s/sx

89
Q

convalescent phase s/sx

A

jaundice beings to disappear
major complaints
malaise
easily fatigued

90
Q

how long does the convalescent phase last

A

weeks to months

can be reinfected during this time

91
Q

results in severe impairment or necrosis of liver cells and potential liver failure

A

fulminant hepatitis

92
Q

fulminant hepatitis occurs bc of complications with hepatitis ___

A

hepatitis B

higher risk when hepatitis D is present

93
Q

what to avoid with hepatitis infection

A

alcohol

94
Q

drug therapy for hepatitis A

A

none, only supportive therapy (antiemetics)

95
Q

acute hepatitis B virus is treated if ___ ___ is present

A

liver failure

96
Q

review slide 33, 35 - drugs for hepatitis B

A

review slide 33, 35 - drugs for hepatitis B

97
Q

review slide 34 - drugs for hepatitis C

A

review slide 34 - drugs for hepatitis C

98
Q

hepatitis management

A

bed rest
small frequent meals
sit up to eat
increase calories, decrease fat
watch protein intake
vitamin K
3.5 - 5 L/daily
avoid alcohol
antiemetics

99
Q

will immunoglobulins be present with chemical induced hepatitis?

A

No

100
Q

drugs that can induce hepatitis

A

isoniazid
statins
acetaminophen
sulfonamides
antimetabolites

101
Q

causes of bacterial liver abscess

A

secondary to trauma or bx

E. Coli is the most common

102
Q

cause of protozoan liver abscess

A

poor hygiene
unsafe sex
contaminated drinking water

103
Q

acute s/sx of liver abscess

A

fever
malaise
vomiting
anorexia
hyperbilirubinemia
RUQ pain

104
Q

what are the 3 clotting factors

A

19
7
2

105
Q

liver trauma treatment/management

A

blood/blood products (FFP, plasma, clotting factors)
IVF
monitor for hemorrhage
monitor for shock
may require sx to stop bleeding

M/S 2 (10 decks)

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