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aa Orgo > Medsurg 3 part 4 > Flashcards

Medsurg 3 part 4 Flashcards

1
Q

Upper gi series with barium- contraindicated in-

A

complete bowel obstruction and perforation

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2
Q

Upper gi series with barium- complications-

A

aspiration, constipation

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3
Q

Lower gi series with barium: diet

A

clear liq diet day before test

NPO starting at midnight

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4
Q

After endoscopy, you must be NPO until

A

gag reflex returns

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5
Q

Cat scan with or without contrast is contraindicated with

A

seafood allergy

pregnancy

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6
Q

Cat scan-with contrast: afterwards encourage the pt to

A

drink fluids to flush out the contrast

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7
Q

Consequences of malnutrition in the elderly: Pulmonary:

A

less able to clear secretions

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8
Q

how often do you flush a non-tunneled central line catheter

A

weekly

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9
Q

how often do you flush a PICC

A

daily

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10
Q

how often do you flush a port central line catheter

A

monthly

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11
Q

Clean central lines openings with alcohol w povidine iodine ___ or ___

A

tincture or chlorohexidine

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12
Q

____ ointments should not be applied to central line openings

A

Antibiotic

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13
Q

Between small bore and large bore feeding tubes, which has the greater risk for complication during insertion

A

small bore (could be misplaced easier)

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14
Q

After NG, check for

A

Observe for coughing, choking,or cyanosis

Have client speak

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15
Q

a narrowing or tightening of the esophagus that causes swallowing difficulties

A

Esophageal stricture

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16
Q

___ ___ tube is used to control ruptured esophageal varices

A

sengstaken-blakemore

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17
Q

if sudden respiratory distress from sengstaken-blakemore tube

A

cut the balloons with scissors

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18
Q

on the salem sump, never

A

tie off the vent (It prevents the tube from sticking to the gastric mucosa)

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19
Q

Columnar epithelium replaces squamous epithelium lining distal esophagus

A

Barrett’s esophagus

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20
Q

Barrett’s esophagus diagnosed with

A

Endoscopic biopsy to look for dysplasia

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21
Q

rare disorder that puts you at risk for esophagus cancer

A

achalasia

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22
Q

lye ingestion puts you at risk for

A

esophagus cancer

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23
Q

GERD involves a weakness in the

A

LES

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24
Q

Besides a weakened LES, GERD can be caused by ___ ___ or ____

A

Hiatal hernia

Scleroderma

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25
Q

word for Food, acid, bile, pancreatic juice from the stomach going to the esophagus

A

reflux

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26
Q

4 Protective factors against reflux:

A

Competent LES
Saliva
Mucosal blood flow
Mucus

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27
Q

A manifestation of GERD is heartburn in the ___ position

A

supine

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28
Q

painful swallowing

A

Odynophagia

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29
Q

besides antacids, another household cure for too much acid is

A

chewing gum

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30
Q

The 2 main drugs of acid suppression

A

Histamine blocker

PPI

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31
Q

GERD tx: Do not lie down within

A

3 hours after eating

32
Q

GERD tx: Reduce intake and avoid after

A

6pm

33
Q

GERD tx: do not use ___ toothpaste

A

mint

34
Q

PUD pain is described as a___

A

Aching

35
Q

PUD pain is described as b___

A

Burning

36
Q

PUD pain is described as c___

A

Cramplike

37
Q

PUD pain is described as g___

A

Gnawing

38
Q

Benign Gastric Ulcer: Even if there is no sign of bleeding, and no evidence to suggest malignancy, it’s essential to do ___ __ or ___

A

brush cytology or biopsy

39
Q

Medical management PUD: reduce ___ secretions

A

reduce gastric secretions (using histamine blockers and PPIs)

40
Q

Medical management PUD: the best method is

A

eliminate the H pylori

41
Q

Just because someone tests positive for h pylori,

A

doesn’t mean they def have ulcer

42
Q

Medical management PUD: classes of drugs used to reduce gastric secretion

A

histamine blockers and PPIs

43
Q

Strengthen mucosal barrier-mucosal barrier fortifies-____-in presence of mild acid forms viscid and sticky gel and adheres to ulcer surface

A

carafate

44
Q

Billiroth 1 is aka

A

gastroduodenostomy (stomach to duodenum)

45
Q

Billiroth 2 is aka

A

gastrojejunostomy (stomach to jejunum)

46
Q

In a total gastrectomy, the esophagus goes right to the jejunum. You have decreased absorption of (3 things)

A

intrinsic
vit D
calcium

47
Q

With billroth ii (gastrojejunostomy) you have decreased ___ and ____ secretion because the usual stimulus of food passing through the duodenum is missing

A

pancreatic and bile

48
Q

Management of dumping syndrome: decreasing amount of and maintaining a high-protein, high fat, low-cho, dry diet. Gastric emptying can be delayed by eating in a recumbent or semi-recumbent position,l lying down after meals, increasing the fat content and avoiding fluids 1 hour before , with or 2 hours after meals

A

food eaten at one time

49
Q

Management of dumping syndrome: maintaining a high-___, high ___, low-___, dry diet.

A

high-protein, high fat, low-cho, dry

50
Q

Management of dumping syndrome: Gastric emptying can be delayed by eating in a ____ position

A

recumbent

51
Q

Management of dumping syndrome: Gastric emptying can be delayed by __ __ after meals

A

lying down

52
Q

____ disease is most common in individuals living in developed countries whose diets consist primarily of refined foods

A

Diverticular

53
Q

what disease is this: you can lose massive amounts of fluid from diarrhea

A

ulcerative colitis

54
Q

occurs is discontinuously/deep layer in any seg of gi tract

A

crohn’s disease

55
Q

major problem with crohn’s disease

A

malabsorption (malnutrition)

56
Q

2 broad ideas of managing UC and crohn’s disease: decrease ___ and rest ___

A

decrease diarrhea

rest bowel

57
Q

Ulcerative colitis affects which layer of the colon?

A

mucosal

58
Q

Ulcerative colitis hallmark

A

bloody diarrhea

59
Q

Ulcerative colitis: Abdominal pain and diarrhea worse after ___ and in the ____

A

meals and in the morning

60
Q

manifestation of Crohn’s vary according to

A

where the lesions are

61
Q

Anti-saccharomyces cerevisiae antibody is a laboratory finding of

A

Crohn’s

62
Q

Ostomy: Skin barriers, such as wafers are cut to fit __ inch around the fistula

A

1/8 inch

63
Q

asterixix aka ___ ___

A

Flapping tremor

64
Q

asterixix is a manifestation of

A

hepatic encephalopathy

65
Q

Hepatitis A: route

A

Oral/fecal/parenteral, sexual

66
Q

Hepatitis A: onset

A

acute with fever

67
Q

Hepatitis A: prophylaxis

A

Hygeine, vaccine

68
Q

Hepatitis A: Antigen/body

A

Anti HAV

69
Q

Hepatitis A: Incubation

A

30 days

70
Q

Sengstaken-Blakemore tube in place for the ___ treatment of hemorrhage from esophageal varices

A

emergency

71
Q

Cholecystitis: ___ and ___ ___ may be elevated

A

bili and alkaline phosphatase

72
Q

Turners and Cullen’s are associated with

A

pancreatitis

73
Q

abdominal distention with periumbilical ecchymosis

A

(Cullen’s sign)

74
Q

ecchymosis of the flank

A

( Turner’s sign)

75
Q

Suggested by persistent pain or continued high amylase levels (may be present for 4-6 wks afterward)

A

Pseudocyst (complication of pancreatitis)

76
Q

which system should you especially watch for pancreatitis complications

A

respiratory

aa Orgo (196 decks)

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