GI and GU Flashcards
components of RUQ
- liver
- gallbladder
- colon
- kidney
- duodenum
- SI
components of RLQ
- ascending colon
- caecum
- appendix
- SI
components of LUQ
- stomach
- spleen
- pancreas
- kidney
- colon
- jejunum
components of LLQ
- descending colon
- colon
- sigmoid colon
- SI
What quadrant is liver in?
RUQ
What quadrant is appendix in?
RLQ
What quadrant is stomach in?
LUQ
hematochezia
bloody stool
melena
dark tarry stool
laparoscopy
insertion of laparoscope into abdominal cavity
- diagnostic or therapeutic
What type of swallow study looks at the whole system and what type looks at the upper swallowing?
barium swallow - entire system
modified barium swallow study - upper system
endoscopy
insertion of endoscope into digestive tract
ERCP
endoscopic retrograde cholangiopancreatography
- used to diagnose and treat gallbladder, biliary system, pancreas, and liver problems
scintigraphy
GI bleeding scans
upper GI series
used to id disorders of esophagus, stomach, and duodenum
_________ pneumonia is a big issue for someone with dysphagia
aspiration
S&S of early dumping
- palpations
- tachycardia
- flushing
- diaphoresis
- syncope
- abdominal symptoms - cramping and bloating
S&S of late dumping
hypoglycemia S&S
- palpations
- tachycardia
- shaky
- fatigue
- sweating
- irritability
S&S of upper GI bleeding (UGBI)
hematemesis - vomiting blood
S&S of lower GI bleeding (LGIB)
hematochezia - blood in stool
melena - dark tarry stool
hemoptysis
coughing up blood
How long must symptoms last to be diagnosed with IBS?
symptoms last for 3 days a month over 3 months
Where does Crohn’s disease occur?
anywhere in GI system
Where does ulcerative colitis occur?
rectum and proximal colon
What can liver disease lead to?
encephalopathy - inflammation of white matter in brain
cholecystitis vs cholelithiasis
cholecystitis - inflammation of gallbladder
cholelithiasis - gallstone formation
What is Murphey’s sign?
have them deep breathe in and push in RUQ as they exhale and if tender then they have gallbladder issue
Patient positioning for comfort after GI surgery
- sidelying to decrease tension on surgical site
- flex knees while HOB lowered to decrease tension
- supine can aggravate dysphagia and GERD
- splinting during mobility/coughing
dysuria
painful urination
nocturia
night time urination
hematuria
blood in urine
proteinuria
urine appears foamy
oliguria
very low urine output
What does increased creatinine plasma levels indicate?
decreased renal function
reference value of estimated GFR
> 60 mL/min/1.73 m^2
What is BUN? reference range
end product of protein and amino acid metabolism
- can cause impaired cognition
10-20 mg/dl
What is a KUB?
radiograph of kidneys, ureters, bladder often done for initial diagnostics
cystoscopy
flexible, fiberoptic scope through the urethra into the bladder
Cystometry
evaluates motor and sensory function of the bladder in patients with incontinence or suspicion of neurologic bladder dysfunction
as urine output _______ , creatinine levels _______
decrease, increase - inverse relationship
pre-renal kidney injury
decreased blood flow (hypovolemic shock)
intra-renal kidney injury
damage to kidney themselves, often by necrosis
post-renal kidney injury
obstruction by kidney stone, tumor, etc.
chronic kidney disease GFR
< 60 mL
acute vs chronic pyelonephritis
acute - sudden onset and presence of bacteria
chronic - destruction of nephrons that leads to chronic kidney disease
symptoms of cystitis and how is it managed
- frequent urination
- dysuria
- lower abdominal or suprapubic pain
- urinalysis may reveal pyuria, hematuria, and bacteriuria
managed by antimicrobial treatment
urethritis and symptoms
infection of urethra - causes burning sensation during urination
cystitis and symptoms
infection of bladder - increased frequency and pain with urination
pyelonephritis and symptoms
infection of kidneys - fever, chills, N&V, back pain
clinical signs of diabetic nephropathy
- microalbuminuria - urinary albumin excretion
- decreased GFR
- acute or chronic kidney disease
stress urinary incontinence description
increased intraabdominal pressure leads to small leakage
stress urinary incontinence cause
weak pelvic floor, dysfunctional urethra
- can occur after pregnancy
urge urinary incontinence description
larger leakage occurs after delayed sensation of full bladder
urge urinary incontinence cause
- neurologic disorders
- spinal cord injury
- detrusor overactivity
overflow urinary incontinence description
leakage of urine from mechanical forces or urinary retention from an overdistended bladder
overflow urinary incontinence cause
- anatomic obstruction by prostate
- DM or spinal cord injury
- neurologic disorders, detrusor failure
mixed urinary incontinence description
combination of stress and urge
functional urinary incontinence description
cognitive or physical impairments, psychological or environmental barriers that prevent voiding
functional urinary incontinence cause
mobility and/or cognitive impairments
- plumbing is normal
AE of alpha-adrenergic antagonists (tamsulosin) for BPH
hypotension
AE of 5a-reductase inhibitors (finasteride) for BPH
hypotension
AE of anticholingeric (oxybutynin) for BPH
Anticholinergics – can’t see, can’t spit, can’t pee, can’t poo
- ABCDs – agitation, blurred vision, constipation confusion, dry mouth, stasis of urine and sweat
AE of b3-adrenergic agonist (mirabegron for BPH
hypertension
Large fluid exchange can promote __________ and ________ of nephrons
hypotension and ischemia
What is a temporary dialysis catheterwhich can typically be used for up to 30 to 45 days?
vas cath
Advantages of vas cath
- quick placement
- used immediately
- outpatient procedure
Disadvantages of vas cath
- may damage central veins
- increase length of hemodialysis treatment
- bathing/swimming not recommended
- potential infection and catheter clotting
What is a surgical connection between artery and vein?
AV fistula
AV fistula advantages
- can function for years
- infection less likely
- clotting less likely
AV fistula disadvantages
- may require another temp access while fistula heals
- maturation can be delayed or fail
- needles required to access AV fistula
What is a small tubing that connects artery to vein?
arteriovenous graft
AVG advantages
- ready to use in 3-4 weeks
- easy to implant
- outpatient procedure
AVG disadvantages
- not as long-lasting as fistula
- needles required to access graft
- prone to clotting
Is PT safe for a patient receiving continuous renal replacement therapy?
yes, bedside PT is safe
Advantages of CRRT
- can be used for less stable patients
- avoids rapid fluid and electrolyte shift
Disadvantages of CRRT
- low clearance rate vs hemodialysis
- more intensive anticoagulation therapy
- patient immobilized for long periods
S&S of Crohn’s disease
- abdominal cramping
- RLQ pain/mass
- diarrhea
- weight loss
- fatigue
- low grade fever
S&S of ulcerative colitis
- lower abdominal pain relieved by defecation
- bloody stools
- diarrhea
- incontinence
- nocturnal defecation
- fatigue
- wt loss
- dehydration
Bloody stool is more common with _________
ulcerative colitis
malnutrition is more common with ___________
Crohn’s disease
what are abdominal surgery precautions?
- no lifting >10#
- no bending more than 90 degrees at hips, no Valsalva maneuvers
- use of a velcro-fastened elasticized soft abdominal binder
