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MS test 2 3/22/17 > MS TEST 2 part 2 > Flashcards

MS TEST 2 part 2 Flashcards

1
Q

obstructed common bile duct will be monitored for:

A

Steatorrhea

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2
Q

Purpose of bile?

A

break down fat

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3
Q

After a Billroth II pt is dizzy, weak, has palpitations, what should nurse tell pt to do?

A

Lie down for 30 min after eating

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4
Q

H- pyori treated with

A

omeprazole, amox, clarithromycin

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5
Q

Age for most upper GI bleed?

A

60% over 65

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6
Q

severity of UGI bleed depends on origin

A

Venous-lower pressure easier to stop capillary - almost miniscule, inflammatory process arterial- worst- high pressure hard to stop

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7
Q

Types of UGI Bleeding

A

hematemesis- coffee grounds or fresh bright red Melena- black tarry stools due to iron- causes by digestion of blood.

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8
Q

occult bleed

A

detected by Guiac test can be tested in stool, vomitus, GI secretions

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9
Q

Melena

A

the longer the passage of blood thru the intestines the darker the stool color (caused by Hgb/release of iron)

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10
Q

Mucosa irritating drugs

A

Aspirin, NSAIDS, corticosteroids, alcohol, anti-platelets , cigarettes

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11
Q

What causes most peptic ulcer disease? Hint (80% of cases!)

A

80% r/t H Pylori or drug use (NSAIDS)

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12
Q

Polyps

A

changes in tissues- can lead to cancer

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13
Q

Stress related mucosal disease

A

instigates sympathetic nervous system that pulls perfusion away from GI causing thinning of the tissues

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14
Q

Endoscopy

A

primary tool for locating source of bleeding

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15
Q

How is lavage done?

A

drop NG tube- instill 100CC ROOM TEMP water then pull liquid out= if pink there is blood

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16
Q

Type of lavage on unconscious pt?

A

tube goes thru mouth

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17
Q

Hgb

A

actual measurement of RBC

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18
Q

Hct

A

percentage of whatever qty Hgb (so it won’t decrease if pt losing blood)

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19
Q

Mallory-Weiss tear

A

tear in esophageal tissue from forceful repeated emesis = will actively bleed until we run endoscope down and try to stop bleeding

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20
Q

portal vein

A

vein at top of liver

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21
Q

gastric varices

A

like a varicose vein but on esophagus

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22
Q

Goal of endoscopic hemostasis therapy

A

achieve coagulation or thrombosis in bleeding artery (stop flow of blood)

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23
Q

How do we stop flow of blood using hemostasis therapy?

A

thermal heat to try to cauterize, laser, cryotherapy

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24
Q

Goal of drug therapy for bleeding

A

decrease bleeding decrease HC acid secretion Neutraliize HCl acid that is present

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25
Q

coumadin antidote

A

vit K

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26
Q

antidote for heparin

A

protamine sulfate

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27
Q

What is the drug therapy for bleeding due to ulceration?

A

Epinephrine = produces tissue edema= pressure on bleeding source (usually combines with other therapy)

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28
Q

Sandostatin (octreotide) or somastatin

A

used for upper GI bleed - reduces blood flow to the GI organs and acid secretion

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29
Q

S/SX GI bleed pt (same as for shock)

A

Low BP Rapid weak pulse Increased thirst cold clammy skin restlessness / anxiety (won’t be able to perfuse tissues) altered LOC

30
Q

urine specific gravity value

A

normal (1.005-1.025)

31
Q

if NG tube is inserted:

A

keep in proper position (GI aspirate should be acidic) +make sure not in the lung+ observe aspirate for blood effectiveness of gastric lavage is questionable

32
Q

DT symptoms

A

agitation uncontrolled shaking sweating vivid hallucinations

33
Q

black tarry stools are caused by:

A

occur with slow bleeding from stomach

34
Q

IBD inflammatory bowel disease

A

Chrohn’s ulcerative colitis

35
Q

IBD

A

periods of remission/exacerbation exact cause unknown no “real” cure

36
Q

ulcerative colitis

A

prob of colon and rectum

37
Q

Chrohn’s disease

A

upper small bowel - autoimmune disease - trigger- inflammatory mediators diet , hygeine, stress, smoking, NSAIDS, genetics

38
Q

Chrohn’s sX

A

diarhhea bloody stool weight loss (no absorptioin) abdominal pain fatigue

39
Q

GI tract complications of IBD

A

hemorrahge strictures perforation=peritonitis fistulas

40
Q

**peritonitis sx

A

pain high fever rigid boardlike hard washboard ab

41
Q

Chrohn’s Symptoms

A

cramping , diarrhea, rectal bleeding , fever, weight loss especially if small bowel is involved since it absorbs nutrients. inflammation involves entire bowel wall

42
Q

colitis

A

disease of mucosal layer of colon and rectum

43
Q

colitis symptoms

A

fever rapid weight loss >10% anemia dehydration tachycardia

44
Q

colitis labs

A

CBC, WBC, serum electrolyte levels serum protein ESR (sed rate= watch to see how long it takes blood to separate) C reactive protein stool culture - pus, blood, mucus WBC, RBC imaging studies (KUB) kidney, urinary, bladder endoscopy

45
Q

colitis goal of treatment

A

rest the bowel control inflammation (steroids?) combat infection correct malnutrition (remember- they need to rest bowel= NPO!) alleviate stress relieve symptoms improve quality of life

46
Q

drug therapy colitis

A

corticosteroids antimicrobials aminosalicylates immunosuppressant biologic targeted therapy = (Humira?) goals of drug treatment are to induce and maintain remission

47
Q

colitis nutritional therapy

A

avoid bulk in diet avoid large bulky meals, cereal, grains= give good protein sources may be NPO or only allowed to have liquids - no lactose

48
Q

meds contributing to nutritional prob for colitis pt

A

sulfasalazine corticosteroids

49
Q

**different diets NEED TO LOOK UP!!! TEST ???

A

clear liquids to full

50
Q

colitis diet

A

high protein , low bulk

51
Q

***Irritable bowel syndrome (IBS)

A

is a functional GI disorder characterized by abdominal pain and altered bowel habits in the absence of a specific and unique organic pathology. intermittent abdominal pain or discomfort stool pattern irregularities. Symptoms may occur for years more frequent among women

52
Q

IBS

A

The predominant clinical manifestations are altered bowel habits, abdominal pain and abdominal distention often people with PTSD, depression, anxiety, panic disorder

53
Q

Prob NOT associated with IBS

A

NOT IBS- look at other issues if these symptoms are present : anemia fever persistent diarrhea rectal bleeding severe constipation weight loss basically a diagnosis is made by exclusion

54
Q

pancreatitis most common in?

A

middle age people african american

55
Q

pain from pancreatitis caused by

A

basically pancrease digesting itself autodigestion of pancreas

56
Q

most common causes for bowel obstruction

A

The most common are adhesions, hernias, cancers, and certain medicines

57
Q

types of bowel obstruction

A

mechanical - something physically blocking it non mechanical- tissues not working right to get adequate blood supply to muscle for peristalsis pseudo-mechanical

58
Q

bowel obstructions

A

accumulation of intestinal contents proximal to obstruction = reduced fluid absorption increased cap permeability third spacing

59
Q

lower intestine bowel obstruction

A

no gas abdominal distension new onset constipation normal bowel sounds until late in the game

60
Q

small bowel obstruction

A

colicky ab pain very light to absent bowel sounds n/v abdominal distension fecal odor to breath fecal emesis LATER.. decresed flatus, constipation

61
Q

how to diagnose bowel obstruction

A

pt history physical exam imaging endoscopy lab study

62
Q

. An 85-year-old woman seen in the primary care provider’s office for a well check complains of difficulty swallowing. What common effect of aging should the nurse assess for as a possible cause?

A

XEROSTOMIA

63
Q

The nurse is assessing a 50-year-old woman admitted with a possible bowel obstruction. Which assessment finding would be expected in this patient?

A

high pitched sound on abdominal auscultation

64
Q

. A 62-year-old woman patient is scheduled for a percutaneous transhepatic cholangiography to restore biliary drainage. The nurse discusses the patient’s health history and is most concerned if the patient makes which statement?

A

my tongue swells when I eat shrimp

65
Q

The nurse cares for a 34-year-old woman after bariatric surgery. The nurse determines that discharge teaching related to diet is successful if the patient makes which statement?

A

A. “A high protein diet that is low in carbohydrates and fat will prevent diarrhea.”

66
Q

The nurse identifies that which patient is at highest risk for developing colon cancer?

A

. A 32-year-old female with a 12-year history of ulcerative colitis

67
Q

The nurse is caring for a 55-year-old man patient with acute pancreatitis resulting from gallstones. Which clinical manifestation would the nurse expect the patient to exhibit?

A

Left upper abdominal pain

68
Q

What questions should we ask when gathering health history for GI pt?

A

• Describe any measures used to treat GI symptoms such as diarrhea or vomiting. • Do you smoke?* Do you drink alcohol?* • Are you exposed to any chemicals on a regular basis?* Have you been exposed in the past?* • Have you recently traveled outside the United States?*

69
Q

What questions would we ask during a nutritional assessment?

A

• Describe your usual daily food and fluid intake. • Do you take any supplemental vitamins or minerals?* • Have you experienced any changes in appetite or food tolerance?* • Has there been a weight change in the past 6-12 mo?* • Are you allergic to any foods?*

70
Q

what questions would we ask a GI pt regarding elimination?

A

• Describe the frequency and time of day you have bowel movements. What is the consistency of the bowel movement? • Do you use laxatives or enemas?* If so, how often? • Have there been any recent changes in your bowel pattern?* • Describe any skin problems caused by GI problems. • Do you need any assistive equipment, such as ostomy equipment, raised toilet seat, commode?

71
Q

What questions might we ask a GI pt regarding sleep?

A

Do you experience any difficulty sleeping because of a GI problem?* • Are you awakened by symptoms such as gas, abdominal pain, diarrhea, or heartburn?*

MS test 2 3/22/17 (3 decks)

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