GI PowerPoint Flashcards
_____ uses a scope and camera to observe (esophagus, stomach and the first part of your small intestine).
_____ uses a scope to observe further down the intestine
Endoscopy
Enteroscopy
An esophageal stricture is
narrowing of the esophagus, or throat, that can make it difficult to swallow
_____ based fecal Occult blood test (gFOBT)
Guiac
_____ is a minimally invasive medical procedure that examines the large intestine from the rectum
to the sigmoid colon, the part of the colon closest to the rectum.
sigmoidoscopy
Steatorrhea is
Excess fat in feces. It can cause stools to be bulky, difficult to flush, pale, oily, and foul-smelling.
Order of physical assessment for GI
Inspection
Ausculation
Percussion
Palpation
Esophagogastroduodenoscopy (EGD), also known as an upper GI endoscopy, is a procedure that examines ….
the lining of the esophagus, stomach, and duodenum (first part of the small intestine
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that uses ….
To examine
an endoscope and X-rays
to examine and treat the bile and pancreatic ducts
A small bowel capsule endoscopy…
Patient swallows a capsule containing a camera
noninvasive diagnostic procedure that allows a doctor to see inside the digestive tract
A liver-spleen scan, also known as a liver scan is….
a nuclear medicine procedure that uses a small amount of radioactive material to check for abnormal areas in the liver or spleen
Bulging pulsating abdominal mass or a bruit is heard during Ausculation
What can the cause be
Special precautions
Abdominal aortic aneurysm
DONT TOUCH
Oncofetal antigens are
Antigens found in both fetuses and adult cancer patients
Normal urine contains some urobilinogen.
Too much urobilinogen in urine may be a sign of a ….
Little or no urobilinogen may be a sign of other problems with your …..
liver disease, such as hepatitis or cirrhosis, or certain types of anemia.
liver, gallbladder, or bile ducts. Urobilinogen comes from bilirubin
The fecal immunochemical test (FIT) is
Preformed yearly
a screening test for colon cancer that looks for blood in stool samples
EGD Endoscopy
Prep
Hold….
NPO?
Remove….
IV needed?
Sedation?
Hold NSAIDS
NPO
Remove dentures
IV needed
Moderate Sedation
EGD Endoscopy
Post
NPO?
VS?
Side rails up?
Monitor for?
No Driving?
NPO until gag reflex returns
VS Q 15 min
Side rails up
Monitor for Pain, Bleeding, Fever
No driving 12 - 18 hrs
Priority care for Post EGD
Prevent aspiration
NPO until gag reflex returns
Endoscopic Retrograde Cholangiopancreatography (ERCP)
PRE & POST Care same as EGD
Teach family to monitor for…
Cholecystitis or cholangitis
Gallbladder inflammation or infection
Small Bowel Capsule Endoscopy
Prep
NPO?
When can they start to consume fluid and foods?
NPO 12 Hrs (includes fluids)
Remain NPO 2 hrs into test
Clear fluids after 2 hrs
Light lunch 4 hours into test
Colonoscopy
Prep
Hold….
Anticoagulant/ NSAIDS
you know the rest of the prep
Colonoscopy
POST
NPO?
VS?
Posistion?
Side rails up?
Monitor for (3)
Driver required?
NPO until Sedation wears off
VS Q 15 mins
Lie on left side
Monitor: Hemorrhage, Pain, Low BP
DRIVER REQUIRED
Liver- Spleen Scan
Radioactive tracer given via IV
Eliminated in urine 24hrs
Avoid in which patient’s?
Teach?
Avoid in pregant
Teach: lie still in exam & wash hands carefully after toilet
Vegan diets can predispose people to anemia from lack of…
Vitamin B12
Ideal BMI range
18.6 - 24.9
Underweight BMI
<18.5
Overweight BMI
25 - 29.9
Obese BMI
> 30
Marasmus
Kwashiorkor
Starvation
3 forms of protein undernutrition
Marasmus is a
deficiency of all macronutrients: carbohydrates, fats, and protein
Kwashiorkor
Protein malnutrition
is mostly found in people living in geographical areas that have limited food resources
Glossitis
Inflammation of the tongue
Stomatitis
A condition that causes painful swelling and sores inside the mouth
Unrecognized Dysphagia may cause these 3 problems in older adults
Undernutrition, dehydration, aspiration
Concern for weight loss
% in a month
% over 6 months
5
10
How long can a nasoenteric tube be inserted
How long can a PEG/J Tube be inserted
<4 weeks
Long term
How often to check PEG tube
Q6
It is proper to rotate a PEG tube 360° daily
True
How long of a supply do you add to a feeding tube?
How often to change bag and line
4 hrs
24 hrs
Refeeding syndrome is
a potentially fatal condition, caused by rapid initiation of refeeding after a period of undernutrition.
To keep tube patent
Flush with water, when?
Q 4h
Before and after meals
After interruption of enternal nutrition
If tube is clogged use
50mL piston syringe and 30 ML
Parenternal Nutrition is used for..
Who decides the formula
When GI tracts can’t be used.
Pharmacy
Give these solutions of TPN bag isn’t available
D10W D20W
Does a TPN bag require a 2nd check by an RN
Yes
Liraglutide
Naltrexone- bupropion
Orlistat
Phentermine-topiate
Drug therapy for Obese
Surgical management of Obesity
If… BMI
BMI or weight more than ____ % of ideal weight
BMI >40
BMI >35 with other health issues
Greater than 100%
Priority for weight loss surgery is…
Airway management
Postoperative weight loss surgery
Apply….
Monitor for….
Abdominal binder
Dumping Syndrome
Postoperative weight loss surgery
Clear liquids in ___ oz cups
On discharge diet?
When can they eat pureed, soft, & solid foods
1
Full liquids on discharge
Puree 1 week
Soft foods several weeks
Solid foods 8 weeks
Dyspepsia
Indigestion
Atrophy of gastric mucous
Lower hydrochloric acid levels
Related disorders
Malabsorption of which vitamins?
Malabsorption of Iron & Vita B12
Overgrowth bacteria
Gastritis
Peristalsis slowed
Dulled nerve impulse
Relat3d disorders
Lower sensation for BM
Constipation/ impaction
Lower number / size of hepatic cells
Related disorder
Drugs not metabolized
Lead to Toxic levels
Aprothrombin time(PT) test measures …
how long it takes for blood to clot.A high PT can indicate that there is serious liver damage orcirrhosis,and that there may be a higher risk ofinternal
Abilirubintest can help investigate issues with the gastrointestinal (GI) tract.
These (2) organs
What does a high or low value mean
Liver disease /gallbladder
High bilirubin means liver is having a hard time converting bilirubin into bile
CBC
Celiacs will have an increased number of _____
Antibodies due to perceiving gluten as a threat
CBC
IBS will have an increased number of
WBC
Can ulcers be detected by a cbc
Yes
H pylori can be detected in a cbc
CRP
High levels of C-reactive protein can indicate these diseases
Crohn’s, acute pancreatitis, IBS
Urine test measuring _____ are used for diagnosing pancreatitis
Amylase
Fecal fat test
High levels of fat in the stoll can indicate these organs aren’t functioning properly
Pancreas: lipase
Liver: bile production
An ALT result of 100 IU/L or higher is a clear indicator of….
A mildly elevated ALT result (30–100 IU/l) may be due to:
Medication, such as statins
A lower than normal ALT result is uncommon and usually isn’t a cause for concern. However, it could mean …..
serious liver disease.
Vitamin B6 deficiency or chronic kidney disease
Low normal range serum amylase and/or lipase suggests this problem
chronic pancreatitis
A fecal immunochemical test (FIT) is a home test that looks for….
blood in stool samples, which can be an early sign of colon cancer
S / S
Sudden, intense pain in the upper right abdomen
Pain that spreads to the back or below the right shoulder blade
Pain that worsens with deep breaths
Tenderness over the abdomen when touched
Cholecystitis
RDN computes Enteral Nutrition formula
Is a script needed by a HCP
Yes
Enterostomal feeding is the placement of a NG tube
True or False
False
Enterostomal feeding is the placement of a PEG/J tube
Tube Feeding care
Check for residual volume
How often
Q 6h
Flush tube with 30ml water and at least 30ml syringe every 4 hours
If clogged…
Use 50 mL piston syringe and 30 mL water
Obesity Class 1,2,3 values
Class 1: 30 - 35
2: 35 - 40
3: >40
Liraglutide
Anti-diabetic medication
It can treat type 2 diabetes. It can also promote weight loss in certain patients.
Which route is this drug available
Sub Q
Naltrexone
Class of medications: Opiate Antagonists.
Bupropion is in a class of medications called antidepressants.
Work together on two areas of the brain
Hunger center and the reward system, to reduce appetite and help control cravings.
Orlistat
Common brands: Alli, Xenical
Action: Lipase inhibitor
S/E…
oily stools, diarrhoea, abdominal pain and faecal spotting
Phentermine-topiramate
Class/action: ….
Anorectics.
It works by decreasing appetite
Most common bariatric surgery
Gastric Bypass
Roux-en-Y
Anastomotic leaks most common serious side effect / cause of death after Gastric Bypass surgery
Monitor for…
Back, shoulder, ab, Restlessness
Tachycardia, oliguria
