GI Flashcards
Right upper stomach pain
Gallstones
Stomach ulcer
Pancreatitis
Upper middle stomach pain
Stomach ulcer
Heartburn
Pancreatitis
Gallstones
Epigastric hernia
Upper left stomach pain
Stomach ulcer
Duodenal ulcer
Biliary Colic
Pancreatitis
Middle right stomach pain
Kidney stones
Urinary infection
Constipation
Lumbar hernia
Middle stomach pain
Pancreatitis
Early appendicitis
Stomach ulcer
Inflammatory bowel
Small bowel
Umbilical hernia
Right lower stomach pain
Appendicitis
Constipation
Pelvic/groin pain
Inguinal hernia
Middle lower stomach pain
Urine infection
Appendicitis
Diverticular disease
Inflammatory bowel
Pelvic pain
Left lower stomach pain
Diverticular disease
Pelvic/groin pain
Inguinal hernia
P O O P E R
Position: upright, sitting Output- adequate hydration Offer fluids Privacy Exercise: gut motility Report results
S C O O P
Size (amount) Consistency Occult blood Odor Peristalsis
Bristol scale
1: rabbit (severe constipation)
2: Grapes (slight constipation)
3: cracked sausage: Normal
4: Smooth snake: Normal
5: soft blobs, clear edges (low fiber)
6: mushy blobs ragged edges (slight diarrhea)
7: Liquid (mega diarrhea)
Pharm for GERD
H2 blockers: (Dines)
PPIS: (Zoles)
Protects esophagus from acid, reduces inflammation
Gastric ulcers
Weight loss
Acid-normal or low
Pain .5-1.5 hr post meal
vomiting
Pain INCREASED by eating
Duodenal ulcer
Most common
Pain 2-3 hr post meal
Food relieves pain
Stress ulcers
physiological stress
shock
cushing’s
ulcer
ulcer-brain injury
Curling’s ulcer
Esophageal Cancer complications/diagnosis
Dysphagia (aspiration)
Weight loss (malnourishment)
Epigastric pain
Respiratory (erosion of tracheobronchial tree)
Hemorrhage (esophageal perforation)
What is the most serious/attention calling symptom of esophageal cancer
Hemorrhage (esophageal perforation)
What is an esophagectomy
Cutting out cancerous length of esophagus, and connecting the rest directly to the stomach
Esophagectomy complications
Dumping syndrome
NG tube movement and repositioning could damage esophagus.
High aspiration risk
Cardiac dysrhythmias likely
Position post esophagectomy
Fowler’s or semi-fowlers: whichever is most comfortable
Nutrition post esophagectomy
IVF, TPN
Speech/nutrition consults.
Liquids/soft foods for 4-8wks.
Keep in upright position to prevent regurgitation.
Gastric surgeries
Gastroduodenostomy (Bilroth I)
Gastrojejunostomy (Bilroth II)
Vagotomy
Pyloroplasty
Peptic ulcer disease complications: Hemorrhage
From erosion
Find where bleeding w/endoscopy, surgery to repair
Give blood and watch for shock
Peptic ulcer disease complications: Perforation
CRITICAL
MOST LETHAL
Can cause peritonitis->sepsis
Need surgery, fluid, blood, and NG tube
Peptic ulcer disease complications: Obstruction
Can cause N/V/C
Inc. abdominal girth
decompress stomach with NG tube
Dumping syndrome
Direct result of surgical removal of large portion of stomach and pyloric sphincter
If you eat too fast stomach dumps food into intestines too fast.
Assoc. w/ hyper-osmolar food.
Upper GI bleeds
Arterial
Coffee ground emesis
Melana (dark, tarry stools)
Watch for blood loss
Gastritis causes
Meds (NSAIDS)
Alcohol
H. pylori infection
Gastritis
Inflammation of gastric lining in stomach
Gastritis manifestations
Anorexia
N/V
Epigastric tenderness
May req. NPO, IV fluids, NG tube
Acute Abdominal pain nursing interventions
Look for S&S for shock->IV fluid boluses
if no shock look for
S&S of perforation (peritonitis)-> abd x ray, NGT draining, IV antibiotics (amoxicillin, gentamycin), URGENT surgical review
Peritonitis
S&S: Board rigid abdomen
Massive fluid shifts
Shock symptoms: vitals rapidly increase then crash super low
Need surgery unless minor case/poor surgical risk
Gastroenteritis
Normally self limiting
S&S D/V
Treated w/ hydration and electrolytes
Normally from foodborne illness
IBS fodmap
EAT LOW FODMAP FOODS
Low fodmap foods
Clementines, blueberry, cantaloupe
Carrots, lettuce, olives
Peanuts, almonds, chickpeas
Coconut milk, Kefir, hard cheese
Meats, fish, eggs, tofu
Gluten free bread, rice, quinoa
High fodmap foods
Apples, peaches, apricots, pears
Asparagus, artichokes, snow peas
Cashews, pistachios, hazelnuts
Dairy, wheat products, soft cheese
Tea, High fructose corn syrup, agave
Crohns vs UC
Crohns: lesions anywhere in GI tract, prolonged diarrhea, fatigue, weight loss.
UC: Located in colon, bloody diarrhea w/mucous
Ulcerative Colitis complications
Hemorrhage
Strictures (narrowing)
Perforation
Toxic megacolon
Colonic dilation
Ulcerative colitis/Crohns meds
5-ASA (Aminosalicates)
Antimicrobials
Corticosteroids
Immunosuppresants
UC surgery
Colon and rectum removal
then
End of ileum brought out as an ileostomy
Crohns patient teaching
NPO at times to promote bowel rest/healing
Seek medical care w/S&S of UTI, could be FISTULA formation. High perf. risk
Bowel obstructions
Treated w/ Fluids, NGT until underlying problem fixed
Higher obstructions present w/ symptoms faster
Colon cancer
Can spread through wall to lymphatic system
Causes: Genetics (african americans highest risk) Over 40 yr. old Men more likely High calorie/fat diet Alcohol/tobacco
Colon cancer symptoms Left side
Left sided lesions:
- Rectal bleeding
- Alternating constipation and diarrhea
- Narrow, ribbon like stool
- Obstruction symptoms
Colon cancer symptoms Right side
- Usually asymptomatic
- Vague abd. discomfort
- Iron deficiency anemia
- Occult bleeding
