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NCLEX > GI > Flashcards

GI Flashcards

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1
Q

what are the 2 functions of the pancreas

A

endocrine - insulin

exocrine - digestion

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2
Q

what are the two types of pancreatitis

A

acute

chronic

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3
Q

what are the two causes of acute pancreatitis

A

alcohol

gallbladder disease

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4
Q

what is the main cause of chronic pancreatitis

A

alcohol

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5
Q

in pancreatitis does the pain increase or decrease with eating

A

increase

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6
Q

what happens with the abdomen in pancreatitis? why?

A

ascites - losing protein rich fluids like enzymes and blood into the abdomeq

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7
Q

what does a rigid board like abdomen incidcate

A

bleeding

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8
Q

what can a rigid board like abdomen lead to

A

bleeding leads to peritonitsi

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9
Q

What is Cullings sign

A

brusing around umbilical area (pancreattisi)

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10
Q

what is Gray Turner’s sign

A

burising on flank area seen with pancreatitis

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11
Q

is jaundice seen with pancreatitis

A

yes

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12
Q

are we worried about hypotension or hypertension with pancreatitis

A

hypotension - bleeding or ascities

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13
Q

what two lab values are most specific in digagnosing pancreatitis

A

serum lipase and amylase (digestive enzymes and shouldn;t be in blood

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14
Q

what happens to WBC in pancreatitis

A

increase

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15
Q

what happens to blood sugar with panrcreatitis

A

increases - can cause permanent diabetes

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16
Q

what happens to ALT, AST levels in pancreatitis?

A

increase

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17
Q

what happens to PT and aPTT in pancreatitis

A

prolonged

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18
Q

what is normal amylase values

A

30-220 U/L

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19
Q

what is the normal lipase range

A

0-110 U/L

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20
Q

what is the normal AST values

A

8-40 U/L

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21
Q

what is the normal ALT levles

A

10-30 U/L

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22
Q

what happens to serum bilirubin in pancreatitits

A

increased

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23
Q

what happens to hemoglobin and hematocrit in pancreatitis

A

low if bleeding

high if dehydrated

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24
Q

what are normal hemoglobin values in males and females

A

male 14-18

female 12-16

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25
Q

what are normal hematocrit values for males and females

A

m: 0.42-0.52
f: .37-.47

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26
Q

what is the goal with pancreatitis

A

control pain

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27
Q

true or false a patient with pancreatitis can still eat

A

false; should be npo don’t want to stimulate gastric secretions/

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28
Q

true or false pancreatitis patients should have NGT to suction and be on bedrest. Why or why not?

A

true; don’t want to stimulate pancrease to make digestive enzyemes
bed rest decrease stomach secretions

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29
Q

what pain medications are commonly used for pancreatitis

A

opioids including fentanyl pathces

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30
Q

what drug class is used to dry up secretions with pancreatitis

A

anticholergices

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31
Q

what types of medications are used for GI protection regarding patients with pancreatitis

A

PPI
H2 receptor antagonists - ranitidine
antacids

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32
Q

What is a good testing strategy to always think of for patients with pancreatitis

A

keep stomach dry and empty

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33
Q

why is insulin used for pancreattis pts.

A

TPN
damaged pancreas
steroids

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34
Q

if your liver is sick what is your #1 concern

A

bleeding

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35
Q

what are the 4 major fn of the liver

A

detoxifying
helps blood clot
metabolize drugs
synthesizies albumin

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36
Q

in cirrhosis what happens to the liver

A

liver cells are destoryed and replaced with connective or scar tissue –> alters liver circulation –> liver BP goes up

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37
Q

does the splenomegaly occur with cirrhosis

A

yes

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38
Q

what happens to serum albumin in cirrhosis? what does this lead to

A

decreased –> albumin helps hold onto water in the system –> acitites

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39
Q

what happens to ALT and AST in cirrhosis

A

increased (liver enzymes)

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40
Q

when your spleen in enlarged what does that mean

A

immune system is involved

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41
Q

what should never be given to people with liver problems

A

acetaminphen

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42
Q

what is the antidote for tylenol overdose

A

acetylcystien mucomyst

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43
Q

can anemia occur with cirrhosis

A

yes

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44
Q

why can cirrhosis progress to hepatic encephalophaty or coma

A

ammonia buildup –> acts like a sedatove

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45
Q

what 3 tests are used to diagnose cirrhosis

A

U/S
CT/MRI
liver biopsy

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46
Q

what lab values are important to check prior to a liver bx

A

PT
INR
aPTT –> scared of bleeding

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47
Q

how do you posistion a patient for a liver bx

A

supine with right arm behind head

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48
Q

what is important to tell a patient to do priro to the liver biopsy being taken? why?

A

take a deep breath and hold

get diaphragm out of the way

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49
Q

how shoulda patient be posistiioned following a liver bx

A

lie on right side to hold pressure

50
Q

what should a client do prior to a parencetisis

A

void –>dont want to puncture bladder

51
Q

how should a pt be posisitoned for a parcenteis

A

sitting up to have fluid settle in one spot

52
Q

what should you worry about anytime you are pulling fluid from a pt.

A

shock

53
Q

what drug class should be avoided with liver pts

A

narcotics —> liver can’t metabolize drugs when it is sick

54
Q

what kind of diet should a liver pt have

A

low sodium and decrease protein (don’t want bulild up of ammonia)

55
Q

what does protein break down to

A

ammonia

liver converts ammonia to urea

56
Q

what causes hepatic coma

A

ammonia buildup

57
Q

what are handwriting changes a sign of

A

liver problems

58
Q

what is fetor

A

breath smells like ammonia –> wine, fresh cut grass, acetone smelling

59
Q

what is the treatment for cirrhosis patients

A

lactulose
cleasing enemas
decraese protein
monitor serum ammonia

60
Q

where are the 3 places varicies form

A

stomach
esophagus
rectum

61
Q

what drug is used to lower liver BP

A

octreotide

62
Q

what is a sengstaken blakemore tube used for

A

balloon tamponade with esophageal varicies

63
Q

what is a saline lavage used for

A

to get blood out of stamch

64
Q

what are the 3 places a peptic ulcer can be found

A

esophagus
stomach
duodenum

65
Q

what are the signs and symptoms of peptic ulcers

A

burning pain usually in the mid-epigastric area/back

heartburn

66
Q

how are peptic ulcers diagnosed

A

astroscopy

67
Q

a pt who is undergoing gastroscopy should be NPO after the procedure till when

A

their gag reflex returns

68
Q

what are 3 signs of perforation in a gastroscopy patient

A

pain
bleeding
trouble swallowing

69
Q

wat is important to tell pts prior to having a gastroscopy

A

no smoking, chewing gum or mints, no nicotine patch stimulates stomach motility
smoking stimulates stomach secretions which will increase the chance of aspiration

70
Q

are abx used for peptic ulcers

A

they can be to get rid of h. pylori

71
Q

what are the two types of ulcers

A

gastric ulcers

duodenal ulcers

72
Q

what are gastric ulcers charichterised by

A 
malnoursihed pts. 
pain is usually half hour to 1 hour after mals
food doesn't help
vomiting does
vomit blood
73
Q

what are characteristics of duodenal ulcers

A

well noursihed patients
ngith time pain is common and occurs 2-3 hours after mals
food helps
blood in stool is common

74
Q

what occurs in a hiatial hernia`

A

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

75
Q

what is the main cause of hiatial hernia

A

large abdomen

76
Q

what are the 4 signs and symptoms of hiatial hernia

A

heartburn
fullness after eating
regurgititaion
dysphatia

77
Q

should pts. with a hiatial hernia eat spaced out large meals or several small meals

A

several small

78
Q

how should patients posisiton themselves after meals if they have a hitial hernia

A

sit up for 1 hr

79
Q

what is dumping syndrome

A

stomach emptines to quick after eating

80
Q

what side should you lye on to promote stomach emptying? keep stomch full?

A

right side - releases it

left side - leaves it in

81
Q

should someone with dumping syndrome drink fluids with meals

A

no –> between meals

82
Q

how should a person with dumping syndrome posisiton themselves

A

semi-recumbent while eating

lay down after meals

83
Q

what ffoods should someone eat if they have dumping syndrome

A

avoid carbs and fats –> carbs and fats empty fast

84
Q

where is ulcerative colitis

A

only in large intestine

85
Q

where does chron’s disease affect

A

ileum usually but can be found anywhere in the samll or large intestines

86
Q

how is chrons and ulcerative collitis diagnosed (3)

A

CT
colonscopy
barium enema

87
Q

what kind of diet should someone have prior to a colonscopy? and for how long?

A

clear and liquid diet for 12-24 hours

88
Q

how long should a client be NPO prior to a colonscopy

A

6-8 hours

89
Q

what medications should be avoided prior to a coloscopy

A

NSAIDs

90
Q

how long should laxitives and enemas be adminsitered

A

till clear

91
Q

what helps with drinking colon prep

A

get it really cold

92
Q

what should be avoided when drinking colon prep

A

straws

93
Q

what are we watching for post op (same with any tube looking around procedure)

A

perforation

94
Q

what are the signs of perforation following a colonscopy

A

pain or unsual discomfort

95
Q

when is a barium enema done

A

if a colonscopy is incompete

96
Q

what medications are vien for ulcerative cholitis and chron’s

A

abx

steroids

97
Q

are antidiarrheals given for ulcerative colitis or chrons

A

only mild ulcerative colitis NOT SEVERE`

98
Q

what are the newest class showing promise for ulcerative coitis and chrons

A

biologics such as adalimumab and infliximab

work by interfeing iwht the bodys immune response acting selectively unlike steroids which suppress entire immune system

99
Q

is sx done for chrons or ulcerative colitis

A

UC

100
Q

what sx is done for UC

A

total colectomy (entire colon)
kock’s ileostomy or a J Pouch (no external bag)
Kocks has nipple to empty
J pouch reatches ileeum to rectum

101
Q

Can chrons have sx

A

yes, usually not but can remove only affectd area

102
Q

what may the client end up with if tehy have chrons sx

A

ileostomy or cholestomy

103
Q

what type of stool comes out of ileostomys? what foods should be avoided? what should be cincluded in diet

A

liquidy stools
hard to digest and rough foods should be avoided
gatroade should be drank ins ummer to replace electrolytes

104
Q

are ileostomys prone to kidney stones? why or why not

A

yes, b/c always a little dehydrated

105
Q

which type of colostoymy has formed stools

A

descending and sigmoid

ascending and trasnverse are semi-liquid stools

106
Q

which type of colostomy is irrigted?

why are they are irrigated

A

descending and sigmoid

for regularity

107
Q

when is the best time to irrigate a colosty

A

same time everyday

after a meal (more peristalsis)

108
Q

why is the more down the colon the more formed the stool

A

b/c water is being removed

109
Q

what should you do if a client starts to cramp following an enema

A

stop and check temp of fluid

110
Q

what is appendicitis related to

A

a low fiber diet

111
Q

how is appendicitis diagnosed

A

increased WBC
u/s
CT

112
Q

do you give enemas or laxitives with suspected appendicitis

A

no, worried about rupture or perforation

113
Q

how should a patient be posisitoned after an appendectomy

A

elevate HOB to decrease pressure on abdomen

114
Q

Is a central line needed for TPN?

A

yes, particles eat up periipheral veins

115
Q

can be TPN be abruptly disconcontined? why or why not

A

no, grdually to avoid hypoglycemia

116
Q

how often should CBG be done for pts on tpn

A

every 6 hours

117
Q

do tpn bags need to be mixed daily

A

yes, new electrolytes may need to be added

118
Q

how long can tpn be held

A

24 horus

119
Q

what is the most frequent complciation with TPN

A

infection

120
Q

what should a nurse have ready for a a health care provider when they are inserting central lines

A

have saline flushes ready

have pt in trendelenberg

121
Q

what posisiton do you put a client in if there is air in a central line

A

left side trendelenberg

NCLEX (10 decks)

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