Gastrointestinal & Urologic Emergencies Flashcards

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1
Q

Solid organs of the GI and urinary systems

A

Liver, spleen, pancreas, kidneys, and ovaries

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2
Q

Hollow organs of the GI and urinary systems

A

Gallbladder, stomach, small intestine, large intestine, and urinary bladder

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3
Q

Sugars start to be absorbed while in the ___

A

Mouth

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4
Q

Most digestion takes place in the ___

A

Stomach

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5
Q

The liver secretes ___ aiding in the digestion of ___

A
  1. Bile
  2. Fats
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6
Q

Hollow pouch located beneath the liver that acts as a reservoir for bile

A

Gallbladder

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7
Q

Sections of the small intestine

A
  1. Duodenum
  2. Jejunum
  3. Ileum
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8
Q

From the stomach, food travels to the ___

A

Small intestine

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9
Q

Where digestive juices from the pancreas and liver mix together

A

Duodenum

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10
Q

Secretes juice containing enzymes that help break down starches, fats, and proteins

A

Pancreas

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11
Q

Breaks down starches into sugar

A

Amylase (enzyme produced in the pancreas)

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12
Q

Produces bicarbonate, insulin, and glucagon

A

Pancreas

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13
Q

Neutralizes the stomach acid in the duodenum

A

Bicarbonate

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14
Q

Help regulate the levels of glucose in the bloodstream

A

Insulin and glucagon

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15
Q

Plays a major role in the absorption of digestive products (small intestine)

A

Jejunum

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16
Q

Absorbs the remaining nutrients. Absorbs bile acids and returns them to the liver for future use, and vitamin B12 for making nerve cells and red blood cells

A

Ileum

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17
Q

A wavelike contraction of smooth muscle in the large intestine

A

Peristalsis

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18
Q

The spleen in part of the ___

A

Lymphatic system

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19
Q

Function of the spleen

A

Significant role with red blood cells and the immune system. Assists in the the filtration of blood, removes old red blood cells, recycles iron, and serves as a blood reservoir. Also produces antibodies to fight off infection

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20
Q

Controls the discharge of certain waste materials filtered from the blood by the kidneys

A

Urinary system

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21
Q

Play an important role in the regulation of the acid-base balance and blood pressure

A

Kidneys

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22
Q

Kidney disease is a common cause of ___

A

Secondary hypertension

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23
Q

Nearly ___ of the output of the blood from the heart passes through the kidneys each minute

A

20%

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24
Q

Large vessels attach the kidneys directly to the ___

A

Aorta and inferior vena cava

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25
Q

The kidneys continuously concentrate this filtered urine by ___

A

Reabsorbing water as it passes through a system of specialized tubes within them

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26
Q

The tubes in the kidneys eventually unite to form the ___

A

Renal pelvis

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27
Q

Cone-shaped collecting area that connects the ureter and the kidney

A

Renal pelvis

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28
Q

Diameter of ureters

A

0.2”

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29
Q

___ occurs in the ureters to move urine to the bladder

A

Peristalsis

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30
Q

The urinary bladder is located ___

A

Immediately behind the pubic symphysis in the pelvic cavity

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31
Q

The ureters enter the bladder ___

A

Posteriorly at its base

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32
Q

Healthy adult amount of daily urine

A

1.5 to 2 liters

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33
Q

The bladder empties through the ___

A

Urethra

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34
Q

The abdominal cavity is lined with a membrane called the ___

A

Peritoneum

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35
Q

The parietal peritoneum lines the ___

A

Walls of the abdominal cavity

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36
Q

The visceral peritoneum covers the ___

A

Organs themselves

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37
Q

The abdominal space normally contains a small amount of ___ to bathe and lubricate organs in the abdominal cavity

A

Peritoneal fluid

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38
Q

Any foreign material can cause irritation of the peritoneum, called ___

A

Peritonitis

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39
Q

The sudden onset of abdominal pain

A

Acute abdomen

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40
Q

Peritonitis is usually associated with ___

A

The acute abdomen, vomiting, and nausea, loss of body fluids into the abdominal cavity

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41
Q

Peritonitis typically causes ___

A

Ileus

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42
Q

Paralysis of the muscular contractions that normally propel material through the intestine

A

Ileus

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43
Q

The retained gas and feces from ileum cause ___

A

Abdominal distention

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44
Q

The only way the stomach can empty itself with ileus

A

Emesis

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45
Q

Emesis

A

Vomiting

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46
Q

The fluid loss into the abdominal cavity during peritonitis can result in ___

A

Abnormal shifts of fluid from the bloodstream into body tissues, decreasing the volume of circulating blood and may lead to decreased BP or even shock. May present with tachycardia and hypotension

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47
Q

Inflammation in small pockets at weak areas in the muscle walls of the intestines

A

Diverticulitis

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48
Q

Inflammation of the gallbladder

A

Cholecystitis

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49
Q

Patients with diverticulitis or cholecystitis may have a ___

A

High fever

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50
Q

Patients with acute appendicitis may have a normal temperature until ___

A

The appendix ruptures and contaminates the peritoneal cavity

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51
Q

Abdominal pain can have different qualities because ___

A

Two different types of nerves supply the peritoneum

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52
Q

The parietal peritoneum and the skin of the abdomen can perceive ___

A

Much of the same sensations, and can easily ID and localize a point of irritation

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53
Q

The visceral peritoneum is supplied by the ___

A

Autonomic nervous system

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54
Q

The visceral peritoneum is stimulated when ___

A

Distention or contraction of the hollow abdominal organs activates the stretch receptors

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55
Q

Irritated visceral peritoneum pain perceived at a distant point on the surface of the body

A

Referred pain

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56
Q

The result of connections between the body’s two separate nervous systems

A

Referred pain

57
Q

Localization of pain for appendicitis

A

RLQ (direct); around naval (referred); rebound tenderness

58
Q

Localization of pain for cholecystitis

A

RUQ (direct); right shoulder (referred)

59
Q

Localization of pain for ulcer

A

Upper midabdomen or upper part of back

60
Q

Localization of pain for diverticulitis

A

LLQ

61
Q

Localization of pain for abdominal aortic aneurysm (ruptured or dissecting)

A

Low part of back and lower quadrants

62
Q

Localization of pain for cystitis (inflammation of the bladder)

A

Lower midabdomen (retropubic)

63
Q

Localization of pain for kidney infection

A

Costovertebral angle

64
Q

Localization of pain for kidney stone

A

Right or left flank, radiating to genitalia

65
Q

Localization of pain for pancreatitis

A

Upper abdomen (both quadrants); back

66
Q

Localization of pain for hernia

A

Anywhere in the abdominal area

67
Q

Localization of pain for peritonitis

A

Diffuse abdominal pain area

68
Q

Prevents damage to the stomach and duodenum due to acids

A

Protective layers of mucus

69
Q

The protective layer of mucus in the stomach and duodenum is eroded, allowing the acid to eat the organ itself

A

Peptic ulcer disease (PUD)

70
Q

Most peptic ulcers are the result of ___

A

Infection of the stomach with Helicobacter pylori bacteria or chronic use of NSAIDs

71
Q

Alcohol and smoking can affect the severity of PUD by ___

A

Increasing gastric acidity

72
Q

Hematemesis

A

Vomiting blood

73
Q

Melena

A

Black, tarry stools containing blood

74
Q

Gallstones that cannot pass cause ___

A

Cholecystitis

75
Q

Cholecystitis commonly produces symptoms about 30 minutes after ___

A

A particularly fatty meal and usually at night

76
Q

Symptoms of cholecystitis

A
  1. Constant severe pain in the right upper back, shoulder area, or flank
  2. Nausea and vomiting
  3. Indigestion
  4. Bloating
  5. Gas
  6. Belching
77
Q

People at a higher risk of developing cholecystitis

A
  1. Women
  2. Older adults
  3. Obese people
  4. People of Scandinavian, Native American, & Hispanic descent
78
Q

___ may present without the normal symptoms of cholecystitis other than localized tenderness

A

Older adults

79
Q

Pancreatitis may be caused by ___

A

An obstructing gallstone, alcohol abuse, and other diseases

80
Q

Pain from pancreatitis may get ___ after eating

A

Worse

81
Q

Symptoms of pancreatitis

A
  1. Severe pain in the LUQ & RUQ, may radiate to back
  2. Pain worse after eating
  3. Nausea and vomiting
  4. Abdominal distention
  5. Tenderness
  6. Fever or tachycardia if complications of sepsis or hemorrhage are present
82
Q

A small recess in the large intestine

A

Appendix

83
Q

Pain progression with appendicitis

A

Generalized, dull, and diffuse, may center in the umbilical area. Later localizes to the RLQ of the abdomen. May also caused referred pain. Rebound tenderness

84
Q

Other symptoms of appendicitis

A

Nausea and vomiting, anorexia, fever, and chills.

85
Q

Who may not have rebound tenderness with appendicitis?

A

Pregnant women

86
Q

Appendicitis pain ___ when the patient’s legs are straightened

A

Increases

87
Q

A Mallory-Weiss tear results from ___

A

Excessive vomiting or retching

88
Q

Hematemesis is frequently seen in patients with ___

A

Upper GI bleeding

89
Q

Melena from upper GI bleeding is dark red due to the ___

A

Partial digestion of the blood

90
Q

Bleeding in the lower GI tract shows up in stools as ___

A

Bright red or maroon colored

91
Q

What causes esophagitis?

A

The lining of the esophagus being inflamed by infection or from acids in the stomach

92
Q

GERD

A

Gastroesophageal reflux disease

93
Q

A condition in which the sphincter between the esophagus and the stomach opens, allowing stomach acid to move up into the esophagus

A

GERD

94
Q

GERD is also called ___

A

Acid reflux disease

95
Q

Occur when the pressure within the blood vessels surrounding the esophagus increases

A

Esophageal varices

96
Q

Esophageal varices is often the result of ___

A

Liver failure

97
Q

Esophageal blood vessels eventually drain their blood into the ___

A

Liver

98
Q

A tear in the junction between the esophagus and the stomach, causing severe bleeding and potentially death

A

Mallory-Weiss tear

99
Q

Comprises a family of conditions revolving around a central theme of infection combined with diarrhea, nausea, and vomiting

A

Gastroenteritis

100
Q

___ is the principal symptom in both infectious and noninfectious gastroenteritis

A

Diarrhea

101
Q

Bleeding from diverticulitis is usually ___

A

Bright red and painless

102
Q

The main symptom of diverticulitis

A

Abdominal pain

103
Q

Created by swelling and inflammation of the blood vessels surrounding the rectum

A

Hemorrhoids

104
Q

Hemorrhoids may result from ___

A

Conditions that increase pressure on the rectum or irritation of the rectum

105
Q

Cystitis is generally caused by a ___

A

Bacterial infection

106
Q

Cystitis is referred to as a ___

A

Urinary tract infection (UTI)

107
Q

Cystitis can become a serious health problem if the infection spreads to the ___

A

Kidneys

108
Q

The ___ play a major role in maintaining homeostasis

A

Kidneys

109
Q

The kidneys preserve homeostasis by ___

A

Eliminating waste from the blood

110
Q

Urea remains in the blood

A

Uremia

111
Q

Renal calculi

A

Kidney stones

112
Q

A sudden decrease in function of the kidney

A

Acute kidney injury (AKI)

113
Q

AKI

A

Acute kidney injury

114
Q

Irreversible failure of the kidney that develops over months and years

A

Chronic kidney disease (CKD)

115
Q

CKD

A

Chronic kidney disease

116
Q

CKD is often caused by ___

A

Diabetes or hypertension

117
Q

Always consider that a woman with lower quadrant pain and tenderness may have a problem with her ___

A

Ovaries, Fallopian tubes, or uterus

118
Q

AAA

A

Abdominal aortic aneurysm

119
Q

The aorta lies immediately behind the ___

A

Peritoneum

120
Q

If the AAA ruptures, the patient will present with ___

A

Signs of acute peritoneal irritation and hemorrhagic shock. May also report radiation of severe pain in addition to back pain

121
Q

AAA pain may be described as ___

A

Tearing

122
Q

A protrusion of an organ or tissue through a hole or opening into a body cavity where it does not belong

A

Hernia

123
Q

A hernia that disappears back into the body cavity in which it belongs

A

Reducible

124
Q

A hernia that cannot be pushed back into the body

A

Incarcerated

125
Q

Complete obstruction of blood circulation in a given organ as a result of compression or entrapment

A

Strangulation

126
Q

Strangulation can cause ___

A

Death of tissue

127
Q

Signs and symptoms of a serious hernia problem

A
  1. Reducible mass that is no longer reducible
  2. Pain at the hernia site
  3. Tenderness when the hernia is palpated
  4. Red or blue skin discoloration over the hernia
128
Q

What additional PPE should be considered for a GI issue?

A

Face shield, gown, and disposable shoe covers

129
Q

Bruising around the umbilicus or on the flanks may indicate ___

A

Internal abdominal bleeding

130
Q

During a GI emergency when asking about medication history, ask about ___

A

Alcohol, antibiotics, pain relievers

131
Q

Specific questions to ask during a GI emergency

A
  1. Nausea and vomiting
  2. Changes in bowel habits
  3. Urination
  4. Weight loss
  5. Belching or flatulence
  6. Pain
  7. Concurrent chest pain
  8. Other symptoms that may be related
132
Q

Involuntary muscle contractions of the abdominal wall; an effort to protect the inflamed abdomen

A

Guarding

133
Q

Steps to assess the abdomen

A
  1. Explain to the patient how you will assess the abdomen
  2. Place the patient in a supine position with the legs drawn up and flexed at the knee to relax the abdominal muscles, unless there is trauma. Determine whether the patient is restless or quiet, and whether motion causes pain
  3. Expose the abdomen and visually assess it
  4. Ask where the pain is most intense. Palpate in a clockwise direction beginning with the quadrant after the one that is tender or painful
  5. Palpate gently. If you see a pulsating mass, do not touch it
  6. Palpate to determine if each quadrant is tense or soft when palpated
  7. Note if pain is localized or diffuse
  8. Palpate and wait for the patient to respond, do not ask if it hurts
  9. Determine if there is rebound tenderness. This indicates peritonitis
  10. Determine whether the patient can relax the abdominal wall on command. Guarding or rigidity may indicate peritonitis
134
Q

High respiratory rate with a normal pulse rate and BP may indicate the patient is unable to ventilate properly because ___

A

Deep breathing causes pain

135
Q

A high respiratory rate and pulse rate with signs of shock, such as pallor and diaphoresis, may indicate ___

A

Septic or hypovolemic shock

136
Q

ESRD

A

End-stage renal disease

137
Q

ESRD is also called ___

A

Chronic renal failure

138
Q

ESRD is treated with ___

A

Peritoneal dialysis (PD) or hemodialysis

139
Q

First series of conditions in a patient who misses a dialysis treatment

A

Weakness and pulmonary edema