Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HURST > GI > Flashcards

GI Flashcards

1
Q

Pancreatitis Patho

A

auto-digestion of pancreas

Pancreas has two separate functions:

 - endocrine - insulin
 - exocrine - digestive enzymes

Two types of pancreatitis: acute and chronic

 - #1 cause is gallbladder dz
 - #2 cause is alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pancreatitis S/sx

A

pain that increases w food
abdominal distention / ascites (losing protein rich fluids like enzymes and blood into abdomen)
abdominal mass = swollen pancreas
rigid, board-like abdomen (with guarding) = bleeding that can lead to peritonitis
bruising around umbilical area = Cullen’s sign
bruising in the flank area = Grey-Turner’s sign
fever (inflammation)
N/V
jaundic
Hypotension from bleeding or ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pancreatitis diagnosis

A

serum lipase and amylase increased (digestive enzymes)
- lipase is specific to pancreas
increased WBCs
increased blood sugar
increased or normal ALT, AST (liver enzymes)
longer PT and aPTT
- liver not making clotting factors
increased serum bilirubin
decreased hemoglobin and hematocrit due to dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Amylase normal value

A

30-220 U/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Lipase normal value

A

0-160 U/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

AST normal value

A

0-35 U/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ALT normal value

A

10-36 U/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Normal Hemoglobin Value

A

Male: 14-18 g/dl

Female: 12-16 g/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Normal Hematocrit Value

A

Male: 42-52%

Female: 37-47%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pancreatitis Treatment

A

CONTROL PAIN

Decrease gastric secretions (NPO, NGT to suction, bed rest) (want stomach empty and dry)
Pain medication (PCA narcotics and fentanyl patches)
- morphine sulfate and hydromorphone
Anticholinergics to dry patient
- benztropine and diphenoxylate/atropine
GI Protectants
- pantoprazole
- famotidine and cimetadine - H2 receptor antagonists
- antacids
Maintain fluid and electrolyte balance and nutritional status (TPN or TNA)
Insulin (pancreas is sick and not producing)
Daily wts
Eliminate alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cirrhosis

A

don’t give Tylenol or narcotics

4 major functions of the liver

 - detoxify the body
 - helps your blood to clot
 - metabolizes drugs
 - synthesizes albumin

liver cells are destroyed and replaced with scar tissue. This alters the circulation and creates portal HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cirrhosis S/sx

A 
firm, nodular liver; jaundice
abdominal pain
chronic dyspepsia (GI upset)
change in bowel habits
ascites
splenomegaly
fatigue
peripheral edema (ascites)
anemia
can progress to hepatic encephalopathy / coma (due to build up of ammonia that acts like sedative)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cirrhosis Diagnosis

A

decreased serum albumin
increased ALT & AST
ultrasound
CT, MRI
Liver biopsy - confirms diagnosis
- make sure to do VS and clotting studies before
- position supine / flat w right arm up and behind head
- exhale and hold breath to get diaphram out of way
- post procedure = lie on right side for pressure to prevent bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cirrhosis Treatment

A 
antacids, vitamins, diuretics
no alcohol
I&O / daily wt
rest (toxins = tired)
prevent bleeding (No IM or aspirin)
measure abdominal girth (ascites)
Paracentesis (to help w breathing if ascites occurs)
    - void before so we don't poke bladder
    - position upright to keep fluid in front (where we're poking)
    - VS (BP goes down and HR goes up)
Monitor for jaundice
Avoid narcotics (liver can't metabolize)
Diet (decrease protein / low sodium)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Protein breaks down to ______ . The _______ converts it to ______ which is then excreted by the ______.

A

Protein breaks down to AMMONIA. The LIVER convers it to UREA which is then excreted by the KIDNEYS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hepatic Coma Patho

A

Protein breaks down into ammonia and the liver converts it to urea which is excreted through the kidneys.

When the liver stops working, ammonia builds up which leads to sedation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hepatic Coma S/sx

A 
minor mental changes / motor problems
difficult to arouse
asterixis (flapping, trembling hands)
handwriting changes
reflexes will decrease
EEG is slow
Fetor = breath smells like acetone / ammonia
LIver people = GI bleed likely
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment for Hepatic Coma

A

lactulose (decreases serum ammonia)
enemas (to get blood out of GI tract)
decrease protein in the diet
monitor serum ammonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Bleeding Esophageal Varices Patho

A

high BP in liver (portal HTN) forces collateral circulation to form
- it forms in stomach, esophagus, and rectum

alcoholic client that is GI bleeding = esophageal varices usually

no problem until hemorrhage / rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Bleeding Esophageal Varices Treatment

A

replace blood
monitor VS
monitor CVP
oxygen (they’ll be anemic / bleeding so give O2)
**octreotide lowers BP in liver and causes vasoconstriction
endoscopic sclerotherapy
esophageal variceal ligation
Balloon tamponade
enemas to get rid of blood
salvine lavage to get blood out of stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

octreotide

A

lowers BP in liver and causes vasoconstriction

given for Bleeding Esophageal Varices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Sengstaken-Blakemore Tube

A

balloon tamponade tube

emergency procedure to stabilize clients w severe hemorrhage

should not be used more than 12 hrs

may need restraints to prevent them pulling out tube bc that’ll block their airway
- if this happens, cut at port to deflate everything and then remove (scissors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Peptic Ulcer Patho

A

common cause of GI bleeding
can be in esophagus, stomach, or duodenum
erosion is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Peptic Ulcers S/sx

A 
burning pain (mid-epigastric area back)
heartburn (dyspepsia)
25
Peptic Ulcer Diagnosis
Gastroscopy (EGD) | Upper GI - looks at esophagus and stomach with dye
26
Gastroscopy (EGD)
NPO pre-procedure sedated NPO until gag reflex returns watch for perforation by watching for perforaction , bleeding, or trouble swallowing
27
Upper GI procedure
looks at esophagus and stomach with dye NPO past midnight no smoking, chewing gum, mints, remove nicotine patches smoking increases stomach motility and secretions which increases chance for aspiration
28
Peptic Ulcer Treatment
antacids (liquid to coat stomach) proton pump inhibitors H2 antagonists (famotidine) GI Cocktail (donnatal, viscous lidocaine, Mylanta II) Antibiotics for H. pylori (clarithromycin, amoxicillin, tetracycline, metronidazole) Sucralfate - forms barrier over wound so acid can't get on ulcer
29
Client Teaching for Peptic Ulcers
``` decrease stress stop smoking eat what you can tolerate avoid temp extremes and spicy foods avoid caffiene need follow-up ```
30
Gastric Ulcers
appear malnourished pain is usually half hour to hour after meals food doesn't help, but vomiting does vomit blood
31
Duodenal ulcers
appear well-nourished night pain is common and occurs 2-3 hours after meals food helps blood in stools
32
Hiatal Hernia Patho and Causes
hole in diaphragm is too large so stomach mvoes up into thoracic cavity common cause is large abdomen (lose weight) other causes are congential abnormalizties, trauma, and straining
33
Hiatal Hernia S/sx
heartburn fullness after eating (get full really quickly) regurgitation dysphagia
34
Hiatal Hernia Treatment
``` small frequent meals sit up 1 hour after eating elevate HOB surgery teach life style changes and healthy diet ```
35
Dumping Syndrome Patho
stomach empties too quickly after eating usually secondary to gastric bypass, gastrectomy, or gallbladder dz
36
Dumping Syndrome S/sx
``` fullness weakness palpitations cramping faintness diarrhea ```
37
lay on ____ side to keep food in stomach
left side = leaves it in | right side = releases it
38
Dumping Syndrome Treatment
semi-recumbent w meals (reclined) lie down after meals on left side no fluids iwth meals (drink between meals) meals should be small and frequent rather than large avoid foods high in carbs and electrolytes (they empty fast)
39
2 Types of Inflammatory Bowel Dz (IBD)
Ulcerative Colitis Crohn's Disease
40
Ulcerative Colitis
just in large intestine
41
Crohn's Disease
also called Regional Enteritis inflammation and erosion of the ileum (small instestine) but can be found anywhere
42
Inflammatory Bowel Dz S/sx (both UC and Crohns)
``` diarrhea rectal bleeding vomiting wt loss cramping dehydration blood in stools anemia rebound tenderness (indicates peritoneal inflammation) fever ```
43
Inflammatory Bowel Dz Diagnosis | both UC and Crohns
CT scan or MRI Colonoscopy (most common) Barium Enema (done if colonoscopy is incomplete)
44
Colonoscopy
clear liquid diet for 12-24 hrs pre-procedure NPO 6-8 hrs pre-procedure avoid NSAIDs (to prevent bleeding) laxatives or enemas until clear Polyethylene glycol (explosive diarrhea) to help client drink colon prep more easily, get it icy cold - don't drink w straw / drink slowly / once glass every 10 min / give w anti-emetic sedated for procedure Post-Colonscopy - watch for perforation (assume worst) / pain or unusual discomfort are s/sx
45
Inflammatory Bowel Dz Treatment | both UC and Crohns
Diet - low residue to limit GI motility to help save fluid - avoid cold foods and smoking (these increase motility) Medications - antibiotics - steroids (decrease inflammation) - biologics and immunomodulators - aminosalicylates (decrease inflammation) Surgery
46
Ulcerative Colitis Surgery
``` Total Colectomy (proctocolectomy) - an ileostomy is formed Kock's ileostomy - vlave that you can open to drain intestines Ileal Pouch Anal Anastomosis (IPAA) - removes colon and attaches ileum to rectum (most pop) ```
47
Crohn's Dz and Surgery
try not to do only remove affected area client may end up w ileostomy or colostomy
48
Ileostomy care
- losing electrolytes and dehydrated - drain liquid all the time - don't have to irrigate ileostomies - avoid foods hard to digest and rough foods that increase motility - gatorade or electrolyte drink in summer - at risk for kidney stones
49
Colostomy Care
ascending and transverse colostomies = semi-liqiud stools descending or sigmoid colostomies = semi-formed or formed * irrigate the descending & sigmoid due to regularity * irrigate same time every day after a meal to promote routine - bathroom training if client starts to cramp, stop fluid, lower bag and check temp of fluid
50
If a client is getting frequent feedings, what side do they need to be on?
right side to promote stomach emptying
51
Appendicitis S/sx
generalized pain initially --> then localizes in RLQ (McBurney's Point) rebound tenderness N/V anorexia
52
Appendicitis Diagnosis
WBC increases Ultrasound to view enlarged appendiz CT - confirms diagnosis Do not give enemas or laxatives bc fear of rupture
53
If appendix has already ruptured, place them on _____ side to trap fluid.
RIGHT
54
Appendicitis Treatment
surgery ONLY - most done via laparoscop unless perforated - after abdominal surgery, place in Semi-Fowlers
55
TPN / PN / TNA
- keep refrigerated and warm for administration (sit out for a few) - cenral line and filter needed - nothing else goes through this line - discontinue graddually to avoid hypoglycemia - may have to start taking insulin / glucose monitoring q6hrs - check urine for glucose and ketones - don't mix ahead (changes daily) - daily wt - can only be hung for 24 hrs - change tubing with each new bag - IV bag may need to be covered - needs to be on a pump - w home TNA, emphasize hand-washing - most frequent complication = infection
56
Protein won't be in urine unless....
there is glomerular damage
57
How to assist with inserting a Central Line
have saline flush available for flush (3/10 of a L syringe) don't start fluids until confirmtaion via CXR - CXR checks for placement and for pneumothorax Trendelenburg to distend veins Left side trendelenburg traps air in heart
58
How to keep air out of Central line when changing the tubing
clamp it off valsalva (deep breath and hum)

HURST (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions