TEST 2 Flashcards
digestion begins
MOUTH
stores food mixes it with gastric secretions empties into…
stomach; small intestine
digestion and absorption of nutrients
small intestine
absorption of water and electrolytes, forms feces
large intestine
what all is included in the biliary tract
gallbladder, liver, bile, bilirubin
what is the liver connected to
gallbladder and the pancreas; ex. if you have a gallbladder issue you could have a liver and pancreas issue too
aids in the digestion of fats
bile
Pigment derived from the breakdown of hemoglobin-yellow color
bilirubin
creates, transports, stores, and releases bile into the duodenum to help in digestion
biliary tract
dry mouth
Xerostomia
decreased appetite in the elderly is due to
medications, lose sense of smell..physiological and socioeconomic
assessment of the gi system most people come in complaining of
abdominal pain
why is it important to ask about past surgeries
because if that person had surgery on their appendix then the appendix cant be causing them pain because they dont have one
antibiotics most likely lead to
diarrhea
what meds to ask if a patient is on with abdominal pain
antibiotics, NSAIDs, opioids, taken anything for constipation or diarrhea
asking for abdominal pain
have any nausea, vomiting, constipation, or diarrhea?
PQRST
Provoking or precipitating or pattern- what were you doing when the pain started
Quality
Radiating/relieving factors- is it better when you lay on your side?
Severity- scale of 0-10 rate it
Timing- when did it start? How long have you had this pain?
looking at the biliary tract with
Endoscopic retrograde cholangiopancreatography (ERCP)
what is normal after an scopy procedure
white stools are the procedure is normal finding. diarrhea and constipation are not!! (barium turns it white)
WBC, RBC, infection, anemia, etc
CBC
BMP
basic metabolic panel
what does BMP tell us
creatinine
BUN
electrolytes
pancreatic enzymes to know
amylase and lipase
albumin
protein- good estimate of nutritional status
bilirubin
tells us how the liver is functioning
ammonia levels
tells us if the liver is impaired this level will be high
LDL and HDL tells us
good and bad cholesterol; lipoproteins (low and high)
specific liver function tests
(ALT, AST, GGT, ALP)
cbc, bmp, cholesterol, ldl, hdl
know ranges
pt
11-16 seconds
total cholesterol
less than 200
platelets
150-400,000
wbc
4-12,000
hemoglobin male
13-18
hemoglobin female
12-16
hematocrit male
37-49
hematocrit female
36-46
found in plant based products-nuts, seeds and vegetable oils
unsaturated fats
what can unsaturated fats do
can decrease serum cholesterol levels
meats, seafood, skinned chicken, whole dilk dairy products
saturated fats
what can saturated fats do
increase the risk of cardiovascular disease
made by hydrogenation-heating liquid vegetable oil –fried foods
trans fat
what does total cholesterol levels include
triglycerides, LDL, HDL
optimal level of ldl
less than 100
optimal level of hdl
greater than 40
overtime what can high levels of ldl cause
atherosclerosis
optimal level of triglycerides
less than 150
Abnormal lipoprotein metabolism
dyslipidemia
medications for dyslipidemia
statins
side effects of statins
Muscle pain
Risk of myopathy
Liver toxicity
how to diagnose someone with malnutrition- what lab
serum albumin
diet that promotes healing
high calorie, high protein food
parenteral nutrition is given how
bloodstream; usually through a central line with the GI track is not good
normal bmi
18.5-24.9
overweight
25-29.9
obese
greater than 30
Android fat distributed over abdomen and upper body (neck, arms, shoulders)
apple shaped
Fat located primarily in upper legs
Muscular mass is less developed.
gynoid
complication of bariatric surgery
dumping syndrome - gastric contents empty too fast into small intestine
metabolic syndrome 5 risk factors
hypertension triglycerides abdominal obesity hdl cholesterol impaired fasting glucose
block neurochemicals that appear to trigger nausea and vomiting
Antiemetics
progressive hypovolemia
bp starts to drop
black tarry stools-longer the passage of blood through the intestines the darker the stool color
Melena
Herniation of a portion of the stomach into the esophagus through an opening or (Hiatus) in the diaphragm
hiatal hernia
hiatal hernia occurs
at night if meal is eaten then a person lies flat
chronic diarrhea lasts
at least 4 weeks
what treatment for diarrhea is contraindicated
antidiarrheal agents with infectious organisms
treatment for c diff
vancomycin and flagyl
risk factor for appendicitis
Diet low in fiber and high in refined sugars and carbs
sign of appendicitis
rovsings sign
what sign will you see in patients with peritonitis
guarding, rigid abdomen
rbc
3.5-5.5
ptt
21-35 seconds
creatinine
0.5-1.2
chloride
96-106
BUN
6-20 if its high you’re dehydrated
patients with liver issues what is one lab value you’re going to test them for
albumin 3-5
bilirubin
0.1-1.2
hepatic encephalopathy is treated with what med
lactulose
total cholesterol is
less than 200
patient who is NPO but is now progressing onto foods how do you give it to them
start with clear liquid diet, then give them high card food; avoid FATTY foods
med list
2:08
fullament hepatitis
hepatic encelopathy ; most severe hep
function of the liver
Carbohydrate metabolism glycogenesis, glycogenolysis
Protein metabolism-synthesis of nonessential
amino acids, clotting factors, urea formation
Fat metabolism-synthesis of lipoproteins, synthesis of fatty acids, breakdown of cholesterol
Detoxification drugs/harmful substances
Steroid metabolism
Bile production and excretion
Storage- glucose in form of glycogen, minerals, vitamins
Mononuclear phagocyte system break down of old RBC, WBC bacteria and other particles, breakdown of hemoglobin from old RBC’s to bilirubin
cullens sign
pancreatitis; bruising around the belly button
greys turner
pancreatitis; bruising on the side
BRAT diet and what is it for
bananas, rice, apple sauce, and toast; used for patients with vomiting and diarrhea issues
what meds do we avoid with gerd
anticholingerics; decreases gastric emptying
What are some drugs we may give to GERD patients?
Cimetidine, Zantac, Pepcid, Prilosec, Nexium, Prevacid
what kind of meds reduce HCl secretion?
cimetidine, zantac, and pepcid
what kind of meds reduce gastric acid secretions and promote ulcer healing?
PPI
refeeding syndrome
hypophosphatemia
