GI System Flashcards
role of small intestine
receiving digestive enzymes from pancreas and liver
churn and mix food making it into chyme
absorb nutrients
move food into colon
where is bile produced
liver
where is bile stored
gallbladder
what is the role of bile?
emulsifies lipids so they can be absorbed
wha tare the digestive enzymes created by the pancrease
trypsin - break down proteins
amylase - break down carbs
lipase - break down lipids
function of colon/large intestine (3)
absorbing water and electrolytes
producing and absorbing vitamins
forming and propelling feces towards rectum for elimination
what are 3 things the liver produces
bile
albumin
cholesterol
which organ converts ammonia to urea
liver
what organ metabolizes bilirubin
liver
if you run out of TPN, what do you give?
dextrose 10% at same rate as TPN
what is docusate
stool softener
what is polyethylene glycol
miralax
laxative
3 antidiarrhelas
loperamide
diphenoxylate
bismuth subsalicylate (pepto bismol)
3 antiemetics
ondansetron (zofran)
promethazine
meclizine
how do you administer ondansetron and why?
administer slowly
fast push can cause QT prolongation and VT
what kind of drug is famotidine
h2 receptor blocker
pepcid
what kind of drug is omeprazole
ppi
how do h2 receptor blockers work
block histamine binding with receptors in mucosal parietal cells –> decreases acid secretion
can h2 receptors be taken with meals?
yes
how do PPIs work
prevent transport of H ions into gastric lumen - bind to gastric parietal cells to decrease acid production
what are 2 nursing considerations for omeprazole
take 30-60 mins before meals
report black, tarry stools
what drug promotes healing of ulcers by providing a barrier over them
sucralfate
how does sucralfate interact with other drugs
can decrease bioavailability of warfarin, digoxin, phenytoin, levothyroxine and some antibiotics
separate drugs for at least 2 hours!
s/s of gastric ulcers
pain 1-2 hours after meal
aggravated by eating
vomiting
weight loss
hematemesis
s/s of duodenal ulcers
pain 2-4 hours after meals
food might relieve pain
weight gain
melena if hemorrhage occurs
where is crohn’s disease
ileum and anywhere throughout small and large intestines
can occur anywhere from mouth to anus
skip lesions
where is ulcerative colitis
large intestine
diverticula
herniation of mucosa through muscle layers of the colon wall
diverticulosis
asymptomatic diverticular disease
diverticulitis
inflammatory stage of diverticulosis
possible causes of diverticular disease
decreased fiber
abnormal neuromuscular function
alterations in motility
> 60 years
what kind of diet do you want for diverticular, crohns and UC
low fiber
avoid cold or hot foods
no smoking
what are bowel mvmts going to look like with ileostomy
very liquid
what are bowel mvmts going to look like with colostomy
more solid
going through colon, patient can absorb water
what is mcburney’s sign
pain during palpation to RLQ
seen with appendicitis
what position is comfortable for appendictis
position right side
low fowlers
what is the number 1 cause of pancreatitis
alcoholism
pathophy of pancreatitis?
digestive enzymes activate inside pancreas and auto digestion starts
s/s of pancreatitis
pain increased with eating
distension
ascites
rigid abdomen
Cullen’s sign
Grey turner’s sign
fever
n/v
jaundice
hypotension
nursing intervetnions for pancreatitis (PANCREAS)
pain control
antispasmodics
NPO/NGT - pancreatic rest
calcium replacement d/t hypocalcemia
replace fluids and electrolytes
elevated enzymes (check amylase and lipase)
antibiotics with fever
steroids
what are 2 causes of cholelithiasis
hyperlipidemia
hyperbilirubinemia
signs of cholelithiasis (gallstones)
RUQ sudden sharp pain that radiates to shoulder blades or right shoulder
worse at night or after a fatty meal
N/V
which hepatitis are fecal oral
A & E
*no risk of chronic infection
which hepatitis are due to infected body fluids
B,C, & D
which hepatitis is common with iv drug use or non-sterilized medical equipment
hep C
which hepatitis is common with infected body fluids like blood or semen
hep B
which hepatitis have vaccinations
A&B
s/s of increasing ammonia
changes in LOC
neuromuscular disturbances
fetor (distinctive musty or sweet breath odor)
sleep, mood and speech issues
tx to decrease ammonia
lactulose
antibiotics (neomycin or rifaximin)
decrease protein in diet
monitor serum ammonia
decrease fluid retention (k sparing)
avoid CNS depressants (benzos and opioids)
5 s/s of cirrhosis
palpable firm liver
ascites & edema d/t decrease albumin
abdominal pain, bloating, poor appetite
spider angiomas
jaundice
what would lab values look like with cirrhosis
decrease albumin
increased AST and ALT
what diet for pts with cirrhosis
low protein, low sodium
