GI system Flashcards
Crohn’s disease
Inflammatory disease of the GI tract, usually affects the ileum, leads to thickening and scarring, narrowed lumen, fistulas, ulcerations and abscesses. Usually the patient experiences remissions and exacerbations.
Diverticulitis
Inflammation of one or more diverticula from penetration of fecal matter through the thin walled diverticula resulting in formation of an abscess.
Gastric resection
Removal of the lower half of the stomach.
Melena
Black tarry stools resulting from bleeding in the upper GI tract.
Murphy’s sign
A sign of gallbladder disease consisting of pain on taking a deep breath when the examiner’s fingers are on the approximate location of the gallbladder.
Pyloroplasty
Enlarging the pylorus to prevent or decrease pyloric obstruction thereby enhancing gastric emptying.
Turner’s sign
Gray-blue discoloration of the flanks seen in acute hemorrhagic pancreatitis.
Ulcerative colitis
Ulcerative and inflammatory disease of the bowel that results in poor absorption of nutrients.
Acute ulcerative colitis results in…
Vascular congestion, hemorrhage, edema, and ulceration of the bowel mucosa.
Chronic ulcerative colitis causes….
Muscular hypertrophy, fat deposits and fibrous tissue with bowel thickening, shortening and narrowing
Vagotomy
Surgical division of the vagus nerve to eliminate the vagal impulses that stimulate hydrochloric acid secretion in the stomach.
Small intestine includes which organs?
Bile and pancreatic ducts, jejunum and ileum.
Function of the large intestine
To absorb water and eliminate waste.
Functions of the liver
- Kupffer cells remove bacteria from blood
- removes excess glucose and amino acids from blood
- synthesizes glucose, amino acids and fats
- aids in digestion of carbs, proteins and fats
- stores and filters blood
- stores vitamins A, B, D, and Iron
- secretes bile to emulsify fats
Function of the Gallbladder
Stores and concentrates bile for the digestion of fats
Pancreas - exocrine functions
- secretes sodium bicarbonate to neutralize stomach acidity
- secretes pancreatic juices containing enzymes that aid in digestion
Gastritis
Inflammation of the stomach or gastric mucosa. Monitor patient for hematemesis, tachycardia and hypotension.
Peptic Ulcer Disease
Ulceration of the mucosal wall of the stomach, pylorus, duodenum or esophagus - erosion may extend into the muscle.
Medical treatment for peptic ulcer disease
Monitor for bleeding, feed patient small bland meals, administer H-receptor agonist or PPIs, antacids, and anticholinergenics.
Total Gastrectomy
Treatment for peptic ulcer disease. Surgical removal of the stomach and attachment of the esophagus to the jejunum.
Vagotomy
Treatment for peptic ulcer disease. Surgical division of the vagus nerve to eliminate hydrochloric acid secretion into the stomach.
Gastric resection
Treatment for peptic ulcer disease. Removal of the lower half of the stomach.
Bilroth 1
Treatment for peptic ulcer disease. Partial stomach removal with attachment to the duodenum.
Bilroth 2
Treatment for peptic ulcer disease. Partial stomach removal with attachment to the jejunum.
Pyloroplasty
Surgical enlargement of the pylorus to decrease the risk of obstruction and facilitate gastric emptying.
Post-op care for surgical treatment of peptic ulcer disease.
- place patient in the Fowler position to facilitate drainage
- NPO 1-3 days until GI system is working
- Monitor patient for hemorrhage, dumping syndrome, diarrhea, hypoglycemia and vitamin B deficiency.
Duodenal Ulcers Symptoms
Having pain in the mid-epigastric area 1.5-3 hours after a meal or during the night. Melena is common and pain is usually relieved when eating food.
Dumping syndrome and its symptoms
Rapid emptying of the stomach contents into the small intestine after a gastric resection.
Symptoms include:
- nausea and vomitting
- abdominal fullness and cramping
- diarrhea
- palpitations and tachycardia
- perspiration
- dizziness and weakness
- hyperparistalsis
Cholecystitis and symptoms
Inflammation of the gallbladder.
Symptoms include:
- nausea and vomiting
- indigestion
- belching
- flatulance
- epigastric pain radiating to scapula 4-6 hours after eating
- rebound tenderness
- Murphy’s sign
- pyrexia
- tachycardia
Surgical interventions for cholecystitis
- Cholecystectomy - removal of the gallbladder
- Choledechoilithotomy - surgical incision to the bile duct to remove stone. Often a T tube is inserted to ensure patentcy of duct and draining until edema subsides.
Cirrhosis
Chronic progressive liver disease characterized by degeneration and destruction of hepatocytes.
Complications of cirrhosis
- Portal hypertension
- Ascites
- Esophageal varicies
- Coagulation defects
- Jaundice
- Portal systemic encephalopathy
- Hepatorenal syndrome (renal failure)
Esophageal varicies
Dilated and tortuous veins in the submucosa of the esophagus caused by portal hypertension.
Treatment for esophageal varicies
- Endoscopic injection of sclerosing agent into and around the bleeding varicose.
- Endoscopic ligation of varicies with elastic band.
- Shunting of blood away from varicies through surgical alteration of venous blood flow.
Hepatitis
Inflammation of the liver caused by a virus, bacteria, exposure to medications or hepatic toxins.
Stages of viral hepatitis
- Preicteric stage - flu like symptoms
- Icteric stage - Jaundice, increase in bilirubin levels, dark or tea colored urine and clay like stools
- Posticteric stage - convalescent stage, reduction of jaundice and return of urine and stools to normal.
Blood value changes in hepatitis
- Increase in ALT, AST, ammonia and bilirubin levels.
Pancreatitis
Acute or chronic inflammation of the pancreas associated with escape of pancreatic enzymes into the surrounding tissue.
Signs and symptoms of pancreatitis
- Sudden onset abdominal pain with tenderness
- Nausea and vomiting
- Cullen’s sign - discoloration of the abdomen
- Turner’s sign - bluish discoloration of flanks
- Weight loss
- Muscle wastage
- Jaundice
- Increased WBC count, glucose, bilirubin, alkaline phosphate, urinary amylase, serum lipase and amylase.
Interventions for pancreatitis
- NPO, IV fluids and parenteral nutrition as required
- H-receptor agonists, PPIs, anti-cholinergenics
- Decrease fat and protein intake
- Supplementary vitamins and minerals
Ulcerative colitis
Ulcerative and inflammatory disease of the colon resulting in poor absorption of nutrients. The colon becomes edematous and may develop bleeding ulcers leading to perforation. Scar tissue develops resulting in a loss of elasticity. Characterized by exacerbations and remissions.
Crohn’s Disease
Inflammatory disease of the GI tract leads to thickening and scarring, narrowed lumen, fistulas, ulcerations and abscesses.
Diverticulosis
An out pouching or herniation of the intestinal mucosa
Diverticulitis
Inflammation of one or more diverticula that occurs through penetration of fecal matter through the thin walled diverticula.
Early symptoms of dumping syndrome
- vertigo
- tachycardia
- sweating
- pallor
- syncope
- palpitations
- desire to lie down
Procedure for colostomy irrigation
- Use 500-1000ml of warm tap water
- Suspend the solution 18 inches above the stoma
- Insert cone 2-4 inches inside stoma
- Decrease flow rate if cramping occurs
Sengstaken-Blakemore tube
Balloon used to in a client with a diagnosis of cirrhosis with ruptured esophageal varices if other treatment measures are unsuccessful. The tube has an esophageal and a gastric balloon. The esophageal balloon exerts pressure on the ruptured esophageal varices and stops the bleeding. The gastric balloon holds the tube in the correct position and prevents migration of the esophageal balloon, which could harm the client.
Hallmark symptom of acute pancreatitis
Severe abdominal pain not relieved by vomiting.
Lannec’s cirrhosis
Results from long term alcohol abuse
Cardiac cirrhosis
Caused by long-term right sided heart failure
Post necrotic cirrhosis
Caused by exposure to hepatoxoins, chemicals, infections or metabolic disorder.
Biliary cirrhosis
Results from a decrease in bile flow and is most commonly caused by long-term obstruction of bile ducts.
Clinical signs and symptoms of portal hypertension
Similar to those of heart failure and include jugular vein distention, lung crackles, and decreased perfusion to all organs. Initially the client may have hypertension, flushed skin, and a bounding pulse.
Asterixis
Flapping tremor of the hand that is an early sign of hepatic encephalopathy. The exact cause of this disorder is not known, but abnormal ammonia metabolism may be implicated. Increased serum ammonia levels are thought to interfere with normal cerebral metabolism. Tremors and drowsiness also would be noted.
Salem sump tube
An NG tube with a large lumen and an air vent
A Dobbhoff weighted tube
Feeding tube
Levin Tube
Tube with a single lumen
Albumin
Responsible for maintaining the osmolality of the blood. When the albumin level is low, osmotic pressure is decreased, which in turn can lead to peripheral edema.
Gluconeogenesis
The production of glucose for energy from protein and fat stores in the body. This can occur with extreme dieting and also with diabetes mellitus
Glycogenolysis
The production of glucose from glycogen stores in the liver.
Cystic duct
Links the pancreas to the gallbladder and passes bile through this duct.
Canaliculi
The liver collects bile here and then bile flows through the right and left hepatic ducts into the common bile duct.
Common bile duct
Connects the liver to the duodenum and supports bile flow.
Latulose
An osmotic laxative used to decrease ammonia levels, which are elevated in hepatic encephalopathy.
Diagnosing a duodenal ulcer
Patient gets relief from pain when eating and has no weight loss
Blood changes in appendicitis
WBC rises and there is a shift to the left (indicating an increase in the number of immature cells).
Normal bowel sounds
High pitched clicks and gurgles
This is a complication of Bilroth 1
Pernicious anemia
