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GI Flashcards

1
Q

Small Intestine Absorption

A

95% of carbs and protein are digested in the first two sections of your small intestine

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2
Q

Fat Soluble Vitamins

A

D, K, A, E

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3
Q

Duodenum

A

first part of small intestine

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4
Q

Protease

A

enzyme released by pancreas that breaks down protein

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5
Q

Analayse

A

enzyme in the pancreas that breaks down protein

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6
Q

Large Intestine

A

rehydrater. Absorbs a bunch of water

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7
Q

Lipase

A

Enzyme in bile that breaks down fat that is released by the pancreas

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8
Q

Bile

A

Produced by the liver and stored by the gallbladder

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9
Q

Portal venous system

A

gut venous system that is feeding your gut and innervating it

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10
Q

Fecal occult blood test: hemoccult

A

This is a test to check the stool for blood
Blue is positive for blood

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11
Q

Abdonminal US

A

o Non-invasive, little prep, no side effects
o Gallbladder, pancreas, appendix
o Fat free meal day before, NPO night prior to surgery

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12
Q

Fluoroscopy with X-ray

A

Use barium (contrast agent): aka barium swallow

Upper GI Study

Useful to detect forgein bodies.

Drinking something while they are taking pictures of you

Tough on the kidneys so drink as much as you can to get it out

Could have white stools after

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13
Q

Upper GI Fibroscopy

A

 Esophagus, stomach, duodenum
 Direct visualization using a camera down your throat
 Conscious sedation
 Hurricane spray to get rid for your gag reflex
 Patient will be sent to PACU and cannot drive post procedure
 May have a sore throat discuss use throat lozenges and soft foods
 NEED INFORMED CONSENT which doctor performs
 WE need to make sure the gag reflex is back because if not they will aspirate

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14
Q

Lower GI fluoroscopy

A

 Instead of swallowing, you get a barium enema
 Examination of colon; look for reason for constipation and GI conditions

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15
Q

CT

A

 With or without contrast (to see vascularity and how the blood vessels are feeding the area)
 No metformin for 48 hours after contrast
 Shows us all we need to see

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16
Q

Colonoscopy

A

 Visual examination of anus, rectum, and colon
 Used to detect and remove polyps
 To diagnose or rule out disorders of colon
 Conscious sedation; patient will need ride home after
 There is bowel prep to remove everything from the GI

Current guidelines: only fluid for 3 days
Day before you take miralax

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17
Q

NG tube

A

 Used for feedings/medications
 Decompression of the stomach (slow suction treats the bowel obstruction)
 Removes contents from the stomach

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18
Q

OG tube

A

goes through the mouth instead of the nose
 We need to intubate them because it is going down their mouth
 Intubated patient
 Short term; less commonly used
 Removes stomach contents
- reduces risk of aspiration
 This is used for intubated patients
- Cannot put medications in an OG tube

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19
Q

Gastrostomy

A

 Opening in the stomach
 Administration of foods, fluids, and meds
 Gastric decompression
 Best for enteral support need longer thatn 4 weeks
 G tubes (via stomach)
 PEG tubes

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20
Q

Jejunostomy

A

 Opening into the jejunum
 Administration of fluids and medications

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21
Q

Considerations for Gastrostomy/Jejunostomy

A

we need to check residual volume because if the food is not going through, then we cannot put more in! Typically if there are 30ccs or less, we can put more through

Oral Care

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22
Q

Position of a person when they are eating

A

30-45 degrees

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23
Q

TPN Considerations

A

total parenteral nutrition

 All nutrients through an IV
 1-3L over 24h
 Continuous infusion
 1-3 times a week we put a fat emulsion
 Has to be through a picc line or a central line ONLY for TPN because it needs to be big
 Regular IV will destroy the vein

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24
Q

PPN

A

partial parenteral nutrition: we CAN put this through an IV. It is not as robust, but we do it for a few days after a throat surgery to rest throat. More short term

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25
What to watch for on TPN or PPN
rebound hypoglycemia  Equivalent of 3 cans coke daily  May need insulin while on TPN because they can seemingly go into hyperglycemia  REBOUND hypoglycemia AFTER they come off of TPA and may need dextrose
26
Plaque
fuzzy feeling on their teeth
27
Tarter
plaque left alone for 48 hours. It can start to mineralize on your teeth and become tartar
28
Esophageal Perforation Causes
boerhaave syndrome (15%): violent vomiting Trauma Chemical Ingestion Procedures
29
Esophageal Perforation Pathophys
- Opening in esophagus - Contents spilling into mediastinum and stomach contents can come up and leak into the mediastinum - Systemic inflammatory response - Can lead to sepsis
30
Esophageal Perforation Presentation
- Neck/shoulder/upper and lower back related to perforation - Cannot lie flat - Tachypnea and tachycardia because they are inflamed - Causes bleeding - Severe hypotension: going into shock - Fever and chills - Dysphagia and vomiting. - PAIN - Could affect lungs and aspirate blood
31
Labs and diagnostics for an Esophageal Perforation
o Fluoroscopy o CT: size will determine what we do to fix it o EGD: NOT in the acute stage. Don’t stick a tube down the throat while they are inflamed. After to see how bad the damage is
32
Meds that can help an Esophageal Perforation
o Broad spectrum antibiotics to prevent sepsis o Probably will be put on TPN if they have surgery
33
Complications of an Esophageal Perforation
Pneumonia: aspiration of contents in to the lungs Sepsis Death ARDS
34
Foreign Bodies of the esophagus
o Not properly shewing food o Children putting objects in mouth o Fish bones o Grapes, peanuts, candies, hot dogs
35
How will client present with esophageal blockage
o Acute dysphagia o Complete=increased saliva and dysphagia o Odynophagia: painful swallowing o Gaging/chocking o CP: chest pain (full cardiac workup)
36
Odynophagia
painful swallowing
37
Meds that help an Esophageal blockage
glucagon nitroglycerin
38
Chemical Burns Causes
- Acid/base o Intention/unintentional o Medications o Chemical burns when a pill gets stuck in the throat
39
Presentation of a chemical burn
o Stridor, Wheezing, Dyspnea, Tachypnea o Abdominal tenderness and guarding (don’t touch me and I don’t wanna swallow) o Bleeding/shock, severe hypotension
40
Labs and diagnostic for a chemical burn
chest/abdominal X-ray Eventual EGD
41
Meds that can help a chemical burn
o Corticosteroids (high dose) o Antibiotics (if infection)
42
Acute interventions for a chemical burn
o Do not induce vomiting (if it burnt going down, it will burn coming up) o Prepare for emergent intubation o Neutralizing chemicals
43
How can nurses help Chemical Burns
o Talk to parents about possible toxins  WE ALWAYS CALL POISON CONTROL o Discuss long term complications o Enteral feedings (G/J tube) o We are really worried about scar tissue that go across the esophagus which will cause strictures  This will require Pneumatic Dilation
44
Pneumatic Dilation
EGD tube with a balloon to stretch the esophagus so that the strictures don't cause constriction
45
GERD pathophys
Incompetent LES
46
Hiatal Hernia
portion of stomach goes through the diaphragm
47
Causes of GERD
Incompetent LES Hiatal Hernia Pregnancy Motility disorder
48
Complications of Gerd
o Esophageal strictures o Esophageal ulcer o Barrett’s esophagus
49
Barrett's esophagus
precancerous change in the esophagus. Constant damage to the esophagus so the esophagus turns to bowel tissue. Anytime you change cellular structures YOU HAVE A RISK OF CANCER
50
Nissen Fundoplication
taking the top part of your stomach and wrapping it around your esophagus and suturing it in place to secure the LES
51
LINX procedure
very invasive. Not easy
52
H2s
Famotidine: exacerbation treatment of GERD this can lead to pernicious anemia if used a ton
53
PPIs
Omiprazole: long turn also blocks b12 absorption and can lead to osteoporosis
54
Prokinetics
metoclopramide: this is used if the reason for the GERD is lack of mobility
55
Hiatal Hernia
diaphragm is weak and allowing part of muscle to come through. Now the LES is not working because it is all stretched out. Decreases blood supply to that portion of the stomach. Severity levels determine how dangerous and bad it is
56
Causes of a Hiatal Hernia
 Weakened muscle  Age related changes  Injury  Persistent pressure
57
How will the client present with a hiatal Hernia
 Acid reflux  Possible bulge in abdomen  Difficulty swallowing  Cp or abdominal pain  SOB  Vomiting blood/black tarry stools
58
Coffee Ground Emesis
Vomiting shit
59
Gastritis
eroded stomach lining/inflammation of the stomach lining
60
Causes of Gastritis
o H. Pylori o NSAIDS o Older Age o Excessive Alcohol o Stress o Autoimmune
61
How will the client present
o Asymptomatic o Gnawing/Pyrosis o N/V, anorexia o Fullness in abdomen after even small meals
62
Severe Gastritis
 Hematochezia (bright red blood)  Hematemesis  Melena
63
Medications that can help Gastritis
Antibiotics PPI to slow down acid production (maintenance) H2 (PRN)
64
Complications gastris
o Burning a hole through the lining so there is going to be bleeding! o Ulcers o Pernicious anemia o Stomach cancer (rare)
65
Peptic Ulcer Disease Location
can occur in the stomach, duodenum, or esophagus
66
PUD causes
- H.Pylori is a common cause - Long term NSAID use is a cause - Other meds - Stress does NOT cause peptic ulcers, just exacerbate it - SSRIs can cause them - Alendronate can cause them
67
What happens in PUD
increased acid vs decreased mucus o Stomach is eroding o Open sores
68
How will client present with PUD
o Asymptomatic o Gnawing/burning epigastric pain o Bloating/belching o Fatty food intolerance o Pyrosis o Nausea o Sometimes vomiting, but that is rare o Where the ulcer is determines what the symptoms will be
69
Labs and Questions
o Stool testing o CBC/BMP o EGD w/ biopsy (H. pylori? If not, do you take NSAIDs everyday? Ibuprophen every day?) o Fluoroscopy
70
Complications of PUD
o Internal bleeding o Infection o Obstruction o Refractory ulcers o Swelling and adhesions which can lead to an obstructure
71
Refractory Ulcers
ulcers that DO NOT HEAL. You keep smoking. You keep eating NSAIDS
72
How can nurses help with PUD
o Have antacids/h2 ready for attack o Avoid NSAIDs o Avoid Triggers o Choose a healthy diet o Consider probiotic foods o Eliminate milk? o Adequate sleep=stronger immune system=less stress
73
PUD Triggers
 Smoke  Alcohol  Spicy foods  Stress
74
Ranitidine
H2 used for PUD attacks
75
Misoprostal
coats the stomach lining until the ulcer heals
76
IBS Meds (Also Used for Diarrhea)
o Lubiprostone o Linaclotide - polyethylene glycol / MiraLAX (Laxatives) - Anti-diarrheal: loperamide / Imodium - Anticholinergics: these treat the abdominal pain - TCS’s: severe anxiety r/t diarrhea
77
Meds for dehydration
Atropine + diphenoxylate

Adults (6 decks)

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