lower GI con't Flashcards
small bowel obstructions - s/sx (shorty’s tummy doesn’t hurt riding borborgymi waves)
pain (intermittent cramping), abdomen non tender, distention, N/V (profuse), visible perastalic waves, hyperactive bowel sounds (borborygmi), electrolyte imbalances
large bowel obstructions - s/sx (large ribbons)
not as many electroylte imbalances and they have bowel sounds early. vomiting follows constipation, ribbon-like stool.
GI cancers - Colorectal Cancer how common?
Colorectal Cancer is 3rd most common cancer
risk factors for GI cancer
smoking, ETOH use, advanced age, high animal fat diet, salty, cured or poorly preserved food, polyps, chronic pancreatitis, family history and obesity
GI cancer - s/sx (The GIs have fatigue)
Fatigue is the MAIN symptom. bloating, blood in stool, fatigue, change in bowel habits, n/v, weight loss, loss of appetite, abdominal pain/tenderness (these are all usually late signs)
Esophageal Cancer - survival rate and who gets it
poor survival rate. usually affects those between 65-75 years; incidence increasing
s/sx of esophageal cancer
progressive dysphagia; pain in the substernal or epigastric area (late) , weight loss, reflux, hemorrhage
stomach cancer - what does it begin with? (pylori is wrecking havoc)
usually begins w/ h.pylori. diets high in salt and smoked foods.
s/sx of stomach cancer (just think, you can’t eat)
weight loss, indigestion, anemia, GI discomfort or pain
polyps
inflammatory, non-cancerous.
Adenomatous polyps are closely linked to
to colorectal cancer.
surgery for colorectal cancer
Polypectomy, Resections (low anterior resection or LAR)
Short bowel syndrome –
lack of surface area to absorb enough nutrients usually after loss of >75% of the small intestines
s/sx of short bowel syndrome
dehydration , weight loss, diarrhea, malnutrition, vitamin deficiencies, and electrolyte imbalances
Dumping syndrome
results for removal of a large part of the stomach and pyloric sphincter and the resulting dumping of chyme into the small intestines that cause large fluid shifts out of the plasma
s/sx of dumping syndrome
Symptoms occur after about 15 minutes of eating are include : weakness, palpitations, dizziness and sweating.
treatment for dumping syndrome - and what about fluid? (it’s logical)
Semi recumbent with meals, no fluids with meals, lie down after meals, decrease carbs
indication for bariatric surgery - how high does BMI need to be?
BMI has to be 40 (extreme obesity) or higher. BMI of 35 - 39.9 is obese.
hernia
organ (usually stomach or intestines) moves through the fascia
risk factors for hernias (not hiatal) - what about BMI?
Prior or family history, > 60 years, males, connective tissue disorders, COPD (chronic cough) , chronic constipation, abdominal wall injury, smoking (damages connective tissue), low BMI
complications of hernias
incarceration and strangulation
Appendicitis
Inflammation caused by obstruction d/t infection, fecal mass, structure, tumor, foreign body
UC pneumonic - ULCERS (poop, blood, cramps)
U - urgent bowel movements
L - low RBCs
C - cramps in abdomen (very painful)
E - electrolyte imbalance, elevated temp
R - rectal bleeding
S - severe diarrhea w/ blood and pus
divertiulitis pneumonic POUCH
P - pain (LLQ)
O - observe bloating and blood
U - unrelenting cramps
C - constipation
H - high temp
pneumonic for gallbladder - GALLBLADDER
G - for GI rest (NPO) provide routine mouth care
A - analgesics and anti-emetics
L- low fat diet when recovered
L - large bore IV for fluids
B - breathing murphys sign
L - labs - electrolytes, WBC, renal function (dehydration), billurbin,
A - antibiotics
D - drain care (cholcyostomy tube) this is not a T-tube. this is a C-tube. this is to help if you can’t immediately get surgery. it drains fluid from gallbladder.
D - deterioration. If not getting better, there will be LOC, tachy, drop in BP (could be sepsis), WBC high, steatorrhea, jaundice, increased NV.
E - ERCP - this removes gallstones from bile duct. scope inserted through mouth to gallbladder.
R - removal of gallbladder - a cholecystectomy. bile now drains into duodenum continuously. monitor for infection. can have shoulder pain.