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nur 225 exam 2 > nur 226 gi and coagulaion > Flashcards

nur 226 gi and coagulaion Flashcards

1
Q

Constipatio
n* Defined

A

small, infrequent,
or difficult BM
* Fewer than 3 BMs/week

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2
Q

Constipatio
n
* Causes

A

Diet (low in fiber)
* Lack of exercise
* Slowed peristalsis
* Pathologic conditions
* Obstruction or
diverticulitis

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3
Q

What is secretory diarrhea associated with?

Vibrio cholerae and Staph aureus can cause this type of diarrhea

A

infection

secretory

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4
Q

C Diff has what type of diarrhea?
a. acute
b. chronic
c. episodic
d. secretory
e. exudative

A

d

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5
Q

What disease causes an overgrowth of toxins that attack the GI tract?

A

C Diff

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6
Q

Causes of C Diff

A

antibiotics, chemotherapy, bowel surgerym direct contact

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7
Q

S/S of C Diff

A

secretory diarrhea (= 3 loose stools in 24
hrs), cramping, low grade fever, nausea, anorexia (decreased appetite), Mucus in stool

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8
Q

What is the complete or partial blockage of the SI or LI?

A

intestinal obstruction

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9
Q

SATA: Which of the following are functional intestinal obstructions?
a. hernia
b. feces
c. peritonitis (narcotics)
d. spinal fracture
e. hypokalemia
f. drugs
g. trauma

A

c, d, e, f, g

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10
Q

Impaction causes

A

Unrelieved constipation
* May lead to obstruction

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11
Q

s/s of impaction

A

May have continuous oozing or diarrhea
* Loss of appetite
* N/V
* Abdominal distention
* Cramping and

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12
Q

Diarrhea
* Defined:

A

increase in frequency and fluidity of bowel
movements

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13
Q

Diarrhea
* Define
acute, chronic and episodic

A

Acute
* Infection, emotional stress, some medications,
and liquid stool around an impaction

  • Chronic – lasting more than 4 weeks
  • Chronic GI infection
  • Alterations in motility or integrity
  • Malabsorption
  • Endocrine disorders
  • Episodic
  • Food allergy or irritant
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14
Q

Osmotic diarrhea

Secretory diarrhea

Exudative diarrhea

Related to motility
disturbances

A

Osmotic diarrhea Magnesium sulfate

Secretory diarrhea Vibrio cholerae &
Staphylococcus aureus

Exudative diarrhea Crohn disease & Ulcerative Colitis

Related to motility
disturbances Dumping syndrome & IBS

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15
Q

C. Diff
* Risk Factors

A

-Age > 65
* Antibiotic
therapy
* Immunocompromised
* Recent
hospitalization
* GI procedure
* Previous C. Diff
infection

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16
Q

C. Diff
* Treatment

A

-Vancomycin 125 mg, 4 times/day

  • Metronidazole
  • Probiotics
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17
Q

Irritable Bowel Syndrome
(IBS)
Defined

Possible causes

A

Defined by diarrhea
and/or constipation
with cramps and no
identified pathology

Possible causes
*Genetics
*Environment (stressors)
*Diet

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18
Q

IBS
* Manifestations

Pharmacotherapy

A

-Diarrhea, Constipation, Combination
of both
-Cramping abdominal pain
* Nausea
* Mucus in stool

Pharmacotherapy
* Antidiarrheals
* Anticholinergic/Antispasmotics
* Laxatives

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19
Q

Functional vs mechanical blockage

A

Mechanical obstruction occurs when there is a physical blockage in the intestine, such as a tumor, hernia, or adhesions.

Functional obstruction, on the other hand, is caused by a disruption in the normal muscle contractions that propel food through the intestines, often due to conditions like ileus or intestinal dysmotility.
Abdominal surgery,Severe trauma
* Spinal fracture
* Drugs (narcotics)

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20
Q

An intestinal obstruction can lead to…

A

increased fluid and gas, distention, water and electrolytes in lumen of SI, decreased perfusion, swelling, increased pressure, fluid in peritoneum

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21
Q

Complications of Intestinal Obstructions
a. vomiting
b. gangrenous tissue
c. hyperkalemia
d. ischemia to bowel
e. sepsis
f. shock (blood leakage)

A

b, d, e, f

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22
Q

What type of disorder is Dumping Syndrome?

A

malabsorption

23
Q

Dumping
Syndrome

A

(post GI surgery problem)

Dumping of stomach contents
into small intestine

food moves quickly from stomach to small intestine

24
Q

Dumping Syndrome
Manifestations

A
  • Nausea
  • Weakness
  • Sweating
  • Diarrhea
25
Q

Dumping Syndrome
drug

AE

A
  • Octreotide (octupus)
  • Antidiarrheal
  • SE: nausea, vomiting and upset stomach
26
Q

T/F: a treatment for Dumping Syndrome is to change your diet.

A

t

27
Q

What is unreleived constipation called?

A

impaction

28
Q

When do you see continuous oozing of diarrhea with abdominal distention and cramping?

A

impaction

29
Q

What is commonly found in the stool with exudative diarrhea?

A

mucus

30
Q

SATA: Which of the following are mechanical intestinal obstructions?
a. hernia
b. tumor
c. feces
d. trauma
e. drugs
f. intusseception
g. hypokalemia

A

a, b, c, f

31
Q

What is the treatment for an intestinal obstruction?

A

surgery, decompression of bowel, IV

32
Q

Your patient Joe recently had a part of his SI removed and is coming into the ER with severe diarrhea. What condition does Joe have? How will you treat Joe?

A

Short Bowel Syndrome, IV fluids

33
Q

Antidiarrheals
* Used to treat

  • Different Groups
A

diarrhea

  • Adsorbants
  • Antimotility
    (anticholinergics and
    opiates)
  • Probiotics
34
Q

Adsorbents

name

moa

AE

Caution

A

bismuth subsalicylate (Pepto-Bismol)
* A form of aspirin

coats the walls of the GI tract

Constipation
* Dark stools and darkening of tongue
* Ringing in the ears

(the constipated moth with black spots and headphones)

  • Caution in those with bleeding problems
35
Q

Antimotility

name

moa

ae

A

Atropine
* loperamide

Slow peristalsis
* Drying effect*

Urinary retention
* Headache, dizziness, anxiety, drowsiness
* Bradycardia, hypotension
* Dry skin
* Flushing

36
Q

Probiotics

A

restores gut flora

Lactobacillius- bacteria in gut
Saccha -C-Diff

37
Q

Laxatives

  • Different Groups
A
  • Bulk-forming
  • Emollient
  • Hyperosmotic
  • Saline
  • Stimulant
38
Q

Bulk-Forming

name

moa

ae

A

psyllium

similar to dietary fiber

  • Absorb water into the intestine, increasing bulk
  • Distends bowel to initiate reflex bowel activity
    and bowel movement
  • OK for long term use
  • Adverse Effects
  • Impaction above strictures
  • Fluid/electrolyte imbalance
  • Gas formation
  • Esophageal blockage
39
Q

Emollient
names
* MOA

  • Adverse Effects
A

docusate sodium

MOA: lubricates fecal material and walls, promotes fat

Uses: prevent opioid-induced constipation

mineral oil
* MOA: lubricate intestines
* Uses: fecal impactions

Adverse Effects: skin rashes, decreased absorption of
vitamins

40
Q

Hyperosmotic

names

MOA

use

AE

A

Glycerin, lactulose and polyethylene glycol

  • MOA
  • Increasing water content in feces
  • Promotes distention, peristalsis, and
    evacuation
  • Uses
  • Evacuate bowels before diagnostics and
    surgical procedures
  • Adverse Effects
  • Abdominal bloating
  • Rectal irritation
  • Electrolyte imbalance
41
Q

Saline
names

  • MOA:
  • Adverse Effects
A

Saline
* Magnesium Salts
* magnesium citrate (Citroma)
* magnesium hydroxide (Phillips Milk of
Magnesia)
* magnesium sulfate (epsom salts)

  • Sodium Salts
  • Fleet enema
  • MOA: increase osmotic pressure and draw water
    into colon
  • Adverse Effects
  • Magnesium toxicity
  • Electrolyte imbalance
  • Cramping, diarrhea
42
Q

Stimulants
names

  • Uses:
  • Adverse Effects
    *
A

Stimulants
* bisacodyl (Ducolax)

  • senna (Senokot)
  • Uses: constipation or whole bowel evacuation
  • OTC
  • Adverse Effects
  • Nutrient malabsorption
  • Gastric irritation
43
Q

most abundant number of proteins

A

Albumin & globulins
* Albumin=57% of plasma protein

44
Q

most plentiful
clotting factor

A

Fibrinogen

45
Q

what is plasma WITHOUT clotting factors

A

serum

46
Q

Normal platelet count

A

150,000-
400,000

47
Q

Thrombocytopenia=

A

<100,000

48
Q

Additional platelets stored in the

A

spleeen

49
Q

Excessive hemostasi causes

A

clot formation
excessive or inappropriate

50
Q

inadequate hemostasis causes

A

bleeding

51
Q

Petechiae

  • Purpura
  • Ecchymosis
  • Telangiectasia
  • Menorrhagia
  • Epitaxis
  • Thrombosis
    *
A

Petechiae
* flat, pinpoint, nonblanching red or purple- capillary hemorrhages in the skin or mucous membranes (<2 mm)

  • Purpura
  • petechiae in groups or patches (2 mm to 1 cm)
  • Ecchymosis
  • bruise- blood in the tissue (> l cm)
  • Telangiectasia
  • small, widened blood vessels on the skin
  • Menorrhagia
  • excessive menstruation
  • Epitaxis (nose bleeds)
  • nasal drainage

Thrombosis
* pathologic formation of clot (ex. DVT)

52
Q

Hematoma

  • Hemarthrosis
  • Hematochezia or melena
  • Hematuria
  • Hematemesis
  • Hemoptysis
A

Hematoma
* raised area of bleeding into the tissue

  • Hemarthrosis
  • bleeding into the joint
  • Hematochezia or melena
  • blood in feces
  • Hematuria
  • blood in urine
  • Hematemesis
  • blood in vomitus
  • Hemoptysis
  • blood in sputum
53
Q
A

nur 225 exam 2 (3 decks)

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