Gi

Question 1

What is the similarity between Crohn’s and Ulcerative Colitis?

Answer 1

Both inflame the lining of the GI tract. Both considered types of Inflammatory bowel disease(IBD).

Question 2

What is the difference between Crohn’s and ulcerative colitis?

Answer 2

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.

Question 3

What are symptoms of either Crohns or UC ?

Answer 3

Abdominal pain, cramping, gas , bloating, fatigue, diarrhea ( possibly bloody with colitis), weight loss, fever and loss of appetite

Question 4

Difference between IBD and IBS

Answer 4

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.

Question 5

Testing and diagnosing IBD

Answer 5

Blood tests

Endoscopic procedures( colonoscopy or endoscopy)

XRAY, small bowel imagine, ultrasound or CAT scan

Question 6

What is Crohn’s Disease?

Answer 6

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.

Question 7

What are treatments for IBD?

Answer 7

Corticosteroids(-sone)

Oral 5-aminosalicylates (-ine) not common

IMMUNE SYSTEM SURPRESSORS

Azathioprine (Imuran) , Mercaptopurine(Purinethol)
Infliximab,

Antibiotics

Pain meds

Supplements for nutrition deficit

Question 8

What are some assessments for a pt with IBD?

Answer 8

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

Question 9

What are some interventions for IBD?

Answer 9

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

Question 10

What are symptoms of a bowel obstruction?

Answer 10

• 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

Question 11

Diagnostic tests for BO?

Answer 11

Abd xray

CT Scan of abd

Question 12

How is a BO treate/resolved?

Answer 12

IV fluids
NG tube temporarily (removes gas and relives pressure - decompress stomach)
Completely blocked- surgery
Possible colostomy/ ileostomy after surgery

Question 13

What medication may be ordered for someone with a BO?

Answer 13

Corticosteroids
Opiod pain killers
Antispasmodics
Antiemetics

Question 14

Assesments with BO?

Answer 14

• Bowel sounds
• vitals
• palpation of abdomen
• pain level
• Pmhx
• symptoms
• Medication Hx
• how long pain ?
• Last Bm

Question 15

Teaching re prevention of BO ?

Answer 15

• 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

Question 16

Signs and symptoms of lower GI Bleed vs upper?

Answer 16

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. .

Question 17

What are the signs and symptoms of pancreatitis?

Answer 17

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)

Question 18

What causes pancreatitis?

Answer 18

Most of the time alcoholism

Also, gallstones, medications, infections, trauma, surgery and metabolic disorder.

Question 19

How is pancreatitis diagnosed?

Answer 19

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

Question 20

How is pancreatitis treated?

Answer 20

IV FLUIDS

pain meds

surgery if pancreas dies is too injured

Chronic: insulin, low fat dieg, restoration of enzymes and hormones, pain managment, steroids

Question 21

what do we do before and after endoscopy or coloscopy ?

Answer 21

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)

Question 22

A patient with AAA possible dissectionnwill present with what?

Answer 22

Extreme lower back pain
Hx of AAA
distention of abdomen

Vs changing is a late sign

Question 23

signs of liver problems?

Answer 23

• 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