GI Flashcards
GI begins
Mouth- teeth, tongue, salivary glands
Esophagus- 10’ carry food to stomach
Stomach- located in ULQ(LUQ) food turn to liquid called chyme, pyloric sphincter keep food from backing into esophagus
Small intestine- 3 parts, duodenum, jejunum,ilium
Large intestine- ascending, transverse, descending illeoCecal valve keeps food from backing into small intestine
Abdomen
Inspect- assess contour while pt. Laying supine
Auscultate-listen for bowel sounds 1 full min every quadrant UR, UL, LL,LR
Palpate-assess for destention and tenderness measure abdominal girth
Percussion- produces sound of organs performed by MD or advance nurse
Assess stole specimen
Check for blood, T.A.C.O
Lab test
Hemoglobin/ hematocrit
12-16/38-46 for women
Electrolytes
K =3.5-5.5
Ca=8-10.5
NA=135-145
Carcinomembryonic (CEA)
Cancer marker, antigen determines cancer
Fecal analysis
Stool sample is collected 3 different times check for hidden blood
Blue color =positive using guaic test
Occult
Check for blood in stool
Ova & parasite
OMP, stool checked for intestinal infection. Bring to lab within 30 min of collecting for testing
Steatorahea
Check for fat in stool, collect stool for 3 days
X ray K U B
Kidney urethra and bladder..flat plate of abdomen
Upper GI series
Looks at esophagus into jejunum. Check for iodine or shellfish allergies. Swallow barium. Detects strictures, ulcers, tumors. Have to give a laxative after. Stool may be clay colored for 3 days
Lower GI series
Visualize position, movement of filling in colon. Given go-Lytely. Check for return of gag reflexes
Ct scan
3 demential view of the abdominal structure. NPO prior to procedure. Check for iodine and shellfish allergies.
Endoscopy
Viewing of oral cavity
Esophagogastroduodenscopy (EGD)
View of the stomach, esophagus, and duodenum for inflammation cancer and bleeding. Place pt. On left side to prevent aspirations, check vs. NPO and check for fever, bleeding and pain.
Proctosigmoidoscopy
Visualize sigmoid, rectum and anal canal for ulcer, punctures, lacerations, tumors and polyps. Give laxative night before. After position place in supine position to prevent orthostatic hypertension.
Colonoscopy
Looks at large intestine. Encourage pt to take deep breath, position on left side, with knees up. Monitor for hemorrhage or severe pain, vasovagil response.
Watch for below b/p
Gastric analysis
Measure secretions in stomach for duodenal ulcers cancer obstruction and pernicious
Basal cell secretion
Acid from stomach check ph and amount. NG tube in inserted in stomach, and hooked to a suction every 15min for 1 hour.. (4x)
Gastric acid stimulation
Measure gastric acid for 1 hour after SQ histamine is given
Endoscopic ultrasonography
Performed via endoscope using sound waves to detect tumors
Magnetic resonance imaging (MRI)
Non invasive test to visualize everything. Contraindicated in obese, pt. Claustrophobic, pace maker, orthopedic hardware, internal metal, all Jewelry and medication patch with metal must be removed. Procedure takes 90 min. May heard loud clinging sounds but ear phones may be used.
Stomatitis
Inflammation of the mouth. S/S pain burning ulcer bleeding gums bad odor.
Treatment- good oral hygiene, topical med, antibiotics,
Candidiasis
Mild fungal infection( thrush). Treat with nystatin swish and swallow
Esophageal varicose
Tortuous dilated veins in lower esophagus caused by portal hypertension. Treatment is sciorosing, placement of sengitation- Blackmore tube for tamponade. Keep scissors bed side in case gastric ballon dislodge.
Hiatal hernia
Protrusion of a portion of the stomach through the diaphragm and into thorax. Possible causes, ascites, turn yellow, pregnancy.
S/S heart burn, difficulty swallowing, dysphasia. Treatment include anatacid, elevate bed for 1hr. Avoid caffeine, smoking, constricted clothing
Cancer of oral cavity
Occur anywhere in mouth or throat. S/S difficulty swallowing, chewing, experience hoarseness or cough, swollen cervical lymph nodes, filling of fullness, pain after eating
Cancer of the esophagus
Malignant tumors of the esophagus. Risk factors smoking, alcohol, poor oral hygiene,spicy food.
GI tube
Purpose is to provide nourishment, meet nutritional needs, administer mess that can not be swallowed, remove gas secretions, control bleeding, promote healing
Example of transabdominal
Gastronomy and jejunostomy tubes
Dyspepsia digestion
Imperfect indigestion caused by rapid ingestion s/s heartburn passing gas filling of gas treatment put on bland diet administer antispasmodic teach pt to modify current eating habit especially spicy foods evaluate the rising of the larynx.
Acute gastritis
Inflammation of the stomach caused by indigestion or corrosive substance. S/s burning pain anorexic headache nausea vomiting diarrhea and hemorrhage diagnostic test.. gastroscope treatment administer antiacid
Chronic gastritis
Occur over time the stomach mucosa thins and atrophied causing difficulty absorbing nutrition causes stomach cells not secreting s/s asymptotic treatment vitamin b12
Type b, cause by p. Pyloric bacterial affection s/s heart burn poor appetite belching NV and sour taste
GERD
Gastric secretions of stomach that back into esophagus and damage esophagus something causes the esophagus sphincter not to close fast enough s/s heart burn regurgitation dysphagia. Medication proton pump inhibitor ex.prilosec switch to low fat high protein diet and avoid caffeine alcohol and avoid laying down for 2 hour after meals.
Peptic ulcer disease(pud)
Erosion of the mucosal and sub mucosal surface of the lining of upper GI tract caused by h.pyloric factors are stress eating to fast smoking hereditary medications as nsaids salicylate and steroids.s/s named by location.
Stress ulcers
Stress response to illness causing reduced blood flow resulting in ischemic damage to mucosa
Cancer of stomach
Malignant tumor second most common in world higher in men.
Colon cancer
Most common type in u.s.
Morbid obesity
Bariastric surgery refers to surgery for morbid obesity. People more then 100 pounds over weight. And interferes with adl’s.
Hemorrhage
Decrease bp increase pulse rate. Caused by dislodged clot.
Gastric distention
Always measure abdominal girth. Block in ng tube
Pernicious anemia
Vitamin b 12 deficiency
Dumping syndrome
Rapid emptying of large amounts of food into small bowel without proper mixing of food with digestive juices.
Ostomy
Surgical created opening, that is diverted into stool or urine to the outside of the body through an opening on the abdomen called a stoma
Stoma
That part of the bowel sutured into the stomach
Ileostomy
Stools are liquid. Contain digestive enzymes that are harmful to the skin. Cover with bag.
Colostomy
Name according to where the bowel is formed ..ascending transverse descending or sigmoid..
Constipation
Causes narcotics
Diarrhea
Fecal matter passes fast through intestines
Acute caused by bacterial /viral infections.
Malabsorption disorder
Cause is celiac disease .it is the inability to observe nutrients.
Celiac disease is intolerance to gluten protein found in grains such as wheat rye oats and barely
S/s steatorrhea, flatulence, cramping,loose stools
Inflammation bowel disease UBS
Diverticulum.. outpouching or sac in the bowel mucosa
Diverticulosis..the disease where there are multiple outpouching in the colon. Most frequently in sigmoid
Diverticulitis… complecation occur when fecal matter penetrate the thin walled diverticula.
Brat diet.. banana rice applesauce toast can not have pop corn for snack.
Hemorrhage
Dilated varicose veins of the anus.
Internal, external, thrombosis
S/s itching, pain, bleeding, bowel problems
Proper diet, sitz bath
Pilonidal cyst or sinus
Lesion or opening located in the cleft of the buttocks. Treatment.. meticulous wound care pack and drain, teach pain control
Antiacid
-Peptobismol.. cause GI bleeding, teach pt. Stool becomes black.
-Interfere with absorption of many meds
-Magnesium base not given to renal pt. Causes to have diarrhea
-Take to neutralize acid in stomach hydrochloride acid
Do not take with in 1 hr of medications
Maalox
Cause toxicity in pt with renal problems.
Contraindicated with pt with renal problems.
Tums
Can’t eat a lot of them at once.
Anti diarrhea
Biggest problem electrolyte imbalance with diarrhea. Young and elderly are at greatest risk. Assess frequency of changes ,monitor fluid imbalance and dehydration.
Emodium
Works well with diarrhea use with caution with renal and liver pt.
Lamota
Used for diarrhea…Anitcholenergic because it has atropine combined with opioids and atropine. Do not give to pt with glaucoma.
Anti emetic
Vomiting can cause dehydration and electrolyte imbalance. Works in different trigger zones in the CNS. Causes Drowsiness ,dry mouth ,abscess swelling of tissue with injection. Monitor heart rate and bp. Ex. Zofran, Dramamine,
Anti flatulent
Used for gas. Have the pt. Walk to help gas pass.positioning can cause. Auscultation bowel sounds
Anti ulcer
Histamine 2 receptor blockers. Suppressed secretion of gastric acid, decrease peptic acid. Monitor epigastric and chest pain. Older pt look for confusion. Med is effective when pt no longer complain of pain. Ex. Tagament … must be taken 1 hr of other drug. Dosage in older or renal may be reduced taken as prescribed. Sudden discontinuation cause chronic ulceration.
Proton pump inhibitor ppi
Suppress gastric acid secretions. Used for peptic ulcer, erosive esophagitis. Assess epigastric and chest pain. Ex. Prilosec Prevacid protinect.
Sucrafate/carafate
Activate gastric acid form a gel over the ulcer.
Prostaglandin e
Inhibits acid increase mucus and by carbonate produce blood flow and promotes mucosa repair. Reduce pt on high dose nsaids. Administer pc.. to reduce incident of diarrhea assess epigastric or chest pain. Coffee ground colored. ex. Cytocet.
Emetic
Makes you vomit. Use in Concious pt ,drug over dose or ingested poison. Nurse need to know What kind of substance was ingested. Make sure pt up right and turned on side for aspiration monitor heart rate and rhythm. Ex. Syrup of Ipecac,
GI stimulants
Increases mortility in GI tract. Use pt. With Gerd ,post op ,nausea ,vomiting. Ex. Reglin, asses bowel sound look for abdominal distention.
Laxatives
Induce bowel illumination more rapid effect then stool softener. Stronger drug act quickly to produce stool will be semi liquid. Treatment of constipation. Bulk forming ex. Metamucil, colace.
Hyper osmotic agent
Osmotic action in colon and causes retention of fluid. Ex. Glycerin suppository. Go lytely. Usually used prior to procedures. Long term cause to be dependent .assess bowel sounds and abdominal distention. Obstruction or abdominal pain do not use.
Accessory organs of digestive system
Liver, pancreas, gallbladder
Liver
Liver is located in the center right abdomin
Receives oxygenated blood from hepatic artery.carbohydrate, amino acid, lipid metabolism.
Phagocytosis… kupffer cells in the liver destroy bacteria that circulate through the liver from colon. cortisol stores glucose in the liver as glycogen. Consist of carbs,fat, protein. Old rbc are destroyed and formed into bilirubin. Store iron and b12.
Gallbladder
Muscular sac 3-4 inches long. Located under left lobe of the liver. Hormone cholecystokinin stimulates gallbladder to empty bile
Pancreas
6inches long URQ. Exocrine and endocrine. Three pancreatic enzymes amylase lipase tri.. exocrine comes with digestion
Assessing liver pancreas gallbladder
Ask what questions. Assess changes in bowel,list all medications, changes in appetite, family history. Social history.
- Inspect on abdominal for striae,bruising, caput medusae, jaundice
- Auscultation all 4 quads full minute.
- percussion done by md or advance nurse
- palpating depress abdomen 1/2-1 inch
Type b hepatitis
enteric blood precautions. Teach pt and family about precautions.
Fulminant acute liver failure
Fatal liver disorder. Symptoms hepatic coma. Change in liver size, encephalopathy…Cause usually drug toxicity or HBV. Assess neurological status.
CHEAP
Clotting defect-risk for DIC/hemorrhage … hepatorenal syndrome…encephalopathy..ascites..portal hypertension
Cardiac liver failure
Caused by pulmonary hypertension
Pancreatitis
Death occur from secondary causes..alcohol abuse.. s/s epigastric luq pain
Cancer of the pancreas
5th leading cause of death
