Gastrointestinal Flashcards
To perform abdominal palpation, the abdominal wall is depressed by
How many cm?
4-6 cm
Phenergan (promethazine)
S/E:
Antiemetic S/effects - Dryness of mouth and blurred
vision, dystonic reaction. Photosensitivity
*** Do not administer to a child less than 2 years old
regardless of its form.
The first portion of the small intestine.
Duodenum
An ulcer usually aggravated by eating especially spicy and
greasy food. Patient usually loses weight.
Gastric ulcer
An ulcer pain that is relieved by food. Usually gain weiaht.
Duodenal ulcer
Chief cause of ulcers
Helicobacter pylori
Symptoms of Dumping Syndrome
Fainting, palpitation, perspiration
Sengstaken- Blakemore Tube stand- by at bedside
Keep scissors at the bedside
SIADH effective treatment determination
Decrease specific gravity
A sign that patient is able to accept body image disturbance
to her colostomy
By participating with her colostomy care.
Client undergoing intestinal surgery with bleeding
Watch out for prolonged prothrombin time (PT)
Source of Salmonella
Soft-boiled egg (raw or undercooked eggs)
Reptiles as it harbors salmonella
Cohn’s disease
Regional ileitis, chronic diarrhea,
provide low residue bland diet
Ulcerative Colitis
Frequent diarrhea about 15-20 times
Tagament (ranitidine) - Inhibits gastric acid secretion side
effects
Diarrhea, vertigo, and agranulocytosis
Peptic Ulcer pain is felt after___ hours
Pain 2 hrs after eating
Clamp before eating, unclamp tube if any nausea and vomiting.
T-tube in choledocystectomy
Pepcid (famotidine)
May be given before or after meals.
Gastric pH
pH of 0-4
Intestinal pH
pH of 7 or greater
Frequency of residual volume check via infusion pump
Every 4 hours
Amount of stomach content returned to gastrostomy tube
No more than150 ml
Hold feeding if residual volume is
> 150 ml from the last infusion of feeding
Do not elevate tube above __ inches above insertion site
18 inches (45cm)
Position assumed by patient when feeding (HOB degree)
Head of bed 30-45 degrees
Feeding is withhold, if amount is
100-150 ml aspirate
Treatment of choice for pernicious anemia
Vitamin B 12 (cyanocobalamin)
Cascara
Is a laxative and large dose can cause hypokalemia
Bisacodyl (Dulcolax) time to administer and time effective.
May be given before breakfast or at bedtime
And effect may take 8-12 hours for the tablet.
May take 15- 60 minutes for the suppository.
Kytril (granisetron)
Prevention of nausea and vomiting associated with
ematogenic cancer therapy. Administer 30 minutes
prior to chemo administration.
Vistaril (Hydroxyzine) vial (intramuscular)
Atarax tablet (orally)
Anti-emetic administered intramuscularly only.
Also used as a preoperative sedation, antipruritic.
SE drowsiness, dryness of the mouth.
Adynamic ileus is also known as:
Paralytic ileus, mechanical obstruction, mechanical bowel obstruction.
Before administering Dulcolax (bisacodyl) what to ask pt.
Characteristic of stool, as client may be regulated
already.
Mylanta or Maalox is administered
After meals and at bed time (HS).
Miralax (polyethelene glycol) indication
Is a osmotic type laxative) used to soften stool and
increases the number of bowel movements.
Instruct client to mix powder with 8Oz (240ml) of
water, juice, soda, tea or coffee.
May take 2-4 days to have bowel movement.
Do not use for more than 2 weeks if not effective.
Discontinue for any diarrhea.
Enemeez Mini enema
Is an over-the-counter stool softener (emollient)
laxative,
Abdominal Assessment:
IAPP
Inspection
Auscultation
Percussion
Palpation
Chest : Inspection Palpation Percussion and Auscultation.
Normal bowel sound?
__ per minute?
More than __ is called hyperactive sound?
____ sound is called borborygmi.
5,
30,
Loud gurgling
Section of small intestine:
Duodenum (absorbs iron, calcium, & carbohydrates),
Jejunum (absorbs
most fats, proteins, and vitamins.)
ileum absorbs intrinsic factors (vitamin B complex & nutrients).
Pain Location
PRQST assessment of abdominal pain:
Wong baker faces
______ diagnostic imaging procedure to examine the: Upper GI : Esophagus, Stomach and Duodenum (Beginning of the small intestine)
Preparation - ________ before the procedure.
Barium Swallow ( Upper Gi series)
NPO for 8-12 hours before the procedure.
Colonoscopy, What do you give and what do you monitor? Encircle
Gastrointestinal Tubes
Organ invaded by helicobacter pylori is stomach.
Organ invaded by clostridium difficile.is large intestine (colon).
What is Achlorhydria?
What are the causes?
What deficiency are you lack?
Stomach surgery ; Pyroplasty and Vagotomy
____ after “ gastrectomy” due to “ rapid emptying of the gastric contents into the small intestine (jejunum)
Dumping Syndrome
Dumping syndrome health teachings:
How do you chew food?
When do you give Fluids?
What is taken to reduce Gi motility?
What do you administer? Every week?
What do you give daily ?
Small frequency
Before 30 minutes or after meals 30
You take Anti cholinergic
b12 every week, first month IM
Daily Calcium,Iron Vit b12 especially to child bearing age.
Managing tube, Please understand “not memorizing”
Patience is the key :)
Incarcerated hernia is a surgical emergency,
How do you diagnosed hernia?
CT SCAN
_____ is visualization of the gallbladder
within 1 hour of tracer injection.
It is IV.
How do you check the gall bladder stone? Thru
HIDA SCAN
Gallbladder stones diagnosed via ultra sound.
Acute Cholecystitis is inflammation of the ____ and is related to the presence of ____ in
90-95% of cases.
_____ refers to the presence of gallstones within the common bile duct.
Gall bladder and gall stones
Choledocholithiasis
_____ X ray film with contrast shows “ Cold Spring” Telescoping of bowel.
Clinical manifestation: abdominal pain
with nausea and vomiting, bloating,
decreased or absent bowel sounds.
Intussusception
____ dilatation of bowel loop with
coffee bean shape in radiographic film.
Clinical manifestations:
abdominal pain, nausea,
vomiting, increased bowel sounds, fever and
elevated WBC.
Strangulation
Read the Nursing Management:
Management of Bowel Obstruction
Position?
What do you insert?
Food aggravates the pain?
What ulcer is that? Usually loses weight
Onset of pain 2-4 hours after meals.
Relieve by eating.
Gastric Ulcer
Duodenal Ulcer
______ can aggravate pain when in contact with food. Pain is felt below or behind the breastbone caused usually associated with “chronic gastro esophageal reflux”
(GERD)disease.
Esophageal ulcer
Helicobacter Pylori (M. Pylori)
Will cause gastritis to ulceration and if untreated may lead to gastric ulcer.
What is the most accurate test for h. Pylori? Endoscopic biopsy
Blood test -
Urea Breath test -
Stool antigen test -
Lap band
Nasogastric tubes
Intestinal tubes
CBJM
___ tube used for gastric decompression or used for feeding.
How many ml do you irrigate?
Do not occlude the vent, (blue pig tail)
When do you clamp?
What do you teach the patient?
Salem lump
2- to 30 ml
Clamp: when ambulating or transporting patient.
Discontinuing NGT
Teach patient to take and hold a deep breath to close epiglottis to facilitate pulling out
NGT with ease.
NGT
Motivate yourself
Feeding tube
When do you evaluate the amount of aspirate ( residual)?
What do you monitor?
What is the Ph range in intestinal?
What is the head of the bead?
Loose stool is normal?
When do you notify the MD?
Vomiting may lead to ____ lieus
Notify MD if ___ sounds are absent.
What do you monitor for Esophagoduodenoscopy?
Is it NPO?
What do you expect after 1 to 2 days?
Signs of Bleeding, Read the notes
!A sudden temperature spike with 1 to 2 hours after the procedure is indicative of a perforation
and should be reported immediately to the physician!
Gastro intestinal Tubes
____ Administered through a Kangaroo Pump?
Position during feeding?
How many inches feeding height?
24 hours is?
12 hours is?
Gastoparesis
Diagnostic test ?
Medications?
Fundo plication
Digestive system:
Large Intestine - a semisolid feces and
compacts feces.
Small intestine - chemical digestion.
Ulcerative Colitis and Crohn’s Disease
You got this! Make your dad proud
Diverticulosis -
What to avoid?
Avoid: All berries with seeds, preserve with seeds, watermelon seeds, corn, popcorn, all nuts
and chunky peanut butter.
Acute stage of diverculosis, when the pockets are infected and inflamed.
It has abdominal pain but where?
Frequently in lower back, fever and chills.
Diverticulitis
Lower left quadrant,
Asacol (mesalamine) oral/rectal to treat _______ is a gastrointestinal anti-inflammatory with side effect of impaired thinking and
taken with full glass of water. Taken with or without food.
Ulcerative colitis
Diverticulitis medication:
Asacol - ?
Bentyl - ?
Clostrdium difficile :
Achalasia
Anti emetics
Anti ulcer and histamine
Famotidine
Pepcid
How to give?
Is it safe during pregnancy?
What do you monitor?
May be given with food.
May be given with antacid
Safe use during pregnancy
Monitor for signs of bleeding.
Read
Proton pump inhibition; Health Teaching
Antacids
Laxatives
Enema
Peak and Trough