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NCLEX > GI > Flashcards

GI Flashcards

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1
Q

Pancreatitis is ___ of the pancreas.

A

auto-digestion

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2
Q

The #1 cause of both acute and chronic pancreatitis is ___.

The #2 cause of acute pancreatitis is ___.

A

ETOH

gallbladder disease

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3
Q

Pain with pancreatitis (increases/decreases) with eating.

A

Eating

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4
Q

Bruising around umbilicus: ___ ___

Bruising around flank area: ___ ___ ___

A

Cullen’s sign

Gray Turner’s sign (Remember: turn your back)

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5
Q

Pancreatitis…the labs all go UP except for H&H. Why?

A

can go up with 3rd spacing

can go down with bleeding

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6
Q

Normal pancreatic enzyme values:

Amylase & Lipase

A

Amylase: 30 - 220
Lipase: 0 - 110
(Remember: “L for Lipase is Less”)

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7
Q

Normal liver enzyme values:

AST & ALT

A

AST: 8 - 40 (M’boro highway)
ALT: 10 - 30 (I Lay down at 10:30)

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8
Q

If liver is sick, the #1 concern is ___. Why?

A

Bleeding
Decrease in clotting factors that are made in the liver!
Pt on BLEEDING PRECAUTIONS

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9
Q

If liver is sick, (increase/decrease) meds. Why?

A

Decrease

Liver can’t metabolize meds as efficiently

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10
Q

4 jobs of the liver:

A

1) DETOXIFY
2) CLOTTING factors
3) METABOLIZE
4) makes ALBUMIN

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11
Q

What causes ascites?

A

The liver isn’t making enough protein so fluid moves to the interstitium

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12
Q

Paracentesis is removal of fluid from the ___ cavity. Why position with HOB straight up?

A

Fluid drains down

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13
Q

What to remember about dosing narcotics to liver pts.

A

Cut dose in half…liver can’t metabolize efficiently. It’s like double dosing them.

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14
Q

Diet concerns for liver pts

A

Decrease protein

Low sodium

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15
Q

Liver pts can’t adequately convert ammonia to ___, so it builds up in the blood. This can decrease ___ & lead to ___ ___.

A

Urea
LOC
hepatic coma

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16
Q

Ammonia acts like a ___

A

sedative

17
Q

Handwriting changes can be an early sign of ___ ___

A

liver disease

18
Q

What med is given to decrease ammonia in the body? How does it work?

A

Lactulose

Eliminates ammonia through the GI tract. Pt has diarrhea…you want diarrhea here!

19
Q

Portal HTN leads to the formation of ___ circulation. What 3 places do these form?

A

collateral

  • stomach
  • esophagus
  • rectum
20
Q

What med lowers BP in the liver? What should we watch out for when using it?

A

Octreotide

Causes vasoconstriction in other areas including the heart!

21
Q

What 3 places do we commonly find peptic ulcers?

A

esophagus
stomach
duodenum

22
Q

S/S of peptic ulcer

A

Burning pain in epigastric area and/or back
Hearburn
May also feel hungry

23
Q

Meds for Peptic Ulcer Dz

A
  • Antacid (empty stomach / at bedtime)
  • PPI
  • H2 blocker
  • Antibiotic (clarithromycin, amoxicillin, tetracycline, metronidazole)
  • Sucralfate (forms barrier over wound)
24
Q

Watch with tetracycline admin…

A

photosensitivity
DON’T GIVE WITH CALCIUM PRODUCTS
stains teeth

25
Q

Dumping syndrome symptoms

A

(Think, similar to stomach bug)

  • fullness
  • weakness
  • palpitations
  • cramping
  • faintness
  • diarrhea
26
Q

What to avoid with dumping syndrome

A

Foods high in carbs and electrolytes

make GI empty fast

27
Q

What does “rebound tenderness” indicate?

A

Inflammation

28
Q

Pt ed for colonoscopy

A
  • clear liquid diet 12-24 hrs preprocedure
  • NPO 6-8 hrs before
  • avoid NSAIDS several days before
  • laxatives/enemas until cleared out
  • polyethyline glycol (Golightly)…serve icy cold to help drink
29
Q

Remember about an ileostomy…

A

Always a little dehydrated b/c poop is liquid
Restore electrolytes, esp in summer (Gatorade)
At risk for kidney stones (dehydrated)

30
Q

Parts of colonoscopy that require irrigation:

When to irrigate?

A

descending and sigmoid
Same time each day
AFTER a meal (peristalsis is up and running)

31
Q

Positioning for irrigating colonoscopy…

Positioning for enema…

A

Colonoscopy –> Doesn’t matter

Enema –> left side (“Left…Leave it in”)

32
Q

Don’t give enemas or laxatives to appendicitis pt b/c…

A

worried about rupture

33
Q

Positioning for appendicitis

A

sitting up, lay toward right side b/c if ruptured the contents will localize on that side

34
Q

TPN…keep ___, but serve ___ ___. Why?

A

keep refrigerated, but serve room temp

B/c so much sugar, bacteria can grow

35
Q

Admin TPN in a ___ ___

Use a filter

A

central line (helps dilute)

36
Q

How to avoid hypoglycemia with TPN

A

Discontinue GRADUALLY

If out of TPN, admin D5W until more comes

37
Q

TPN is selective to the pt. Only good for ___ hrs

A

24

38
Q

When changing central line tubing, what are 3 ways that help avoid getting air in the line?

A
  • clamp it off
  • Valsalva
  • take a deep breath and hum

NCLEX (13 decks)

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