Gastrointestinal System Flashcards
A fowler or semi fowler position is beneficial in reducing
the amount of regurgitation as well as in preventing the encroachment of the stomach tissue upward through the opening in the diaphragm.
Antiulcer drug abbreviation and action
anatacids
histamine 2 antagonists
proton pump inhibitors
Antacids- “oxide”- neutralize stomach acid content
Histamine 2 Antagonists- “tidine”- Prophylactic treatment for clients at risk for developing ulcers
Proton Pump Inhibitors-“prazole” - Treatment of erosive esophagitis associated with GERD
What does stress do to ulcers?
Exacerbates them
What are the clinical manifestations of a GI Bleed?
- Pallor: conjunctival, mucous membranes, nail beds
- Dark tarry stools
- Bright red or coffee-ground emesis
- Abdominal mass or bruit
- Decreased BP, rapid pulse, cool extremities, increased respirations
How much fluid loss does the GI tract account for?
100-200 mL/ Day
Opioids tend to decrease gastric
motility
Differentiate between diverticulosis and diverticulitis
Diverticulosis is the presence of pouches in the wall of the intestine. There is usu no discomfort, and the problem goes unnoticed.
Diverticulitis is an inflammation of the diverticula which can lead to perforation of the bowel
What are the nutritional needs for a patient having diverticulitis?
Acute
Recovery
Maintenance
Acute: NPO, graduating to liquids
Recovery: No fiber or foods that irritate the bowel
Maintenance: High-fiber diet with bulk forming laxative to prevent pooling of foods in the pouches. Avoid small poorly digested foods
What is a mechanical bowel obstruction?
Due to disorder outside the bowel (hernia, adhesions) caused by disorders within the bowel (tumor,diverticulitis) or by blockage of the lumen in the intestine.
What is a nonmechanical bowel obstruction?
Due to a paralytic ileus, which does not involve any actual physical obstruction but results from inability of the bowel itself to function.
What are the nursing priorities for an abdominal mass?
- NPO
- NG tube
- IV fluids
- Surgical preparations of bowel
- Food and Fluids are restricted for 8 - 10 hours before surgery
- if the patient has bowel obstruction or perforation bowel cleansing is contraindicated
- Oral erythromycin and neomycin are given to further decrease the amount of colonic and rectal bacteria
- If possible, all clients who require surgery for obstruction undergo NG intubation and suction before surgery
- Teaching
Diet to prevent bowel cancer
- Eat cruciferous vegetables; cabbage family
- Increase fiber intake
- Maintain average body weight
- Eat less animal fat
What are the recommendations for early detection of colon cancer?
- Digital rectal examination every year after 40
- A stool blood test every year after 50
- A colonoscopy or sigmoidoscopy examination every 10 years after the age of 50 in average-risk clients, or more often based on the advice of physician
What is an early sign of colon cancer?
Rectal bleeding
What are the clinical manifestations of jaundice?
- Yellow skin, sclera, or mucous membranes
- Dark clay colored urine
- chalky or clay colored stools
What is fetor hepaticus?
Distinctive breath odor of chronic liver disease. It is characterized by a fruity or musty odor that results from the damaged liver’s inability to metabolize and detoxify mercaptan, which is produced by the bacteria degradation of methionine, a sulfurous amino acid.
Paracentesis and peritoneovenous shunts are indicated for
ascities
Esophageal varices may rupture and cause
hemorrhage
What is the immediate medical management of esophageal varices?
insertion of an esophagogastric balloon tamponade. Other therapies include vasopressors, vitamin K, coagulation factors, and blood transfusions
What is the action of lactulose?
Used to decrease ammonia levels and bowel ph.
Tell me about hepatitis A Source Vaccine Potential for liver disease Immunity
Source: Contaminated food or water
Vaccine: Yes
Potential for liver disease: No
Immunity: Yes
Tell me about hepatitis B Source Vaccine Potential for liver disease Immunity
Source: Contaminated blood products
Vaccine; yes
Potential for liver disease: yes
Immunity : Yes
Tell me about hepatitis C Source Vaccine Potential for liver disease Immunity
Source: Contaminated blood products
Vaccine; No
Potential for liver disease: yes
Immunity: no
Where is acute pancreatic pain located?
retroperitoneally
How do reduce acute pancreatic pain?
Sitting up or leaning forward
What are the non surgical management methods for a client with cholecystitis
- Low fat diet
- Medication for pain and clotting
- Decompression of the stomach via NG tube
List four nursing interventions for the client with a hiatal hernia?
- Sit up while eating and for 1 hour after eating
- Eat frequent small meals
- Eliminate problematic foods
List 3 categories of medication used in the treatment of PUD
- Antacids
- H2 Receptor blockers
- Mucosal healing agents
- Proton Pump Inhibitors
LIst the symptoms of upper and lower GI bleeds
Upper: Melena, hematemesis, and tarry stools
Lower: bloody and tarry stools
What bowel sounds disruptions occur with and intestinal obstruction?
Early: High Pitched
Late: Diminished/ Absent
List 4 nursing interventions for postoperative care of a client with a colostomy?
- Irrigate daily and at the same time
- Use warm water for irrigations
- Wash around stoma with mild soap and water after each ostomy bag change
- Ensure pouch opening extends at least 1/8 of an inch around stoma
List the common clinical manifestations of Jaundice?
- Sclera icterus
- Dark urine
- Chalky clay colored stools
What are the common food intolerances for clients with cholelithiasis “gallstones”
Fried, spicy, and fatty foods
List 5 symptoms indicative of colon cancer
- rectal bleeding
- Change in bowel habits
- Sense of incomplete evacuation
- Abdominal pain and nausea
- weight loss
In a client with cirrhosis, it is imperative to prevent further bleeding and observe for bleeding tendencies. List 6 relevant nursing interventions
- Avoid injections
- Use small bore needles for IV insertion
- Maintain pressure for 5 minutes on all venipuncture sites
- Use an electric razor
- Use a soft bristle tooth brush
- Check stool for blood
What is the main side effect of lactulose, Which is used to reduce ammonia levels in clients with cirrhosis
Diarrhea
List 4 groups who have a high risk for contracting hepatitis
- Homosexual males
- IV drug users
- Recent peircings/ tattoos
- Health care workers
How should the nurse administer pancreatic enzymes
- Give with meal or snack
- Power forms should be mixed with fruit juice
