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Medical-Surgical Nursing > Gastrointestinal System > Flashcards

Gastrointestinal System Flashcards

1
Q

Reflux, regurgitation and back-flow of gastric acid

contents

A

GERD

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2
Q

Most common symptom of GERD

A

Heartburn / Pyrosis

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3
Q

Symptom of Gerd - 2B

A

Belching / Bloating

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4
Q

Symptom of Gerd - 2R

A

Regurgitation / Reflux

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5
Q

Symptom of Gerd - 2D

A

Dyspepsia / Dysphagia

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6
Q

Diagnostic Test for GERD

A

Esophageal pH monitoring

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7
Q

Normal PH level of acid in stomach

A

2-3

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8
Q

Most important Diagnostic test for GERD

A

Barium Swallow

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9
Q

Effect of Relaxation of LES on pressure

A

Decreased pressure

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10
Q

Long-standing untreated precancerous GERD

A

Barrett’s esophagus

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11
Q

Complication of GERD that results to stricture and ulceration

A

Esophagitis

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12
Q

Adenocarcinoma / cancerous GERD

A

Esophageal cancer

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13
Q

Surgical procedure for GERD

A

Anti-reflux surgery (Nissen and Toupet fundoplication)

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14
Q

Normal value for Esophageal PH monitoring

A

Below 7.35`

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15
Q

Antireflux surgery: One suture/complete

A

Nissen Fundoplication

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16
Q

Antireflux surgery: Two suture/Partial

A

Toupet

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17
Q

GERD Pharmacological Mnemonic

A 
PAPA
Proton Pump Inhibitor
Antacid
Prokinetics
Anti-histamine
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18
Q

Primary meds for hyperacidity

A

PPI & anti-histamine

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19
Q

Indicated for quick/short-lived relief of mild, intermittent heartburn

A

Antacid

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20
Q

Increases LES pressure & Improve gastric emptying & regurgitation

A

Prokinetics

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21
Q

Examples of anti-histamines for GERD

A

Cimetidine / Ranitidine

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22
Q

Examples of PPI for GERD

A

Omeprazole / Lanzoprazole / Rabeprazole

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23
Q

Examples of Prokinetics for GERD

A

Metoclopramide / Baclofen / Cisapride

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24
Q

Nursing Management for Antacids & anti-ulcer meds

A

Report signs of GI bleeding

like black stool, tarry stool, and abdominal pain

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25
Q

Imbalanced Nutrition interventions for GERD

A

Non-irritating foods

Avoid reflux-inducing foods

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26
Q

Acute Pain interventions for GERD

A

SFF
Eat slowly
Avoid eating 2-3 hours before sleep
Give fluid in between meals

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27
Q

Protrusion/ enlargement/ pushing upward of stomach and gastric mucosa in the lower thoracic cavity or esophageal hiatus

A

Hiatal Hernia

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28
Q

Type of Hiatal Hernia: GEJ protrude/move upward with intact diaphragm

A

Type 1: Sliding / Esophageal Hernia

Most common

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29
Q

Type of Hiatal Hernia: GEJ no movement with Non-intact diaphragm

A

Type 2: PARAESOPHAGEAL or Diaphragmatic Hernia

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30
Q

Symptom of Hiatal Hernia

A 
HERNIA
Heartburn
Epigastric pain
Regurgitation
Nocturnal heartburn
Indigestion
After eating - Dysphagia, Belching, Fullness
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31
Q

Diagnostic test for Hiatal Hernia

A

Barium Swallow
Xray
Upper GI series

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32
Q

Hiatal Hernia Pharmacological Mnemonic

A

APA
Anti-histamine
Proton Pump Inhibitor
Antacid

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33
Q

Surgical procedures for Hiatal Hernia

A

Herniotomy
Herniorrhaphy
Anti-reflux procedure
Gastropexy

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34
Q

Hiatal Hernia surgery: To open & excise

A

Herniotomy

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35
Q

Hiatal Hernia surgery: To repair the hernia sac

A

Herniorrhaphy

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36
Q

correct twisting/ torsion of stomach,
prevent restriction of blood flow, reduce hernia,
increase LES pressure

A

Gastropexy

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37
Q

Absent or ineffective peristalsis of the distal esophagus

A

Esophageal Atresia

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38
Q

Esophagus failed to relax, narrows, strictures, dilates, incomplete relax, obstructs, decrease emptying (food content causes dilation proximal to the obstructed area)

A

Esophageal Atresia

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39
Q

Risk factor of Esophageal Atresia

A

Idiopathic

Age

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40
Q

Stages of Esophageal Atresia

A

Early & advanced

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41
Q

Stages of Esophageal Atresia: tapering or NARROWING of lower esophagus

A

Early

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42
Q 
Stages of Esophageal Atresia: DILATED tortuous esophagus (food and fluid)
or megaesophagus (enlargement of lower esophagus)
A

advanced

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43
Q

Symptom of Esophageal Atresia

A 
Dysphagia (most common/primary) 
Sensation globus 
Substernal chest pain - after meal
Heartburn (pyrosis)
**Halitosis (foul smelling breath)
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44
Q

Complications of Esophageal Atresia

A

Aspiration (gastric content)
Pulmonary complication
Esophagitis

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45
Q

Confirmatory Diagnostic test of Esophageal Atresia

A

Manometry

- measures esophageal pressure

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46
Q

Nursing intervention for Esophageal Atresia

A

Elevated HOB while sleeping
Semi-soft diet
Drink fluids during meals

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47
Q

Esophageal Atresia Meds

A

Botulinum toxin

Calcium channel blocker (Nifedipine)/ Nitrates ( ISDN or Isordil only)

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48
Q

Indication of Botox for Esophageal Atresia

A

endoscopically to inhibit contraction of smooth muscles, therefore relaxes the smooth muscles

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49
Q

Surgical procedure for Esophageal Atresia: endoscopic procedure using balloon to stretch the narrowed esophagus

A

Pneumatic dilatation (surgical reparation)

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50
Q

N.I for Pneumatic dilatation

A

watch out for perforation - fever, abdominal tenderness

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51
Q

Surgical procedure for Esophageal Atresia: cuts/ separate esophageal muscle fibers to relieve stricture, allow food to pass

A

Esophagomyotomy (Heller myotomy)

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52
Q

UGIB: profuse, bright red blood

A

Arterial Bleeding

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53
Q

UGIB: blood in stomach for some time

A

Coffee-ground vomitus

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54
Q

UGIB: black tarry stool, upper GI bleeding (slow or prolong)

A

Melena

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55
Q

UGIB: blood loss > 1.5L

A

Massive UGIH (Upper Gastrointestinal Hemorrhage)

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56
Q

WORST manifestation in GI bleeding

A

Perforation/ Peritonitis

Absence of bowel sounds

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57
Q

Normal Pulse Pressure

A

+3

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58
Q

Primary tool to diagnose source/location of UGIB, 1st line management

A

Endoscopy

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59
Q

N.I for UGIB: best measure for vital perfusion

A

Measure urine output

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60
Q

N.I for UGIB: fluid volume status,
hemodynamic monitoring
- SYSTEMIC fluid status of body

A

Central Venous Pressure line

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61
Q

N.I for UGIB: Which IVF to give and why?

A

Lactated Ringers

  • contains sodium, potassium, magnesium, chloride
  • corrects overall electrolyte imbalance
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62
Q

N.I for UGIB: What kind of needle for IVF and why?

A

Large bore needle

- used for high fluid volume rescucitation

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63
Q

Normal CVP line value

A

0-8 mmHg

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64
Q

Gastric Lavage: Vasoconstricting effect

A

Cold

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65
Q

Gastric Lavage: Vasodilating effect

A

Hot

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66
Q

Important N.I for Gastric lavage

A

Withhold feeding if there’s presence of blood

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67
Q

Inflammation of gastric and stomach mucosa

A

Gastritis

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68
Q

Diagnostic test for gastritis

A

Endoscopy
1 minute ultra rapid urease test (breath test) for detecting
H. pylori (>200)

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69
Q

Most common factor for acute gastritis

A

Alcohol intake

70
Q

Gastritis: Antidote for corrosive chemicals (STRONG ACIDIC)

A

Aluminum Hydroxide

71
Q

Gastritis: Antidote for corrosive chemicals (ALKALINE)

A

Diluted vinegar/ lemon juice

72
Q

Medications for H.pylori infection

A

ANTIBIOTIC
amoxicillin, clarithromycin, tetracycline,
metronidazole

73
Q

N.I for Gastritis: When can the patient have solid food?

A

The patient can have solid food when the patient have done flatus

74
Q

N.I for Gastritis: Reason why emesis and lavage is avoided?

A

strong corrosion to prevent further damage and perforation of esophagus

75
Q

Ulceration, hallowing, excavation and erosion of mucosal wall of the esophagus, stomach and duodenum

Food relieves pain

A

Peptic Ulcer

76
Q

Most common cause of Peptic Ulcer

A

Bacterial infection (H. Pylori)

77
Q

Type of PUD: Deeper; more penetrating ulcer

A

Cushing Ulcer

78
Q

Etiology of Cushing Ulcer

A

BRAIN disorder, increased ICP, vagal stimulation, hypersecretion of Hydrochloric acid

79
Q

Type of PUD: 3 days after severe burns

A

Curling’s Ulcer

80
Q

HIGH epigastric burning, gaseous pain
Pain tends to WORSEN with food
abdominal discomfort occurs 1-2 hours after meals

A

Gastric Ulcer

81
Q

burning cramp-like pain

midepigastric and back pain

A

Duodenal Ulcer

82
Q

most accurate and most preferred diagnostic procedure for Peptic Ulcer

83
Q

PUD Medications: ONLY medication that will cover the ulcer and act
as the protective barrier

A

Sucralfate

84
Q

Surgical procedure for Gastric ulcer

A

Billroth 1

85
Q

Surgical procedure for Duodenal ulcer

A

Billroth 2

86
Q

Surgical procedure that reducing the stomach 70- 80%; leads to dumping syndrome

A

Bariatric surgery

87
Q

set of manifestations; it is not a disease nor a disorder

88
Q

Establish condition with identifiable cause

89
Q

Irregularity, disturbance, or interruption of normal functions.

90
Q

Unpleasant GI symptoms and physiologic response characterized by rapid emptying of stomach content and rapid passage of foods to jejunum

A

Dumping

Syndrome

91
Q

Causes of Dumping syndrome

A

Gastric surgery
Bariatric surgery
Rapid NGT/enteral/bolus feeding

92
Q

Manifestations of Dumping Syndrome

A 
Abdominal pain
Borborygmi
Diarrhea
Alternating hyper/hypoglycemia
Anorexia
93
Q

How to prevent Dumping syndrome?

A

Slow Feeding

Checking of gastric residual Vol

94
Q

What to do if there’s a presence of blood during checking of GRV?

A

Gastric Lavage

95
Q

What to do If the gastric residual is >100 mL?

A

Check again after 1 hour or minus from the total prescribed feeding

96
Q

N.I Dumping Syndrome: AVOID the ff (4)

A

Eating large meals
Lying down after eating
Giving NGT too rapidly
Positioning NGT too high

97
Q

Characteristics of Constipation (5)

A
  • Reduced stool volume
  • Abnormal infrequency/inequality/irregularity of defecation
  • Incomplete passage of hard stool
  • Difficulty passing stool
  • Borborygmus (Hyperactive)
98
Q

Complications of Constipation (4)

A

Hemorrhoids
HTN
Megacolon
Bowel perforation

99
Q

Key factors N.I for Constipation (4)

A

Diet: High fiber
Lots of fluids
Exercise
Bowel habit

100
Q

Diarrhea can lead to — that may result to death

A

Hypokalemia (<3 mEqs)

101
Q

Inflammation of the stomach and small intestine

A

Gastroenteritis

102
Q

3 common causes of Gastroenteritis

A

Infection
Viral*
Lifestyle: Travel

103
Q

1st sign of Gastroenteritis

104
Q

Difference of AGE from Diarrhea

A

Presence of low grade fever

105
Q

Examples of Antidiarrheal agent for AGE

A

Loperamide

Imodium

106
Q

Chronic GI functional disorder (diarrhea/constipation) that alters intestinal motility, bowel pattern

NO abdominal alteration (inflamed, or damage) in the GI tract

A

Irritable Bowel Syndrome

107
Q

Common cause of IBS

A

psychological distress, depression, anxiety, stress, panic

108
Q

N.I for IBS (3)

A

Cognitive behavioral therapy/Stress management
Good dietary habit
Avoid food irritants

109
Q

Impaired/decreased absorption (carbohydrates, fats, protein, vitamin, minerals) that results to interruption in regulating normal digestion process

Digestive system (stomach, SI, liver, pancreas) inability to absorb nutrients

A

Malabsorption Syndrome

110
Q

Chief result of Malabsorption Syndrome

A

Malnutrition

111
Q

Characteristic of stool in malabsorption syndrome

A

Steatorrhea

112
Q

Systemic Effect of Malabsorption syndrome

A

Osteoporosis and anemia (vitamin mineral deficiency)

113
Q

autoimmune disease damages the small intestine mucosa: (duodenum, jejunum, ileum) gluten-sensitive enteropathy

A

Celiac Sprue

114
Q

chronic disorder disruption of jejunal and ileal tissues leading to malnutrition

A

Tropical Sprue

115
Q

Risk factors of Celiac Disease (2)

A 
Family history (genetic markers: HLA-DQ2,8)
Rheumatoid Arthritis
116
Q

To avoid triggering celiac disease

A

Gluten-free diet only

- only effective treatment

117
Q

Absent/deficient lactase enzymes (unable to breakdown lactose into glucose and galactose

A

Lactose Intolerance

118
Q

Most common complication of Lactose intolerance

A

Osteoporosis

119
Q

Inflammation, edema, and infection of the appendix

A

Appendicitis

120
Q

First symptom of Appendicitis

A

Nausea & vomiting

121
Q

Onset/Secondary symptom of Appendicitis

A

Perumbilical pain

122
Q

Best known symptom of Appendicitis

A

McBurney’s point (RLQ pain)

123
Q

3 signs to confirm appendictis

A

Rovsing sign
Psoas sign
Obturator sign

124
Q

pain elicited in the right lower quadrant with palpation pressure in the left lower quadrant

A

Rovsing sign

125
Q

(RLQ pain with extension of the right hip or with flexion of the right hip against resistance)

A

Psoas sign

126
Q

Pain on passive internal rotation of the flexed thigh for appendicitis

A

Obturator sign

127
Q

Sign of ruptured appendix

A

Bloomberg’s sign

Rigidity/ Board like palpation

128
Q

Complication of Appendicitis from delayed dx/tx

A

Peritonitis

129
Q

Surgical procedure for peritonitis that resulted from appedicitis

A

Ex Lap

- cause entire region is already affected

130
Q

Major N.I for appendicitis (3)

A 
Don't take analgesic
- masks pain symptoms
Don't give laxative/enema
- to prevent perforation of appendix
Prepare for surgery ASAP
131
Q

Standard surgical procedure for appendicitis

A

Appendectomy

132
Q

What to do to prevent complications of appendectomy (2)

A

incisional care

resume to activities 2-3 weeks after surgery

133
Q

What to do to prevent complications of appendectomy: ATELECTASIS

A

Semi-fowler and early ambulation

134
Q

3 Most appropriate test for appendicitis

A 
CBC
- high wbc and esr
CT scan
- preferred diag test
Xray
135
Q

Post op medication for appendectomy

A

Opioid Analgesic

136
Q

Life threatening condition that causes localized or generalized inflammation and infection of the normally sterile peritoneal cavity

A

Peritonitis

137
Q

Universal sign of Peritonitis

A

Abdominal tenderness

138
Q

2 Most common sign of peritonitis

A

Severe abdominal pain & board like muscular rigidity

139
Q

Most common complication of Peritonitis

A

Paralytic Ileus

140
Q

4 Diagnostic test for peritonitis

A

Peritoneal aspiration C&S
peritoneoscopy
CBC
Xray

141
Q

CBC for peritonitis reveals what

A

high wbc

low hgb, hct

142
Q

Abdominal Xray for peritonitis reveals what

A

air, fluid, distended loops

143
Q

Medical tx for peritonitis to decrease gastric distention and prevent leakage of bowel contents into peritoneum

A

NG suction / Intestinal intubation

144
Q

3 N.I for Peritonitis

A

Pain control
Airway Clearance
Fluid Balance

145
Q

Abnormal saclike herniation, outpouching, saccular dilation of bowel mucosal lining

Inflammation and infection of the diverticula due to defective muscle layer, weak intestinal wall, and lodging/retention of food, waste, bacteria

A

Diverticulitis

146
Q

Most common location of Diverticulitis

A

Sigmoid Colon

147
Q

non-inflammatory diverticula

A

Diverticulosis

148
Q

Most common site for diverticulosis

A

sigmoid colon

and descending colon

149
Q

2 predisposing factor of Diverticulitis

A

diet (low fiber/lack dietary fiber

husk food with seeds

150
Q

Location of pain in diverticulitis

A

LLQ

- location of sigmoid and descending colon

151
Q

3 Clinical manifestation of Diverticulitis

A

tenesmus
palpable mass
bloating/flatulence

152
Q

If left untreated, diverticulitis can lead to

A

septicemia

153
Q

most preferred diagnostic test/procedure of choice for diverticulitis

154
Q

CBC in diverticulitis revelas

A

high WBC, ESR

155
Q

4 Pharmacologic tx for Divertoculitis

A

Bulk forming laxative
Antibiotic
Analgesic
Antispasmodic

156
Q

Surgical procedure for Diverticulitis

A

Hartmann surgery

157
Q

Tumors adenocarcinoma of the colon and rectum

A

Colorectal cancer

158
Q

Risk factors of Colorectal CA (4)

A

Family hx
Lifestyle
Diet
GI disease

159
Q

First symptom of Colorectal CA

A

Weight loss

160
Q

Most common symptom of Colorectal CA

A

Change in bowel habit

- Chronic constipation

161
Q

Second symptom of colorecal CA

A

Bloody stool

162
Q

Most common site of metastasis in Colorectal CA

163
Q

gold standard, most preferred test for Colorectal CA

A

Colonoscopy

164
Q

reliable prognostic predictor for Colorectal CA

A

High CEA level

165
Q

Stoma Care for Colorectal Cancer (Normal)

A

pink, reddish, pink, moist, slight edema

166
Q

Stoma Care for Colorectal Cancer (Abnormal)

167
Q

primary and main treatment for colon cancer

A

Colectomy, Colostomy

168
Q

3 Adjuvant terapy for Colorectal CA

A

Chemotherapy
Radiation
biologic-5-fluorouracil

169
Q

Autoimmune disorder wherein antigen triggered inflammation. It includes Crohn’s and Ulcerative colitis

Chronic inflammation of GI tract disorder (diarrhea, pain)

A

Inflammatory Bowel Disease (IBD)

170
Q

DOC for IBD

A

Sulfasalazine 5 Aminosalicylate acid

171
Q

Indication of Sulfasalazine

A

to suppress inflammatory response mediators (like cytokines)

172
Q

Other Meds for IBD (2)

A

Corticosteroids (Prednisone)

Immunosuppressant (Methotrexate)

Medical-Surgical Nursing (3 decks)

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