Med-Surg: GI, Hepatic, Pancreatic/1 Flashcards
gastric aspirate checks for and dx test for what
checks hydrochloric acid and pepsin; evaluates for zollinger-ellison syndrome
gastric aspirate procedure
5
- NPO 12 hours
- avoid alcohol, tobacco, meds that change gastric pH for 24 hours
- insert NG tube
- aspirate contents
- obtain pH
lab profiles that we check for hepatic or pancreatic disease
6
- albumin
- ammonia
- bilirubin
- cholesterol
- liver enzymes
- pancreatic enzymes
we check ammonia levels to determine what
the livers ability to break down protein by products
bilirubin is measured direclty in the
blood
what do we check in cholesterol
4
total
ldl
hdl
triglycerides
liver enzymes include
3
- alt/sgpt
- ast/sgot
- alp
pancreatic enzymes include
3
- amylase
- lipase
- prothrombin time
recommended annually to detect colon cancer
fecal occult blood test
fecal screening - instruct patient to do what
avoid red meat, aspirin, turnips, and horseradish at least 72 hours prior to avoid false positive; avoid vitamin C-rich foods to prevent false negative; NSAIDs and anticoagulants should be d/c 7 days prior to testing
hydrogen breath test
2
- evaluates carb absorption
2. aids in detection of bacterial overgrowth in intestine
urea breath test detects
h. pylori
urea breath test instructions - avoid
- one month
- one week
- 24 hours
antibiotics and bismuth subsalicylate 1 month before test; PPIs and sucralfate 1 week before; H2 inhibitors 24 hours before
allows direct visualization of tissues, cavities, and organs using a flexible fiber-optic tube
endoscopy
colonoscopy prep
4
- bowel prep 1-3 days before
- clear liquid diet 12-24 h before
- NPO except water 6-8 hours before
- IV sedation
sigmoidoscopy prep
5
- clear liquid diet pre 24 h
- laxative the evening before
- enema morning of
- sedation is not required
- tissue biopsy may be performed
small bowel capsule endoscopy prep
6
- only water 8-10 pre op
- NPO 2 hour before
- client’s abd is marked for location of placement for sensors
- administer video capsule with full glass of water
- normal diet 4 hours post
- takes about 8 hours
EGD prep
4
- npo 6-8 hours before
- avoid anticoags, asa, or nsaids for days before
- IV sedation
- atropine to dry secretions
barium series
x ray visualization from the mouth to the duodenojejunal junction
liver biopsy - position client how after
on affected side to promote hemostasis
parencentesis positition
upright
gastric pH should be
1.5-4
intestinal pH should be
around 6
respiratory aspirate is around
7 or high pH
NG tube feeding
5
- obtain x ray for placement
- assess gastric pH before each feeding and q4h for continuous feedings
- maintain semi fowlers while feeding
- assess residual
- replace tube every 4 weeks
NG tube residuals
2
hold or stop feeding and do not refeed aspirate if:
- > 100mL for intermittent feedings
- 2 hours worth of continuous feeding
intestinal tubes - tube misplacement/dislodgement, aspiration
immediately remove any tube suspected of being dislodged or misplaced
intestinal tube feedings - most common electrolyte imbalances are
2
- hyponatremia
2. hyperkalemia
PEG tube feeding
5
- assess skin
- assess residual
- infuse slowly
- flush with 30 mL warm water before and after feeding
- maintain semi fowlers 1-2 post feeding
TPN - dressing change
q72H, strict surgical asepsis
TPN - change tubing and remaining TPN how often
every 24 hours
TPN - for pt receiving fat emulsions, monitor for fat overload syndrome
- fever
- increased triglycerides
- clotting problems
- system organ failure
