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NCLEX > GI > Flashcards

GI Flashcards

Pancreatitis, Appendicitis, SBO, Celiac, Cholecystitis, Cirrhosis, Diverticulitis, Diverticulosis, Esophageal Varices, Gastroenteritis, GERD, Hepatitis, Peptic Ulcer

1
Q

Patho of pancreatitis

A

Inflammation of pancreas
Pancreatic duct obstruction and hypersecretion of pancreatic exocrine enzymes -> enzymes activated -> autodigestion
Impaired exocrine and endocrine fx

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2
Q

Risk factors of pancreatitis

A

Alcohol ingestion
Gallstones
Thiazide diuretics
Viral infx
Trauma

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3
Q

S+S of pancreatitis

A

Severe pain after eating
Pain located in epigastric region or LUQ
N+V
Elevated lipase and amylase levels

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4
Q

Complications of pancreatitis

A

Hypovolemic shock
ARDS
Retroperitoneal hemorrhage (Cullen sign)
Hypocalcemia
Hyperglycemia

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5
Q

Nursing interventions of pancreatitis

A

IV everything (opioids, fluids, antiemetics)
NPO
Alcohol cessation
Insulin

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6
Q

Nursing interventions for chronic pancreatitis

A

Alcohol cessation
Insulin
Small, bland, frequent meals that are low in fat
Administer pancreatic enzymes
Supplemental vitamins and minerals

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7
Q

S+S of Appendicitis

A

GRADE
Abdominal guarding
Rebound tenderness and RLQ pain
Anorexia and absent bowel sounds
Abdominal pain -> McBurne’s point
Elevated temp and WBCs

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8
Q

Nursing interventions of appendicitis

A

Assess bowel sounds
NPO
IV fluids and abx
Antiemetics and antipyretics
Semi-Fowler (no lying flat)
Avoid applying heat, cathartics, or enemas

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9
Q

1 fact about appendicitis

A

Avoid applying heat, cathartics, or enemas -> risk for appendix rupture

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10
Q

SBO complications

A

Peritonitis

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11
Q

S+S of SBO and labs

A

Colicky abdominal pain
Abdominal distention
Inability to pass flatus or stool
N+V (bile-stained)
Hypokalemia and metabolic alkalosis

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12
Q

Nursing interventions of SBO

A

NPO
Manage pain
AVOID opioids (may result in uncontrolled constipation)
NG tube
Antiemetics
IV fluids
Monitor: bowel sounds, abdominal distention, passage of gas/stool, signs of peritoneal irritation
Strict I+O

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13
Q

Peritoneal irritation S+S

A

Muscle guarding
Rebound pain
Pain if bed is shaken

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14
Q

Diet of celiac dz

A

Avoid BROW
Barley
Rye
Oats
Wheat
Diet high in calories and proteins

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15
Q

Nutritional deficiencies in celiac dz

A

Ferrous sulfate
Vitamins

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16
Q

Risk factors of cholecytitis

A

Female over 40 yo
Multiparous women
Obesity
Oral contraceptive use
Elevated serum cholesterol levels
Family hx

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17
Q

S+S of cholecystitis

A

Colicky pain in RUQ (can worsen after eating)
Murphy sign
Localized guarding
Fever and tachycardia
Leukocytosis
Perforation (peritonitis)
Prior hx of indigestion after eating fatty foods

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18
Q

Nursing interventions of cholecystitis

A

Prepare for cholecystectomy
Pain management
IV fluids and electrolytes
IV antiemetics
NPO -> low fat -> regular diet
IV abx

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19
Q

Cirrhosis is known as…

A

End stage of liver

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20
Q

Risk factors of cirrhosis

A

Chronic viral hepatitis
Chronic, excessive alcohol use
Non-alcoholic fatty liver dz

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21
Q

S+S of cirrhosis

A

Jaundice
Darkened urine
Pale stool
Ecchymosis
Edema
Build up of estrogen
Portal HTN (esophageal varices, ascites, splenomegaly)

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22
Q

Lab values of cirrhosis

A

Increased bilirubin, clotting times, ALT/AST, ammonia
Decreased albumin, platelets, WBC

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23
Q

Nursing interventions of cirrhosis

A

Elevate HOB
Diuretics
Manage ascites -> paracentesis
Daily weight and abdominal girth measurements
Sodium and fluid restrictions
Monitor for signs of bleeding and hepatic encephalopathy
Avoid sedatives and hepatotoxins

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24
Q

Hepatic encephalopathy S+S

A

Altered mental status
Asterixis
Confusion

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25
Q

Paracentesis tx

A

Treat hypotension w/ colloid solution (25% albumin IV)

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26
Q

Complications of diverticulitis

A

Abscess formation
Perforation -> peritonitis
Hemorrhage
Fistula formation

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27
Q

S+S of diverticulitis

A

Fever
Prior constipation -> loose stools now
Abdominal pain that worsens w/ strain
N+V
Tenderness and palpable mass
Leukocytosis

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28
Q

Nursing interventions of diverticulitis

A

IV fluids, IV abx, pain management
Clear liquid diet or NPO
Surgery (bowel resection)

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29
Q

Teaching of diverticultitis

A

Routine exercise
Fluid intake
Diet modifications: high fiber
Avoid straining during bowel mvts

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30
Q

Patho of diverticulosis

A

Occurs when sac-like pouches form in colon wall due to constipation, increased intraabdominal pressure

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31
Q

S+S of diverticulosis

A

Asymptomatic
but diverticulitis and GI bleed

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32
Q

Nursing interventions of diverticulosis

A

High fiber diet
Exercise
Smoking cessation
Avoid excess red meat

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33
Q

Esophageal varices (rupture) S+S

A

Vomiting bright red blood/clots
Coffee-ground emesis or melena
Hypotension
Tachycardia
Pale or cyanotic skin

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34
Q

Nursing interventions of esophageal varices

A

NPO
Intubate if bleeding is massive
IV fluids and RBCs
Prepare for emergency EGD

35
Q

Meds for esophageal varices

A

Octreotide infusion (vasoconstriction)
PPI

36
Q

S+S of gastroenteritis

A

Diarrhea (can be bloody)
NV
Fever
Abdominal pain
Hyperactive bowel sounds
Abdominal tenderness during palpation

37
Q

Complications of gastroenteritis

A

Dehydration and hypovolemia
Electrolyte abnormalities

38
Q

Nursing interventions for gastroenteritis

A

Monitor for dehydration: oral rehydration of IV fluids if severe
Advance diet as tolerated
Avoid carbonation
Avoid fluids w/ high amts of sugar
Strict I+O

39
Q

Risk factors for GERD

A

Obesity
Pregnancy
Hiatal hernia
Tobacco and alcohol consumption
Foods: high fat diet, chocolate, peppermint
Meds: anticholinergic meds or opioids

40
Q

Complications of GERD

A

Esophageal ulcer -> bleeding
Barret’s -> esophageal cancer
Scar -> stricture
Worsening of respiratory conditions

41
Q

S+S of GERD

A

Heartburn
Epigastric pain
Indigestion
Dysphagia
Regurgitation
Hoarseness
Respiratory symptoms
S+S increased by bending, lying, eating, stooping

42
Q

Pt teaching of GERD

A

Avoid dietary triggers: caffeine, chocolate, alcohol, carbonation, spicy, citrus
Small, frequent meals
Avoid lying down for 2-3 hrs after eating
Elevate HOB

43
Q

Meds for GERD

A

Antacids
H2 receptor antagonists
PPI

44
Q

Hepatitis A

A

Fecal-oral route
Sources: poor sanitation
Crowded places

45
Q

Hepatitis B and C

A

Bloodborne: sharing needles, hemodialysis, blood transfusion
Sexual contact
Perinatal

46
Q

Acute hepatitis S+S

A

Fever
Anorexia, nausea, malaise
Pain
Jaundice
Pruritis
Dark urine and pale stools

47
Q

Nursing interventions for Hep B and C

A

Antivirals

48
Q

Nursing interventions for Hep A

A

Hand hygiene precautions

49
Q

Complications of Hep

A

Changes in neuro status
Bleeding
Fluid retention

50
Q

Teaching for hepatitis

A

Avoid high fat diet
Small and frequent meals
Avoid liver toxins

51
Q

Teaching for hepatitis A

A

Refrain from sharing utensils or drinking glasses
Vaxx
Proper hand hygiene

52
Q

Teaching for Hep B and C

A

Refrain from sharing razors, needles, syringes
Use condoms
Hep B vaxx

53
Q

Risk factors of peptic ulcer dz

A

H. pylori
NSAIDs and corticosteroids
Smoking
Alcohol consumption
Excess caffeine
High levels of stress
Trauma/critical illness

54
Q

Complications of peptic ulcer

A

GI bleeding
Perforation

55
Q

Nursing interventions for non-bleeding peptic ulcer (meds)

A

Abx if H pylori present
Oral PPI
Sucralfate

56
Q

Nursing interventions for bleeding peptic ulcer

A

NPO
Anticipate endoscopy
Monitor hemoglobin and hematocrit

57
Q

Upper GI bleed S+S

A

Melena
NSAID use
Hematemesis
Hx of H. pylori

58
Q

Lower GI bleed S+S

A

Bright red stools
Hx of diverticulosis

59
Q

Liver dysfx lab values

A

Increased ammonia (hepatic encephalopathy), bilirubin, INR/prolonged PT (bruising, bleeding)

Decreased albumin (fluid overload), platelets (petechiae)

60
Q

Proper home care of an ascending colostomy

A

Clarify enteric-coated meds
Identify foods that cause excess gas and odor
Increased fluid intake

61
Q

For colostomy irrigation, what locations is that for?

A

Descending/sigmoid

62
Q

Hiatial hernia

A

Regurgitation of acid into esophagus b/c upper part of stomach herniates upward through diaphragm

63
Q

BASICALLY Hiatal hernia =

A

gastric contents move in wrong direction at correct rate

64
Q

S+S of Hiatal hernia

A

GERD when you lie down after you eat

65
Q

Tx of Hiatal hernia

A

Want the stomach to empty faster
High position
High fluids
High carbs
Low protein

66
Q

Dumping syndrome

A

Gastric contents dump too quickly into duodenum

67
Q

BASICALLY dumping syndrome

A

gastric contents move in right direction at the wrong rate

68
Q

S+S of dumping syndrome

A

Drunk + shock + abdominal distress

69
Q

Tx of dumping syndrome

A

Want the stomach to empty slower
Low position
Low fluids
Low carbs
High protein

70
Q

Acute ulcerative colitis exacerbation teaching

A

Avoid triggers
Take vitamin and mineral supplements
Use skin barrier cream
2000-3000 mL fluid daily
Take sulfasalazine

71
Q

Cholecystitis referred areas of pain

A

Right area of neck
Back (right) - upper

72
Q

Pancreatitis referred areas of pain

A

LUQ
Left upper side of back

73
Q

Appendicitis referred areas of pain

A

Umbilical area

74
Q

Nephrolithiasis referred areas of pain

A

Left hip-groin
Left hip (posterior)

75
Q

Clay colored (gray) stool indicates

A

Biliary obstruction

76
Q

Mucus or pus visible stool indicates

A

Ulcerative colitis

77
Q

Greasy, foamy, foul-smelling, fatty stools indicates

A

Chronic pancreatitis

78
Q

Ostomy bag should be changed every

79
Q

High ALT/AST indicates…

A

Liver
Hepatitis

80
Q

High lipase indicates…

A

Pancreatitis

81
Q

Liver cirrhosis S+S

A

Fatigue
Jaundice
Abdominal ascites
Spider angiomas
Palmar erythema
Peripheral edema

82
Q

Tx of cirrhosis (liver)

A

Diuretics
Paracentesis
Monitor for signs of hepatic encephalopathy
Measure abdominal girth

83
Q

Peptic ulcers S+S

A

Pain - mid-epigastric region
Pain occurs 2-4 hrs after a meal or wakes up pt at night
Relieved by antacids

NCLEX (40 decks)

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