Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Surg 1 > Nursing Care of Pt w/ GI Disorders > Flashcards

Nursing Care of Pt w/ GI Disorders Flashcards

1
Q

Fx of the Digestive Tract

A
  • Breakdown of food for digestion
  • Absorption of nutrients produced by digestion into the bloodstream
  • Elimination of undigested foodstuffs and other waste products
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Digestion is

A

phase of the digestive process that occurs when enzymes mix with ingested food and when proteins, fats, and sugars are broken down into their component molecules.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Absorption

A

phase of the digestive process that occurs when small molecules, vitamins, and minerals pass through the walls of the small and large intestine and into the bloodstream.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Elimination

A

phase of the digestive process that occurs after digestion and absorption, when waste products are eliminated from the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Major enzymes and secretions of the mouth

A
  • saliva
  • salivary amylase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Major enzymes and secretions of the stomach

A
  • hydrochloric acid
  • pepsin
  • intrinsic factor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Major enzymes and secretions of the small intestines

A
  • amylase
  • lipase
  • trypsin
  • bile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Assessment of GI tract

A
  • Include all info related to GI
    • pain
    • dyspepsia
    • gas
    • N/V
    • constipation/diarrhea
    • jaundice etc.
  • Psychosocial, spiritual and cultural factors
  • Assess knowledge
  • need for education
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

General Assessment includes

A
  • Mouth
  • Abdomen
  • Stool tests
  • Blood tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Stool tests include

A
  • fecal occult blood tests
  • stool examination for
    • ova
    • parasites
    • bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Blood tests include

A
  • CBC
  • chemistry
  • AST
  • ALT
  • amylase
  • lipase
  • bilirubin
  • carcinoembryonic antigen (CEA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sites for referred abdominal pain

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Quadrants of the abdomen

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Regions of the Abdomen

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Correct order of abdominal assessment

A
  1. Inspection
  2. auscultation
  3. percussion
  4. palpation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dx tests for abdomen

A
  • stool specimens
  • breath tests
  • abdominal ultrasound
  • imaging studies: CT, PET, MRI
  • Upper GI tract study
  • Lower GI tract study
  • GI mobility studies
  • Endoscopic procedures
  • other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CT scan

A

CT scan - computed tomography

  • Purpose
    • to detect tissue densities and abnormalities in the abd, liver, pancrease, spleen and biliary tract
  • Client Prep - with or without contrast
    • NPO 4 hrs prior if contrast used
    • IV access
  • Follow-up care
    • none specific unless sedation needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Upper GI radiographic series

A
  • Purpose
    • detect abnormalities of the esophagus, stomach or duodenum
  • Client prep
    • NPO (8hrs)
    • PO contrast
    • no opioids or anticholinergic meds for 24hrs prior
  • Follow-up Care
    • drink plenty of fluids to eliminate barium
    • Laxative may be given
    • Stool may be chalky for 24-72 hrs after exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Barium Enema

A
  • Purpose
    • detect changes in large intestines
  • Client Prep
    • clear liquids only 12-24hrs prior
    • NPO 8hrs prior
    • bowel cleansing night before exam
  • Follow-up Care
    • same as upper GI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Esophagogastroduodenoscopy (EGD)

A
  • Purpose
    • visualize the mucosal
  • Client Prep
    • NPO at least 8hr prior
  • Follow-up care
    • NPO until gag reflex returns
    • check temp frequently for first 2 hrs post-surgery
    • begin with clears and advance as ordered
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Endoscopic Retrograde Cholangiopancreatography (ERCP)

A
  • Purpose
    • visualize the liver, gallbladder, bile ducts and pancreas
    • determine obstructions
  • Client prep
    • same as EGD
  • Follow-up care
    • Same as EGD
    • also, educate on the s/s of possible pancreatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

S/S of pancreatitis

A
  • nausea
  • abdominal pain
  • elevated temp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Colonoscopy

A
  • Purpose
    • view large bowel for…obtaining bx, removing polyps, evaluate cause of chronic bowel problems, locate source of GI bleeding
  • Client prep
    • clear liquids 12-24 hrs prior
    • NPO 6-8hrs prior
    • bowel cleansing night before
  • follow-up care
    • VS monitoring freq, monitor for s/s of perforation and hemorrhage
    • will have lots of gas afterwards (feeling of fullness and cramping)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Interventions for Malnourishment

A
  • NG tube
  • G-tube/percutaneous endoscopic gastrostomy (PEG) tube feedings
  • TPN
    • Central Line
    • Incompatible with meds
    • Prevent infections
    • Glucose monitoring q6h
    • Electrolyte imbalances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Appendicitis

A

Inflammation of the appendix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Causes of appendicitis

A
  • obstruction of the lumen by accumulated
    • feces
    • foreign bodies
    • tumor of the cecum or appendix
    • thickening of the mucosa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

S/S of appendicitis

A
  • increased WBCs
  • peri-umbilical pain (McBurney’s point) eventually shifting to RLQ
  • rebound tenderness (Rovsing’s sign)
    • kids do not get rebound like adults
  • N/V
  • anorexia
  • possible low-grade fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Assessment and Dx for appendicitis

A
  • abd assessment
  • CBC - elevated WBC
  • x-ray
  • ultrasound
  • ct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Interventions for appendicitis

A
  • IV fluids
  • Antibiotics
  • Surgical removal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Gastroenteritis

A
  • Inflammation of the stomach and intestinal tract that causes V/D or both
  • Most common causes are viruses and bacteria
  • Other cause - protozoa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

S/S of gastroenteritis

A
  • N/V
  • dehydration
  • malaise
  • abdominal cramps
  • fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Prevention and assessment of gastroenteritis

A
  • handwashing
  • principle food handling (eggs and raw meat)
  • Assessment - abdomen and hydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Labs for gastroenteritis

A
  • CBC
    • for dehydration and WBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Treatment of gastroenteritis

A
  • elimination of symptoms
  • underlying cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Parasitic Disorders of the GI tract

A
  • Parasitic Disorders - Helminthes
  • Round worm most common
  • Others include: flatworms, tapeworms, pinworms, hookworms, and flukes
  • Transmission occurs through skin or ingestion of helinthes eggs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Obesity

A

Weight greater than 20% or greater than ideal body weight

BMI

  • Overweight - 25-29.9 Kg/m2
  • Obese > 30 Kg/m2
    • Class I - 30-34.9 Kg/m2
    • Class II - 35-39.9 Kg/m2
    • Class III - 40-49.9 Kg/m2 (morbid)
  • Super Obesity > 50 Kg/m2
37
Q

Interventions for Obesity

A
  • Weight loss through exercise and calorie restriction
  • support groups
  • behavior modification
38
Q

Comorbidities with Obesity

A
  • Type II diabetes
  • Hypertension
  • stroke
  • hyperlipidemia
  • obstructive sleep apnea
  • asthma
  • breast, prostate and colon cancer
  • joint damage etc
39
Q

Bariatric Surgery

A
  • limits how much the stomach can hold or decrease absorption
  • Decreased Calorie/Nutrient Absorption
40
Q

Complications of Gastric Restrictive Surgeries

A
  • Vomiting
  • dumping syndrome
  • erosion of the gastric tissue
  • breakdown of staple line
  • leaking of stomach secretions
  • rhabdomyolysis
  • infection or death
41
Q

Postoperative Care

A
  • Airway management
  • Clear Liquid Diet
  • Progresses to Full Liquids, Pureed Foods
  • Regular Foods at 6 Weeks
  • Psychosocial support
42
Q

Obesity
Nursing Diagnoses

A
  • Imbalanced Nutrition: More Than Body Requirements
  • Outcomes:
    • Establish desired weight goal
    • Increase activity level
    • Maintain appropriate nutrition
    • Identify patterns of eating/modify
43
Q

Hiatal Hernia

A

Lower Esophagus/Stomach Slides up through Hiatus of Diaphragm into Thorax

Seen in

  • women
  • >60
  • Obese
  • Pregnant
44
Q

S/S of Hiatal Hernia

A
  • None
  • Pain
  • Heartburn
  • Fullness
  • Reflux
45
Q

Dx of hiatal hernia

A
  • X-ray
  • Fluoroscopy
46
Q

Therapeutic Interventions

A
  • Antacids
  • Small meals
  • No reclining 1 hour after eating
  • Raise head of Bed 6-12
  • No bedtime snacks, spicy foods, alcohol, caffeine, smoking
47
Q

Treatment of Hiatal hernia

A
  • Surgical management
    • fundoplication
  • Nursng Care
    • teaching
    • preop care
    • postop care
      • dysphagia with eating
48
Q

Gastroesophageal Reflux Disease (GERD)

A
  • Gastric secretions reflux into the esophagus
  • esophagus can be damaged
  • lower esophageal sphincter does not close tightly
49
Q

S/S of Gastroesophageal

A
  • Heartburn
  • Regurgitation
  • Dysphagia
  • Bleeding
50
Q

Complications of GERD

A
  • aspiration
  • scar tissue
  • esophagitis
  • esophageal cancer
  • bronchospasm
  • larygeospasm
  • aspiration pneumonia
51
Q

Dx of GERD

A
  • Barium Swallow
  • Esophagoscopy
52
Q

Interventions for GERD

A
  • Lifestyle changes
  • medications
    • antacids
    • H2 receptor antagonists
    • proton pump inhibitors
    • prokinetic agents
  • Fundoplication
53
Q

Nursing care/education for GERD

A
  • Lose weight
  • low-fat, high-protein diet
  • avoid caffeine, milk products, spicy foods
  • medications
54
Q

Peptic Ulcer Disease

A
  • Erosion of GI lining (prostoglandin needed to form mucosal lining)
  • Primarily caused by Bacterium H. pylori
  • Curable
    • 10% of individuals in US will develop peptic ulcers
  • Influenced by smoking
  • Gastric and duodenal types
55
Q

What is the effect of NSAIDS on the stomach lining

A

It decreases prostoglandin which is needed to form the mucous in the stomach lining that protects it from erosion by stomach acid.

56
Q

Peptic Ulcer Disease

Gastric

A
  • High left Epigastric/Upper Abdominal burning/Gnawing pain
  • Increased 1-2 hours PC or with food
  • Will have blood in their stool - Know hemoccult
  • Can perforate
    • Rebound tenderness
    • Guardiing – DON’T TOUCH! IT HURTS
      abdominal rigidity
    • Hyperactive or hypoactive bowel sounds
57
Q

Peptic Ulcer Disease

Duodenal

A
  • Midepigastric/Upper Abdominal Burning/ Cramping Pain
  • Increased 2-4 hours after meal/ middle of the night
  • relieved with foods or Antacids
58
Q

S/S of peptic ulcer disease

A
  • Anorexia
  • N/V
  • Bleeding
59
Q

Dx of Peptic Ulcer Disease

A
  • Helicobactor pylori
  • Upper GI series - Barium
  • EGD (esophagogastroduodenoscopy
  • fecal cultures
60
Q

Interventions for Peptic Ulcer Disease

A
  • Antibiotics
  • Proton Pump Inhibitors
  • Histamine H2 Antagonists
  • Bismuth Subsaicylate - slows growth of H. Pylori
  • Sucralfate (Carafate)
  • Antacids - raise pH
  • Surgical - remove ulcerated area
61
Q

Tx for Peptic Ulcer Disease

A
  • Bland diet (if it makes them feel better)
  • Avoid irritants: Smoking, Caffeine (not EBP), Alcohol, Beer
62
Q

Nursing Dx for Peptic Ulcer Disease

A
  • Acute Pain
    • rate pain
    • respond to pain
    • smaller/frequent meals
    • reduce irrritants
  • Risk for Injury
    • monitor for blood in vomit/stool
    • changes in VS
    • monitor labs - bleeding
  • Deficient Knowledge
    • based on need
63
Q

Stress Ulcers

A
  • Ischemia Damaging Mucous Barrier
    • ischemia - inadequate blood supply to organ
  • Acid Secretions Create Ulcers
64
Q

Preventative Tx for Stress Ulcers

A
  • Quick Trauma Care
  • Early feeding - if GI tract is working
  • Testing gastric pH - Keep above 5
  • Antacids
  • Histamine blockers
  • Sucralfate
65
Q

Causes Gastric Bleeding

A
  • Occult or Observable
  • From Ulcer perforation, tumor, gastric surgery
  • Symptoms vary by severity
66
Q

Gastric Bleeding Tx

A
  • treat hypovolemic shock if present
    • monitor VS
  • NPO
  • IV fluid
  • blood
  • NG tube
  • oxygen
67
Q

Diarrhea

A
  • both a diagnosis and a symptom
  • Fecal matter & Fluids/Electrolytes pass rapidly
  • Decreased absorption
68
Q

Causes of Diarrhea

A
  • Bacterial/viral infection (acute)
  • Food Allergies
  • Disease processes
    • Removal of gallbladder
    • Crohn’s disease
    • Ulcerative colitis
    • Neurological
    • Impaction
    • Radiation
    • Dumping syndrome
69
Q

S/S of Diarrhea

A
  • Fever
  • Foul smell
  • Abdominal cramping
  • Distension
  • Anorexia
  • Intestinal rumbling
70
Q

Interventions for Diarrhea

A
  • Identify cause
  • Replace fluids/electrolytes
  • Increase fiber/bulk
  • Diphenoxylate (Lomotil)
  • Loperamide (Imodium)
  • Lactinex restores normal flora
  • Antimicrobial agents
71
Q

Crohn’s Disease

A
  • Inflammatory bowel disease
  • Occurs in any part of the intestine
  • Remission/Exacerbation cycles
  • Cause unknown
  • Hereditary component
72
Q

S/S of Crohn’s Disease

A
  • Abdominal pain or cramping
  • Low grade fever
  • Weight loss
  • Diarrhea/Constipation
  • Mucous/Blood in stool
  • Fluid/Electrolyte imbalance
73
Q

Complications of Crohn’s

A
  • Malnutrition
    • growth delays in puberty
  • Inflammation of
    • skin
    • joints
    • back
    • eyes
    • liver
    • gallbladder
  • Perianal Fissures
  • Abscesses
  • Fistulas
74
Q

Dx of Crohn’s Disease

A
  • Endoscopy w/ Biopsy
    • EGD
    • Colonoscopy
  • Upper GI/Barium Enema
  • CT/MRI/Ultrasound
  • CBC
  • Electrolytes
  • Stool cultures
75
Q

Interventions for Crohn’s Disease

A
  • Avoid offending foods
  • Surgery if necessary
  • Elemental formula or TPN if necessary
  • Support and Education
  • Medications
    • Anti-inflammatories
      • Mesalamine
      • Sulfasalizine
    • Antidiarrheal
    • Antibiotics
      • Metronidazole
      • Ciprofloxacin
    • Immunosuppressants
      • Infliximab
      • Adalimumab
      • Azathioprine
      • Methotrexate
    • Corticosteroids
      • Prednisone
76
Q

Ulcerative Colitis

A
  • Inflammatory bowel disease
  • Large colon and Rectum
  • Remissions/Exacerbations cycles
77
Q

S/S of Ulcerative Colitis

A
  • Abdominal pain
  • 5-20 stools/day
  • rectal bleeding
  • fecal urgency
  • anorexia
  • weight loss
  • cramping
  • vomiting
  • fever
  • dehydration
78
Q

Interventions for Ulcerative Colitis

A
  • Avoid offending foods
  • Surgery if necessary
  • Elemental formula or TPN if necessary
  • Medications
    • Anti-inflammatories
    • Antispasmodics
      • Dicyclomine
      • Hyoscyamine
    • Antidiarrheal
      • Diphenoxylate and atropine
      • Loperamide
    • Immunosuppressants
    • Corticosteroids
79
Q

Irritable bowel syndrome

A
  • Altered intestinal motility
  • Increased sensitivity to visceral sensations
  • bowel mucosa not changed
  • Psychological stress/ food intolerances
  • more common in women
80
Q

S/S of Irritable bowel syndrome

A
  • Gas
  • bloating
  • constipation
  • diarrhea
  • abdominal pain
  • depression
  • anxiety
81
Q

Dx for Irritable bowel syndrome

A
  • Hx
  • Physical exam
82
Q

Interventions for Irritable bowel syndrome

A
  • High fiber and bran diet
  • avoid trigger foods
  • smaller, frequent meals
  • stress management
  • behavioral therapy
  • exercise
  • medications
    • antidepressants Antispasmodics
    • tegaserod maleate/Zelnorm
83
Q

Pathophysiology and Etiology of

Abdominal Hernias

A
  • Pathophysiology - protrusion of organ or structure through weakness or tear in the wall of the abdomen
  • Etiology - weakness in abdominal wall with increased Intra-abdominal pressure
84
Q

Types of abdominal hernias

A
  • Inguinal
  • Umbilical
  • Ventral (incisional)
85
Q

S/S of abdominal hernias

A
  • None
  • Bulging
86
Q

Complications of abdominal hernias

A

Strangulated incarcerated hernia

87
Q

Interventions for abdominal hernias

A
  • None
  • observation
  • supportive devices
  • surgery
    • herniorrhaphy
    • hernioplasty
88
Q

Nursing care for abdominal hernias

A
  • Education
  • Postop
    • limited activity
      • walking can resume next day
      • moderate activity first 2-6 wks
    • no coughing first 2-6 wks
    • education
      • report any noticeable bulges
89
Q
A

Med Surg 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions