T3 - GI Assessment (Josh) Flashcards
The GI tract extends from the — to the — and is about — feet long.
mouth
anus
25
What are the four layers of the GI tract?
Mucosa (inner)
Submucosa
Serosa
Muscular (outer)
— is the largest organ of the body, except for skin, and has lots of blood supply (about — mL per min)
Liver
1500
What is the name of the Pancreatic Duct that empties pancreatic enzymes into the intestine?
Duct of Wirsung
What is the Sphincter of Oddi?
the sphincter that allows passage of bile and pancreatic enzymes into the intestines
What is the Accessory Duct of Santorini?
the duct that empties liver and gallbladder bile into the intestine
What is the name for the opening in the intestine that allows passage of bile and pancreatic enzymes?
(note: I’m not talking about the Sphincter of Oddi…this is after that)
Duodenal Papillae
ampulla of Vater
What changes in older adult happen in stomach and what should we suggest?
decreased hydrochloric acid
suggest bland foods
What changes in older adult happen in Large Intestine and what should we suggest?
decreased peristalsis and decreased sensation to defecate
Increase fiber and fluids and keep track of BMs
What changes in older adult happen in Pancreas and what should we suggest?
Decrease lipase production leading to steatorrhea (fatty stools)
eat more small, frequent meals to decrease fat in stools
What changes in older adult happen in Liver and what should we suggest?
decrease in hepatic funciton leading to decreased drug metabolism
keep accurate account of meds
What blood Lab studies are for GI system?
CBC
PT
Electroylytes
Albumin
AST
ALT
Amylase
Lipase
Bilirubin
Ammonia
What lab tests are done with stool?
Fecal Occult Blood Test (FOBT)
FIT (Fecal Immunochemical Test)
Stool DNA (sDNA)
Which blood tests is not very sensitive and gives lots of false positives?
FOBT
What should we educate client about FOBT?
Not very sensitive (false positives)
Be off anticoagulants for a week
Don’t eat anything that could dye the stool
Since FOBT is not very sensitive and gives false postives, what test is better to test for Fecal blood?
FIT (Fecal Immunochemical Test)
***more sensitive
***don’t have to worry about foods or meds you’re taking
What labs are done with urine?
Amylase (test for pancreatic function)
Urobilingen (test for increased bilirubin)
What are the Upper GI Series tests?
Barium Swallow
Small Bowel Follow Thru (SBFT)
- **NPO x 8 hrs prior
- **NO ANTICHOLINERGICS 24 hrs prior
- **Drink fluids afterwards
What are the Lower GI Series tests?
Bariium Enema
***drink lots of fluids to prevent constipation afterwards
What is an EGD?
Esophagogastroduodenoscopy
***direct visualization of esophagus, stomach, duodenum
What should we teach about EGD?
NPO 8 hrs prior
No anticoagulants
NPO after until gag reflex returns (1-2 hrs) because they were given meds to paralyze gag reflex during procedure
Monitor RR (capnography)
What is PTC?
Percutaneous Transhepatic Cholangiography
***putting needle in hepatic vein and watching it thru xray
***not done much at all
What is ERCP?
Endoscopic Retrograde Cholangiopancreatography
***like EGD but goes deeper
***looks at liver, GB, bile ducts, pancreas
What should we teach about ERCP?
same as EGD
lasts around 2 hrs
dye can be used and the tilt patient back and forth to get dye to spread around
What is the pill camera they swallow called?
Small Bowel Capsule Endoscopy
***identifies source of bleeding
***they’ll poop out the camera
When should we get Colonoscopy if we have NO family history of colon cancer?
age 50 and every 10 years
What should we teach about Colonoscopy?
NPO
Clean bowels out first
No anticoagulants
Mild sedation
Lay on left-lateral side when test is done to allow air to be expelled after procedure
Because EGD and Colonoscopy require conscious sedation, what should we do?
Monitor RR
They can’t drive for 12 hrs afterwards
What test measures Hydrochloric Acid and Pepsin?
Gastric Analysis
- **NPO 12 hrs prior
- **NGT to suction to collect samples
An ultrasound is not invasive, but what is required for it to be accurate?
full bladder
