Gi Flashcards
What is the similarity between Crohn’s and Ulcerative Colitis?
Both inflame the lining of the GI tract. Both considered types of Inflammatory bowel disease(IBD).
What is the difference between Crohn’s and ulcerative colitis?
Crohn’s inflammation usually occurs in the lower part of the small bowel and colon. Can penetrate intestinal layers from inner to outer lining.
UC only affects portions of the large intestine, including rectum and anus and only inflames the inner most lining of bowel tissue. Usually starts at rectum and extends upwards.
What are symptoms of either Crohns or UC ?
Abdominal pain, cramping, gas , bloating, fatigue, diarrhea ( possibly bloody with colitis), weight loss, fever and loss of appetite
Difference between IBD and IBS
IBD is chronic, inflammation is key
IBS is a problem that arises due to the brain’s interpretation of whats going on in the bowel, inflammation is not present.
CAN BE DIAGNOSED WITH BOTH.
Testing and diagnosing IBD
Blood tests
Endoscopic procedures( colonoscopy or endoscopy)
XRAY, small bowel imagine, ultrasound or CAT scan
What is Crohn’s Disease?
Type of inflammatory Bowel Disease that may affect any part of the GI tract. It disrupts the body’s ability to digest food, absorb nutrients and eliminate waste in a healthy manner.
What are treatments for IBD?
Corticosteroids(-sone)
Oral 5-aminosalicylates (-ine) not common
IMMUNE SYSTEM SURPRESSORS
Azathioprine (Imuran) , Mercaptopurine(Purinethol)
Infliximab,
Antibiotics
Pain meds
Supplements for nutrition deficit
What are some assessments for a pt with IBD?
Pain assessment
Blood in stool assessment also Hgb
Any triggers the pt has
Assess for distension and Last BM
Asses for infection and S&S
What are some interventions for IBD?
Encourage fluids
Decrease stimuli ( spicy foods, carbonated drinks, alcohol, caffeine)
Encourage diet ( proteins, vitamins, fats, fruits, veggies)
Eat small meals.
Sip fluid rather than gulp, to decrease air to GI
Meds
Dietician involved
What are symptoms of a bowel obstruction?
- Lots of pain in abdomen ( cramping)
- Vomiting
- Bloating and /or distention of abd.
- Constipation and lack of gas( if complete blockage)
- Diarrhea if partly blocked
Diagnostic tests for BO?
Abd xray
CT Scan of abd
How is a BO treate/resolved?
IV fluids
NG tube temporarily (removes gas and relives pressure - decompress stomach)
Completely blocked- surgery
Possible colostomy/ ileostomy after surgery
What medication may be ordered for someone with a BO?
Corticosteroids
Opiod pain killers
Antispasmodics
Antiemetics
Assesments with BO?
- Bowel sounds
- vitals
- palpation of abdomen
- pain level
- Pmhx
- symptoms
- Medication Hx
- how long pain ?
- Last Bm
Teaching re prevention of BO ?
- deal with constipation asap
- drink 8-10 glasses water a day
- teach signs and symptoms in case reoccurrence
- Encourage pt to take meds associated with IBD or laxatives
- NO LAXATIVES IF BO , severe S&S
Signs and symptoms of lower GI Bleed vs upper?
Upper- stool will be dark in color , fatigue, weakness, pain when swallowing if ulcer, potentially caused by GERD or trauma.
Lower- bright blood in stool, fresh blood. fatigue, weakness depending on severity and speed of bleed. Cause by cancer, trauma or IBD etc. .
What are the signs and symptoms of pancreatitis?
Acute:
Upper (left) abd pain that radiates to back
Can be aggravated by eating
Swollen/tender abd Nausea and vomiting Fever Increase in HR palpable pancreas for both
Chronic:
weight loss due to decrease enzymes to breakdown food
Diabetes if beta cells are affected(insulin)
What causes pancreatitis?
Most of the time alcoholism
Also, gallstones, medications, infections, trauma, surgery and metabolic disorder.
How is pancreatitis diagnosed?
Pancreatic function test- enzymes amylase and protease etc. ( self digest pancreas)
Glucose tolerance test- damage to B cells?
Ultrasound /Ct of pancreas
ERCP to assess pancreatic and bile ducts
Biopsy of pancreas
How is pancreatitis treated?
IV FLUIDS
pain meds
surgery if pancreas dies is too injured
Chronic: insulin, low fat dieg, restoration of enzymes and hormones, pain managment, steroids
what do we do before and after endoscopy or coloscopy ?
Endoscopy- Npo 8 hours before, assess need for sedation if anxious , goes in through mouth.
Coloscopy- Possible enema to clear out bowel, can eat but maybe clear fluids before procedure. In through rectum
Assess afterwards for trauma/ bleeding and also return of gag reflex for endoscopy( lidocaine)
A patient with AAA possible dissectionnwill present with what?
Extreme lower back pain
Hx of AAA
distention of abdomen
Vs changing is a late sign
signs of liver problems?
- Abnormal AST/ ALT ( low??) liver function tests
- Pain in RUQ radiating
- Jaundice
- distention
- Fluid build up/back up ( portal hypertension)
- Edema
- hx alcoholism/ Hepatitis
- palpable liver esp with liver cirrhosis
