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Competency Exam > GI Dysfunction > Flashcards

GI Dysfunction Flashcards

1
Q

What is cholecystitis?

A

inflammation of the gallbladder
acute or chronic
associated with gallstones

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2
Q

s/sx of cholecystitis

A 
N/V
indigestion
belching, flatulence
RUQ pain
guarding, rigidity, rebound tenderness
mass palpated in RUQ
elevated temp
tachy
s/sx of dehydration
epigastric pain that radiations to scapula 2-4 hours after eating; lasting 4-6 hours
\+ Murphy's sign
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3
Q

what is Murphys sign?

A

can not take a deep breath when examiners fingers are passed below the hepatic margin

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4
Q

s/sx if there is a biliary obstruction r/t to cholecystitis

A

jaundice
dark orange, foamy urine
steatorrhea, clay colored feces
pruritus

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5
Q

take morphine or codeine during cholecystitis may cause what?

A

spasm of the sphincter of Oddi and increase pain

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6
Q

Diet for cholecystitis

A

NPO during N/V episodes

low-fat meals more frequently in small amounts

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7
Q

Chenodeoxycholic acid (Chenodiol) and ursodiol (Actigal) are administered PO for what?

A

to decrease the size of gallstones or to dissolve small stones

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8
Q

What is cholecystectomy?

A

removal of the gallbladder

can be done laparoscopically

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9
Q

What is choledochotomy?

A

incision into the common bile duct to remove the stone

can be done laparoscopically

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10
Q

What is a hernia?

A

protrusion of viscus through an abnormal opening or a weakened area in the wall of the cavity in any part of the body

commonly occurs in the abdominal cavity

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11
Q

Reducible vs. irreducible/incarcerated hernia

A

R: can be placed back into the abdominal cavity

I: cannot be placed back into the abdominal cavity

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12
Q

What are the 4 types of hernias?

A

inguinal
femoral
umbilical
ventral/incisional

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13
Q

What is an inguinal hernia?

A

point of weakness in the abdominal wall where the spermatic cord in men and round ligament in women emerge

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14
Q

What is a femoral hernia?

A

protrusion through the femoral ring canal

can become easily strangulated; occurs more frequently in women

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15
Q

What is an umbilical hernia?

A

occurs when the rectus muscle is weak, or the umbilical fails to close after birth

most commonly seen in children

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16
Q

What is a ventral/incisional hernia?

A

d/t weakness of the abdominal wall at the site of a previous incision

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17
Q

What is a truss?

A

device that applies pressure to the hernia, keeping it in the abdominal cavity

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18
Q

What is appendicitis?

A

inflammation of the appendix

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19
Q

causes of appendicitis

A

appendix may be gangrenous or rupture
perforation
abscesses

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20
Q

s/sx of appendicitis

A 
periumbilical pain that shifts to RLQ at McBurney's point
low grade fever
anorexia
N/V
localized tenderness
rebound tenderness/muscle guarding
Rovsing's sign
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21
Q

what is Rovsing’s sing?

A

pain felt in the RLQ when the LLQ is palpated

22
Q

What is peritonitis?

A

inflammation of the peritoneum

23
Q

causes of peritonitis

A 
adhesions (scar tissue)
ileus
PNA
hypovolemic shock
septicemia
intrabdominal abscess
paralytic ileus
organ failure
24
Q

s/sx of peritonitis

A 
abdominal pain
tenderness over involved area
rebound tenderness
muscular rigidity
spasms
abdominal distention or ascites
fever
tachy
N/V
altered bowel habits
25
Q

What is peptic ulcer disease?

A

any ulceration of the mucosa of the esophagus, stomach, or duodenum

26
Q

What are the most common peptic ulcers?

A

gastic ulcers

duodenal ulcers

27
Q

Typical age range for PUD

A

45-70 y/o

28
Q

risk factors for PUD

A 
chronic use of ASA, NSAIDS, corticosteroids
smoking
family hx
alcohol use
gastritis
29
Q

s/sx of PUD

A

gnawing, sharp pain that occurs to the L of or mid-epigastric region 1-2 hours after eating
N/V
bleeding

30
Q

PUD treatment

A

rest
bland diet (6 small meals daily)
stop smoking
antacids (Ca carbonate, Al hydroxide gels)
H2 Receptor blockers (Tagamet, Zantac, Pepcid)
Anticholinergic (ProBanthine)

31
Q

What is diverticulitis?

A

complication from diverticulosis in which an inflammation of perforation of the diverticulum results

32
Q

About ___% of the the population ___ y/o and older have diverticula and the percentage increases with age.

A

50%
40 y/o

more common in men than women

33
Q

diverticulitis risk factors

A

increasing age
stress
lack of fiber and bran in the diet

34
Q

cause of diverticulitis

A

when food particles and bacteria becomes trapped in the diverticulum, creating a hardened mass known as fecalith

35
Q

s/sx of diverticulitis

A 
many pts are asymptomatic
abdominal pain
D/C
bleeding
gas formation
abdominal distention
fever
36
Q

What is IBS?

A

disorder of GI motility with progressive changes in bowel function from diarrhea and constipation, or alternating between the 2

37
Q

s/sx of IBS

A

episodic abdominal pain, cramping
bloating
flatulence
alternating D/C

38
Q

IBS treatment/care

A

well-balance, high fiber diet for constipation
limit fiber and irritating foods for diarrhea
8 glasses of water daily
record amount, consistency of stools
establish a regular time for BM daily
discourage alcohol and caffeine use

39
Q

What are hemorrhoids?

A

dilated and distended veins in the anal and rectal areas that are located either internally or externally

40
Q

hemorrhoids are typically seen in adults age ___ - ___ y/o

A

20-50

41
Q

risk factors for hemorrhoids

A

pregnancy
prolonged constipation
straining during defecation
portal HTN

42
Q

s/sx of hemorrhoids

A

bleeding with BM
itching and pain
internal/external bulge
mucous discharge

43
Q

What are the 5 different types of ostomies?

A 
colostomy
ileostomy
cecostomy
loop colostomy
double-barrel colostomy
44
Q

What is a colostomy?

A

surgical opening created from the colon through the abdominal wall

45
Q

What is a ileostomy?

A

opening from the ileum through the abdominal wall

46
Q

What is a cecostomy?

A

opening of the cecum through the abdominal wall

47
Q

What is a loop colostomy?

A

temporary colostomy that is made when immediate relief is needed for the bowel, often r/t obstruction

48
Q

What is a double-barrel colostomy?

A

temporary colostomy that is made after bowel resection if anastomosis is not an option at the time of surgery

49
Q

When should an ostomy pouch be emptied?

A

when it is no more than 1/2 full

50
Q

What and how much should a colostomy be irrigated with?

A

500-1000 mL of warm, tap water

51
Q

How to introduce foods after an ostomy

A

slowly, one at a time to check for tolerance

Competency Exam (15 decks)

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