Brainscape's Knowledge GenomeTM

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


See full index

MedSurg - Exam 1 > GI > Flashcards

GI Flashcards

1
Q

Peritonitis Etiology

A

Bacterial Infection & Perforation of the GI tract

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

Peritonitis Manifestation/Assessment

A
  1. Pain: Diffuse, turns into a more constant, intense & localized. Worse when moving
  2. Extremely tender, distended, rigid abd
  3. Late Stage: septic shock
  4. Anorexia, n/v, fever, tachy, hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Peritonitis Diagnostics

A
  1. WBC- elevated (H&H is low if bleeding)
  2. Electrolyte imbalances
  3. Xray - Free air & fluid & distended bowel loops
  4. CT scan - abscesses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of Peritonitis

A

Peritoneal dialysis, perfd appendicitis, perfd duodenal ulcer, diverticulitis, intestinal obstruction, pancreatitis, perfd gastric ulcer, H.pylori, external sources (trauma, injury, GSW, perfd tumor)

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

Salem Sump

A

Type of NGT
Large bore, double lunem, rigid
Blue pigtail: vents to prevent sticking to stomach and prevents reflux of the tube
Utilized for decompression, irrigation, short term aspiration
small/large bowel obstruction to prevent further vomiting

Inserted through the nose, instruct pt to tilt their chin forward & swallow water while you are inserting it.
To measure: from nose to xphoid process
Very uncomfortable for pt.
Should be on intermittent low wall suction 30-40 (high causes pH and electrolyte imbalances)

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

Gastric Lavage

A

“Wash out belly” from overdose
Analysis for labs

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

NGT Proper Placement

A

KUB (xray)

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

Actions to take if concerns with placement of NGT

A

STOP feeding

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

NG Tube

A

Very fine tubing, high risk of clogging
Place pt in 30-45 degrees (can cause pneumonia)

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

Uses of Enteral Nutrition

A
  • Decompression/Drainage
  • Anytime the stomach has to be bypassed - risk of aspiration
  • bowel obstruction
  • inability to swallow
  • active GI bleed
  • lavage
  • diagnose (gastric analysis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

High Risk for NGT

A

Decreased mental consciousness
Altered mental status

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

Peritonitis Medical Management

A

Monitor/replace fluid & electrolytes
Pain control
IV abx
Sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Levin Tube

A

Type of NGT
Single-lumen
Utilized for decompression
Used only for feeding and admin meds
Not typically used for suctioning due to its harshness against lining

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

PEG tube

A

Percutaneous Endoscopic Gastrostomy
Long-term
Refusal/Unable to eat, extreme malabsorption, psychiatric reasons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Antacids

A

Acid neutralizing agent
1. Mg OH- (MOM)
2. Al OH- (Amphojel) phosphate binder : increased Al elimination
3. Ca CO3- (Tums) : constipation
4. Na HCO3- (alka seltzer) does not tx ulcers
5. Combo of Al, Mg hydroxide & simethicone (Mylanta)

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

H2RA

A

Antiulcer - PUD, GERD, heartburn, esophagitis
“Tidine”
Give with meals or
Do not stop abruptly

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

Sucralfate (Carafate)

A
  • Antiulcer GI Protectant, mucosal barrier
  • sticky
  • take on empty stomach
18
Q

Bismuth subsalicafate (Pepto-Bismol, Kaopectate)

A
  • Antiulcer GI Protectant
  • has antibacterial action against H.pylori
  • used for antidiarrheal
  • black,gray stool
  • risk of salicylate toxicity (tinnitus)
19
Q

Misoprostol (Cytotec)

A
  • Antiulcer GI Protectant
  • suppresses acid & inc mucus
  • NO pregnancy
20
Q

PPIs

A

Antiulcer
Prevents pumping acid
Give before meals, AM
Must slowly taper off
S/E: VitB12 deficiency, bone fractures, malabsorption, CDAD

21
Q

Anti-flatulent

A

Simethicone (Gas-X)

22
Q

Barrett Esophagus

A

Irritation of the lining caused by chronic reflux
Changes the lining similar to stomach & intestines
S/S heartburn
Diagnostic: EGD (esophagogastroduodenoscopy) can do biopsy, position on L side
TX: PPIs, repeat EGD 3-5 yrs, endoscopic resection, RF ablation

23
Q

GERD

A

Common disorder marked by backflow of gastric/duodenal contents
Leads to: pyloric stenosis, incompetent esophageal sphincter, Barrett’s

24
Q

GERD Diagnostics

A

EGD
Barium swallow
Wireless capsule pH monitoring (Bravo test)

25
Q

GERD Management

A

Low fat diet

Avoid: caffeine, alcohol, tobacco, milk, mint, carbonated beverages, eating/drinking before bed, tight fitting clothes

HOB elevated 30

Meds: antacids, antiulcers, Reglan

26
Q

H.pylori Diagnostics

A

EGD w/ biopsy
Blood test for antibodies
Breath test
Stool test

27
Q

H.pylori TX

A

Triple Therapy: Amoxicillin, Clarithromycin, PPI

Quad Therapy: bismuth subsalicylate, tetracycline, metronidazole, PPI

28
Q

Gastritis (ACUTE)

A

Causes: (EROSIVE - NSAIDs, alcohol, gastric radiation) (NON EROSIVE - H.pylori)

Manifestations: anorexia, epigastric pain, hematemisis (coffee ground), BRBPR

29
Q

Gastritis (CHRONIC)

A

Manifestations: bleeding ulcer, early satiety, heartburn, vague, epigastric, discomfort, relieved by eating, sour taste in mouth, belching, intolerant to spicy fatty foods

Assessment: fatigue, heartburn, malabsorption of vitamin B12 (pernicious anemia)

Management: diet, modification, reduce stress, avoid alcohol & NSAIDs, medication

30
Q

Gastritis

A

Inflammation/Disruption of mucosal barrier (or lack thereof) that leads to superficial erosion, eventually causing hemorrhage

General Management: Monitor for hemorrhagic gastritis, encourage fluids, avoid irritating foods, symptoms/pain relief

31
Q

Peptic Ulcer Disease

A

Cant withstand HCl & pepsin

Involves gastric, duodenal, esophageal, or combination of all

Deep erosion that may extend into the muscle layers and through the peritoneum

Risk factors: age, stress, chronic NSAIDs, H.pylori, tobacco & alcohol, family hx, type O blood, COPD, cirrhosis, CKD

32
Q

Causes of PUD

A

H.pylori
NSAID overuse
Stress
Smoking
Alcohol
Genetics

33
Q

PUD Complications

A

Hemorrhage
Perforation/penetration
Gastric outlet obstruction (pylorus)

34
Q

Stress Ulcer

A

Acute mucosal ulceration of the duodenal or gastric area as a result of physiological stressful event Such as ventilator, burns shock, sepsis, MODS

35
Q

Manifestations of PUD

A

Asymptomatic initially

Pyrosis
GI bleeding
sour burping
burning sensation in the mid epigastric area or back
pain after eating (gastric ulcer quicker than duodenal)
Bleeding ulcers may not be painful (essentially healing)
If perfd sudden severe pain in upper abd

36
Q

PUD Diagnostics

A

Upper endoscopy
CBC - detect bleeding, antibodies
Occult blood test
Stool test - H.pylori
Urea breath - H.pylori

37
Q

PUD Management & Interventions

A
  • 6 sm meals per day
  • no eating/drinking before bed
  • H.pylori triple/quad therapy
  • antiulcers

Sx (may be an emergent situation)
- vagostomy
- pyloroplasty
- antrectomy w/ gastroduodenostomy Billroth I or II

38
Q

Dumping Syndrome

A

Rapid emptying of gastric entente into the small intestine from surgical removal of a significant portion of the stomach or pyloric sphincter
Lasts for a few months
Occurs 10 to 30 minutes after eating
Resolves within one hour or with bowel evacuation (enema, suction/vacuum)

39
Q

Prevention of Dumping Syndrome

A

5-6 sm meals
Avoid fluids with meals
Inc fiber intake
Lie down to slow digestion
Octreotide (sandostatin) slows down gastric emptying

40
Q

Vagotomy

A

Cut vagus nerve to reduce gastric secretion
Diminishes rest & digest effects

S/E: feeling full, dumping syndrome, gastritis

41
Q

Pyloroplasty

A

Widen the pyloric sphincter which fixes the thickened pylorus causing blockage

Same S/E as vagotomy

42
Q

EN High Risk

A
  • altered LOC
  • poor/absent cough/gag reflex
  • agitation during insertion

MedSurg - Exam 1 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions