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409 > GI > Flashcards

GI Flashcards

1
Q

what causes esophageal varices

A

cirrhosis

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2
Q

what is the cardinal sign of esophageal varices

A

elevated pressure in the veins

“portal htn” - portal veins

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3
Q

eso varices are prone to

A

rupture

massive hemorrhage in the upper GI tract

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4
Q

eso vraices bleeds can travel down to rectum

A

true

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5
Q

tf- eso varices has a low mortality rate

A

false- high

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6
Q

clinical manifestations of eso varices

A

hematemesis
melana
deterioration of mental status
s/s of shock

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7
Q

what is melana

A

dark tarry stools

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8
Q

deterioration of mental status from eso varices is due to what

A

blood toxicity

low brain perfusion with O2

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9
Q

how is eso varices dx’d

A

endoscopy- possible interventional
CT
angiograms
x rays

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10
Q

t/f- eso varices pt must be admitted to the ICU

A

true

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11
Q

when treating eso varices, what do we monitor for

A

VS
volume status
elctrolytes

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12
Q

explain how we maintain fluid volume in pt w/ eso varices

A

return lost blood with bank blood
do not overload
fluid bolus’

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13
Q

what do meds do we administer for eso var

A

vasopressin
sandostatin
beta blockers

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14
Q

vasopressin and sandostatin are both…

A

vasoconstrictors

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15
Q

when are vasoconstrictors used in eso var?

A

acute bleeding situations

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16
Q

when are beta blockers used for eso var pt?

A

after an acute event

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17
Q

how is beta blockers admin for eso var pt?

A

iv

at a higher dose

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18
Q

why are beta blockers given to eso var pt?

A

maintain bp

vasocontrictive effect

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19
Q

how is hemorrhage controlled in the pt w/ eso var?

A

balloon tamponade
variceal banding therapy
transjugular Intrahepatic Portosystem Shunting(TIPS)

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20
Q

how does a balloon tamponade

A

NG tube
balloon is inflated over the bleed
pressure is exerted to control the bleeding

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21
Q

does a balloon tamponade completely obstruct the esophagus

A

yes

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22
Q

how does variceal banding work

A

similar to balloon

rigid pressure on area of bleed

23
Q

t/f - variceal banding is an acute intervention

A

true

24
Q

how does TIPS work

A

supports drainage of portal venous blood
decreases pressure in the portal system
allows for better circulation from the liver

25
Q

the blakemore tube allows for what

A

gastric aspiration
esoph aspiration
gastric balloon inflation
eso balloon inflation

26
Q

what do we assess the blakemore tube for

A

correct labels and fxs

27
Q

the blakemore tube requires what kind o monitoring

A

constant reassessment

28
Q

with a blakemore, th pt is always at risk for what

A

aspiration

29
Q

what do we assess in a pt with a blakemore tube?

A

resp assessment

abdominal assessment

30
Q

t/f- hepatic encephalopathy is a life threatening complication of liver disease

A

true

31
Q

hepatic enceph leads to …

A

profound liver failure

32
Q

neuropsychiatric manifestations of hepatic failure

A

minor mental health changes- disheveled, unkempt

motor disturbances- arms/hands do a flapping gesture

33
Q

hepatic enceph is a/w

A

portal htn

34
Q

what happens patho when hepatic enceph occurs

A

shunting of blood from the portal venous system into the circ system (collateral circulation)

35
Q

clinical manifestations of hepatic enceph

A

confused
unkempt
alteration in mood, sleep

36
Q

pregression of hepatic enceph

A 
become more and more difficult to awaken
- obtunded to unresponsive
disoriented
coma
seizures
37
Q

what will be ordered if mental status changes as a reuslt of hepat enceph

A

an EEG

- ordered and placed for 24 hrs

38
Q

what is the role of the pancreas

A

endocrine and aids in digestion

39
Q

pancreatic disease can occur in which parts

A

head
body
tail

40
Q

what is the problem with dx’ing and treating pancreatic cancer?

A

pts seek attention late in the disease process

41
Q

what s/s will pancreatic cancer patients present with

A

pain
jaundice
weight loss

42
Q

how do u dx pancreatic cancer

A

spiral ct

endoscopic procedures

43
Q

is total excision of the pancreas possible as an intervention

A

no

44
Q

how does pancreatic cancer metastasize?

A

liver
lungs
bone

45
Q

what palliative care do we give for pancreatic cancer

A

pain mgmt

nutritional - enteral, parenteral

46
Q

clinical manifestations of pancreatic cancers

A 
obstruction of the common bile ducts
jaundice
clay colored stools
dark urine
pain
47
Q

medical mgmt of pancreatic cancer

A

pancreaticoduodenectomy

aka whipples procedure

48
Q

what is whipples procedure

A

removal of the gallbladder

49
Q

what else can be removed during whipples procedure

A 
portions of the
stomach
duodenum
proximal jejunum
head of the pancreas
distal common bile duct
50
Q

what procedure is needed for whipples procedure to be effective

A

re-enastomosis

51
Q

complications of whipples procedure

A

leakage/bleed
GI complications
infec

52
Q

nursing care after whipples procedure

A 
pain mgmt
iv fluid replacement
nutritional
monitor for bleeding
diabetes
53
Q

what kind of nutrition is needed after a whipples procedure

A

distal jejunostomy or parenteral

54
Q

why might someone become diabetic after the whipples procedure?

A

islets of langerhans dont fx properly

409 (11 decks)

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