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NCLEX > GI > Flashcards

GI Flashcards

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1
Q

auto digestion of the pancreas

A

pancreatitis

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2
Q

endocrine function of the pancreas

A

insulin

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3
Q

exocrine function of the pancreas

A

digestive enzymes

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4
Q

1 cause of acute pancreatitis

A

alcohol

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5
Q

2 cause of acute pancreatitis

A

gallbladder disease

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6
Q

1 cause of chronic pancreatitis

A

alcohol

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7
Q

sx of pancreatitis

A 
pain
ascites
abdominal mass
rigid abdomen
culler's sign
fever
N/V
jaundice
hypotension
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8
Q

bruising around umbilical area

A

cullen’s sign

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9
Q

bruising around flank area

A

grey-turner’s sign

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10
Q

how do you diagnose pancreatitis

A

elevated liver enzymes
elevated WBCs
increased blood sugar
increased serum bilirubin

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11
Q

with pancreatitis the PT and aPTT is _____.

A

longer

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12
Q

normal amylase

A

30-220

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13
Q

normal lipase

A

0-110

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14
Q

normal AST

A

8-40

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15
Q

normal ALT

A

10-30

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16
Q

treatment for pancreatitis

A

control pain
steroids
anticholinergics
GI protectants

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17
Q

with pancreatitis we want the stomach ____ and _____

A

empty and dry

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18
Q

male hemoglobin levels

A

14-18

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19
Q

female hemoglobin levels

A

12-16

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20
Q

male Hct levels

A

42-52%

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21
Q

female Hct levels

A

37-47%

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22
Q

why do we give anticholinergics with pancreatitis?

A

dry up secretions

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23
Q

examples of anticholinergics

A

benztropine

atropine

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24
Q

examples of GI protectants

A

pantoprazole
ranitifidine
famotidine
antacids

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25
Q

since we want the stomach empty and dry the client with pancreatitis needs

A

NPO
NGT to suction
bedrest

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26
Q

why will pancreatitis patients need insulin?

A

pancreas is sick
steroid use
TPN

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27
Q

4 major functions of the liver

A

detoxifying the body
helps blood clot
breaks down drugs
synthesizes albumin

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28
Q

with cirrhosis of the liver, liver cells are destroyed and replaced with scar tissue with alters the circulation within the liver, which in turn makes the BP in the liver go up….this is called?

A

portal HTN

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29
Q

if your liver is sick ____ is your #1 concern

A

bleeding

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30
Q

if your liver is sick ___ the dose of meds

A

decrease

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31
Q

never give ___ to people with liver problems

A

tylenol

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32
Q

antidote for tylenol

A

acetylcysteine (mucomyst)

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33
Q

sx of cirrhosis

A 
firm, nodular liver
abdominal pain
chronic dyspepsia
change in bowel habits
ascites
splenomegaly
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34
Q

serum albumin with cirrhosis

A

decreased

3rd spacing

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35
Q

ALT and AST in cirrhosis

A

increased

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36
Q

when the spleen is enlarged, the _____ system is involved

A

immune

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37
Q

dx of cirrhosis by?

A

liver biopsy
CT/MRI
ultrasound

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38
Q

which labs need to be viewed prior to liver biopsy

A

PT, INR, aPTT

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39
Q

how do you position client for liver biopsy

A

supine with R arm behind head

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40
Q

post liver biopsy position?

A

lie on R side

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41
Q

treatment for cirrhosis

A

antacids, vitamins, diuretics
no more alcohol
I/Os, daily weights
measure abdominal girth

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42
Q

removal of fluid from the peritoneal cavity

A

paracentesis

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43
Q

have the client ____ before paracentesis

A

void

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44
Q

position for paracentesis

A

sitting up

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45
Q

with “shocky” clients, the BP goes ____ and the pulse goes ____

A

down

up

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46
Q

anytime you are pulling fluids you can throw them into ____

A

shock

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47
Q

avoid ____ because the liver can’t metabolize drugs well when it’s sick

A

narcotics

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48
Q

if you give a liver client narcotics, it’s the same thing as doing what to them?

A

double dosing them

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49
Q

diet for cirrhosis

A

decrease protein

low sodium diet

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50
Q

protein breaks down to _____

A

ammonia

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51
Q

the liver converts ammonia to ____

A

urea

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52
Q

the kidneys excrete the ____

A

urea

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53
Q

when the liver is impaired, it can’t make the conversion to urea and _____ builds up in the blood

A

ammonia

54
Q

what does the increase in ammonia do?

A

decrease LOC

55
Q

ammonia acts as a ____

A

sedative

56
Q

sx of hepatic coma

A 
mental changes
difficult to awake
asterixis
slow EEG
fector
57
Q

what is fector?

A

breath smells like ammonia

58
Q

treatment for hepatic coma

A

lactulose
cleansing enema
decrease protein in the diet

59
Q

lactulose decreases serum _____

A

ammonia

60
Q

high BP in the liver known as ____ ___ forces collateral circulation to form

A

portal HTN

61
Q

the collateral circulation forms in 3 different places?

A

stomach
esophagus
rectum

62
Q

when you see an alcoholic client that is GI bleeding it is usually _____ _____

A

esophageal varices

63
Q

esophageal varices are usually no problem until they _____

A

rupture

64
Q

treatment for esophageal varices

A

replace blood
VS
CVP
Oxygen

65
Q

_______ medication helps with esophageal varices by lowering BP in the liver

A

octreotide (sandostatin)

66
Q

an infrequently used emergency procedure that may be used to stabilize clients with severe hemorrhage with esophageal varices

A

balloon tamponade

67
Q

balloon tamponade should not be used more than _____ hrs

A

12

68
Q

purpose of balloon tamponade

A

hold pressure on bleeding varices

69
Q

common cause of GI bleeding

A

peptic ulcers

70
Q

peptic ulcers are most common in ?

A

males

71
Q

sx of Peptic ulcers

A

burning pain

heartburn

72
Q

dx of peptic ulcers

A

gastroscopy

Upper GI

73
Q

what’s important about gastroscopy

A

NPO before

they’re sedated

74
Q

watch for perforation with gastroscopy by watching for what 3 things?

A

pain
bleeding
trouble swallowing

75
Q

looks at the stomach with dye

A

upper GI study

76
Q

NPO for how long for upper GI

A

NPO past midnight

77
Q

education before upper GI

A

no smoking, gum, or mints

no smoking/nicotine patches

78
Q

treatment of peptic ulcers

A

antacids
PPIs
H2 antagonist

79
Q

client teaching with peptic ulcers

A

decrease stress
stop smoking
avoid spicy foods

80
Q

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

A

gastric ulcers

81
Q

well-nourished
night time pain and 2-3 hrs after meals
eating helps
blood in stools

A

duodenal ulcers

82
Q

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

A

hiatal hernia

83
Q

main cause of hiatal hernia

A

large abdomen

84
Q

other causes of hiatal hernia

A

congenital abnormalities
trauma
straining

85
Q

sx of hiatal hernia

A

heartburn
fullness after eating
regurgitation
dysphagia

86
Q

tx of hiatal hernia

A

small freq meals
sit up 1 hr after meals
elevate HOB
surgery

87
Q

when the stomach empties too quickly after eating and the client experiences many uncomfortable to severe side effects…usually secondary to gastric bypass, gastrectomy, or gallbladder disease

A

dumping syndrome

88
Q

sx of dumping syndrome

A 
fullness
weakness
palpitations
cramping
faintness
diarrhea
89
Q

left side lying=

A

leaves it in

90
Q

right side lying=

A

releases it

91
Q

tx of dumping syndrome

A 
semi-recumbent with meals
lie down after meals
no fluids with meals
small freq. meals
avoid food high in carbs and electrolytes
92
Q

ulcerative inflammatory bowel disease

only in lg. intestine

A

ulcerative colitis

93
Q

inflammation and erosion of the ileum but can be found anywhere in the small or large intestine

A

chron’s disease

94
Q

sx of ulcerative colitis and chron’s disease

A 
diarrhea
rectal bleeding
weight loss
vomiting
cramping
dehydration
blood in stools
anemia
rebound tenderness
fever
95
Q

what does rebound tenderness indicate?

A

peritoneal inflammation

96
Q

dx of ulcerative colitis and chron’s disease

A

CT
colonoscopy
barium enema

97
Q

clear liquids __-__hrs before colonoscopy

A

12-24

98
Q

NPO __-__hrs before colonoscopy

A

6-8

99
Q

they drink go-lytely before the colonoscopy. the other name for this is?

A

sodium polystyrene sulfonate

100
Q

to help your client drink a colon prep more easily, get it _____

A

ice cold

101
Q

post op colonoscopy watch for?

A

perforation

102
Q

sx of perforation after colonoscopy

A

pain/unusual discomfort

103
Q

treatment for ulcerative colitis and chron’s disease

A

diet
meds
surgery

104
Q

diet for ulcerative colitis and chron’s disease

A

low fiber diet

avoid cold foods, hot foods, and smoking

105
Q

meds for ulcerative colitis and chron’s disease

A

antidiarrheals
ATBs
steroids

106
Q

surgery for ulcerative colitis

A

total colectomy

kock’s illeostomy

107
Q

a kock’s pouch hav a nipple valve that opens and closes to ____ the intestines

A

empty

108
Q

the J pouch procedure removes the colon and attaches the ____ to the ____

A

illeum to the rectum

109
Q

with chron’s they try not to do ____

A

surgery

110
Q

an ostomy in the ileum is called an ___

A

ileostomy

111
Q

an ostomy in the colon is called a _____

A

colostomy

112
Q

an ileostomy is going to drain _____ all the time

A

liquid

113
Q

do you have to irrigate ileostomy?

A

NO

114
Q

ileostomy patients are always at risk for ___ ___ because they are always a little dehydrated

A

kidney stones

115
Q

a colostomy in the ascending and transverse colon have what type of stools

A

semi liquid

116
Q

colostomy in the descending or sigmoid colon have what type of stools?

A

semi-formed or formed

117
Q

which ostomys do you irrigate?

A

descending and sigmoid

118
Q

sx of appendicitis

A

pain at mcburney’s point
rebound tenderness
N/V
anorexia

119
Q

dx of appendicitis

A

increased WBCs
ultrasound
CT

120
Q

do not give ___ or ___ with appendicitis because we are worried about perforation

A

enemas or laxatives

121
Q

treatment for appendicitis

A

surgery

122
Q

after appendectomy what position should they be in?

A

HOB up

123
Q

keep TPN refrigerated but ___ for administration

A

warm

124
Q

what 2 things are needed for TPN

A

filter and central line

125
Q

BG monitoring q ___ hrs with TPN

A

6 hrs

126
Q

TPN can only be hung for ___ hrs

A

24

127
Q

check urine for ___ and ____ with TPN

A

glucose and ketones

128
Q

position to put in a central ine

A

trendelenburg

129
Q

if air gets in the central line what position do you put them in?

A

left side trendelenburg

130
Q

when changing the tubing for central line, how do you avoid getting air in the line?

A

clamp it off
valsalva
take a deep breath and HUM

131
Q

why is x-ray done post insertion of central line?

A

placement

and to make sure they don’t have pneumothorax

132
Q

central lines go into the ___ ___

A

RA

NCLEX (10 decks)

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