lower GI con't

Question 1

small bowel obstructions - s/sx (shorty’s tummy doesn’t hurt riding borborgymi waves)

Answer 1

pain (intermittent cramping), abdomen non tender, distention, N/V (profuse), visible perastalic waves, hyperactive bowel sounds (borborygmi), electrolyte imbalances

Question 2

large bowel obstructions - s/sx (large ribbons)

Answer 2

not as many electroylte imbalances and they have bowel sounds early. vomiting follows constipation, ribbon-like stool.

Question 3

GI cancers - Colorectal Cancer how common?

Answer 3

Colorectal Cancer is 3rd most common cancer

Question 4

risk factors for GI cancer

Answer 4

smoking, ETOH use, advanced age, high animal fat diet, salty, cured or poorly preserved food, polyps, chronic pancreatitis, family history and obesity

Question 5

GI cancer - s/sx (The GIs have fatigue)

Answer 5

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)

Question 6

Esophageal Cancer - survival rate and who gets it

Answer 6

poor survival rate. usually affects those between 65-75 years; incidence increasing

Question 7

s/sx of esophageal cancer

Answer 7

progressive dysphagia; pain in the substernal or epigastric area (late) , weight loss, reflux, hemorrhage

Question 8

stomach cancer - what does it begin with? (pylori is wrecking havoc)

Answer 8

usually begins w/ h.pylori. diets high in salt and smoked foods.

Question 9

s/sx of stomach cancer (just think, you can’t eat)

Answer 9

weight loss, indigestion, anemia, GI discomfort or pain

Question 10

polyps

Answer 10

inflammatory, non-cancerous.

Question 11

Adenomatous polyps are closely linked to

Answer 11

to colorectal cancer.

Question 12

surgery for colorectal cancer

Answer 12

Polypectomy, Resections (low anterior resection or LAR)

Question 13

Short bowel syndrome –

Answer 13

lack of surface area to absorb enough nutrients usually after loss of >75% of the small intestines

Question 14

s/sx of short bowel syndrome

Answer 14

dehydration , weight loss, diarrhea, malnutrition, vitamin deficiencies, and electrolyte imbalances

Question 15

Dumping syndrome

Answer 15

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

Question 16

s/sx of dumping syndrome

Answer 16

Symptoms occur after about 15 minutes of eating are include : weakness, palpitations, dizziness and sweating.

Question 17

treatment for dumping syndrome - and what about fluid? (it’s logical)

Answer 17

Semi recumbent with meals, no fluids with meals, lie down after meals, decrease carbs

Question 18

indication for bariatric surgery - how high does BMI need to be?

Answer 18

BMI has to be 40 (extreme obesity) or higher. BMI of 35 - 39.9 is obese.

Question 19

hernia

Answer 19

organ (usually stomach or intestines) moves through the fascia

Question 20

risk factors for hernias (not hiatal) - what about BMI?

Answer 20

Prior or family history, > 60 years, males, connective tissue disorders, COPD (chronic cough) , chronic constipation, abdominal wall injury, smoking (damages connective tissue), low BMI

Question 21

complications of hernias

Answer 21

incarceration and strangulation

Question 22

Appendicitis

Answer 22

Inflammation caused by obstruction d/t infection, fecal mass, structure, tumor, foreign body

Question 23

UC pneumonic - ULCERS (poop, blood, cramps)

Answer 23

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

Question 24

divertiulitis pneumonic POUCH

Answer 24

P - pain (LLQ)
O - observe bloating and blood
U - unrelenting cramps
C - constipation
H - high temp

Question 25

pneumonic for gallbladder - GALLBLADDER

Answer 25

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.