Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CEN > Gastrointestinal Emergencies > Flashcards

Gastrointestinal Emergencies Flashcards

1. Explain the concepts related to care of an emergency department patient experiencing a gastrointestinal emergency. 2. Describe the various patient presentations related to gastrointestinal emergencies. 3. List interventions necessary for a patient presenting with a gastrointestinal emergency.

1
Q

abdominal inspection

A

look for bruising, pulsating masses, shape of abdomen, scars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

abdominal auscultation

A

normal bowel sounds 5-35/min

listen for bruits

best indicator for peristalsis is flatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

abdominal percussion

A

liver, splenic borders

liver edge soft, distinct, even with right costal margin

normal sounds: tympany over hollow organs, dullness over solid organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

abdominal palpation

A

assess rigidity, guarding, pain, masses, hernia

tenderness - pain upon pressure

rebound tenderness - pain upon removal of pressure

palpate painful quadrant last

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

patient position indicating abdominal emergencies

A

movement less likely to indicate serious etiology

rigidly still or fetal position classic sign of peritonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

sx with abdominal pain suggestive of surgical or emergent conditions

A

fever
protracted vomiting
syncope or pre-syncope
evidence of GI blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

define GERD

A

reflux of gastric contents into esophagus, causing sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

define esophagitis

A

inflammation of esophagus, often 2ndary to long-term GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

causes of esophagitis

A

long-term GERD
infection
radiation
ingestion of caustic substances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

sx GERD/esophagitis

A 
steady substernal pain
discomfort increase with swallowing
burning of esophagus
-may radiate
-onset 30-60 min after eating
-discomfort occurs with activities that increase intra-abdominal pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

complications of GERD/esophagitis

A

sore throat, hoarse throat
nausea, anorexia, weight loss
occasional vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

cholingergics for GERD/esophagitis

A

increases lower esophageal sphincter pressure, facilitates gastric emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

types of cholinergics for GERD/esophagitis

A

bethanechol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

dopamine antagonist for GERD/esophagitis

A

moves food through GI system more quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

types of dopamine antagonist for GERD/esophagitis

A

metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

antacids for GERD/esophagitis

A

neutralizes acids in stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

types of antacids for GERD/esophagitis

A

calcium carbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

histamine (H2) receptor antagonists for GERD/esophagitis

A

blocks acid production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

types of histamine (H2) receptor antagonists for GERD/esophagitis

A

ranitidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

proton pump inhibitors for GERD/esophagitis

A

inhibits acid pumps in stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

types of proton pump inhibitors for GERD/esophagitis

A

lansoprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

acid protective agents for GERD/esophagitis

A

provides thick protective coating over lower esophagus and stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

types of acid protective agents for GERD/esophagitis

A

sucralfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

dc teaching for GERD/esophagitis

A 
small, frequent meals
low fat diet
raise HOB
weight loss
avoid:
-eating <2 hrs before bed
-peppermint, spearmint
-chocolate, hot/cold food, spicy food, citrus, carbonation
-tobacco, salicylates, caffeine, alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

most common causes of non-variceal upper GI bleeding

A 
duodenal/gastric ulcers
gastric erosions
Mallory-Weiss tears
esophagitis
frequent NSAIDs
presence of varices
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

sx upper GI bleed

A

hematemesis/melena
weakness, dizziness, syncope
postural hypotension
sx hypovolemic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

occult blood testing in upper GI bleeds

A

false positives: red meat, radishes, turnips, cabbage, cauliflower, horseradish, raw broccoli, cantaloupe

false negatives: citrus, vitamin C, supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

labs with upper GI bleeds

A

BUN increases, creatinine remains same d/t breakdown of blood cells

if both elevate, suspect renal disease as cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

define peptic ulcer disease

A

disruption of protective mucosal barriers and increased acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

contributing factors to peptic ulcers

A

NSAID

H. pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

types of peptic ulcers

A

duodenal
gastric
stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

duodenal ulcers

A

age 30-55
pain before eating
pain relieved with eating, antacids
heals spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

gastric ulcers

A

age 55-70
pain after eating
weight loss
chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

stress ulcers

A

usually ischemic stress d/t prolonged physical stress such as illness, trauma, neural injury

more ICU than ED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

interventions for peptic ulcers

A

H2 blockers or PPIs
stop NSAIDs
abx for H pylor
-clarithromycin and amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

define GERD

A

reflux of gastric contents into esophagus, causing sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

define esophagitis

A

inflammation of esophagus, often 2ndary to long-term GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

causes of esophagitis

A

long-term GERD
infection
radiation
ingestion of caustic substances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

sx GERD/esophagitis

A 
steady substernal pain
discomfort increase with swallowing
burning of esophagus
-may radiate
-onset 30-60 min after eating
-discomfort occurs with activities that increase intra-abdominal pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

complications of GERD/esophagitis

A

sore throat, hoarse throat
nausea, anorexia, weight loss
occasional vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

cholingergics for GERD/esophagitis

A

increases lower esophageal sphincter pressure, facilitates gastric emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

types of cholinergics for GERD/esophagitis

A

bethanechol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

dopamine antagonist for GERD/esophagitis

A

moves food through GI system more quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

types of dopamine antagonist for GERD/esophagitis

A

metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

antacids for GERD/esophagitis

A

neutralizes acids in stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

types of antacids for GERD/esophagitis

A

calcium carbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

histamine (H2) receptor antagonists for GERD/esophagitis

A

blocks acid production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

types of histamine (H2) receptor antagonists for GERD/esophagitis

A

ranitidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

proton pump inhibitors for GERD/esophagitis

A

inhibits acid pumps in stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

types of proton pump inhibitors for GERD/esophagitis

A

lansoprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

disposition for pediatric V/D

A

mild-moderate:

  • dc with oral replacement therapy and when to return
  • PCP in 1-2 days

severe: admission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

types of acid protective agents for GERD/esophagitis

A

sucralfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

dc teaching for GERD/esophagitis

A 
small, frequent meals
low fat diet
raise HOB
weight loss
avoid:
-eating <2 hrs before bed
-peppermint, spearmint
-chocolate, hot/cold food, spicy food, citrus, carbonation
-tobacco, salicylates, caffeine, alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

most common causes of non-variceal upper GI bleeding

A 
duodenal/gastric ulcers
gastric erosions
Mallory-Weiss tears
esophagitis
frequent NSAIDs
presence of varices
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

sx upper GI bleed

A

hematemesis/melena
weakness, dizziness, syncope
postural hypotension
sx hypovolemic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

occult blood testing in upper GI bleeds

A

false positives: red meat, radishes, turnips, cabbage, cauliflower, horseradish, raw broccoli, cantaloupe

false negatives: citrus, vitamin C, supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

labs with upper GI bleeds

A

BUN increases, creatinine remains same d/t breakdown of blood cells

if both elevate, suspect renal disease as cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

define peptic ulcer disease

A

disruption of protective mucosal barriers and increased acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

contributing factors to peptic ulcers

A

NSAID

H. pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

types of peptic ulcers

A

duodenal
gastric
stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

duodenal ulcers

A

age 30-55
pain before eating
pain relieved with eating, antacids
heals spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

gastric ulcers

A

age 55-70
pain after eating
weight loss
chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

types of gastric tubes for esophageal varices

A

Sengstaken-Blakemore tube
Minnesota tube
Linton-Nicholas tube

all w/ similar functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

interventions for peptic ulcers

A

H2 blockers or PPIs
stop NSAIDs
abx for H pylor
-clarithromycin and amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

define lower GI bleed

A

blood loss originating distal to ligament of Treitz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Linton-Nicholas tube

A

control of bleeding esophageal varices

triple-lumen to suction esophageal fluids above balloon and gastric fluids below balloon to determine origin of bleeding

large 700-800 ml latex balloon provides rapid hemorrhage control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

assess lower GI bleed

A

occult blood

consider CA in patients > 50 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

sx Mallory-Weiss tears

A

bleeding self limiting
red/coffee ground hematemesis
red, bloody stool (hematochezia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

infectious causes of acute gastroenteritis

A 
rotavirus
Norwalk virus
S. dysenteriae
salmonella
e.coli
campylobacter jejuni (bloody diarrhea and fever)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

intervene for Mallory-Weiss tears

A

antiemetics
NG tube for occult blood test
endoscopy
avoid balloon tamponade except as a last resort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

sx acute gastroenteritis

A 
diarrhea, N/V
diffuse/cramping lower abd pain
fever
dehydration
splenomegaly - bacterial
consider food, travel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

complications of acute gastroenteritis

A

metabolic acidosis
potassium, glucose, calcium abnormalities

consider cardiac workup esp for women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

pharm for acute gastroenteritis

A

antiemetics
anticholinergic
abx (bacterial)
corticosteroids (parasite)

74
Q

dc for acute gastroenteritis

A

hydrate
clear fluids if watery stool
advance diet with loose stool
regular diet with partially formed stool

75
Q

define pediatric vomiting and diarrhea

A

usually self-limiting viral gastroenteritis

76
Q

infectious causes of pediatric V/D

A

fecal-oral or person-person
viral during winter
bacterial during summer

77
Q

noninfectious causes of pediatric V/D

A 
toxins
GI bleed
malabsorption syndromes
bowel disorders
cathartic abuse
abx and other meds
78
Q

sx pediatric V/D

A 
sunken fontanels
reduces LOC
dry mucus membranes
reduced skin turgor
sunken, tearless eyes
tachypnea
oliguria
tachycardia
hypotension
79
Q

intervene for pediatric V/D

A

oral, VI zofran
oral rehydration qh
IV hydration for moderate-severe
-isotonic crystalloid 20ml/kg

80
Q

disposition for pediatric V/D

A

mild-moderate:

  • dc with oral replacement therapy and when to return
  • PCP in 1-2 days

severe: admission

81
Q

inserting NG tube

A

high Fowler for alert
L side, head down for obtunded pts

measure length
smallest possible tube
flex head forward
small sips of water

only small sprays of benzocaine etc.

82
Q

precautions for NG tube insertion

A

contraindicated w/ facial/head trauma or basilar skull fx

attending should insert w/ varices

monitor for hyponatremia if irrigating

83
Q

define pyloric stenosis

A

hyperplasia/hypertrophy of pylorus muscle at outflow tract of stomach to duodenum, preventing stomach from emptying

84
Q

sx pyloric stenosis

A 
usually 2-5 weeks old
projectile vomiting after eating
hungry after eating/vomiting
poor weight gain
few stools
peristaltic waves
palpable RUQ mass
dehydration
85
Q

intervene for pyloric stenosis

A 
IV fluids
K+ replacement
I/O
gastric tube 
surgery
86
Q

pleural effusions in pancreatitis

A

pancreatic inflammation and tissue damage from pancreatic enzymes trigger inflammatory cascade, causing increased capillary permeability

87
Q

sx esophageal obstruction

A

“something stuck”
difficulty swallowing
drooling

subcutaneous emphysema of neck if esophageal perforation has occurred

88
Q

intervene for esophageal obstruction

A

c/f airway obstruction
upright position
esophagoscopy

IV glucagon to relax smooth muscle if object can pass safety through GI system

89
Q

define esophageal varices

A

bleeding from distended blood vessels in esophagus and stomach, usually 2ndary to liver disease

90
Q

risk factors for esophageal varices

A

cirrhosis
portal HTN
chronic alcohol use

91
Q

intervene for esophageal varices

A

treat hypovolemic shock
caution with gastric tube
endoscopic procedures to stop bleeding

92
Q

types of gastric tubes for esophageal varices

A

Sengstaken-Blakemore tube
Minnesota tube
Linton-Nicholas tube

93
Q

Segstaken-Blakemore tube

A

emergency control for bleeding esophageal varices

diagnostic aid

oral or nasal

94
Q

Minnesota tube

A

four-lumen, double-balloon to tx bleeding esophageal varices or simple esophageal hemorrhaging

3rd and 4th lumens facilitate suctioning above esophageal balloon and in stomach

95
Q

Linton-Nicholas tube

A

control of bleeding esophageal varices

triple-lumen to suction esophageal fluids above balloon and gastric fluids below balloon to determine origin of bleeding

large 700-800 ml latex balloon provides rapid hemorrhage control

96
Q

define Mallory-Weiss syndrome

A

small tears in junction of esophagus and stomach

97
Q

sx Mallory-Weiss tears

A

bleeding self limiting
red/coffee ground hematemesis
possible hematochezia

98
Q

risk factors for Mallory-Weiss tears

A

hx retching, vomiting following by hematemesis

alcohol, aspirin use, heavy lifting, coughing, bulimia or pregnancy

99
Q

intervene for Mallory-Weiss tears

A

antiemetics
endoscopy
avoid balloon tamponade except as a last resort

100
Q

define cholecystitis

A

inflammation of gallbladder

101
Q

sx cholecystitis

A

pain, cramping, bloating, guarding, rigidity

worse after deep breath and fatty foods/large meal

fever, chills, jaundice, dar urine

Murphy sign

102
Q

tips for assessing jaundice

A

yellow discoloration of elastic tissue such as sclera or hard palate, esp in darker-skinned patients

103
Q

Murphy sign

A

associated with cholecystitis

assessed via palpation of right subcostal area while pt inspires deeply. Positive response occurs when pt experiences pain w/ palpation while inspiring and may experience inspiratory arrest.

104
Q

assessing cholecystitis

A

CBC - leukocytosis
LFTS - elevated ALT and bili
abd US

105
Q

intervene for cholecystitis

A

antiemetics, analgesics
NPO, gastric tube
abx, cholecystectomy

106
Q

dc teaching for all hepatitis

A

avoid alcohol, steroids
small, frequent meals
low fat, high carbs

107
Q

sx pancreatitis

A

sudden onset epigastric pain radiating to back (dull and steady)

abd tenderness, guarding, N/V, anorexia, fever, tachycardia

worse w/ eating, alcohol, walking, supine

better with leaning forward or fetal position

108
Q

sx pediatric liver disease

A

usually asymptomatic

symptoms:
obesity
RUQ, nonspecific pain
hepatomegaly
fatigue
109
Q

amylase and lipase in pancreatitis

A

amylase rises quickly but normalizes 24-72 hours

lipase rises more slowly but is detectable for up to 2 weeks

110
Q

intervene for pancreatitis

A 
IV calcium replacement
analgesia (not morphine)
decrease vagal stimulation
antispasmodics
antacids
H2 blockers
calcium gluconate (hypocalcemia)
corticosteroids
glucagon
111
Q

why not morphine for pancreatitis?

A

can cause spasm in sphincter of Oddi

112
Q

why glucagon in pancreatitis

A

decrease pancreatic inflammation, amylase, pancreatic secretions

113
Q

complications of pancreatitis

A 
hypocalcemia
pleural effusions
ARDS
retroperitoneal bleeding
pancreatic infection
114
Q

hypocalcemia in pancreatitis

A

free fatty acids formed by release of lipase into soft tissue space bind w/ calcium and cause decrease in ionized calcium

tetany, serum Ca < 8

115
Q

pleural effusions in pancreatitis

A

pancreatic inflammation and tissue damage from pancreatic enzymes trigger inflammatory cascade, causing increased capillary permeability

116
Q

ARDS in pancreatitis

A

inflammatory cascade causes fluid to leak into pleural space, leading to pleural effusions and fluid in the alveoli (ARDS)

117
Q

retroperitoneal bleeding and hypovolemia in pancreatitis

A

autolysis caused by pancreatic enzymes can cause bleeding from pancreas and other abd structures

118
Q

sx retroperitoneal bleeding due to pancreatitis

A 
hypotension, tachycardia
decreasing hematocrit
abd distention
Grey-Turner sign
Cullen sign
119
Q

Grey-Turner and Cullen sign in pancreatitis

A

Grey-Turner: ecchymosis to flanks
Cullen: ecchymosis to umbilical area

24-48 hours to develop

each indicates pancreatitis, both indicates peritoneal necrosis

120
Q

other causes of Grey-Turner and Cullen sign

A

bleeding d/t abd trauma
aortic rupture
ruptured ectopic

121
Q

interventions for UC or Crohn’s disease

A 
lifestyle changes
analgesia, antipyretics 
IV fluids
anticholinergics
antidiarrheal
anti inflammatories
antimicrobials
corticosteroids 
immunosuppressant
122
Q

sx pancreatic infection

A

worsening fever
increasing abd pain
sepsis

123
Q

hepatitis A

A

fecal-oral exposure can cause epidemic

vaccination

124
Q

hepatitis B

A

parenteral, sexual, occupational, human bite exposure

acute or chronic

vaccination

125
Q

hepatitis C

A

parenteral, sexual, occupational, human bite exposure

50% chronic, may be asymptomatic at first

126
Q

hepatitis D

A

needs Hep B to duplicate and survive

127
Q

hepatitis E

A

enteric (contaminated food, water) from fecal matter

rare in US

128
Q

sx mild hepatitis

A 
malaise
fatigue
anorexia
N/V
RUQ pain
joint pain
generalized edema
ascites
129
Q

sx severe hepatitis

A 
jaundice
clay-colored stool
steatorrhea
dark-colored, foamy urine
generalied edema
ascites
130
Q

labs in hepatitis

A

increased ammonia, bili, LFTs, PT, PTT

decreased urea, albumin, Ca

131
Q

intervene for hepatitis

A

lactulose
remove peritoneal fluid
replace albumin, vit K

132
Q

meds for severe or chronic hepatitis

A

interferon

ribavirin

133
Q

intervene for intestinal obstructions

A 
NPO, NG tube
barium enema (intussusception)
surgery:
-volvulus
-pyloric stenosis
-perforation
134
Q

dc teaching for hepatitis B,C,D

A

do not donate blood or tissue
safe sex
do not share personal items

135
Q

dc teaching for all hepatitis

A

avoid alcohol, steroids
small, frequent meals
low fat, high carbs

136
Q

pediatric considerations in liver disease

A

obesity most common cause

nonalcoholic fatty liver disease occurs in 38% of obese children

also cholelithiasis

137
Q

sx pediatric liver disease

A

usually asymptomatic

symptoms:
obesity
RUQ, nonspecific pain
hepatomegaly
fatigue
138
Q

define appendicitis

A

obstruction of appendiceal lumen, decreasing blood flow, causing necrosis and perforation, and can lead to peritonitis

most common in males 10-30 yo. Extreme ages may have atypical presentations

139
Q

pediatric considerations for appendicitis

A

most common cause of abdominal pain in children

rare in children under 2 yo

140
Q

early sx pancreatitis

A

dull, steady, periumbilical pain
anorexia, nausea
mild fever

141
Q

later sx pancreatitis

A

12-48 hours
RLQ pain
flexing knees may help
rebound tenderness

142
Q

what is rebound tenderness a sign of?

A

sign of peritoneal irritation aka peritonitis

143
Q

pregnancy considerations in appendicitis

A

pain may be in RUQ instead of RLQ due to uterus pushing appendix upward

144
Q

labs in appendicitis

A

CBC - leukocytosis

145
Q

intervene for appendicitis

A

NPO, serial abd exams

surgery

146
Q

define ulcerative colitis

A

chronic inflammatory disease affecting only large intestine, usually sigmoid and rectal areas

affects mucosal and submucosal layers

147
Q

define Crohn’s disease

A

chronic inflammatory disease affecting any part of GI tract (mouth to anus)

most common site of inflammation is transition between small and large intestine

148
Q

complications of UC or Crohn’s disease

A 
fistulas (Crohn's)
intestinal obstructions
malnutrition
bowel perf
toxic megacolon
149
Q

toxic megacolon

A

severe dilation of bowel associated with colitis

150
Q

interventions for UC or Crohn’s disease

A 
lifestyle changes
analgesia, antipyretics 
IV fluids
anticholinergics
antidiarrheal
anti inflammatories
antimicrobials
corticosteroids 
immunosuppressant
151
Q

causes of intestinal obstructions

A

physical
nervous system disorders
inflammatory conditions

152
Q

physical intestinal obstructions

A

fecal impaction
hernia
intussusception
volvulus

153
Q

nervous system intestinal obstructions

A

paralytic ileus

154
Q

inflammatory intestinal obstructions

A

abscess

inflammatory bowel disease

155
Q

onset of intestinal obstructions

A

small: rapid
large: gradual

156
Q

vomiting in intestinal obstructions

A

small: frequent, copious (bile and feces)
large: rate

157
Q

pain in intestinal obstructions

A

small: colicky, cramp-like, intermittent, wave-like pain
large: low grade, cramping

158
Q

bowel movements in intestinal obstructions

A

small: BMs early, constipation late
large: absolute constipation

159
Q

abd distention in intestinal obstructions

A

small: minimally increased
large: greatly increased

160
Q

general sx intestinal obstructions (small and large)

A

fever, tachycardia
HTN early, hypotension late
increased WBC
borborygmi (stomach rumble)

high pitched peristaltic rush proximal to obstruction leading to absent bowel sounds (late)

161
Q

complications of intestinal obstructions

A

dehydration
electrolyte imbalances
bowel ischemia
ruptured bowel

162
Q

intervene for intestinal obstructions

A 
NPO, NG tube
barium enema (intussusception)
surgery:
-volvulus
-pyloric stenosis
-perforation
163
Q

define intussusception

A

telescoping of one segment of bowel into another

164
Q

who does intussusception affect?

A

commonly children 3 mo to 5 years

usually 6 mo

males > females

165
Q

causes of intussusception

A

after viral infection
polyps
hyperactive peristalsis
abnormal bowel lining

166
Q

sx intussusception

A

sudden, acute crampy episodic pain with flexed knees

pain free between episodes

bilious vomiting, abd distention, sausage-shaped palpable mass in RUQ

currant jelly stools w/ bloody mucus is a late sign

167
Q

assessing intussusception

A

barium or air enema can be diagnostic

168
Q

define volvulus

A

strangulation of superior mesenteric artery and bowel infarction d/t abnormal bowel rotation with mesenteric attachment

169
Q

volvulus overview

A

usually first month of life
congenital

intermittent volvulus can occur (also in adults)

170
Q

sx volvulus

A 
bilious vomiting
abd pain and distention
bloody stools
hematemesis
visible peristaltic waves
peritoneal signs if perforation
171
Q

define diverticula

A

outpouching of colon

172
Q

define diverticulitis

A

inflammation of diverticula of colon - usually sigmoid

173
Q

define diverticulosis

A

presence of noninflamed diverticula

174
Q

sx diverticulitis

A

generalized, abrupt onset of aching, cramping pain local to LLQ

anorexia, N/V

175
Q

dc teaching for diverticulitis

A 
avoid straining during BMs
40 oz water qd
low fat/fiber diet when acute
high fiber when not acute
stool softeners
avoid alcohol, nuts, popcorn
176
Q

define peritonitis

A

inflammation of peritoneum

177
Q

primary peritonitis

A

blood-borne organisms enter peritoneal cavity

178
Q

secondary peritonitis

A

abd organs perforate and release contents into peritoneal cavity (more common than primary)

179
Q

causes of peritonitis

A

ruptured appendix
pancreatitis
penetrating trauma
peritoneal dialysis

180
Q

sx peritonitis

A

diffuse pain worse with moving, coughing, better when flexing knees

ttp, rebound tenderness, guarding, rigid abdomen

fever, sepsis

diminished, absent bowel sounds

dehydration

resp difficulties

CEN (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions