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Adults 1 > GI > Flashcards

GI Flashcards

1
Q

Dysphagia: Definition

A

difficulty swallowing

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2
Q

Dysphagia: clinical manifestions

A
  • c/o of difficulty swallowing
  • drooling/ leaking while eating or drinking
  • coughing or choking while eating or drinking
  • recurrent pneumonia or chest congestion
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3
Q

Dysphagia: Nursing Diagnosis

A
  • risk for aspiration

- altered comfort with pain on swallowing

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4
Q

Dysphagia: Nursing Management

A
  • upright for meals
  • thick liquids
  • not feeding while drowsy
  • assisting in cutting food
  • encourage chin tunk
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5
Q

Dumping Syndrome: definition

A

-rapid empty of stomach contents into jejunum

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6
Q

Dumping Syndrome: clinical manifestations

A
  • N/V/D
  • abdominal cramping
  • feelings of fullness
  • palpitations
  • tachycardia/ hypotension
  • diaphoresis
  • weakness/ dizziness/ dehydration
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7
Q

Dumping Syndrome: patient teaching

A
  • low carb and high protein diet
  • avoid: fruit juices, sweet, candies, soda, fried foods, fatty food
  • eat 6 evenly spaced meals without drinking
  • reclining after meals
  • antispasmodic/sedative can delay gastric empty
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8
Q

Appendicitis: definition

A
  • incomplete emptying of appendix cause infection and inflammation
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9
Q

Appendicitis: clinical manifestations

A
  • epigastric pain
  • Mcbrunner’s tenderness: peri umbilical tendered in RLQ
  • Rovsing sign: if LLQ palpated pain is felt in RLQ
  • rebound tenderness
  • nausea/ vomiting
  • fever
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10
Q

Appendicitis: diagnosis

A
  • elevated WBC

- CT scan

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11
Q

Appendicitis: treatment

A

appendectomy

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12
Q

Appendicitis: complications

A
  • rupture of appendix
  • peritonitis
  • abscess formation
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13
Q

Hiatal Hernia: definition

A
  • upper stomach goes through stretched esophageal sphincter and into the esophagus
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14
Q

Hiatal Hernia: Types

A
  • sliding: moved up and down

- paraesophageal: stay in place and risk for strangulations

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15
Q

Hiatal Hernia: clinical manifestations

A
  • pyrosis
  • regurgitation, belching, vomiting
  • dysphagia
  • feelings of fullness
  • most cases asymptomatic
  • abdominal distention and recline make symptoms worse
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16
Q

Hiatal Hernia: diagnosis

A

Barium swallow

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17
Q

Hiatal Hernia: Treatment

A

goal: reduce gastric distention and maintain function gastroesophageal sphincter
- weight loss
- small stomach volume: smaller more frequent meals, less fluid in stomach
- eat upright, upright for an hour, no bending post meal
- sleep HOB 4-8 inches

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18
Q

Hiatal Hernia and GERD fundoplication

A
  • for high risk of aspiration and severe chronic reflux

- wrap stomach around to make sphincter GE smaller

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19
Q

Barium swallow things to note

A
  • NPO before test

- laxative after

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20
Q

Hiatal Hernia and GERD medications

A
  • prokinetic agents: accelerate gastric emptying
  • antacids: neutralize acid
  • H2 receptor antagonist: decrease acid production
  • PPI: decrease gastric acid production
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21
Q

GERD: definition

A

reflux of gastric contents into esophagus

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22
Q

GERD: causes

A
  • decreased lower esophageal sphincter tone
  • increased intra-abdominal pressure
  • pyloric stenosis
  • Hiatal Hernia
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23
Q

GERD: caused of decreased LES tone

A
  • nicotine
  • caffeine
  • ETOH
  • milk
  • chocolate
  • fatty food
  • medications
  • peppermint/spearmint
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24
Q

GERD: clinical manifestation

A
  • pyrosis
  • dyspepsia
  • pain on swallowing
  • regurgitation of stomach contents
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25
Q

GERD: diagnosis

A

barium swallow

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26
Q

GERD: treatment

A

goal: relieve symptoms and heal mucosa
- med: H2 blockers, PPI, antacids
- eat 2-3 hours before bed
- sleep with HOB up
- weight loss
- avoid irritants

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27
Q

gastritis: Definition

A

-inflamamtion of gastric mucosa

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28
Q

gastritis: acute clinical manifestations

A
  • headache
  • N/V
  • hiccuping
  • fatigue
  • sometimes bleeding
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29
Q

gastritis: chronic clinical manifestations

A
  • epigastric discomfort
  • pyrosis
  • N/V
  • belching
  • anorexia
  • sour taste
  • intolerance to some food
  • vitamin deficiency
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30
Q

gastritis: non-erosive

A

usually caused by H pylori

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31
Q

gastritis: diagnosis

A
  • H pylori test

- UGI x ray

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32
Q

gastritis: treatment

A
  • treat H pylori
  • NPO while symptomatic
  • avoid caffeine, nicotine, ETOH
  • meds: H2 blockers or PPI
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33
Q

gastritis: erosive

A

caused by

  • over use of ASA, NSAIDs, alcohol
  • bile reflux
  • radiation therapy
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34
Q

Peptic Ulcers: definition

A
  • excavation in mucosal wall caused by overproduction of acid or by mucosal damage
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35
Q

Peptic Ulcers: causes

A
  • Stress
  • Med: ASA, NSAIDS
  • Smoking
  • ETOH
  • gastritis
  • H pylori
36
Q

Peptic Ulcers: gastric ulcers: clinical manifestations

A
  • associated with cancer
  • dull, gnawing epigastric pain 1/2-1 hr after meal
  • no pain at night
  • eating make it worse
  • hemorrhage more likely
  • hematemesis and melena
37
Q

Peptic Ulcers: duodenal ulcer: clinical manifestations

A
  • 2-3 hour after meal
  • pain at night
  • eating can relieve
  • Melena and red bloody stool
38
Q

Peptic Ulcers: treatment

A
  • treat H. pylori
  • NPO when symptomatic
  • avoid nicotine, ETOH, caffeine
  • Meds: H2 blocker or PPI
  • Avoid ASA and NSAIDS
39
Q

Peptic Ulcers: Complications

A
  • hemorrhage
  • perforation
  • pyloric obstruction
40
Q

Peptic Ulcers: surgical procedures

A
  • vagotomy: cut off part of vagus nerve stop sending message to make acid
  • antrectomy: cut off part of stomach that makes acid
  • pyloroplasty: enlarging opening to let stomach contents flow more feely
41
Q

H pylori treatment

A

-triple or quadruple therapy

42
Q

Bowel Obstruction: definition

A

anything that blocks forward movement of intestinal content

43
Q

Bowel Obstruction: Types

A
  • Mechanical: pressure exerted on wall prevent forward movement
  • functional: paralytic ileus: lack of innervation or decreased muscle tone
  • herination, adhesion, intussciption, voluvus
44
Q

Bowel Obstruction: early obstruction

A
  • BS sounds tinkle need obstruction; and silent after
  • short, intermittent pain
  • bilious vomit
45
Q

Bowel Obstruction: late obstruction

A
  • BS silent
  • distention
  • vomit has fecal odor
  • shock
46
Q

Bowel Obstruction: other clinical manifestations

A
  • cramp
  • nausea
  • diarrhea
  • constipation
  • fever and tachycardia: late finding, strangulation
47
Q

Bowel Obstruction: Acute

A
  • fever
  • tachycardia
  • peritoneal signs
48
Q

Bowel Obstruction: Management

A
  • NPO: gastric decompression
  • IV hydration
  • monitor fluid electrolyte balance
  • fever
  • pain relief
  • assess for return of bowel sounds and flatus
  • measure abdominal girth
49
Q

Peritonitis: defintion

A

inflammation of peritoneal cavity lining

50
Q

Peritonitis: clinical manifestations

A
  • abdominal pain/ rigidness
  • worsening/ unexplained encephalopathy
  • diarrhea
  • worsening/new renal failure
  • ascites that does not resolve with diuretics
  • fever and chills
  • ileus
51
Q

Peritonitis: diagnosis

A
  • labs
  • x ray
  • CT scan
52
Q

Peritonitis: Treatment

A
  • IV hydration
  • antibiotics
  • surgery
53
Q

Peritonitis: complications

54
Q

Peritonitis: nursing diagnosis

A
  • risk for infection
  • fluid volume deficit
  • anxiety/fear
  • knowledge deficit
  • imbalanced nutrition
55
Q

Fecal Diversion: indications

A
  • cancer
  • Inflammatory bowel disorders
  • temporary: protect anastomosis
56
Q

Fecal Diversion:patient implication

A
  • body iamge
  • attitude toward body function
  • appliance and self care ability
57
Q

Fecal Diversion: types

A

colostomy: large intestine redirected to abd. wall
ileostomy: small intestine redirected to abd. wall

58
Q

Fecal Diversion: colostomy: indications

A
  • colon/rectum cancer
  • chron’s disease
  • ulcerive colitis
  • trauma
  • diverticular disease
59
Q

Fecal Diversion: preoperative care

A
  • pain management
  • OOB in 8 hours
  • assess for return of peristalsis can take up to 3 days
  • NGT may be placed for flatus
  • If ileostomy: drink 2-3L of water
  • wound assessment
  • prevent infection, respiratory/thromboembolic complications
  • avoid foods that cause odor
  • appliance care
  • teach self care and emotional need
60
Q

Irritable Bowel Syndrome: definition

A
  • unknown cause

- functional problem with intestinal motility

61
Q

Irritable Bowel Syndrome: factors related to

A
  • smoking
  • stress
  • women
  • high fat diet
  • depression
62
Q

Irritable Bowel Syndrome: diagnosis

A

r/o pathophysiology

63
Q

Irritable Bowel Syndrome: treatment

A
  • identify irritants

- promote regularity of BM: exercise, probiotics, fiber

64
Q

IBD: Chron’s: definition

A

inflammation of bowel from esophagus to sigmoid colon in patches

65
Q

IBD: Chron’s: clinical manifestations that are different than UC

A
  • RLQ pain post meal
  • minimal bleeding
  • N/V/D
  • systemic: joint pain, skin lesions, conjunctivitis, oral ulcers
  • malabsorption, anemia, weight loss, diarrhea
66
Q

IBD: Chron’s: diagnosis

A
  • UGI barium
  • stool steatorrhea
  • occult blood test
  • blood test: albumin, total nutritional assessment, electrolytes, CBC, ESR
67
Q

IBD: Ulcerative Colitis: definition

A

inflammation of sigmoid colon

68
Q

IBD: Ulcerative Colitis: clinical manifestations different than Chron’s

A
  • LLQ pain
  • bleeding, dehydration
  • fever
  • fatigue
  • loss of appetite
  • urgent BM
  • anemia, wight loss, malabsorption, diarrhea
69
Q

IBD: Ulcerative Colitis: diagnosis

A
  • colonoscopy: not in acute: risk for bleeding
  • bloody stool
  • blood test: anemia (hemoglobin and hematocrit), total nutritional assessment, electrolytes
70
Q

IBD: treatment and Management

A
  • in acute exacerbation: Bowel rest: NPO/ gastric decompression
  • IV fluids
  • TPN
  • Meds
  • malnutrition: low residue, high protein, high calories
  • prevent worsening of inflammation
71
Q

diverticular disease: definition

A
  • disease of diverticulum
72
Q

diverticulitis: definition

A

-inflammation and infection of diverticula

73
Q

diverticulitis: clinical manifestation

A
  • abd. pain (LLQ)
  • constipation/diarrhea
  • fever
  • N/V
74
Q

diverticulitis: complications

A
  • perforation
  • peritonitis
  • abscess formation
  • bleeding
  • colonic obstruction
75
Q

diverticulitis: diagnosis

A
  • abd. x ray

- abd CT: contrast test

76
Q

diverticulitis: treatment of mild

A
  • oral antibiotics

- liquid diet w/ low fiber foods and progress

77
Q

diverticulitis: treatment of moderate to severe

A
  • NPO/ NGT (gastric decompression)
  • broad spectrum
  • surgical intervention
  • drainage of access/ collection of pus
  • remove affect section of colon
78
Q

diverticulosis: definition

A

weak muscle tone causes formation of diverticula

79
Q

diverticulosis: causes

A
  • congenital wall weakening
  • low fiber intake
  • straining on defectation
  • age
80
Q

diverticulosis: clinical manifestation

A
  • ongoing bowel irregularites
  • constipation/diarrhea
  • Nausea
  • bloating
  • anorexia
  • abd. distention
81
Q

diverticulosis: diagnosis

A

colonoscopy

82
Q

diverticulosis: treatment and teaching

A
  • high fiber diet
  • bulk laxatives
  • avoid nut, corn,
  • exercise
  • permanent but manageable
  • teach signs of diverticulitis
83
Q

Nutrition Feeding: Nasogastric diagnostic indications

A
  • evaluate UGI bleeding
  • aspiration of gastric content
  • Identify esophagus and stomach on chest x ray
  • administer radiograph contest to GI track
84
Q

Nutrition Feeding: Nasogastric therapeutic indications

A
  • gastric decomposition
  • relive small bowel obstruction symptoms
  • bowel rest
  • aspiration
  • medication administration
  • feeding
  • check placed before use
85
Q

Nutrition Feeding: parenteral:TPN indications

A
  • oral intake is insufficient
  • pt unwilling to ingest adequate nutrients
  • pre/post operative
  • Chron’s
  • can ingest orally or by tube

Adults 1 (3 decks)

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