Test 4: GI Flashcards
Intestinal Obstruction: Causes, Types, Treatment
Causes:
Gastric Juices
Air
Object
Fluid Enzymes
Types:
Mechanical or Non Mechanical
Treatment:
- Goal is to stop PAIN
- Non-surgical and surgical fixes
Mechanical Obstruction
Physical Block - vulvulous, intussception, tumor, adhesion, hernia, feces
Related to problem OUTSIDE intestinal wall
S/Sx:
Abdominal Distention
Increased peristalsis
Decreased Absorption
N/V
Constant abdominal pain
Increase cap perm
Decrease BV
Decrease electrolytes - Na, K, Cl
Complication: peritonitis
Peritonitis: S/Sx, Treatment
S/Sx:
Increase HR, BP, RR
Sudden abdominal pain
Rigid board like abdomen
Treatment:
Abx at FIRST sign
Non-Mechanical Obstruction
Paralytic illeus
Can be neuromuscular in cause
S/Sx
Decrease peristalsis or absent BS
Pain is colicky
Non-Surgical Obstruction Fixes and Meds
NPO - ice chips OK
NGT (Low continuous suction)
Disimpaction
Aggressive fluids - isotonic LR/NS
Monitor for fluid overload
Medicine:
Reglan - n/v, increase gastric motility
IV Abx
Alvimompan - restore bowel function
GI Bleed: What is it, Major vs Minor, S/Sx, Treatment
What is it?
- Perforation of GI wall lining due to volvulus, complete strangulation
- Complication of PUD
Minor <1000mL
Major >1000mL
S/Sx:
Dizzy
syncope
Decrease BP
SOB
Confusion
Melena
Occult Blood
Hematemesis
Coffee ground emesis
Treatment:
Fluids
H/H
Blood Products
EKG
Clotting Factors
Shock Treatment
PPI
PUD Bleeding
Bright = high
darker = low
Hepatic Encephalopathy
May cause mental status change
Associated with late stage cirrhosis
Unfiltered blood goes back into central circulation and toxins will circulate in the body - bacteria and protein interact and ammonia forms in GI tract
Treatment:
Lactulose - need 2-3 stools/day to be effective
Non-absorbable Abx - Rifampin (prevents ammonia formation) or neomycin (BS)
