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Module 3 (MedSurg 1) > GI > Flashcards

GI Flashcards

1
Q

Antibiotics: Metronidazole
Side effects

A

nausea and HA

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2
Q

Antibiotics: Metronidazole
Nurse Administration/Teachings

A

Avoid alcohol. (make violently ill)
Should not be taken during pregnancy
Teach must take all meds!

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3
Q

Antibiotics: Metronidazole most effective against

A

Most effective against H. pylori
– more than one antibiotic should be used.
Teach must take all meds!

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4
Q

Histamine Receptor Antagonist (H2 blocker) all end in

A

-ine

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5
Q

Ranitidine does what

A

suppress the secretion of gastric acid
- serious side effects are uncommon

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6
Q

PPI stands for

A

Proton pump inhibitors

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7
Q

PPI medication

A

pantoprazole

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8
Q

Pantoprazole does what

A

suppress secretion if gastric acid (most effective)

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9
Q

Which drug is most effective at suppressing gastric acid

A

Pantoprazole

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10
Q

Pantoprazole side effects

A

Diarrhea headaches

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11
Q

Pantoprazole ADR

A

Pt needs to take the lowest dose for the shortest time possible

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12
Q

Pantoprazole Nursing Administration

A

tablets cannot be crushed

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13
Q

Antiulcer drug

A

sucralfate

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14
Q

Sucralfate does what

A

Creates a protective barrier against acid

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15
Q

Sucralfate Nursing Admin.

A

Administer one hour before meals and bedtime

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16
Q

Antacid

A

Aluminum hydroxide

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17
Q

Aluminum hydroxide does what

A

Neutralize stomach acid

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18
Q

Ondansetron side effects

A

Headache and diarrhea

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19
Q

Aluminum hydroxide ADR

A

constipation

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20
Q

Aluminum hydroxide Nursing Admin.

A

Take with glass of water

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21
Q

Ondansetron Should not be given to pt with

A

long QT syndrome

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22
Q

Antiemetic drugs

A

Ondansetron, promethazine, dimenhydrinate

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23
Q

Ondansetron does what

A

prevent N/V

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24
Q

promethazine does what

A

decrease vomiting

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25
Q

promethazine side effects

A

Respiratory depression
Local tissue damage injection site grimacing, sticking out the tongue or smacking the lips

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26
Q

promethazine ADR

A

Respiratory depression
Local tissue damage injection site

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27
Q

dimenhydrinate does what

A

motion sickness

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28
Q

dimenhydrinate side effects

A

sedation
dry mouth
constipation

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29
Q

Bulk laxative

A

works over a few days

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30
Q

Bulk-forming laxative

A

psyllium and docusate sodium

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31
Q

psyllium does what

A

Acts fiber in the bowel increases bulk of fecal volume – therefore stimulates peristalsis

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32
Q

psyllium nursing admin.

A

work 1-3 days
full glass of water

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33
Q

prokinetic drug

A

metoclopramide by
- Increase upper GI motility and suppresses emesis

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34
Q

Docusate sodium does what

A

stool softener

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35
Q

Stimulant laxative works

A

almost immediately for surgery clean out

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36
Q

stimulant laxative (surgery)

A

bisacodyl

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37
Q

Bisacodyl does what

A

Increases the number of water/electrolytes within the intestinal lumen.

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38
Q

Antidiarrheal

A
  1. Diphenoxylate (Lomotil)
  2. Loperamide (Imodium)
    - by decreasing intestinal motility
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39
Q

Bisacodyl Nursing Admin.

A

Acts within 6-12 hours after taking.
Need to teach pt about key factors to establishing good bowel habits and reducing laxative abuse

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40
Q

Fluid and Electrolyte

A

Intake and Absorption = Output

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41
Q

Fluid and Electrolyte Causes

A

exercise
diarrhea
vomiting
burns
major trauma

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42
Q

Fluid and Electrolyte Ques

A

dehydration
- electrolytes low (sodium and potassium)
skin turgor
heart rate
dry

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43
Q

Fluid and Electrolyte Labs

A

potassium
sodium

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44
Q

Dehydration =

A

Hyponatremia
Hypokalemia

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45
Q

priority of nursing care in Fluid and Electrolyte

A

Rehydration
and confirm the rehydration with labs

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46
Q

Excess Nutrition causes

A

CAD
Increase BP
stroke
fatty liver disease
sleep apnea
asthma
musculoskeletal disorder
some Ca

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47
Q

Deficit Nutrition causes

A

elderly
loss of appetite
environmental factors

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48
Q

Nutrition deficit Ques

A

no teeth
denture pain

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49
Q

Nutrition Nursing Interventions

A

PEG better placement
- GI continues to work
NG Tube feedings
TPN through Central Line = by passes GI system

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50
Q

Causes of elimination

A

meds (steroids cause constipation)
inflammatory conditions
infection condition
obstruction

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51
Q

What systems can be surgically done to help elimination problems?

A

colostomy
ileostomy

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52
Q

Causes of inflammation in GI

A

gastroenteritis
cirrhosis
diverticulitis
crohn’s disease
ulcerative colitis

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53
Q

Different types of Infections include

A

Hep A, B, C
C. diff
H. pylori

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54
Q

GERD

A

Gastroesophageal Reflux Disease

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55
Q

GERD S/S

A

VOMITING
BURNING IN NOSTRILS WHEN LYING DOWN
TASTE ACID

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56
Q

GERD Causes

A

pregnancy and obesity

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57
Q

GERD Nursing/Teaching

A

Dietary – get rid of acidity (coffee, black tea, alcohol, citrus, tomatoes, spice, chocolate, fatty foods)
-Bland DIET
SLEEP WITH HOB ELEVATED
WEIGHT LOSS

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58
Q

GERD Meds

A

H2 Blocker
Antacid
Prokinetic

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59
Q

Dysphagia

A

difficulty swallowing

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60
Q

Dysphagia causes

A

Parkinson’s, alzheimer’s, dementia, burns, inflammation, stroke

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61
Q

Dysphagia s/s

A

drooling, coughing while eating, gurgling, wt loss

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62
Q

Dysphagia nursing/teaching

A

Thickener diet
HOB 30 degrees at least 1 hour
help eat food

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63
Q

Dysphagia s/s could lead to if severe

A

aspiration pneumonia

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64
Q

What is a hiatal hernia?

A
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65
Q

Achalasia s/s

A

halitosis
belch
feeling of food stuck

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66
Q

Achalasia pathophysiology

A

Peristalsis of the lower 2/3 of the esophagus is absent. The exact causes is unknown. What is known is a lost in inhibitory neurons to the esophagus

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67
Q

Achalasia Teaching

A

sit up

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68
Q

Achalasia meds

A

Botox injection lasting 6 months
endoscopic dilation of the area
calcium channel blockers

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69
Q

Achalasia dx

A

Barium swallow

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70
Q

constipation s/s

A

stool hard and dry

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71
Q

constipation causes

A

meds
sedentary lifestyle
low fiber diet
dehydration

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72
Q

constipation dx test

A

x-ray
barium enema

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73
Q

Constipation Teachings

A

balanced diet
exercise
water with meds

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74
Q

Meds for Constipation

A

bulk-forming laxatives stool softeners (docusate sodium and psyllium)

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75
Q

IBS stands for

A

irritable bowel syndrome

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76
Q

Irritable bowel syndrome can have what type of stool

A

diarrhea or constipation

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77
Q

C.diff is a

A

bacterium that can cause diarrhea to life threatening inflammation of the colon

78
Q

Causes of C.diff

A

found in environment (soil, air, water, feces, processed meat)
- commonly associated with health care
- passed in feces ar=nd spread to food, surfaces, objects when hand hygiene is poor

79
Q

Tx for C.diff

A

antibiotic therapy
fecal transplant

80
Q

Dx of C. diff. through

A

stool specimens

81
Q

Symptomatic patients of C. diff need to be placed under what isolation

A

special contact
gown and gloves
Wash with soap and water

82
Q

C.diff S/S

A

Fever
Blood or pus in the stool
Nausea
Dehydration
Loss of appetite
Weight loss
Swollen abdomen
Kidney failure
Increased WBC
dehydration

83
Q

Diarrhea S/S

A

3+ loose stools a day
fever
N/V
muscle weakness

84
Q

If a person has diarrhea, the nurse needs to get a good

A

health hx
**traveled outside of the country
**family members sick
**how was food made
**antibiotics

85
Q

Lab work for diarrhea

A

stool culture
blood work

86
Q

Causes of diarrhea

A

viruses
bacteria (c. diff)
e. coli

87
Q

Diarrhea could lead to

A

hypovolemia, dysrhythmias due to loss of electrolytes
send them to telemetry

88
Q

Diarrhea Interventions

A

sodium and potassium supplements
fluids
call light
skin breakdown
pericare
clean linens and pads
BLAND Diet

89
Q

Meds for Diarrhea

A

antibiotics
(Bisacodyl) - antidiarrheal
IV fluids

90
Q

If a patient has IBS they should use a

A

food diary
I&Os

91
Q

EGD stands for

A

Esophagogastroduodenoscopy

92
Q

EGD uses

A

propofol
or conscious sedation (versed and opioid)
https://www.youtube.com/watch?v=vItktDQo-mE

93
Q

Colonoscopy

A

NPO past midnight
BLAND diet
stimulant laxative for prep
at 45
Hx then screening occurs when the other was dx if runs in family
https://www.youtube.com/watch?v=VBraB8Oe9Fk

94
Q

Diverticular Disease

A

95% sigmoid colon
Saclike herniation of the lining of the bowel through a defect in the muscle layer.
Can happen anywhere in the bowel
Processed food

95
Q

Diverticulum

A

saclike herniation of the lining of the bowel

96
Q

Diverticulosis

A

multiple diverticula present NO inflammation/symptoms

97
Q

Diverticulitis

A

infection/inflammation of the diverticulum

98
Q

When do you use an NG Tube

A

when the pt needs to rest their stomach
no feedings only suction

99
Q

Acute diverticulitis

A

: let the colon rest and decrease inflammation. Can be managed at home: clear liquid, bed rest, and analgesic.

100
Q

Risk factors of Acute Diverticulitis

A

constipation
lack of fiber
obesity
smoking
inactivity

101
Q

Meds for diverticulitis

A

antibiotics
PPI
Opioid pain
fluids NPO
don’t need feedings

102
Q

S.S of diverticulitis

A

HIGH WBCs
vomiting
abd pain
fever
and chills
belly feels hard like washboard

103
Q

Labs Dx for diverticulitis

A

colonoscopy
CT scan with contrast

104
Q

Complications of diverticulitis

A

Peritonitis – inflammation of the peritoneum
Abscess
Perforation – will require a procedure that involves resection of the involved colon with primary anastomosis

105
Q

Diverticulitis

A

hang antibiotics
NPO
NG TUBE
Surgery later to have affected intestine removed
possible colostomy temporary for 6 months to heal

106
Q

Acute Pancreatitis Causes/Risk Factors

A

gallbladder disease (stone blockage)
chronic alcohol use

107
Q

Pancreatitis in digestion

A

pancreases secrete high concentrations of bicarbonate which neutralizes the acid in the chyme
- secretes HCO3

108
Q

Pancreas is made up of what parts

A

head
body
tail

109
Q

Meds for Acute Pancreatitis

A

pain meds
PPI
Antispasmodics

110
Q

Chronic Pancreatitis most common cause

A

alcohol abuse

111
Q

Acute Pancreatitis

A

enzymes from gallstone blockage build up

112
Q

Acute Pancreatitis S/S

A

sudden onset, pain, fever, n/v, jaundice, hypotension

113
Q

Acute Pancreatitis Lab

A

serum amylases and lipase high
WBC
Urinary amylase

114
Q

Acute Pancreatitis

A

NPO
NG Tube
Ivs with fluid
pain management

115
Q

Acute Pancreatitis mortality

A

life-threatening.

116
Q

Acute Pancreatitis Discharge Teachings

A

pt needs to understand the reason for Pancreatitis.
Understand the need to rest to recover
if alcohol is involved – find support

117
Q

Peptic Ulcer Disease Risk Factors

A

H. pylori
long term use of NSAIDs
physical stress (physical stress alone can not cause ulcers, but impaired body due to server illness/trauma be prone to develop ulcers)

118
Q

Can physical stress alone cause peptic ulcer disease?

A

no, with impaired body due to illness

119
Q

Peptic Ulcer Disease S/S

A

Burning sensation between meal/ night, pain stop if you eat or take antacids, the pain comes and goes, bloating

120
Q

Peptic Ulcer Disease Labs

A

urea breathing test - noninvasive dx
Biopsy from stomach lining by means of EGD (endoscopy)
CBC
stool (for blood) to determine H.pylori

121
Q

Meds for peptic ulcer disease

A

Antibiotics for h. pylori
PPI (pantoprazole) - prevent ulcers
- lowest dose for a short time, possible for C.diff
Sucralfate (coats lining)
- 1 hour before meals and bedtime
H2 Blocker (Ranitidine)
Antacid (Aluminum hydroxide)

122
Q

What is better to take than antacid for peptic ulcer disease?

A

Ranitidine

123
Q

Complications of peptic ulcer disease

A

Hemorrhage
Perforation
Gastric Outlet Obstruction

124
Q

Hemorrhage from peptic ulcer disease

A

low BP
increase hr
small over time and rapid vomiting and diarrhea
establish airway by sitting up
Blood test for (H&H)

125
Q

Perforation

A

needle into balloon causes
leak gastric juice
leads to sepsis

126
Q

Gastric Outlet Obstruction

A

inflammation at the small bowel sphincter causing nothing to empty

127
Q

Peptic Ulcer Disease

A

BLAND diet
H.pylori = antibiotics
limit NSAIDs
moderate exercise
NG Tube to stretch and rest (only suction INT)
NPO
Monitor I&Os
IV
Oral Care

128
Q

Hepatitis means

A

inflammation of the liver

129
Q

Hep A mode of infection

A

oral to fecal contamination

130
Q

Hep A Teaching

A

good handwashing
vaccination since 1995

131
Q

Hep B infection through

A

mom to baby
needle sticks
body fluids - semen, vaginal secretions, and saliva

132
Q

Hep B vaccinations are required starting at

A

birth (3 shots)

133
Q

Hep C mode of infection

A

tattoos
IV drug abuse
sharing contaminated needles
high-risk sexual behavior
blood transfusion before 1992

134
Q

The elderly need to be screened for what

A

Hep C

135
Q

Hep C pathophysiology

A

15-20 year delay between infection and manifestations of liver damage . This poses a challenge for the health care providers.

136
Q

Liver Failure

A

cirrhosis
Hep B or C
fatty liver disease
drug-induced hep

137
Q

Liver Failure S/S

A

Liver enzymes abnormal
AST & ALT -Indictor of liver damage
Liver Function:
PT
Albumin
Bilirubin
Ammonia Level – Hepatic Encephalopathy
ascites

138
Q

Drug-Induced Hepatitis caused by

A

Acetaminophen

139
Q

Nonalcoholic fatty Liver Disease

A

This is disease is growing because of the increase in our population of obese adults and children

140
Q

Main goal if dx with Nonalcoholic fatty Liver Disease

A

lose weight

141
Q

Ascites

A

accumulation of serous fluid in the peritoneal or abdominal cavity (third spacing). The main cause is from cirrhosis of the liver. A paracentesis is a sterile procedure to withdraw fluid from the abdominal cavity

142
Q

Ascites Interventions

A

Paracentesis
measure girth every shift and prn
daily wt
low sodium diet
diuretic meds
Monitor breathing and airway

143
Q

Ammonia encephalopathy can cause

A

coma
- five lactulose to have massive BM and intubated with rectal tube

144
Q

What are the 2 types of inflammatory bowel diseases?

A

Crohn’s
Ulcerative colitis

145
Q

Does Crohn’s have a cure?

A

no

146
Q

Crohn’s can occur where
most common

A

mouth to anus
most common distal ileum and proximal colon

147
Q

Crohn’s is called a “skipping lesion” why?

A

occurs by transmural (goes through the entire wall) and can occur between healthy and disease bowels

148
Q

What is common for active Crohn’s patients to have

A

fistulas

149
Q

crohn’s pts develop mal-

A

absorption
(alveoli get sad and weak with inflammation and don’t absorb nutrients

150
Q

S/S of Crohn’s

A

diarrhea
cramping
pain
wt loss
fever
fatigue

151
Q

Main goal for treatment of Crohn’s

A

Rest bowel - TPN
Control inflammation
Combat infection
Correct malnutrition- imbalance nutrition: less than body requirements relate to decreased absorption and increased nutrient loss through diarrhea
Alleviate stress - difficult to cope with the life changes
Provide symptomatic relief
Improve quality of life (OSTOMY)

152
Q

Crohn’s patient have what percentage of causing bowel obstructions easily?

A

60%
- TPN

153
Q

Most pts with Crohn’s will have a bowel section due to

A

stricture, obstructions, bleeding and fistula
multiple surgeries because the disease will return

154
Q

Inflammatory Bowel disease

A

chronic inflammation of the GI tract.
- periods of remission of symptoms and periods of exacerbation.

155
Q

Inflammatory bowel disease occurs

A

usually occurs during the teen years and early adult years and after the age of 60 years. IBD is more common in families that have medical history of this disease in their family.

156
Q

IBD is more common in

A

families that have a medical history of this disease in their family.

157
Q

When caring for a pt during exacerbation

A

Monitor serum electrolytes, CBC
Vital Signs
S/S of dehydration due to diarrhea
Skin breakdown due to diarrhea
Accurate I&O making sure to observe for blood in the stool.

158
Q

If a pt is unable to tolerate food, they may be placed on a

A

TPN

159
Q

Ulcerative Colitis only occurs in the

A

colon
works from the anus and up

160
Q

The inflammation from Ulcerative colitis occurs in the

A

mucosal layer

161
Q

S/S of ulcerative colitis

A

bloody diarrhea (10+ stools a day)
cramping
pain
wt loss
fever
fatigue
anemia
anorexia

162
Q

What is the cure for ulcerative colitis

A

total proctocolectomy
- colostomy for the rest of their life

163
Q

The main goal of treatment for ulcerative colitis

A

Rest bowel - TPN
Control inflammation
Combat infection
Correct malnutrition- imbalanced nutrition: less than body requirements related to decreased absorption and increased nutrient loss through diarrhea
Alleviate stress - difficulty to cope with the life changes
Provide symptomatic relief
Improve the quality of life - colostomy

164
Q

Cholecystitis means

A

inflammation of the gallbladder

165
Q

Cholecystitis risk factors

A

more common in women over the age of 40, postmenopausal, sedentary lifestyle, obesity, familial tendency

166
Q

Cholecystitis meds

A

pain meds, antiemetics, antibiotics

167
Q

Cholecystitis s/s

A

pain and can be associated after eating high-fat meal, fever, jaundice, pain can be referred to right shoulder/scapula, n/v

168
Q

Cholecystitis lab/dx test

A

ultrasonography, liver function test, serum bilirubin, WBC, HIDA scan

169
Q

Cholecystitis Teaching and Interventions

A

Post-op antibiotics
teach no greasy foods
nausea raise HOB
pain - reposition

170
Q

ERCP allows for

A

visualization of gallbladder, cystic duct, common hepatic duct, and common bile duct

171
Q

TPN means

A

Nutrients are given directly into the bloodstream when the GI tract cannot be used for ingestion, digestion, and absorption

172
Q

TPN is given through a

A

central line or a PICC
- can cause infection or hypoglycemic quickly)

173
Q

TPN solutions are prepared by

A

pharmacist using strict aseptic techniques under a laminar flow hood
and customized to meet the needs of each pt individually
- nothing added or infused

174
Q

Possible complications of TPN

A

infection
hypoglycemic
burns
intubation
pancreatitis

175
Q

Patients on TPN with also be on a what based on high sugar

A

SSI

176
Q

Enteral feeding devices include

A

PEG
Gastrostomy
Jejunostomy
Nasal

177
Q

Enteral feedings are

A

feedings of nutritious directly into the GI tract

178
Q

Enteral feedings are for pts with

A

anorexia
head/neck CA
critical illness
etc.

179
Q

If feeding for extended time, what will be placed

A

G tube

180
Q

Possible complications of enteral feedings

A

Aspiration/dislodgement of the tube is an important safety concern.

181
Q

Intestinal obstruction in the small bowel 4 hallmark s/s

A

throw up fecal matter and pooping
n/v, cramps, pain, distention & constipation

182
Q

Intestinal obstruction in s. intestine other s/s rather than hallmarks

A

fever
signs of dehydration
acutely ill
SBO - vomit content hint at where
LBO - change in bm
DECREASE FLATUS

183
Q

Meds of intestinal obstruction

A

IV fluids
antiemetic
antibiotic therapy
pain meds

184
Q

tYPES OF OBSTRUCTIONS MORE COMMON IN SBO

A

surgical adhesions
crohn’s
CA

185
Q

tYPES OF OBSTRUCTIONS MORE COMMON IN LBO

A

colorectal cancer

186
Q

Intestinal obstruction shows

A

Reduced or absent peristalsis.
Paralytic ileus – lack of peristalsis/bowel sounds. This can be from neuromuscular or vascular

187
Q

Paralytic ileus –

A

ack of peristalsis/bowel sounds. This can be from neuromuscular or vascular disorder

188
Q

Intestinal obstruction lab/tests/endoscopy

A

CT scan
abd x-ray
CBC
blood chemistry

189
Q

Surgical adhesion

A

surgery on abdomen
like a rubber band suffocating the tissue that just needs to be released for the intestine to expand again

190
Q

Interventions for intestinal obstruction

A

SBO - NG suction, fluid hydration, teach family NPO
Both - pain meds, fluids,

191
Q

Pulling the NG Tube and getting a normal diet progressing

A

Pull NG Tube day after is ordered
- clamp for 2-5 hours
- give clear liquids and more based on the progression of the patients feelings
- if can’t keep it down NG tube does not have to be reinserted, just unclamp

Module 3 (MedSurg 1) (12 decks)

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