Gastrointestinal Flashcards
What happens in pancreatitis
It is the auto-digestion of the pancreas
What are the functions of the pancreas
1) endocrine function-releases insulin
2) exocrine function-releases digestive enzymes to ducts
What are the 2 types of pancreatitis and what is the primary cause
Acute and chronic and Alcohol/gall bladder disease
When someone’s lipase and amylaze are up, wbc blood sugar, alt and ast are elvated. it takes longer to clot blood and bilirubin are up what could this mean
Pancreatitits
What are the major functions of the liver
- detoxify the body
- helps with blood clot
- metabolzies drugs
- synthesizes albumin
What happens when someone has cirrhosis of the liver
The liver cells are destroyed and replaced with scar tissue causing decrease perfusion and causes BP to increase–> Portal hypertension
Order for: -U/S -CT, MRI -Liver biopsy What could these indicate for
Cirrhosis of liver
What should u obtain prior to a liver biopsy
PT, INR and aPTT
Vital signs
How do you position a client for a liver biopsy
Supine with right arm up and out of the way, ask the patient to exhale and hold breath
How do you position a client post- liver biopsy
Lie on right side, because we are worried about bleeding
What causes a person experiencing hepatic coma to have a low loc
increased ammonia levels that can’t be converted to urea by the liver causes a build up of ammonia in the blood and this causes a decrease loc
What happens when there is an increase in BP in the liver;
Collateral circulation
Where does blood flow to when we have collaterall circulation
Esophagus, stomach and rectum
What is the most common cause of a GI bleed,
Peptic ulcer
Where can a peptic ulcer be seen
Esophagus, stomach and duodenum
Is Erosion present with peptic ulcer
Yes
How do we diagnose a peptic ulcer
Gastroscopy (EGD, endoscopy)
What nursing precations should be considered for a person undergoing a gastroscopy
Remain NPO pre-procedure and until gag reflex returns
Watch for perforation, watch for pain bleeding and swallowing difficulty
No smoking, chewing gum or have any nicotine patches
Which ulcer is it that vomitting helps and food doesn’t help
Gastric ulcer
Which ulcer is it that food helps and there is blood in stool
Duodenal ulcer
What happens that causes a hiatal hernia
A hole in the diaphragm causing the stomach to move up into the thoracic cavity… because abdomen is too big or the patient has had a trauma/ surgery or it is a congenital deformity
What is dumping syndrome
it is when the stomach empties too quickly after eating could be secondary to a gastric bypass, gastrectomy or gall bladder disease
Where is ulcerative colitis found
Large intestine
Where is chron’s found
Ileum but more so anywhere in the small or large intestine
What helps diagnose a ulcerative colitis and chron’s disease
CT
Colonoscopy
Barium enema
What should you as nurse take precautions before a colonoscopy
The patient should be on a clear diet for 12-24 hours and NPO 6-8 hours pre procedure
Avoid NSAIDS
Give laxatives and enemas until stool is clear
Polyethylene glycol- to make the patient pee
sedated for procedure
What helps the patient drink the colon prep
If the prep was icy cold
What should client be taught for post-colonoscopy
Watch for perforation, pain discomfort
What should be given if colonoscopy is incomplete
Barium enema
When a person gets ileostomy care what should the nurse expect
Liquid drain, avoid foods hard to digest and rough foods, give gatorade and the patient could be at risk for kidney stones
When a person gets colostomy care what should the nurse expect
Water and nutrients are being absorbed and stool is forming
When should a nurse irrigate
Only irrigate in the descending and sigmoid part of the colon
What position do you put the patient to irrigate them
Similar to enema receiving, any position
If the client starts to cramp when receiving enema what do you do
Stop the enema, lower the bag and check the temperature of the fluid
What is an appendix related to
Low fiber diet
How do we diagnose an appendix
increased wbc
CT
Ultrasound
Do you give enemas or laxative to a patient who has appendicitis
No because it could cause perforation
What should we take into consideration when dealing with TPN
Keep it refrigerated; warm for administration Use Central Line (PICC) only for TPN Filter needed Discontinue if hypoglycemia daily weights and take insulin check for urine (for ketones & glucose) Never mix ahead of time can only be hung for 24 hours change tube with each bag needs to be on pump emphasize hand washing
What’s a complication to watch out for with TPN
Infection
When assisting a physician with inserting a Central Line what should you do prior to flushing
Get a confirmation of placement via CXR before saline flush
What position do you have the client in with inserting a central line
Trendelenburg
If air goes into the line what do you put the client in
Keep the patient trendelenburg but place client on L side
When changing tubning and to avoid air inline what can you do?
Clamp it off
Ask the client to bear down (Valsalva)
and to take a deep breath and hummm
Why is an xray done post insertion of a central line
To make sure for placement and also to make sure that the client does not have a pneumothorax
