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z Here you go, Alexis! > gi > Flashcards

gi Flashcards

1
Q

acute pancreatitis causes x2

A

alcohol, gallbladder disease

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2
Q

chronic pancreatitis #1 cause

A

alcohol

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3
Q

ascites

A

losing protein rich fluids like enzymes and blood into the abdomen

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4
Q

rigid board-like abdomen indicative of

A

bleeding that can lead to peritonitis

pain, inflammation, tenderness

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5
Q

1 concern if liver is sick

A

bleeding

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6
Q

4 major functions of the liver

A

detoxifying body
helps blood clot
metabolize drugs
synthesize albumin

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7
Q

cirrhosis

A

liver cells destroyed and replaced with scar tissue

  • altered circulation in liver
  • hypertension
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8
Q

when spleen is enlarged…

A

immune system is involved

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9
Q

hepatic encephalopathy/coma

A

cirrhosis can progress to this

liver damaged = ammonia builds up = goes to brain = sedative

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10
Q

paracentesis

A

removal of fluid from peritoneal cavity;
beware shock (removal of fluids)
- portal hypertension
- vessels to liver stretch
- no albumin to hold in fluid (liver damaged)
- fluid pools in potential space to relieve pressure

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11
Q

give a liver client narcotics =

A

essentially double dosing them! liver can’t metabolize when sick.

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12
Q

describe body metabolism of protein

A

protein = ammonia = liver converts to urea = kidneys excrete urea

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13
Q

ammonia effect

A

sedation

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14
Q

asterixis

A

“liver flap” - hand tremor

indicative of ammonia build up (hepatic coma)

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15
Q

fetor

A

breath smells like ammonia (acetone-y, bottle of wine, fresh cut grass)

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16
Q

hepatic coma

A

can result from ammonia build up due to liver’s inability to break it down to urea for excretion

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17
Q

hepatic coma/ammonia build up s/s

A

mental changes/motor problems
asterixis, handwriting changes
fetor
bleeding

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18
Q

hepatic coma tx

A

lactulose (pulls fluid, ammonia into GI tract and out via diarrhea)

cleansing enemas (get blood out because blood = protein)

decrease protein in diet

monitor serum ammonia

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19
Q

bleeding esophageal varices

A

portal hypertension forces collateral circulation to form - usually no problem until rupture

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20
Q

portal hypertension creates collateral circulation in x3

A

esophagus
stomach
rectum

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21
Q

alcoholic client that is GI bleeding is usually

A

esophageal varices (portal hypertension collateral circulation)

22
Q

peptic ulcers

A

common cause of gi bleeding; erosion present
esophagus, stomach, duodenum

usually males

23
Q

smoking effect on gi

A

increases stomach motility, increases stomach secretions

24
Q

when do you take antacids?

A

when stomach is empty and at bedtime

25
Q

gastric ulcer

A

malnourished, pain is usually half hour to 1 hour after meals, food doesn’t help but vomiting does, vomit blood

26
Q

duodenal ulcers

A

well-nourished, night time pain is common and 2-3 hours after meals, food helps, blood in stools

27
Q

hiatal hernia

A

hole in the diaphragm is too large so stomach moves up into thoracic cavity

main cause: large abdomen; also - congenital, trauma, surgery

28
Q

dumping syndrome

A

stomach empties too quickly after eating = many uncomfortable side effects;

usually s/t gastric bypass, gastrectomy, gall bladder disease

29
Q

ulcerative colitis

A

ulcerative inflammatory bowel disease - just the large intestine (colon)

30
Q

crohn’s disease

A

aka “regional enteritis” - inflammation and erosion of ileum, but can be found anywhere in small or large intestines

31
Q

rebound tenderness indicative of

A

peritoneal inflammation (irritation) aka peritonitis

32
Q

diet for ulcerative colitis and crohn’s

A

low fiber - trying to limit gi motility to help save fluid

avoid cold/hot foods and smoking (all increase motility)

33
Q

ileostomy care nota bene x4

A
  • drains liquid all the time; don’t have to irrigate
  • avoid hard to digest and rough foods (increase motility)
  • gatorade in summer
  • at risk for kidney stones (always a little dehydrated)
34
Q

which types of colostomy do you irrigate?

A

descending and sigmoid (formed stools! - ascending and transverse = semi-liquid stool)

35
Q

best times to irrigate colostomy x2

A

same time every day

after meal

36
Q

if client cramps during enema… x2

A

lower bag (slow fluids), check fluid temp

37
Q

appendicitis

A

related to low fiber diet
abdominal pain first, nausea/vomiting second
do not give enemas or laxatives! (possible rupture)

38
Q

appendicitis: #1 worry

A

rupture!

39
Q

localized pain in McBurney’s point indicative of

A

appendicitis

right lower quadrant

40
Q

position of choice after any major abdominal surgery

A

HOB up (relieves pressure on abdomen, decreases tension on suture line)

41
Q

position of choice pre major abdominal surgery

A

HOB up, right side (bowel content into one quadrant)

fetal position okay (comfort)

42
Q

total parenteral nutrition nota bene x6

A

keep refrigerated but warm for administration
central line, dedicated line only
discontinue gradually (avoid hypoglycemia)
hang for 24 hours max
change tubing every bag
always pump less than 42ml/hr

43
Q

most frequent complication of tpn

A

infection

44
Q

how to avoid getting air in line when changing tubing on central line

A

clamp

valsalva (deep breath and hum)

45
Q

pancreatitis treatment x6

A

control pain (decrease gastric secretions with NPO, NGT to suction, bed rest, meds)

steroids (decrease inflammation)

anticholinergics (dry)

ppi, h2 antag, antacids

maintain f/e balance, nutritional status, daily weight, no alcohol

insulin (pancreas damaged, steroids suppress, tpn high in glucose)

46
Q

cirrhosis diet

A 
decrease protein (avoid ammonia build up)
low Na
47
Q

client teaching for peptic ulcers

A

decrease stress
stop smoking
eat what you tolerate (avoid super spicy, extreme temp, caffeine)
follow for a year

48
Q

hiatal hernia treatment

A 
small, frequent meals
sit up 1 hour after eating
elevate HOB
surgery
teach lifestyle changes, health diet
49
Q

lay on what side to keep food in the stomach?

A

left side (right side empties it)

50
Q

dumping syndrome treatment

A 
semi-recumbent with meals (left side!)
lie down after
no fluids with meals (in between)
small, frequent meals
avoid high carbs and electrolytes (empty fast)

z Here you go, Alexis! (23 decks)

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