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ati comprehensive > Med-Surg: GI, Hepatic, Pancreatic/4 > Flashcards

Med-Surg: GI, Hepatic, Pancreatic/4 Flashcards

1
Q

bariatric surgery indications

3

A
  1. BMI >40
  2. BMI > 35 with other diseases
  3. repeated failure of nonsurgical weight reduction
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2
Q

bari surgery - diet post op

A

liquids and pureed foods for first 6 weeks

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3
Q

bari surgery post op care

6

A
  1. # 1 airway
  2. ensure abd binder in place
  3. place in semi fowlers
  4. ambulate asap, day of surgery
  5. measure and compare abd girth
  6. listen for bowel sounds
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4
Q

bari surgery - feedings post op should be

2

A
  1. six small feedings per day

2. begin with 1 oz cups of clear liquids

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5
Q

dumping syndrome s/s

6

A
  1. tachycardia
  2. nausea
  3. diarrhea
  4. abd cramping
  5. diaphoresis
  6. anastomotic leak
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6
Q

colostomy - avoid what foods

5

A
  1. nuts
  2. popcorn
  3. celery
  4. seeds
  5. coconut
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7
Q

colostomy - foods that can cause odor and gas

6

A
  1. cruciferous veggies
  2. asparagus
  3. fish
  4. eggs
  5. garlic
  6. beans
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8
Q

cirrhosis contributing factors

4

A
  1. alcoholism
  2. postnecrotic
  3. biliary disease
  4. severe right sided HF
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9
Q

cirrhosis mani. early

4

A
  1. enlarged liver
  2. jaundice
  3. GI disturbances
  4. weight loss
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10
Q

cirrhosis mani. late

8

A
  1. liver becomes smaller and nodular
  2. splenomegaly
  3. ascites
  4. bleeding tendencies, decreased vit K and PT time, anemia
  5. esophageal varices
  6. pruritis of skin
  7. clay colored stools; no bile in them
  8. tea colored urine; bile in urine
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11
Q

cirrhosis diet

A

high calorie, low protein (10-20 g/day), low fat, low sodium diet

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12
Q

cirrhosis - sodium and fluid

A

limit

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13
Q

lactulose

A

decreases ammonia levels in cirrhosis

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14
Q

hep a route

A

fecal oral

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15
Q

hep B route

A

blood

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16
Q

hep C route

A

blood

17
Q

hep A mani.

2

A
  1. mild

2. flu like

18
Q

hep B mani.

9

A
  1. may be asymptomatic
  2. RUQ pain
  3. anorexia
  4. NV
  5. fatigue
  6. febrile
  7. dark urine
  8. light colored stool
  9. jaundice
19
Q

hep C mani.

3

A
  1. most are asymp.
  2. dx with blood testing
  3. chronic inflammation progresses to cirrhosis
20
Q

hep A prevention

2

A
  1. hand washing

2. vaccine ages 2+ (two doses 6-18 months apart)

21
Q

hep B prevention

2

A
  1. vaccine infants and high risk populations

2. 3 doses over 6-month time

22
Q

hep C prevention

A

avoid high risk behaviors

23
Q

hep B and C tx

3

A
  1. antiviral drugs
  2. peginterferon alfa-2B
  3. monitor kidney function
24
Q

cholecystitis

A

inflammation of gallbladder

25
Q

cholelithiasis

A

presence of stones in the gallbladder

26
Q

gallbladder disease CF

5

A
  1. more common in females
  2. obesity
  3. high fat diet
  4. older adults
  5. DM type 2
27
Q

gallbladder manif.

7

A
  1. sharp right upper quadrant, epigastric, or shoulder pain
  2. NV after ingestion of high fat food
  3. murphy’s sign
  4. flatulence
  5. dyspepsia
  6. dark urine
  7. clay colored stool
28
Q

cholecystectomy post op

4

A
  1. may have T tube 1-2 weeks
  2. monitor drainage, keep below level of GB
  3. report drainage greater than 1000ml/day
  4. never irrigate without order
29
Q

GB disease client education

3

A
  1. resume regular low fat diet
  2. prevent dumping syndrome
  3. care of T tube
30
Q

chronic pancreatitis CFs

6

A
  1. alcohol
  2. gallstones
  3. illegal drug use
  4. infection
  5. blunt abd trauma
  6. operative manipulation and trauma
31
Q

pancreatitis manif.

9

A
  1. severe mid-epigastric or LUQ pain
  2. pain intensifies after meals and when lying down
  3. NV
  4. weight loss
  5. abd tenderness
  6. ascites
  7. elevated amylase and lipase
  8. steatorrhea
  9. Turner and Cullen’s sign
32
Q

pancreatitis position of comfort

A

upright leaning forward

33
Q

pancreatitis - monitor for what electo

A

hypocalcemia and hypomag

34
Q

pancreatitis rx for pain that is contraindicated

A

meperidine

35
Q

client education for chronic pancreatitis

3

A
  1. take enzymes before meals and snacks
  2. nutrition: high caloric needs, low fat
  3. no alcohol
36
Q

pancreatic cancer dx procedures

5

A
  1. carcinoembryonic antigen (CEA) levels - normal is <2.5 nonsmokers, <5 smokers
  2. elevated serum amylase and lipase
  3. elevated alkaline phosphate and bilirubin
  4. ERCP
  5. US, CT scan

ati comprehensive (17 decks)

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