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TERM 4 N2261 KNLG 3 > GI 1 - STOMACH & INTESTINES > Flashcards

GI 1 - STOMACH & INTESTINES Flashcards

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1
Q

In the small intestine, chyme mixes with what 3 substances?

A

Intestinal secretions, bile, pancreatic enzymes

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2
Q

What factors are produced by the microorganisms of the large intestine?

A

Vitamin K and B

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3
Q

Serum electrolytes are especially important to monitor in patients with which statuses?

A
  1. NG for decompression
  2. Poor intake
  3. Altered absorption
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4
Q

What 7 tests make up the LFTs?

A

Liver enzymes:
ALT, ALP, AST, GGT

Bilirubin

Albumin

Total protein

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5
Q

Which diagnostic test would be used to assess fluid collections or blood flow to various areas?

A

CT scan

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6
Q

What are 4 ways to take a culture for H.pylori?

A

Breath, urine, serum, biopsy

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7
Q

What is the etiology of appendicitis?

A

Occlusion of appendiceal lumen by a fecalith, causing tissue irritation, bacterial invasion

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8
Q

Where is pain usually located in appendicitis?

A

Periumbilical, leading to RLQ

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9
Q

How is management of perforated appendicitis different than regular appendicitis?

A

6-8 hrs conservative management (fluids and antibiotics) before appendectomy

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10
Q

What surgical intervention may be performed in patients with ulcerative colitis?

A

Total proctocolectomy with permanent ileostomy or ileoanal reservoir

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11
Q

What are differences between ulcerative colitis and crohn’s disease?

A

UC: bloody diarrhea, colonic dilation, risk for cancer

Crohn’s: autoimmune, colonic stricture, fistula formation

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12
Q

What is the most common cause for small bowel occlusion?

A

Adhesions (scar tissue)

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13
Q

What are 3 most common causes for large bowel occlusion?

A
  1. Carcinoma
  2. Volvulus (twisting)
  3. Diverticular disease
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14
Q

What are 2 examples of underlying causes for non-mechanical bowel obstruction?

A

Neuromuscular or vascular disorder

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15
Q

After total gastrectomy, what reconstructive surgery is performed?

A

Roux-en-Y esophagojejunostomy
(as well as jejunojejunostomy)

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16
Q

After subtotal gastrectomy, what reconstructive surgery is performed?

A

Roux-en-Y gastrojejunostomy
(as well as jejunojejunostomy)

17
Q

When advancing the diet of patients post gastrectomy, what 3 complications should be monitored for?

A
  1. Dumping syndrome
  2. Postprandial hypoglycemia
  3. Anastomotic leak
18
Q

What are the two terms for ostomies that specify whether the ostomy is permanent or temporary?

A

End or loop

19
Q

When is temporary ostomy indicated, and how long are they usually present for?

A

Bowel rest and healing; 6 months

20
Q

About how long can an ostomy flange be worn?

A

5-7 days

21
Q

What is the only thing that should be used to wash the stoma?

A

Water

22
Q

What is the term for surgical removal of the distal sigmoid, rectum, and anus via a perineal incision?

A

Abdominoperineal resection (APR)

23
Q

During GI assessment, why is asking about appetite relevant?

A

It can indicate perfusion to GI tract

24
Q

After insertion of an NG tube and confirming placement, what else needs to be done before you can use it?

A

Need to get a doctor’s order

25
Q

What position should the patient with an NG tube be placed in?

A

HOB elevated

26
Q

What kind of output from a JP drain may indicate complications?

A
  1. More sanguineous
  2. Purulent
  3. Food
  4. Increased output with diet progression
27
Q

What 5 pieces of information are essential to know about a patient’s tubes/lines/drains?

A
  1. Indication
  2. Securement method
  3. Tubing is connected/patent
  4. Drainage method (gravity, compression, suction)
  5. Output (volume, character)
28
Q

Which NG tubes are nurses not permitted to move?

A

Those that are close to an anastomosis

29
Q

What are two clinical concerns in a case of acute blood loss?

A

Hypovolemic shock
Decreased oxygen carrying capacity

30
Q

What are 3 possible causes for perioperative UGIB?

A
  1. Mallory-weiss tear
  2. Ulcer
  3. Surgical site bleed
31
Q

What Hgb value is concerning for anemia?

A

generally <80, or a post op decrease of 20 points depending on the patient

32
Q

Why is serum lactate monitored to assess for acute blood loss?

A

To understand degree of anaerobic metabolism in tissues due to hypoxia (often seen in shock)

33
Q

What are the 2 priorities in patients with acute blood loss?

A
  1. Replace blood volume
  2. Find the source and fix it

(Request help as needed)

34
Q

What are 3 symptoms of bowel perforation?

A
  1. Sudden dramatic abdominal pain
  2. General severe abdo pain
  3. Rigid abdomen
35
Q

Why would the nurse take the initiative to insert 2 large gauge peripheral IVs to manage GI bleed?

A

Allows for rapid fluid/blood product administration

36
Q

What diet restriction

A

TERM 4 N2261 KNLG 3 (9 decks)

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