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Nursing school level 2 > NURS 343 GI test > Flashcards

NURS 343 GI test Flashcards

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1
Q

most common upper GI problem

A

GERD

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2
Q

GERD results when

A

defenses of the lower esophagus are overwhelmed by reflux of gastric contents into the esophagus

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3
Q

most common cause of GERD

A

hiatal hernia

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4
Q

other causes of GERD

A

allergic esophagitis, decrease gastric emptying, obesity, pregnancy, cigarette

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5
Q

clinical manifestations of GERD

A

heartburn, dyspepsia, regurgitation, non cardiac chest pain, some respiratory symptoms

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6
Q

hiatal hernia

A

stomach pushing up at the diaphragm

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7
Q

GERD is directly related to

A

esophagus cancer

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8
Q

complications of GERD

A

esophagitis and Barrett’s esophagus

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9
Q

Barrett’s esophagus

A

changes to tissue of the esophagus that resembles the lining of the intestine

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10
Q

diagnostics for GERD

A

EGD - esophagogaatroduodenoscopy, esophagram barium swallow, physical, or biopsy

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11
Q

treatment of GERD

A

medications: H2 receptor blockers, PPIs, cholinergic, antacids, motility enhancers

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12
Q

diet for GERD

A

decrease high fat food, fluids in between meals, and avoid smoking, caffeine, acidic stuff

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13
Q

patient teaching for GERD

A

avoid smoking, food triggers, gas forming or reflux inducing food, acid foods, and eat small frequent meals, and elevate HOB at night

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14
Q

surgical procedures for GERD

A

laparoscopic - Nissen and toupet fundoplications

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15
Q

goal of surgical procedures for GERD

A

reduce reflux by enhancing the integrity of the LES

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16
Q

when do you result to surgery with GERD

A

when conservative therapy fails, medication intolerance, Barrett metaplasia…

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17
Q

Nursing Management of postoperative fundoplication patients

A

Thorough assessment monitoring for postop complications.
Administer PPI before the first meal of the day.
Administer antiemetics PRN
Assess and administer pain medications
NPO until peristalsis returns, then clears and slowly advance
Out of bed ASAP and regular ambulation
Record I&O’s
Ongoing teaching and preparation for discharge

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18
Q

main causes of peptic ulcers

A

aspirin and NSAIDs

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19
Q

other causes of peptic ulcer

A

alcohol stress smoking

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20
Q

mortality is higher in which ulcers

A

gastric ulcers

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21
Q

gastric ulcer pain

A

burning gassy pain felt high in epigastric 1-2 hours after meal

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22
Q

duodenal ulcer pain

A

burning crampy upper abdominal pain usually 2-5 hours post meal

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23
Q

peptic ulcer disease complications

A

hemorrhage, perforation, gastric outlet obstruction

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24
Q

most deadly complication of peptic ulcer disease

A

perforation especially if gastric ulcer and is very painful

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25
Q

gastric outlet obstruction

A

obstruction that results in edema, inflammation, scar tissue, or pylorospasm

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26
Q

peptic ulcer disease management

A

discontinue NSAIDs, treat h. pylori if present, possible surgery, PPIs or H2 blockers

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27
Q

labs for peptic ulcer disease

A

CBC with diff, CMP focus on liver, serum amylase, stool cultures, H&H

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28
Q

gallbladder does what

A

holds the bile that goes into the intestines and helps with digestion

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29
Q

cholelithiasis

A

stones in the gallbladder

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30
Q

cholelithiasis is more frequent in

A

women over 40 and in pregnancy

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31
Q

cholecystitis

A

inflammation of the gallbladder can be from gallstones or biliary sludge

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32
Q

cholecystitis is most commonly associated with

A

obstruction and can be acute or chronic

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33
Q

cholelithiasis occurs when

A

the balance of cholesterol, bile salts, and calcium in solution are altered

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34
Q

bile flow decreases from

A

immobility, pregnancy, and inflammation or obstructive lesion of biliary system

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35
Q

gallbladder disease risk factors

A

living in a developed country (diet), FFFF (fat, female, fertile, forty), estrogen therapy, sedentary lifestyle, familial tendency, high in native Americans

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36
Q

initial clinical manifestations of gallbladder disease

A

indigestion, right upper quadrant pain, acute pain, V/N

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37
Q

total gallbladder obstruction clinical manifestations

A

jaundice, dark amber urine, clay color stools, pruritus, intolerance of fatty food

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38
Q

complications of cholecystitis

A

gangrenous cholescystis, infection, pancreatitis, common bile duct stone, rupture, carcinoma

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39
Q

diagnostics for gallstone

A

ultrasound - NPO 8-12 hours prior, ERCP - NPO 8 hours prior

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40
Q

ERCP

A

Endoscopic retrograde cholangio-pancreatography

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41
Q

labs for gallstones

A

elevated WBC, elevated direct and indirect bilirubin, AST and ALT might be elevated

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42
Q

if ultrasounds is negative for gallstone diagnostic what is usually next

A

HIDA scan - cholescintigraphy

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43
Q

medical treatment for gallstones

A

NPO, medications, gastric decompression with BG tube, ERCP, surgery

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44
Q

medications for treatment of gallstones

A

pain control - morphine and toradol, antibiotics, antiemetics for N/V, IV fluids, atropine for anticholinergic effect

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45
Q

treatment of choice for gallstones

A

laparoscopic cholecystectomy

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46
Q

laparoscopic cholecystectomy

A

removal of gallbladder through one of the four puncture holes. minimally invasive and can usually discharge on the same day

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47
Q

main complication of laparoscopic cholecystectomy

A

injury to the common bile duct. also a risk for intestinal perforation

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48
Q

open cholecystectomy

A

removal of gallbladder through right subcostal incision and T-tube inserted into the common bile duct which allows bile to drain

49
Q

when is open cholecystectomy usually done

A

when suspect or confirmed gallbladder cancer, patients with cirrhosis, pregnant patient

50
Q

nurse should be monitoring for what after a cholecystectomy

A

monitor for complications such as laprascopic, infection, bleeding, bile leakage, injury/perforation

51
Q

laprascopic

A

shoulder pain from irritation of phrenic nerve and diaphragm due to retained CO2

52
Q

how can you increase comfort for pt with laprascopic

A

Sims position

53
Q

nursing care after cholecystectomy

A

pain management, encourage ambulation and turn cough and deep breath, observe for jaundice, treatment for N/V

54
Q

patient education after cholecystectomy

A

clear liquids first and advance diet as tolerated, smaller meals, fat intake will depend on tolerance, and take fat soluble vitamins

55
Q

1 and #2 causes of pancreatitis

A 
#1 - gallbladder disease
#2 - alcohol
56
Q

other causes of pancreatitis

A

smoking, abd trauma, medications, infection, tumor

57
Q

clinical manifestations of acute pancreatitis

A

pain - epigastric and radiating to back left flank and shoulder, N/V, low grade fever, hypotension, tachycardia, jaundice, paralytic ileus, tetany

58
Q

acute pancreatitis pain gets worse

A

when lying down or while eating and after alcohol or high fat foods

59
Q

tetany

A

involuntary contraction of muscles - hypocalcemia

60
Q

paralytic ileus

A

absent or decreased bowel sounds

61
Q

acute pancreatitis diagnostic studies

A

blood test, abdominal ultrasound, x-ray, CT scan, possible ERCP

62
Q

blood test for acute pancreatitis

A

amylase and lipase will be elevated, elevated glucose, low calcium, increase triglycerides

63
Q

nursing care during acute pancreatitis

A

relieve pain, prevent shock, reduce pancreatic secretions, fluid electrolytes, prevent infection, treat underlying cause if possible

64
Q

medications during acute pancreatitis

A

morphine for pain, antibiotic, H2 blocker, PPI, pancreatic enzyme, oxygen, possible ERCP

65
Q

acute pancreatitis patient NPO until

A

pain free

66
Q

what can help with N/V and gastric distention

A

NG tube suctioning

67
Q

pancreatitis diet

A

when pain subsides advance slowly starting with clears and advance to bland low fat diet. avoid caffeine smoking and alcohol

68
Q

position for comfort during pancreatitis

A

fetal, side-lying, HOB elevated, sitting up leaning forward

69
Q

monitor what during pancreatitis

A

blood glucose and give insulin as ordered. monitor hydration status

70
Q

A 71-year-old female patient comes to the ER complaining of “coffee-ground” emesis. The nurse will anticipate preparing this patient for:

A

endoscopy

71
Q

most common reason for emergency abdominal surgery

A

appendicitis

72
Q

appendicitis is most common in

A

males between 10-30

73
Q

acute appendicitis clinical manifestations

A

periumbilical abdominal pain followed by anorexia, n/v, low grade fever

74
Q

pain of appendicitis will eventually localize to

A

right lower quadrant - McBurneys point

75
Q

appendicitis will show what signs

A

peritoneal

76
Q

labs you want to look at with appendicitis

A

CBC with differential which will often show left shift, UA, BMP, HCG

77
Q

is a CT or MRI preferred with appendicitis

A

CT

78
Q

inflammatory bowel disease

A

chronic autoimmune inflammation of the GI tract

79
Q

two classifications of inflammatory bowel disease

A

ulcerative colitis and crohns

80
Q

crohns lesions are most common in the

A

distal ileum

81
Q

ulcerative colitis happens in the

A

rectosigmoid colon and rectum

82
Q

ulcerative colitis usually begins in the

A

rectum and spreads to the entire colon

83
Q

crohns manifestations

A

diarrhea, abd pain, cramping, weight loss

84
Q

ulcerative colitis

A

bloody stools, left lower quadrant pain, diarrhea, weight loss not as common as crohns

85
Q

crohns complication

A

hemorrhage, obstruction, F&E imbalance, fistula

86
Q

ulcerative colitis complication

A

increased risk of colorectal cancer, perforation, bleeding, vomiting, toxic megacolon

87
Q

assessment of inflammatory bowel disease

A

hydration, nutritional status, amount and character of stools

88
Q

diagnostics of inflammatory bowel disease

A

stool cultures, ct scan, colonoscopy with biopsy

89
Q

goals of treatment for inflammatory bowel disease

A

NPO to rest the bowel, control inflammation, combat infection, improve quality of life

90
Q

medications for inflammatory bowel disease

A

5-aminosalicylates, antimicrobials, corticosteroids, immunosuppresents

91
Q

inflammatory bowel disease pt need to be supplemented with

A

iron and B 12

92
Q

B12 med called

A

cobalabin

93
Q

avoid what foods with inflammatory bowel disease

A

lactose, high fat, cold foods and high fiber foods

94
Q

inflammatory bowel disease nursing dx

A

diarrhea related bowel inflammation, imbalanced nutrition, and ineffective coping related to chronic disease

95
Q

risk factors of colorectal cancer

A

history of IBD, DM, smoking, alcohol, obesity, consuming more than 7 servings a week of red meat, family history, and KRAS gene mutation

96
Q

clinical manifestations of colorectal cancer

A

iron deficiency anemia, rectal bleeding, abdominal pain, change in bowel habits

97
Q

late signs of CRC

A

abdominal mass, ascites, hepatomegaly

98
Q

diagnostics of CRC

A

colonoscopy, CT, CEA lab, H&P including family history

99
Q

screening tests over 50 when CRC suspected

A

flexible sigmoidoscopy q5, colonoscopy q 10, CT colonography, fecal occult blood test yearly

100
Q

treatment for CRC

A

surgery, radiation, chemo

101
Q

post op ileostomy complications

A

F&E imbalance, hemorrhage, SBO, dehydration

102
Q

SBO

A

small bowel obstruction

103
Q

management ileostomy

A

assess Bowel sounds, stoma viability, and drainage every 4 hours

104
Q

nursing care for ileostomy patient

A

pouch, emotional support, diet

105
Q

what types of questions do you want to ask patients

A

open ended questions

106
Q

diverticulum is most common in

A

the sigmoid colon

107
Q

diverticulum extend into the

A

muscle

108
Q

when diverticulum become inflamed

A

the condition is called diverticulitis

109
Q

diverticulitis clinical manifestations

A

abdominal pain usually in left lower quadrant, fever, N/V

110
Q

diverticulitis lab

A

elevated WBCs with left shift

111
Q

risk factors for diverticulitis

A

older adults, usually over 60 with western diets

112
Q

diagnostic tests for diverticulitis

A

CT scan, H&P, check stool, barium enema

113
Q

complications of diverticulitis

A

bleeding, infection, perforation

114
Q

peritonitis

A

Inflammation of the membrane lining the abdominal wall and covering the abdominal organs

115
Q

management of diverticulitis

A

clear liquids and low bulk until inflammation resolved, antibiotics, IV fluid during bowel rest

116
Q

what antibiotic do pt with diverticulitis usually get

A

flagyl

117
Q

patient teaching for pt with diverticulitis

A

liquid diet until diverticulitis resolved then high fiber diet avoid seeds, nuts, popcorn

118
Q

nursing diagnosis for diverticulitis

A

acute or chronic pain, knowledge deficient, impaired tissue integrity

Nursing school level 2 (15 decks)

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