GI Flashcards by Will S

Right upper stomach pain

Gallstones

Stomach ulcer

Pancreatitis

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Upper middle stomach pain

Stomach ulcer

Heartburn

Pancreatitis

Gallstones

Epigastric hernia

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Upper left stomach pain

Stomach ulcer

Duodenal ulcer

Biliary Colic

Pancreatitis

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Middle right stomach pain

Kidney stones

Urinary infection

Constipation

Lumbar hernia

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Middle stomach pain

Pancreatitis

Early appendicitis

Stomach ulcer

Inflammatory bowel

Small bowel

Umbilical hernia

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Right lower stomach pain

Appendicitis

Constipation

Pelvic/groin pain

Inguinal hernia

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Middle lower stomach pain

Urine infection

Appendicitis

Diverticular disease

Inflammatory bowel

Pelvic pain

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Left lower stomach pain

Diverticular disease

Pelvic/groin pain

Inguinal hernia

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P
O
O
P
E
R

Position: upright, sitting
Output- adequate hydration
Offer fluids
Privacy
Exercise: gut motility
Report results

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S
C
O
O
P

Size (amount)
Consistency
Occult blood
Odor
Peristalsis

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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)

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Pharm for GERD

H2 blockers: (Dines)

PPIS: (Zoles)

Protects esophagus from acid, reduces inflammation

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Gastric ulcers

Weight loss

Acid-normal or low

Pain .5-1.5 hr post meal

vomiting

Pain INCREASED by eating

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Duodenal ulcer

Most common

Pain 2-3 hr post meal

Food relieves pain

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Stress ulcers

physiological stress

shock

cushing’s

ulcer

ulcer-brain injury

Curling’s ulcer

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Esophageal Cancer complications/diagnosis

Dysphagia (aspiration)

Weight loss (malnourishment)

Epigastric pain

Respiratory (erosion of tracheobronchial tree)

Hemorrhage (esophageal perforation)

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

Hemorrhage (esophageal perforation)

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What is an esophagectomy

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

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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