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NURS122 > GI > Flashcards

GI Flashcards

1
Q

what is considered upper abdominal issues

A
  • GERD
  • peptic ulcers
  • gastritis
  • gastroparesis
  • gallstones
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2
Q

what is considered lower abdominal issues

A
  • celiac disease
  • diverticular disease
  • IBS
  • inflammatory bowel disease
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3
Q

symptoms of upper GI issue

A
  • bleeding
  • anemia
  • early satiety
  • unexplained weight loss >10%
  • progressive dysphagia
  • odynophagia (pain or discomfort when swallowing)
  • persistent vomiting
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4
Q

what does C-reactive protein tell you

A

inflammation

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5
Q

causes of gastritis

A
  • H.pylori
  • excessive smoking or drinking
  • prolonged NSAID use
  • cocaine
  • weakened stomach lining (i.e. pernicious anemia)
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6
Q

most important system to check although it is GI issues

A

cardiac first - pulses, cap refill, O2 sat monitor

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7
Q

isolation precaution for gastritis

A

contact precautions

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8
Q

how often to take I/Os for at risk pt

A

q1hr

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9
Q

how often to check weight for at risk pt

A

q4hr

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10
Q

what type of IV fluid to give for gastritis

A

D5W w/ 0.9NS + 20KCl

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11
Q

nurse teaching for gastritis

A
  • perianal hygiene
  • food prep practices
  • vaccines
  • continued ORT (oral rehydration therapy) at home
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12
Q

what type of acid/base issue might vomiting and diarrhea lead to

A

hyperchloremic acidosis from loss of sodium bicarbonate

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13
Q

minimum of fluids for maintenance & how much fluid intake we should have per day

A

125-150mLs /hr
should have 2-3L per day

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14
Q

most common causes of appendicitis & age range for getting it

A
  • infection from stomach migrated to appendix
  • obstruction of stool

most common in teenage years

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15
Q

why is abx &IV fluids typically given to someone with appendicitis

A

prophylactic prevention in case it ruptures
IV fluids to avoid dehydration

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16
Q

what is GI bleed pt at risk for

A
  • hemorrhage
  • hypovolemic shock
  • aspiration
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17
Q

what’s the treatment for GI bleed

A
  • blood transfusion
  • NG tube for gastric lavage
  • stop bleed
  • meds: epinephrine, vasopressin
  • meds: octreotide
  • PPI: pantoprazole
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18
Q

why give vasopressin (ADH) for GI bleed

A

it constricts the GI blood vessels to slow bleed

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19
Q

what is a sign of a massive GI bleed

A

foul smelling, marron or purple color jelly stool

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20
Q

what can hyperperistalsis indicate

A

intestine issue such as obstruction

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21
Q

teaching for fluoroscopic x-rays

A
  • enemas need to be given
  • NPO for 8 hrs at least
  • lost of fluids & laxatives to expel the contrast
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22
Q

what position should the pt be in for endoscopy

A

left side with head bend forward

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23
Q

how does ERCP (endoscopic retrograde cholangiopancreatography) work

A

endoscopy into duodenum & inject contrast dye into common bile ducts to see gallstones, tumor, or biopsy

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24
Q

how does capsule endoscopy work

A

pt swallows small camera to see small bowel that wasn’t seen in regular endoscopy

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25
Q

contraindications for barium swallow

A

pregnancy - since barium has radiation
perforation of esophagus or intestines
blockage or severe constipation
severe issues with swallowing
sensitivities

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26
Q

how does barium affect stool color

A

white or light color until clears

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27
Q

preparation for colonoscopy

A

clear liquids the day before
Golytely night before (may cause ab cramping) - osmotic laxative to cleanse

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28
Q

when is colonoscopy recommended

A

pts over age 50

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29
Q

how is gastric contents analyzed

A

NG tube and see contents

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30
Q

gerontological considerations

A
  • stomach produces less acid - less protection when taking NSAIDs
  • muscles can slow leading to acid reflux or constipation
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31
Q

S/S of diverticulitis

A
  • gas, bloated, cramps, constipation
  • if inflamed: pain, cramps, fever, vomiting
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32
Q

what is Barrett’s esophagus

A

if GERD is untreated and the acid affect the esophagus and leading to cancer

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33
Q

S/S of gastritis

A
  • N&V
  • abd pain, cramps
  • indigestion, uncomfortable between meals or at night
  • hiccups
  • loss of appetite
  • black tarry stools
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34
Q

treatment for gastritis

A
  • avoid gluten & dairy
  • avoid hot & spicy foods
  • take antacids prn
  • abx w/ acid blocking drug for H.pylori
  • vitB12 shots for pernicious anemia
35
Q

S/S of appendicitis

A
  • LRQ pain that radiates from naval
  • pain that worsens with movement
  • N&V
  • loss of appetite
  • fever
  • constipation or diarrhea
  • flatulence or bloating
36
Q

where is McBurney’s Point for appendicitis

A

abd wall between navel and LLQ that causes pain in LRQ

37
Q

when do appendix typically burst from appendicitis

A

24-72 hrs

38
Q

what is Rovsing’s sign for appendicitis

A

palpation of LLQ that leads to pain in LRQ

39
Q

Testing for appendicitis

A
  • CBC (especially neutrophils 2,500-7,000)
  • CT, ultrasound
  • c-reactive protein for inflammation
40
Q

laparotomy vs. laparoscopy

A

laparotomy is small incision in abdomen
laparoscopy is inserting a small scope in

41
Q

what position to place patient after appendix sx

A

high-fowler’s to decrease tension in abdomen

42
Q

what is octreotide used for

A

decrease HCl & decrease splanchnic blood flow
IV bolus up to 5-6 days after bleed

43
Q

MOA of PPI pantoprazole

A

inhibits pump that secretes HCl acid
neutralizing effect lasts longer than antiacids
can take up to 4 days before effect is seen

44
Q

list HH2 receptor antagonist drugs

A

ranitidine
cimetidine
famotidine
nizatidine

-“tidine”

45
Q

MOA of ranitidine

A

inhibit histamine at H2 receptors to decrease parietal cell acid secretion

46
Q

when should pts take pantoprazole

A

before meals

47
Q

when should pts take ranitidine

A

with or after meals
before sleep

48
Q

use HH2 receptor antagonists cautiously in which pts

A

kidney dx pts

49
Q

what is small intestine adhesions

A

fibrous tissue that form after sx from extreme inflammation
can lead to GI obstruction

50
Q

what is small intestine volvulus

A

twisting of intestines that can lead to obstruction

51
Q

what is small intestine intussusception

A

“telescoping” of one segment into the next section that can lead to obstruction

52
Q

stricture of colon means

A

narrowing of colon caused by scarring of inflammation

53
Q

causes of GI obstruction

A
  • small intestine adhesion, volvulus, intussusception
  • birth defect
  • tumors
  • hernias
  • IBS (i.e. Crohn’s)
  • swallowed objects in children
54
Q

what can ileus lead to

A

gastroenteritis, appendicitis
electrolyte imbalances

55
Q

what is pseudo-obstruction

A

obstruction due to muscle or nerve issue

56
Q

causes of pseudo-obstruction

A

Parkinson’s, MS
Hirschsprung’s dx - lack of nerves in large intestine
diabetes
hypothyroidism

57
Q

symptoms of obstruction

A
  • severe bloating
  • pain
  • decreased appetite
  • N&V
  • constipation (complete) or diarrhea (partial block)
58
Q

treatment for obstruction

A
  • IV fluids
  • NG suction
  • surgery - colostomy, ileostomy, partial bowel removal
59
Q

DC teaching after obstruction sx

A
  • eat small meals throughout day
  • take sips of clear liquids throughout day
  • add new foods back to diet slowly
  • if constipation or discomfort avoid solid foods & clear liquid only
  • limit exercise for 4-6wks
  • ileostomy or colostomy care
60
Q

list 3
antiemetics

A

ondansetron
metoclopramide
dimenhydrinate

61
Q

what type of foods should pts with ileostomy restrict

A
  • fiber
  • soda, nuts, peppers
  • limit smoking
  • dairy
62
Q

change in pain when someone with duodenal ulcer vs. gastric ulcer ingests food

A

decrease in pain for duodenal ulcer
increase in pain for gastric ulcer

63
Q

use of magnesium hydroxide

A

known as “milk of magnesia”
increases GI motility

64
Q

how does vomiting and diarrhea affect electrolytes

A

decrease in electrolytes so should be monitored closely

65
Q

what happens to the enzymes that the pancreas typically releases when the pt has pancreatitis

A

increase in enzymes due to poor modulation

66
Q

what foods should a pt with colostomy eat

A

yogurt
crackers
toast
to prevent flatus and odor

67
Q

what foods can a pt with celiac dx eat and not eat

A

don’t eat gluten
eat more fiber foods - beans, nuts, fruits, veg

68
Q

main symptom to look out for when a pt is taking metoclopramide

A

extrapyramidal symptoms i.e. ataxia

69
Q

main symptom to look out for when a pt is taking ondansetron

A

monitor ECG for QT prolongation

70
Q

main symptoms of dramamine (dimenhydrinate)

A

drowsiness, dry mouth, blurred vision

71
Q

how should antiacids be taken

A

with a full glass of water when acid levels are highest so 1-3hrs post meal and before bedtime

72
Q

how does changes in CEA (carcinoembryonic antigen) level change with cancer

A

increases with cancer

73
Q

Hgb level for pt with colorectal cancer

A

decrease due to intestinal bleed

74
Q

foods to eat vs. not eat to avoid dumping syndrome post gastrectomy

A

eat more protein
eat less carbs or sugary foods & fluids

75
Q

why would cirrhosis lead to bleeding of the esophageal varices

A

increased portal vein pressure that leads to enlarged veins of the esophagus

76
Q

what type of foods should a pt with pancreatitis consume and not consume

A

low fat
high protein diet

77
Q

prolonged use of PPI can lead to what

A

fractures especially in elderly
pneumonia or C.diff

78
Q

list some antiacids

A
  • aluminum hydroxide
  • magnesium hydroxide
  • calcium carbonate
  • sodium bicarbonate
79
Q

what does metoclopramide do

A

antiemetic
increased motility of stomach and esophagus

80
Q

which antibiotics can eliminate H. pylori

A
  • metronidazole
  • amoxicillin
  • clarithromycin
  • tetracycline
81
Q

what is sucralfate used for

A

coats ulcer and protects it
prevents H. pylori from binding to mucosal wall
inhibits acid

82
Q

expected effects of taking sucralfate

A

black stool

83
Q

when to take sucralfate

A

1 hr before meals or bedtime

84
Q

what drug not to take & adverse effect of sucralfate

A

don’t take with aspirin, NSAIDs
may cause constipation

NURS122 (28 decks)

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