Gastrointestinal hurst Flashcards
signs of pancreatitis
pain increases with eating
abdominal distension/ascites
abdominal mass (swollen pancreas)
rigid birdlike abdomen with guarding (bleeding that cal lead to peritonitis)
cullens sign
grey turner sign
fever
inflammation
nausea
vomiting
aundice
hypotension (bleeding, ascites)
Diagnosis of pancreatitis
increase serum lipase and amylase
increased WBC
increased Blood sugar
increased liver enzymes
PT, aPTT longer
serum bilirubin increase
What happens with H/H with pancreatits
increased with concentration/dehydration
decreased with bleeding
treatment of pancreatits
pain control
anticholinergics
GI protectants
maintain fluid electrolyte balance
maintain nutritional status >ease into a diet
keep stomach empty and dry
insulin
daily weights
eliminate alcohol
lab values for amylase
30-330
lab values for lipase
0-160
lab values for AST
0-35
lab values for ALT
10-36
lab values for hemoglobin
male 14-18
female 12-16
hematocrit lab values
male 42%-52%
female 37%-47%
what are the 4 major functions of the liver
detoxify the body
help blood to clot
help metabolize drugs
synthesizes albumin
cirrhosis pathophysiology
liver cells are destroyed and are replaced with connective/scar tissue alters the circulation within the liver> the bp in the liver goes up called portal hypertension
signs of cirrhosis
firm, nodular liver, jaundice
abdominal pain
chronic dyspepsia
change in bowel habits
ascites
spenomegaly
fatigue
peripheral edema
anemia
can proggress to hepatic coma
diagnosis of cirrhosis
decreased serum albumin
increase ALT and SLT
ultrasound
CT, MRI
liver biopsy
positioning for liver biopsy
supine with right arm behind head
exhale and hold 3-5 seconds to get diaphragm out of the way
light on right side after procedure to hold pressure
monitor for bleeding
treatment of cirrhosis
antacids, vitamins, diuretics
no more alcohol
I&O and daily weight
rest
prevent bleeding
measure abdominal girth
paracentesis (monitor for shock)
monitor for jaundice
avoid narcotics
decrease protein
low sodium diet
peptic ulcers signs
burning pain
heartburn
peptic ulcer diagnosis
gastroscopy
upper GI
gastroscopy considerations
NPO pre procedure and until gag reflex returns
sedated
watch for perforation by watching for pain, bleeding, or if they are having trouble swallowing
what does an upper GI do
looks at the esophagus and stomach with die
considerations for upper GI
no smoking, chewing gum, or mints remove any nicotine patches
why is smoking bad near upper GI
it increases stomach motility which will affect test
increases stomach secretions which will increase the chance of aspiration
medications for peptic ulcers
liquid antacids
proton pump inhibitors
h2 antagonists
ABX (h pylori)
sucralfate
client teaching or peptic ulcers
decrease stress
stop smoking
avoid temperature extremes in food and caffeine
follow up
what is a hiatal hernia
hole in the diaphragm is too large so stomach move up into the thoracic cavity
causes of hiatal hernia
large abdomen,
congenital
trauma and straining
signs of hiatal hernia
heartburn
regurgitation
dysphagia
treatment of hiatal hernia
small frequent meals
sit up 1 hour after eating
elevate HOB
surgery
lifestyle changes
what is dumping sundrome
stomach empties too quickly after eating
common causes of dumping syndrome
gastric bypass
gastrectomy
gallbladder disease
signs of dumping syndrome
fullness
weakness
palpitations
cramping
faintness
diarrhea
treatment of dumping syndrome
semi-recumbent with meals
lie down after meals on left
no fluid with meals
small frequent meals
avoid foods high in carbs and electrolytes (empty fast)
hey do you lay on your left with dumping syndrome
left side leaves it in
right side releases it
what conditions are included in IBD
churns and ulcerative colitis
signs of IBD
diarrhea
rectal bleeding
vomiting
weight loss
cramping
dehydration
blood in stools
anemia
rebound tenderness
fever
colonoscopy considerations
clear liquid diet 12-24 Hours prior
NPO 6-8 hours prior
avoid NSAIDS for several days
laxatives or enema until clear
polyethylene glycol
colon prep helps if icy and cold
sedated
monitor for perforation post
diet for IBD
low residue diet
avoid cold foods and smoking (they increase motility)
ileostomy post op care
It will drain fluid all the time (dont have to irrigate)
avoid foods hard to digest and rough food
gatorade in summer
at risk for kidney stones (always dehydrated)
colostomy care
ascending and transverse semi liquid stools
descending or sigmoid semi formed or formed
irrigate descending and sigmoid for regularity
when is the best time to irrigate colostomy
same time everyday
after a meal
