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Illness and Patho 1 > GI > Flashcards

GI Flashcards

1
Q

Acute inflammation of the vermiform appendix

A

Appendicitis

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2
Q

Where do patients with appendicitis have pain?

A

In the epigastic or periumbilical area

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3
Q

When do patients with appendicitis have nausea and vomiting?

A

After the abdominal pain

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4
Q

What are the signs of appendicitis?

A

Pain at McBurney’s point and rebound tenderness

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5
Q

Why is appendicitis very difficult to diagnose?

A

Because it is a diagnosis of exclusion

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6
Q

Why should patients with appendicitis not be given laxatives?

A

They can cause perforation of the appendix

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7
Q

Why should patients with appendicitis not use heat for the pain?

A

Because heat causes the circulation in the appendix to increase, leading to inflammation and perforation

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8
Q

How should patients with appendicitis be positioned?

A

Semi-fowlers

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9
Q

What are the priorities when a patient comes into the ER with appendicitis?

A

Make that patient NPO and give IV fluids and electrolytes

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10
Q

How many mL of sterile fluid are normally in the peritoneal cavity to prevent friction?

A

50

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11
Q

Life threatening acute inflammation of visceral/parietal peritoneum and endothelial lining of abdominal cavity, or peritoneum

A

Peritonitis

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12
Q

What does primary peritonitis indicate?

A

Peritoneum is infected via the bloodstream

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13
Q

What does secondary peritonitis indicate?

A

Contamination of the peritoneal cavity by bacteria or chemicals

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14
Q

Why does peritonitis have to be treated immediately?

A

To stop the shunting of blood to the area of inflammation and causing third spacing and hypovolemic shock

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15
Q

What are the signs of peritonitis?

A

Rigid, board like abdomen, pain, distention, high fever, tachycardia, dehydration, low urine output, hiccups, compromised respiratory status, nausea, vomiting, diminished bowel sounds, inability to pass flatus or feces, and anorexia

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16
Q

Why do hiccups occur with peritonitis?

A

Diaphragmatic irritation and increased white blood cells

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17
Q

How is peritonitis diagnosed?

A

Peritoneal lavage

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18
Q

How is peritonitis managed?

A

IV fluids, antibiotics, NG suctioning

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19
Q

What position do patients with peritonitis need to be in?

A

Semi-Fowlers

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20
Q

Widespread inflammation of mail the rectum and rectosigmoid colon, associated with periodic remissions and exacerbations

A

Ulcerative Colitis

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21
Q

Unpleasant and urgent senstation to deficate

A

Tenesmus

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22
Q

What is the poop of a patient with ulcerative colitis like?

A

10-20 bloody stools daily

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23
Q

What would the labs of a patient with ulcerative colitis be?

A

Decreased H&H, increased WBCs, c-reactive protein, increased erythrocyte sed, decreased electrolytes

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24
Q

What is the most definitive test for ulcerative colitis?

A

Colonoscopy

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25
Q

What are the drugs used to treat ulcerative colitis?

A

Glucocorticoid, antidiarrheal drugs, and Humira

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26
Q

What are the side effects of antidiarrheal drugs?

A

Colon dilation and toxic megacolon

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27
Q

What needs to be taught with Humira?

A

Watch for signs and symptoms of infection

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28
Q

What should patients with ulcerative colitis avoid?

A

Caffeine, pepper, alcohol, and smoking

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29
Q

What do patients with ostomies need to be taught?

A

Don’t leave supplies in the car

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30
Q

What should a stoma look like?

A

Pinkish to cherry red

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31
Q

What are the nursing interventions for patients with ostomies?

A

Skin protection, monitor blood and fluid loss, and psychological care

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32
Q

Inflammatory disease of the small intestine and colon causing thickening of the bowel wall with deep ulcerations and fistulas

A

Crohn’s Disease

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33
Q

What causes Crohn’s?

A

Possibly genetic, immune, or environmental factors

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34
Q

What do patients with ulcerative colitis look like?

A

Very sickly

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35
Q

What is the poop of a Crohn’s patient like?

A

5-6 loose stools daily

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36
Q

How do obstructions occur in Crohn’s patients?

A

Inflammation and scarring from the fistulas cause a narrowing of the intestines

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37
Q

What is the priority for patients with fistulas with Crohn’s disease?

A

Always protect the skin

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38
Q

What is the criteria for patients to have a wound vac?

A

They must be in a positive nitrogen balance

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39
Q

What would the bowel sounds of a patient with Crohn’s be?

A

Hyperactive in all four quadrants

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40
Q

Where is the pain for patients with Crohn’s?

A

Right lower quadrant

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41
Q

Why would patients with Crohn’s be anemic?

A

Because they can’t absorb intrinsic factor

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42
Q

What drugs can be used to treat Crohn’s?

A

Flagyl, methotrexate, remicade and Humira

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43
Q

What does Flagyl do?

A

Fights infection in deep, dark places

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44
Q

What teaching needs to accompany taking Flagyl?

A

Don’t drink

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45
Q

What does Methotrexate do?

A

It is an immunosuppressant that kills rapidly dividing cells

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46
Q

What does Humira do?

A

Immunosuppressant

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47
Q

What teaching needs to accompany Humira?

A

Stay away from crowds and report signs of infection

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48
Q

What is the priority for patients with Crohn’s?

A

Nutritional management

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49
Q

What is the diagnostic test for Crohn’s?

A

Biopsy

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50
Q

The presence of many abnormal pouch like herniation in the wall of the intestine

A

Diverticulitis

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51
Q

Where do patients with diverticulitis have pain?

A

Left lower quadrant

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52
Q

What are the signs of diverticulitis?

A

Abdominal distension, guarding, rebound tenderness, decreased BP, hypovolemia, low grade fever, and nausea

53
Q

How is diverticulitis diagnosed?

A

Barium show

54
Q

What are the primary interventions for patients with diverticulitis?

A

Drug therapy, nutritional therapy, and rest

55
Q

What drugs are used for patients with diverticulitis?

A

Flagyl, cipro, anticholinergics, and analgesics

56
Q

What needs to be avoided for patients with diverticulitis?

A

Avoid laxatives and enemas

57
Q

What does a bowel prep do?

A

Cleansing and then neomycin

58
Q

A lack of desire to eat despite physiologic stimuli that would normally produce hunger?

A

Anorexia

59
Q

The forceful emptying of the stomach and intestinal contents through the mouth

A

Vomiting

60
Q

What are the most common symptoms of nausea?

A

Hypersalivation and tachycardia

61
Q

Nonproductive vomiting

A

Retching

62
Q

What is projectile vomiting associated with?

A

Head injuries and and structural deficits

63
Q

What elevated electrolyte causes constipation?

A

Calcium

64
Q

A reflux of chyme from the stomach to the esophagus

A

GER

65
Q

What is GERD caused by?

A

A loose lower esophageal sphincter

66
Q

What is the hallmark of GERD?

A

Abdominal pain within 1 hour of eating

67
Q

What cells heal erosions called by GERD?

A

Barrett’s epithelium

68
Q

How can GERD be treated?

A

Avoid food that irritates stomach, eat slowly, lose weight, sleep on right side

69
Q

Name the protein pump inhibitors

A

Prilosec, pantoprazole, and Nexium

70
Q

What is Nissen Fundiplication?

A

Using laproscopic surgery to reinforce the lower esophageal sphincter

71
Q

What is the post op care for patients with nissen fundiplication?

A

Avoid foods and beverages that cause gas, NG tube

72
Q

Chronic GI disorder characterized by chronic or recurrent diarrhea, constipation, and/or abdominal pain and bloating

A

Irritable Bowel Syndrome

73
Q

What are the clinical manifestations of IBS?

A

Abdominal pain relieved by defication or sleep with the sensation of incomplete bowel emptying

74
Q

Where is the pain associated with IBS?

A

Left lower quadrant

75
Q

What would the assessment of IBS patients reveal?

A

Normal weight, normal nutrition, normal fluid and electrolytes, and normal bowel sounds

76
Q

What do patients with IBS need to be taught?

A

Don’t abuse laxatives, don’t delay the urge to deficate, increase fluids

77
Q

What drugs are used to treat IBS?

A

Bulk forming laxatives, Bentyl, Ditropan, antidiarrheals, and Elavil

78
Q

What teaching accompanies bulk forming laxatives?

A

Take at mealtimes with a glass of water

79
Q

What is Bentyl used for?

A

Relieves cramps caused by smooth muscle spasms

80
Q

What are the side effects of Bentyl?

A

Blurred vision, SOB, headache, drowsiness, and lack of sweatin

81
Q

What is Ditropan used for?

A

It stops urge urinary incontinence

82
Q

What is Elavil used for?

A

Relieves cramping

83
Q

What are the side effects of Elavil?

A

Turns urine blue-green, constipation, dry mouth, and orthostatics

84
Q

Unnaturally swollen or distended veins in the anorectal region

A

Hemorrhoids

85
Q

How are hemorrhoids treated?

A

Preparation H, Rubber band treatment, diet high in fiber and fluids

86
Q

What is the complications for hemorrhoids?

A

Bleeding

87
Q

What is a nonmechanical intestine obstruction?

A

Paralytic Ileus

88
Q

In what kind of obstruction are there borborygmi?

A

Mechanical Obstruction

89
Q

In what kind of obstruction are there no bowel sounds?

A

Nonmechanical Obstruction

90
Q

What is the hallmark of colorectal cancer?

A

Weight loss

91
Q

Where is the most common place for colorectal cancer to occur?

A

In the exit of the rectum

92
Q

What diet modifications can treat colorectal cancer?

A

Low fat, low carbs, high fiber

93
Q

What is the most common sign of colorectal cancer?

A

Rectal bleeding

94
Q

What is the diagnostic test for colorectal cancer?

A

Colonoscopy

95
Q

What speeds up the return of bowel sounds and flatulence?

A

Ambulation

96
Q

When can food be given post GI surgery?

A

After the gag reflex, bowel sounds, and flatulence returns

97
Q

When do colostomy pouches need emptied?

A

When they are 1/3 - 1/2 full

98
Q

Small growths in the intestinal tract that are covered with mucosa and are attached to the surface of the intestine

A

Polyps

99
Q

What can polyps cause?

A

Bleeding, intestinal obstruction, and intussusception

100
Q

What are 99% of peptic ulcers caused by?

A

H. Pylori

101
Q

Ulcers characterized by high gastric acid secretion in the duodenum

A

Duodenal Ulcers

102
Q

Break in the mucosa of the stomach

A

Gastric Ulcer

103
Q

When do gastric ulcers cause pain?

A

Pain with an empty stomach

104
Q

What causes stress ulcers?

A

Trauma, burns, head injuries, shock, or sepsis

105
Q

What is the hallmark of stress ulcers?

A

Upper GI hemorrhage

106
Q

When a patient is in shock, what can be done to prevent stress ulcers?

A

Start on tube feeds

107
Q

What are Curling’s ulcers caused by?

A

Burns

108
Q

What are Cushing’s ulcers caused by?

A

Head injury

109
Q

What causes PUD?

A

NSAIDs, smoking, caffeine, Theophlylline and alcohol

110
Q

How does Theophlylline cause ulcers?

A

It stimulates the HCL production

111
Q

Where is the pain from gastric ulcers located?

A

Right upper quadrant

112
Q

What is the most serious complication of ulcers?

A

Bleeding

113
Q

What tests diagnose ulcers?

A

CBC and H&H, EGD

114
Q

If a patient is hemorrhaging from an ulcer, what do you do?

A

Treat and prevent dehydration, stop the bleeding

115
Q

What drug can be given to stop hemorrhaging?

A

Vasopressin

116
Q

What are the three major complications that can occur from an ulcer?

A

Hemorrhage, Gastric Perforation, and Obstruction

117
Q

What is the pharmacological treatment for ulcers?

A

Two antibiotics and a PPI

118
Q

What does Carafate do?

A

Forms a viscid and stick gel and adheres to ulcer surfaces, forming a protective barrier

119
Q

What teaching do patients on Carafate need?

A

Give on an empty stomach one hour before meals and at bed time

120
Q

What surgical intervention can be used to treat PUD?

A

Vagotomy, antrectomy, or gastrectomy

121
Q

What does a vagotomy do?

A

Eliminates the acid secreting stimulus to gastric cells and eliminates pain

122
Q

What are the gastrectomy options?

A

Billroth 1 and 2

123
Q

Patients with gastrectomy will develop what kind of anemia?

A

Pernicious or Folic Acid deficiency

124
Q

What surgery is dumping syndrome associated with ?

A

Billroth 2

125
Q

What is dumping syndrome?

A

Feeling like you will die after eating

126
Q

How can dumping syndrome be avoided?

A

High protein, high fat and low carb diet, eat in recumbent position, avoid fluids, lie down after meals

127
Q

What are the manifestations of a gastrojsjunocolic fistula?

A

Fecal vomiting

128
Q

Why are protonix given to a patient experiencing a hemorrhage from PUD?

A

To protect the blood clot over the ulcer

129
Q

What are the nursing interventions for PUD?

A

Pain, altered nutrition, and fluid volume deficit

Illness and Patho 1 (12 decks)

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