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Med surg exam 2 > GI > Flashcards

GI Flashcards

1
Q

Right upper stomach pain

A

Gallstones

Stomach ulcer

Pancreatitis

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2
Q

Upper middle stomach pain

A

Stomach ulcer

Heartburn

Pancreatitis

Gallstones

Epigastric hernia

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3
Q

Upper left stomach pain

A

Stomach ulcer

Duodenal ulcer

Biliary Colic

Pancreatitis

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4
Q

Middle right stomach pain

A

Kidney stones

Urinary infection

Constipation

Lumbar hernia

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5
Q

Middle stomach pain

A

Pancreatitis

Early appendicitis

Stomach ulcer

Inflammatory bowel

Small bowel

Umbilical hernia

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6
Q

Right lower stomach pain

A

Appendicitis

Constipation

Pelvic/groin pain

Inguinal hernia

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7
Q

Middle lower stomach pain

A

Urine infection

Appendicitis

Diverticular disease

Inflammatory bowel

Pelvic pain

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8
Q

Left lower stomach pain

A

Diverticular disease

Pelvic/groin pain

Inguinal hernia

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9
Q 
P
O
O
P
E
R
A 
Position: upright, sitting
Output- adequate hydration
Offer fluids
Privacy
Exercise: gut motility
Report results
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10
Q 
S
C
O
O
P
A 
Size (amount)
Consistency
Occult blood
Odor
Peristalsis
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11
Q

Bristol scale

A

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)

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12
Q

Pharm for GERD

A

H2 blockers: (Dines)

PPIS: (Zoles)

Protects esophagus from acid, reduces inflammation

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13
Q

Gastric ulcers

A

Weight loss

Acid-normal or low

Pain .5-1.5 hr post meal

vomiting

Pain INCREASED by eating

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14
Q

Duodenal ulcer

A

Most common

Pain 2-3 hr post meal

Food relieves pain

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15
Q

Stress ulcers

A

physiological stress

shock

cushing’s

ulcer

ulcer-brain injury

Curling’s ulcer

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16
Q

Esophageal Cancer complications/diagnosis

A

Dysphagia (aspiration)

Weight loss (malnourishment)

Epigastric pain

Respiratory (erosion of tracheobronchial tree)

Hemorrhage (esophageal perforation)

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17
Q

What is the most serious/attention calling symptom of esophageal cancer

A

Hemorrhage (esophageal perforation)

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18
Q

What is an esophagectomy

A

Cutting out cancerous length of esophagus, and connecting the rest directly to the stomach

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19
Q

Esophagectomy complications

A

Dumping syndrome

NG tube movement and repositioning could damage esophagus.

High aspiration risk

Cardiac dysrhythmias likely

20
Q

Position post esophagectomy

A

Fowler’s or semi-fowlers: whichever is most comfortable

21
Q

Nutrition post esophagectomy

A

IVF, TPN

Speech/nutrition consults.

Liquids/soft foods for 4-8wks.

Keep in upright position to prevent regurgitation.

22
Q

Gastric surgeries

A

Gastroduodenostomy (Bilroth I)

Gastrojejunostomy (Bilroth II)

Vagotomy

Pyloroplasty

23
Q

Peptic ulcer disease complications: Hemorrhage

A

From erosion

Find where bleeding w/endoscopy, surgery to repair

Give blood and watch for shock

24
Q

Peptic ulcer disease complications: Perforation

A

CRITICAL

MOST LETHAL

Can cause peritonitis->sepsis

Need surgery, fluid, blood, and NG tube

25
Q

Peptic ulcer disease complications: Obstruction

A

Can cause N/V/C

Inc. abdominal girth

decompress stomach with NG tube

26
Q

Dumping syndrome

A

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.

27
Q

Upper GI bleeds

A

Arterial
Coffee ground emesis
Melana (dark, tarry stools)

Watch for blood loss

28
Q

Gastritis causes

A

Meds (NSAIDS)
Alcohol
H. pylori infection

29
Q

Gastritis

A

Inflammation of gastric lining in stomach

30
Q

Gastritis manifestations

A

Anorexia

N/V

Epigastric tenderness

May req. NPO, IV fluids, NG tube

31
Q

Acute Abdominal pain nursing interventions

A

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

32
Q

Peritonitis

A

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

33
Q

Gastroenteritis

A

Normally self limiting

S&S D/V

Treated w/ hydration and electrolytes

Normally from foodborne illness

34
Q

IBS fodmap

A

EAT LOW FODMAP FOODS

35
Q

Low fodmap foods

A

Clementines, blueberry, cantaloupe

Carrots, lettuce, olives

Peanuts, almonds, chickpeas

Coconut milk, Kefir, hard cheese

Meats, fish, eggs, tofu

Gluten free bread, rice, quinoa

36
Q

High fodmap foods

A

Apples, peaches, apricots, pears

Asparagus, artichokes, snow peas

Cashews, pistachios, hazelnuts

Dairy, wheat products, soft cheese

Tea, High fructose corn syrup, agave

37
Q

Crohns vs UC

A

Crohns: lesions anywhere in GI tract, prolonged diarrhea, fatigue, weight loss.

UC: Located in colon, bloody diarrhea w/mucous

38
Q

Ulcerative Colitis complications

A

Hemorrhage
Strictures (narrowing)
Perforation

Toxic megacolon

Colonic dilation

39
Q

Ulcerative colitis/Crohns meds

A

5-ASA (Aminosalicates)

Antimicrobials

Corticosteroids

Immunosuppresants

40
Q

UC surgery

A

Colon and rectum removal

then

End of ileum brought out as an ileostomy

41
Q

Crohns patient teaching

A

NPO at times to promote bowel rest/healing

Seek medical care w/S&S of UTI, could be FISTULA formation. High perf. risk

42
Q

Bowel obstructions

A

Treated w/ Fluids, NGT until underlying problem fixed

Higher obstructions present w/ symptoms faster

43
Q

Colon cancer

A

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
44
Q

Colon cancer symptoms Left side

A

Left sided lesions:

  • Rectal bleeding
  • Alternating constipation and diarrhea
  • Narrow, ribbon like stool
  • Obstruction symptoms
45
Q

Colon cancer symptoms Right side

A
  • Usually asymptomatic
  • Vague abd. discomfort
  • Iron deficiency anemia
  • Occult bleeding

Med surg exam 2 (7 decks)

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