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semester 4 > GI test > Flashcards

GI test Flashcards

1
Q

Major Functions of the GI Tract

A

-Breakdown of food particles into molecular form for digestion.
-Absorption into bloodstream of small nutrient molecules produced by digestion.
-Elimination of undigested unabsorbed food stuffs and other waste products.

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2
Q

Enzymes that digest Carbohydrates

A

Amylase
Ptyalin, Maltase, Sucrase, and Lactase

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3
Q

Enzymes/Secretion that digest Proteins

A

Trypsin
Pepsin, Aminopeptidase, Dipeptidase, and Hydrochloric acid

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4
Q

Enzymes/Secretions that digest Fats

A

Pharyngeal lipase
Steapsin, Pancreatic Lipase, and bile

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5
Q

What could a removed or partially removed stomach lead to

A

no stomach no B12 absorbed. B12 leads to paraniscious (sp) anemia. Look at hg/hct

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6
Q

intrinsic factor does what

A

promotes B12 absorption

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7
Q

small intestine function

A

Secretion of mucous
Absorption of nutrients
Movement of nutrients into the bloodstream

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8
Q

barium swallow teaching

A

teach the patient after the barium swallow to increase fluids to facilitate evacuation of stool and barium (check for fluid restrictions first)

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9
Q

CEA and CA 19-9 test looks for

A

cancer markers

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10
Q

Xerostomia

A

dry mouth

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11
Q

signs of aging on GI system

A

Xerostomia – dry mouth
* Decreased appetite
* Decreased ability to taste
* Delayed emptying of the esophagus
* Decreased HCl acid secretion
Constipation
* Liver size decreased
* Gallbladder disease
* Risk for decreased food intake

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12
Q

Gastrointestinal Intubation Reasons

A

Decompress the stomach
Lavage the stomach
Diagnose GI disorders
Administer medications and feeding
To compress a bleeding site
To aspirate gastric contents for analysis
To remove gas and toxins from the stomach, to diagnose GI motility disorders

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13
Q

what to do with a moist PEG tube

A

If pt has a Peg tube and its all moist around the area be sure to call the doc and get an order for antifungal medication

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14
Q

Signs of aspiration

A

Increased respiration, decreased pulse ox, crackles in lungs. STOP tube feeding and call doc

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15
Q

Indication for PN

A

malabsorption. 7 days unable to eat
Assess for hypoglycemia

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16
Q

why to not slow PN rates

A

rebound hypoglycemia

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17
Q

Parotitis

A

inflammation of parotid gland

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18
Q

Sialadenitis

A

inflammation of the salivary glands

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19
Q

Sialolithiasis

A

inflammation of the salivary stones

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20
Q

Oral and Laryngeal Cancers risk factors

A

Tobacco
Alcohol
HPV
History of head and neck cancer
Being a man
May occur in any area, but lips, lateral tongue, and floor of the mouth are most frequently affected
Over age of 60

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21
Q

Radical Neck Dissection Surgery nursing shit

A

ABCs > bleeding > patient’s ability to communicate
Preform Allen Test (test ulnar artery to ensure the radial artery will be sufficient)
Normal output is 80-100 mL output- watch for large clots, milky white fluid (infection/Chyle fistula) and excessive bleeding

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22
Q

Chyle fistula

A

can lead to dehydration, third spacing, poor wound healing. Call doc

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23
Q

Nursing Care of the Patient With a Radical Neck Dissection

A

Assess vitals every 1-2 hours, unless critical then it becomes every 15
Bed of head at 30 degrees, avoid Vlasova maneuver
May need suction, do not suction near suture line.
If they get a muscle removed assess grip and blood flow (pale, dusky, cool)

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24
Q

GERD meal recommendation

A

small and frequent

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25
Q

Esophageal Varices

A

true medical emergency
Risk factors – alcoholism, fatty liver, cirrhosis
Signs & Symptoms – vomiting blood, black and tarry stools

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26
Q

Bilirubin

A

product of red blood cell breakdown

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27
Q

liver function tests

A

AST, ALT, GGT, GGTP, LDH

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28
Q

Alanine aminotransferase (ALT)

A

levels increase primarily in liver disorders; used to monitor the course of hepatitis, cirrhosis, the effects of treatments that may be toxic to the liver

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29
Q

Aspartate aminotransferase (AST)

A

not specific to liver diseases however levels of AST may be increased in cirrhosis, hepatitis, and liver cancer

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30
Q

Gamma-glutamyl transferase (GGT)

A

levels are associated with cholestasis; alcoholic liver disease

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31
Q

Fatty liver disease

A

Nonalcoholic fatty liver disease (NAFLD)
Nonalcoholic steatohepatitis (NASH)

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32
Q

Manifestations of Liver Disease

A

Jaundice
Portal hypertension
Ascites and varices
Hepatic encephalopathy or coma
Nutritional deficiencies

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33
Q

Pruritus

A

very itchy skin

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34
Q

s/s Hepatocellular jaundice

A

Mild or severely ill
Lack of appetite, nausea or vomiting, weight loss
Malaise, fatigue, weakness
Headache, chills, fever, infection

35
Q

s/s Obstructive jaundice

A

Dark orange-brown urine, clay-colored stools
Dyspepsia and intolerance of fats, impaired digestion
Pruritus – very itchy

36
Q

Portal Hypertension

A

Obstructed blood flow through the liver results in increased pressure throughout the portal venous system
Results in
Ascites and Esophageal varices

37
Q

Treatment of Ascites

A

Low-sodium diet
Diuretics
Bed rest
Paracentesis
Administration of salt-poor albumin
Transjugular intrahepatic portosystemic shunt (TIPS)
Other methods: peritoneovenous shunt

38
Q

goal with lactulose

A

3 soft bowel movements a day (actually super bad diarrhea)

39
Q

Medical Management of Hepatic Encephalopathy

A

Discontinue sedatives, analgesics, and tranquilizers. HIGH RISK for safety issues
Eliminate precipitating cause
Lactulose to reduce serum ammonia levels
IV glucose to minimize protein catabolism
Protein restriction
Reduction of ammonia from GI tract by gastric suction, enemas, oral antibiotics

40
Q

Nursing Management of Esophageal Varices

A

Maintain safe environment; prevent injury, bleeding and infection

41
Q

Hepatitis A and E route s

A

oral fecal

42
Q

Hepatitis B and C routes

A

blood

43
Q

Hepatitis D risk factors

A

only people with B are in danger

44
Q

Nonviral Hepatitis

A

drug induced

45
Q

Manifestations Hep A

A

mild flu-like symptoms, low-grade fever, anorexia, later jaundice and dark urine, indigestion and epigastric distress, enlargement of liver and spleen

46
Q

Hepatitis A prevention

A

Good handwashing, safe water, and proper sewage disposal
Vaccine
Immunoglobulin for contacts to provide passive immunity

47
Q

Management of Hepatitis B

A

Vaccine: for persons at high risk, routine vaccination of infants
Passive immunization for those exposed
Standard precautions and infection control measures
Screening of blood and blood products

48
Q

Cholelithiasis

A

gallstones

49
Q

Medical Management of Cholelithiasis

A

ERCP - remove or break up
Dietary management
Medications: ursodeoxycholic acid and chenodeoxycholic acid
Laparoscopic cholecystectomy
Nonsurgical removal - Intracorporeal or extracorporeal lithotripsy

50
Q

Acute Pancreatitis can lead to

A

Autodigestion from premature activation of enzymes
Primary factors:
Biliary tract disease EtOH

51
Q

s/s pancreatitis

A

Sharp mid to LUQ pain, N/V, hypotension, tachycardia, jaundice, absent bowel sounds, low grade fever, tetany
Turner’s and Cullen’s Sign

52
Q

Pancreatoduodenectomy (Whipple Procedure)

A

Removes gall bladder, part of stomach and part of common bile duct and duodenum

53
Q

Erosive Gastritis

A

Mucosa isn’t just damaged, it is going almost down to the sub mucosa
Radiation therapy, meds, alcohol could be the cause

54
Q

Manifestations of acute Gastritis

A

epigastric pain, dyspepsia, anorexia, hiccups, nausea, vomiting. Erosive gastritis can lead to melena, hematemesis, or hematochezia

55
Q

Manifestations of chronic Gastritis

A

fatigue, pyrosis, belching, sour taste in the mouth, halitosis, early satiety, anorexia, nausea, and vomiting. May have pernicious anemia due to malabsorption of B12. Some are asymptomatic

56
Q

Medical Management of Gastritis

A

Acute
Refrain from alcohol and food until symptoms subside
Supportive therapy: IV fluids, nasogastric intubation, antacids, histamine-2 receptor antagonists, proton pump inhibitors
Chronic
Modify diet, promote rest, reduce stress, avoid alcohol and NSAIDs
Pharmacologic therapy

57
Q

Peptic Ulcer Disease is associated with what infection?

A

H. Pylori

58
Q

risk factors for peptic ulcer disease

A

Risk factors include excessive secretion of stomach acid, dietary factors, chronic use of NSAIDs, alcohol, stress, smoking, and familial tendency

59
Q

rates of duodenal ulcers

A

Duodenal ulcers account for about 80% of all peptic ulcers. H. Pylori found in 90-95% of duodenal ulcers.

60
Q

what to monitor for with peptic ulcer disease

A

Hemorrhage – look for vs changes
Perforation and penetration – sudden very hard and rigid abdomen (surgical emergency) s/s shock
Gastric outlet obstruction

61
Q

perforation and penetration s/s

A

sudden hard and rigid abdomen

62
Q

dumping syndrome

A

malabsorption of vitamins and minerals, might need supplemental vit b12
for dumping syndrome avoid fluid with meals, avoid high carb high sugar diets

can cause hyper then sudden hypoglycemia

63
Q

what can perforation lead to

A

peritonitis (inflammation of abdominal lining)

64
Q

dumping syndrome management

A

To delay stomach emptying and dumping syndrome, assume low Fowler position after meals; lie down for 20 to 30 minutes
Take antispasmodics as prescribed
Avoid fluid with meals

65
Q

Gastroparesis causes

A

Problems with vagus nerve (cranial nerve X)
Nerve damage secondary to diabetes
Drugs that decrease gastric motility

66
Q

constipation causes

A

medications, chronic laxative use, weakness, immobility, fatigue, inability to increase intra-abdominal pressure, diet, ignoring urge to defecate, and lack of regular exercise

67
Q

complications of constipation

A

Decreased cardiac output – straining increases interthorasic pressure
Fecal impaction
Hemorrhoids
Fissures
Rectal prolapse
Megacolon

68
Q

diarrhea causes

A

infections, medications, tube feeding formulas, malabsorption, metabolic and endocrine disorders, and various disease processes

69
Q

diarrhea complications

A

Fluid and electrolyte imbalances
Dehydration
Cardiac dysrhythmias
Chronic diarrhea can result in skin care issues related to irritant dermatitis

70
Q

c-diff

A

Patients receiving clindamycin, ampicillin, amoxacillin, cephalosporins are susceptable.
**Clostridium Difficile – can be transmitted nosocomially (highly contagious) – private room
Contact Precautions
Metronidazole (Flagyl), Vancomycin (PO)
Handwashing
Fecal Transplant – ew

71
Q

Clinical Manifestations of Malabsorption

A

Hallmark finding is diarrhea or frequent, loose, bulky, foul-smelling stools, high-fat content and often grayish
Symptoms similar to irritable bowel syndrome
Manifested by weight loss and vitamin and mineral deficiency

72
Q

Diverticular Disease

A

Diverticular disease increases with age and is associated with a low-fiber diet
Diverticulum: sac-like herniation of the lining of the bowel that extends through a defect in the muscle layer
May occur anywhere in the intestine but most common in the sigmoid colon
Diverticulosis: multiple diverticula without inflammation
Diverticulitis: infection and inflammation of diverticula

73
Q

Crohn’s disease

A

subacute chronic inflammation of the GI tract. Can have remission and exacerbation. Can have bits inflamed, cobblestone pattern. Very rarely have bloody stools

74
Q

Ulcerative colitis

A

can have exacerbation and remission. Have abd cramps, bloody diarrhea, starts in the rectum and spreads up the colon.

75
Q

Ulcerative colitis location

A

begins in rectum and spreads toward the cecum

76
Q

crohn’s disease location

A

most often in the terminal ilium with patchy involvement through all layers of the bowel

77
Q

ulcerative colitis peak incidence at age

A

15-25 yr and 55-65 yr

78
Q

crohn’s disease peak incidence at age

A

15-40

79
Q

ulcerative colitis number of stools

A

10-20 liquid bloody stools per day

80
Q

crohn’s disease number of stools

A

5-6 soft, loose stools per day, non-bloody

81
Q

complications of ulcerative colitis

A

hemorrhage, nutritional deficiencies

82
Q

crohn’s disease complications

A

fistulas (common), nutritional deficiencies

83
Q

ulcerative colitis need for surgery?

A

infrequent

84
Q

crohn’s disease need for surgery?

A

frequent

semester 4 (11 decks)

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