Gastrointestinal Flashcards
pyloric sphincter
closes to keep food in the stomach, and opens to send food into the small intestine
small intestines
receive digestive enzymes from pancreas and liver, make food into chyme and absorb nutrients
liver functions
produce bile, albumin, cholesterol, converts glucose to glycogen for storage, converts ammonia to urea, metabolizes bilirubin in the breakdowns of RBCs, metabolizes drugs and toxins, produces clotting factors and regulates blood clotting
gallbladder
stores and releases bladder into small intestine
pancreas
regulates blood sugar, and produces and releases digestive enzymes; trypsin, amylase, lipase (released into duodenum)
Large Intestine
absorbs water and electrolytes, produces and absorbs vitamins, forms and propels feces toward rectum for elimination
TPN
delivered intravenously, contains dextrose, amino acids, and electrolytes; central line is preferred
TPN complications
infection, fluid overload hypo/hyper-glycemia, embolism
if TPN runs out and you don’t have anymore what should you do
do not turn off suddenly, give dextrose 10% at same rate the TPN was running
TPN bag and tubing is changed every
24 hours
ondansetron nursing consideration
administer slowly, fast push can cause QT prolongation and VT
antiulcer agents include
H2 receptor blockers, PPIs, antacids, GI protectant
Famotidine
H2 receptor antagonist (antihistamine); blocks release of histamine which blocks acid secretion; separate this class from other medications as they are likely to interact
Famotidine use
short term tx of gastric and duodenal ulcers, GERD, hypersecretion of stomach acid conditions, chronic NSAID use
Omeprazole
PPI; GERD and ulcers, decreases gastric acid production; administer 30-60 minutes, report black, tarry stools
sucralfate
aluminum hyroxide and sucrose; promotes healing of ulcers by providing a barrier over them, short term tx of duodenal or gastric ulcers, peptic esophagitis, NSAID/ASA induced GI damage
surcralfate nursing considerations
take on empty stomach 1 hr before meals or 2 hours after and at bedtime (usually taken 4 times a day), don’t give within 30 min of antacids as it decreases effectiveness, monitor BG in diabetics as it contains sucrose
can decrease availability of warfarin, digoxin, phenytoin, levothyroxine and classes of abx - separate these drugs from sucralfate for at least 2 hrs
NG tube measurement
nose to ear to xiphoid process
blakemore tube
inserted through nose down esophagus and into stomach with balloons that can be inflated to stop bleeding esophageal varices
blakemore tube nursing consideration
must keep a pair of scissors at bedside in case of emergency; if inflate balloon becomes dislodged it can compress the trachea and cause respiratory arrest; if happens cut balloon port to let air escape
hold feeds if gastric residual is greater than
500ml
esophageal varices
dilated submucosal veins in esophagus, can burst and bleed; caused by liver disease and alcoholism tx: blakemore tube and surgery
GERD what is it and tx and complications
acid refluxes from stomach into esophagus causing esophagitis Tx: sit upright after eating, eat small frequent meals, H2 blockers and PPIs, complication: Barrett’s esophagus
Gastritis
inflammatory disorder of gastric mucosa; acute gastritis is associated with H.pylori and NSAID use
gastritis S&S and tx
vague abdominal discomfort, epigastric tenderness, bleeding
tx: healing occurs spontaneously within a few days, no NSAIDs, H2 receptor blockers, PPIs, abx if cause is H. pylori
Barrett’s esophagus
reflux for extended period of time, acid has caused changes to cells of esophagus which are cancerous
Gastric ulcer S&S
pain 1-2 hrs after meals and gets worse when eating, abd pain aggravated by eating, vomiting, weight loss, hematemesis if hemorrhage occurs
Gastric ulcer tx
treat H.pylori infection with abx if this is the cause, reduce stomach acid with PPIs and H2 receptor blocks
duodenal ulcer S&S
pain 2-4 hrs after meals, food may relieve pain, weight gain, melena if hemorrhage occurs