GI

Question 1

GI changes in elderly

Answer 1

1.decreased hydrochloric acid, peristalsis, lipase production, protein synthesis, and liver enzymes

Question 2

physical assessment of abdomen

Answer 2

inspection, auscultation, percussion, palpation

Question 3

elderly diet changes

Answer 3

small frequent meals high in fiber, vitamins, and iron w plenty of water

Question 4

large pulsating mass in abdomen

Answer 4

don’t touch, tell dr quadrant of origin and direction of flow
-intestinal obstruction of aortic aneurysm

Question 5

range of bowel sounds

Answer 5

use diaphragm of stethescope

hypo- after abdominal surgery , peritonitis, paralytic ulcer

Question 6

borborygmus

Answer 6

loud increased sounds- diarrhea

Question 7

bruits

Answer 7

swoosh sound- aneurysm

Question 8

upper endoscopy interventions for decreased RR

Answer 8

use a stimulus such as sternal rub to encourage deeper and faster respirations

Question 9

colonoscopy education

Answer 9

1. clear liquid diet
2. avoid red, orange or purple beverages
3. drink electrolyte drinks
4. NPO 4-6 hrs before proceedure
5. avoid aspirin, anticoagulants, and antiplatelets several days prior
6. bowel prep- chill, no elderly

Question 10

candida albicans (oral thrush) treatment

Answer 10

nystatin (mycostantin) oral suspension swish/swallow
ice pop troches
topical triamcinolone in benzocaine
oral dexamethasone

Question 11

erythroplakia

Answer 11

precancerous, red velvety mucosal lesions on the surface of oral mucosa

Question 12

leukoplakia

Answer 12

thick white firmly attached patches that can’t be easily scraped off

Question 13

lidocaine for pain cautions

Answer 13

can cause burns from hot liquids or risk for chocking

Question 14

acute sialadentis interventions

Answer 14

IV fluids/hydration, warm compress, massage of the gland, use saliva substitute, use sialagogues (lemon or citrus flavor)

Question 15

contributing factors to decreased lower esophageal sphincter

Answer 15

caffiene, chocolate, citrus, tomatoes, smoking, calcium channel blockers, nitrates, mint, alcohol, anticholenergic drugs, high levels of estrogen/progesterone, NG tube placement

Question 16

GERD symptoms

Answer 16

dyspepsia, regurgitation, cough/wheeze at night, water brash, dysphagia, odynophagia, epigastric pain, belch/fart, nausea, pyrosis (heartburn), globus (feeling of something in back of throat), pharyngitis

Question 17

peptic ulcer disease diet

Answer 17

avoid substances that increase gastric acid secretion- caffeine containing beverages and all coffee

Question 18

antacid side effects

Answer 18

sodium excess, hypernatremia, water retention, metabolic alkalosis, acid rebound, diarrhea, constipation

Question 19

dyspepsia

Answer 19

heartburn

Question 20

pernicious anemia vitamin supplementation

Answer 20

B12

Question 21

helicobacter infection meds (MOC)

Answer 21

triple therapy- metronidazole (amoxicillin), omeprazole (lansoprazole), and clarithomycin
quad- add PPI

Question 22

liver disease and increased bleeding

Answer 22

PT is prolonged because the liver decreases production of prothrombin, low platelet counts
splenomegally destroys platelets causing thrombocytopenia

Question 23

hepatic encephalopathy cause

Answer 23

shunting of portal venous blood into central circulation so the liver is bypassed

Question 24

hepatic encephalopathy

Answer 24

cognitive syndrome that results from liver failure and cirrhosis

• sleep/mood/speech disturbance early -treatable
• LOC and neuromuscular later

Question 25

beta cells in pancrease

Answer 25

insulin

Question 26

alpha cells

Answer 26

glucagon

Question 27

3 pancreas enzymes

Answer 27

lipase, trypsin, elastase

Question 28

omeprazole

Answer 28

30 min before meal, take whole

• long term use osteoporotic fractures and reduced aniplatelet drug clopidogrel effect
• don’t stop abruptly