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SET 2 > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What is the function of the pancreas?

A

Endocrine produces insulin

exocrine produces digestive enzymes

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2
Q

Two types of causes of pancreatitis?

A

1 is the gallbladder

2 cause is alcohol

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3
Q

s/s of pancreatitis

A 
pain
abd distention/ascites
abd mass - swollen pancreas
rigid guarding
brusing around umbilical area - cullen sign
fever
inflammation 
n/v
jaundice
hypotention
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4
Q

Diagnosis for pancreatitis

A 
Serum lipase and amylase 
WBC up
Bs up
alt/ast up
pt att longer
serum bilirubin up
hemoglobin up / down depending if they are bleeding or dehydrated
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5
Q

Values for amylase

A

30-220

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6
Q

Txt for pancreatitis

A 
*control pain
decrease gastric secretions by NPO, NG, Bed rest
Pain meds 
Anticholingeric why
benzotropine
gi protectants 
pantopraazole
ranitidine
antacids
maintain f/e 
diet
insulin why?
daily weights
eliminate alcohol
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7
Q

Liver functions

A

The liver detoxifies the body and helps with clotting, metabolizing drus, and synethesize albumin

SO your concern would be bleeding

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8
Q

Patho for Liver Cirrhosis

A

Liver cells are destroyed and replaced with scar tissue, which alters circulation making bp go up called portal HTN

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9
Q

S/s of Cirrhosis

A 
Firm Nodular 
Abd pain 
Chronic dyspepsia
change in bowel
ascites
splenomeagly
decreased albumin
up ast/alt
anemia
can become hepatic encephalopathy

*never given tylenol with liver problems
antidote is mucomysst

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10
Q

Diagnosis of Cirrhosis

A 
Ultrasound
Ct/ MRI
Biopsy of liver preprocedure - PT.INR/ aPTT 
VS
Supine with arm up and hold breath why?
Post Procedure 
Side lying why?
VS why? - hemorrhage
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11
Q

Txt of Cirrhosis

A 
Antacids/vit/diuretics
no alcohol
i/o daily weights cause of ? 
Rest
Prevent bleeding 
Measure abdominal girth
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12
Q

Paracentisis for cirrhosis and

what diet?

A

Removes fluid from periotonial cavity
client should void, make the sit up, vs to ensure no shock. have a good skin care cause jaundice makes them itch, avoid narcotics. * Diet must be low in protein and low in sodium

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13
Q

Hepatic COMA

A

Protein broken down is amonia and liver converts it to urea and excreted through the kidney when liver is impaired this cant happen and amonia builds up, decreasing LOC.

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14
Q

S/s of Hepatic Coma

A 
mental/motor changes
diffiult to wake
asterixis 
handwriting changes
eeg slow
fetor
things that will aggravate amonia 
and watch for potential to have GI bleed
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15
Q

Txt for hepatic coma and the diet they would be on

A

lactulose
enema
decrease protein
and monitor serum amonia

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16
Q

Bleeding Esophageal varicies

A

Portal HTN, occurs in stomach, esophagus and rectum
Alcoholic clients w/ GI usually has varicies
Only noteable when it bursts aka person is vomitting bright red

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17
Q

Txt for Varicies

A 
Replace blood 
monitor vs 
cvp
oxygen because anemic
give octreotide which lowers bp
endoscopic sclerotherapy
esophageal ligation
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18
Q

What is a temporary fix for varicies?

A

Balloon tamponade that can only be utilized for 12 hrs because itll hold pressure in the bleeding varicies

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19
Q

What is peptic ulcers?

A

common cause of gi

erosion present occuring in the esophagus, stomach, duodenum

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20
Q

S/s of peptic ulcer

A

burning pain - epigastric

heart burn

21
Q

Diagnosis for peptic

A

gastroscopy- need to be npo, sedated

must wait till gag reflex returns and watching for pain/bleeding, trouble swallowing means - PERFORATION

22
Q

Diagnosis Upper GI

A

visual exam with a dye of the esophagus and stomach, NPO at midnight no smoking eating etc as it increases motility smoking also increases stomach secretions risking aspiration

23
Q

Meds for peptic ulcer

A 
Antacids liquid why
proton pump -prazole
h2 antagonis - dine
GI cocktail
antibiotics 
Sucralfate - barrier over wound
24
Q

Client teaching for peptic ulcer

A

decrease stress

stop smoking and no irritants like spicy and caffiene

25
Q

What is gastric ulcer

A

Happens to malnourished pain felt after half to 1 hr and vomitts blood

26
Q

What is duodenal ulcers

A

Well nourshied pain at night 2-3 hrs after meal and food makes it feel better

27
Q

What is hiatal hernia

A

A hole in diaphragm causing stomach to move into thoracic cavity. abdomen appears large - overweight.

28
Q

s/s of hiatal hernia

A

heartburn
fullness
regurgitation
dysphagia

29
Q

Txt for hiatal hernia

A

Small freq meals, sit up 1hr with HOB surgery and teach healthy diet

30
Q

what is dumping syndrome

A

emptying too quickly after eating and can be uncomfortable caused by
gastric bypass , gasrectomy
gall baldder disease

31
Q

s/s dumping syndrome

A 
fullness
weakness
palpitations
cramping
faintness
diarrhea
32
Q

Txt dumping syndrome

A

Semi-recumbent
lie down with meals on left side
no fluids with meals avoid food high in carbs and watch for electrolytes

33
Q

Ulcerative Colitis

A

IBD in large intestine

Crohns, inflammation in ileum

34
Q

S/s of ulcerative colitis

A 
diarrhea
rectal bleeding
dehydration
blood instool
vomitting
weight loss
anemia
rebound tenderness - peritoneal inflammation 
fever
cramping
35
Q

Diagnosis of Ulcerative Colitis

A

ct/mri

colonoscopy 
clear liquid diet 12-24 hrs
NPO 6-8 hrs before 
avoid NSAIDS
laxatives until clear
polyethylene 
prep drinks icy cold no straw
sedated for procedure
watch for perforation such as pain or unusual abd discomfort.

– barium enema

36
Q

diet for ulcerative

A

low residue and avoid cold foods and smoking

37
Q

meds for ulcerative

A

abx
steriods
biologics and immunomodulators
aminosalicylates

38
Q

surgery for ulcerative

A

total colectomy or kock illostomy no external pouch and empty intestines through nipple pouch

IPAA removes colon and attaches to illeum and to the rectum

39
Q

Crohns ( try not to do surgery)

A

remove only affected areas may end up with -ostomy ileostomy or colostomy

40
Q

Post op care for illeostomy

A

drains liquid all the time no irrigation
avoid foods hard to digest
gatorade may be provided for electrolytes and they are at risk for kidney stones why?

41
Q

Colostomy care

A

nutrients are absorbed as stool and forms.
colostomy as and trans - sem liquid
colos - des and sigmoid - semi formed or formed

you irrigating the descending and signoid
why irrigate for regularity

42
Q

When is the best time to irrigate

A

same time after a meal

same principle as enema if cramp occurs stop fluid and lower bag check temp

43
Q

Appendicitis

A 
Inflammation of appendix worry about rupture
generalized pain RLQ 
Rebound tenderness 
N/V 
starts with abd pain , na/vom
anorexia
44
Q

Diagnosis for appendicitis

A

WBC up
ultrasound
CT
no enema

45
Q

Pre and Post op for appendicitis

A

pre surg sit up on right side
done by laparaoscope
after surgery elevate hob

46
Q

TPN Nursing Considerations

A 
Refridgerate and warm for admin
Central line, filter needed 
discontinue gradually hypo
daily weights / start taking insulin
and monitor q6hr
check urine for glucose and ketones
hung for 24hrs
change tubing and new bag each day 
IV bag dark 
needs a pump 
watch for infection
47
Q

Assisting primary healthcare provider with central line

A

Flush with saline
Do not start fluids till confirmed CXR - ensures placement and prevent pnuemothorax
Position trendelenburg for distended veins, if air goes put client on left side trendelenburg

48
Q

How to avoid air getting in the line?

A

Clamp it

Valsalva

SET 2 (16 decks)

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