Adult Health Test 1- Gi

Front 1

Jejunostomy:
-output?
-temp or perm?

Back 1

High output
Temporary

Front 2

Ileostomy:
-output?
-temp or perm?

Back 2

High output
usually temporary

Front 3

Colostomy:
-output?
-temp or perm?

Back 3

dependent on location
both

Front 4

When would you NOT want to irrigate?

Back 4

With a temporary colostomy becuase it makes the pt more dependent or if the pt cannot commit

Front 5

Sulfasalazine SE

Back 5

Can make the client suceptible to sunburn-WEAR suncreen

Front 6

Steatorrhea

Back 6

symptoms are large, fatty, foul-smelling stools

Front 7

Hematochezia

Back 7

bright blood in the stool

Front 8

CEA

Back 8

used to monitor treatment of cancer or detectreoccurrence-NOT A SCREENING TOOL

Front 9

What are the parameters of obesity?

Back 9

BMI > 30

Front 10

Indications for bariatric surgery

Back 10

BMI > 40 or 200% of ideal weight, inability to undergo diet

Front 11

Lap-Band

Back 11

creating small pouch out of the top of the stomach and narrow passage from the pouch to the lower part of the stomach to reduce the amount of food consumed at a time

Front 12

Gastric Bypass

Back 12

reducing size of the stomach and bypass part of the small intestines

Front 13

Adverse effects of Bariatric surgery

Back 13

*Dumping syndrome*- N, sweating, lightheadedness, weakness, diarrhea

Front 14

GERD

Back 14

1. dysfxn of LES where it opens spontaneously or does not close properly OR
2. prolonged exposure to gastric acids

Front 15

Causes of GERD

Back 15

alcohol, smoking, poor posture, tight fitting clothes, CA Channel Blockers, pregnancy, diabetes

Front 16

Manifestations of GERD

Back 16

#1-Persistent Heartburn-not MI if relieved by antacids
-bitter taste in mouth
-dry cough
-wheezing
-tightness in throat
-dysphagia

Front 17

Medications to Manage GERD

Back 17

PPI(-azole)-LONG TERM THERAPY
H2receptor antagonist(-tidine)
pro-motility agents- Reglan
Anatacids- SHORT TERM
Coating agents(sucrafate)
Foaming agents(gaviscon)

Front 18

Surgery for treatment of GERD

Back 18

Fundoplication-wrap part of stomach around LES to prevent reflux

Front 19

What is a hiatal hernia?

Back 19

When the esophageal hiatus is larger than normal and a portion of the stomach protrudes through the hiatus into the chest

Front 20

What can cause a hiatal hernia?

Back 20

Weakening of the supporting tissue
Increased pressure in the stomach
Can be congenital

Front 21

Clinical manifestations of a hiatal hernia

Back 21

Heartburn, dysphagia, chest pain/discomfort, N, bleeding, feeling full, occult bleeding

Front 22

Oral cancer- prevalence and who is more at risk?

Back 22

5% of all CA
2x more prevalent in men, esp. men >40

Front 23

CA lesion of oral CA usually develops on the ...

Back 23

lower lip, tongue, and floor of mouth

Front 24

Earliest CM of Oral CA

Back 24

painless oral ulceration or lesion

Front 25

Late symptoms of Oral CA

Back 25

difficulty speaking, swallowing, or chewing
swollen lymph nodes
blood-tinged sputum

Front 26

Esophageal CA- who is most at risk?

Back 26

White males

Front 27

Esophageal CAous lesions usually develop where?

Back 27

in lower 1/3 of esophagous

Front 28

CM of Esophageal CA

Back 28

Progressive dysphagia and wt loss

Front 29

CM of Esophageal CA that has advanced to late stage

Back 29

Tracheoesophageal fistulas
Hypercalcemia

Front 30

Surgical complications of esophagectomy

Back 30

anastomosis leak
pneumonia
ARDS
Gastric necrosis
cardiac dysrhythmias
infection and sepsis

Front 31

What is erosive gastritis?

Back 31

Acute gastritis that ocurs as a complication of other life-threatening conditions such as shock, major surgery, etc often due to ischemia or gastric mucosa

Front 32

What is the number one cause of GI ulcers?

Back 32

Peptic Ulcer Disease

Front 33

PUD

Back 33

a. h.pylori infection + NSAIDs
b. Zollinger-Ellison Syndrome-caused by gastrinoma and gastrin-secreting tumor of the pancreas, stomach, or intestines. VERY HIGH LEVELS OF HCL

Front 34

Causes of GI Ulcers

Back 34

trauma, shock, burns, surgery
H.Pylori infection
Medication/Medical condition

Front 35

Complications of GI Ulcers

Back 35

Hemorrhage, Obstruction, Perforation

Front 36

Symptoms of Hemorrhage with GI Ulcers

Back 36

black, tarry stools
wt loss, fatigue, hypovolemic shock, orthostatic hypotension

Front 37

Symptoms of Obstruction with GI Ulcers

Back 37

N/V, electrolyte imbalances, metabolic alkalosis, sensations of fullness

Front 38

Symptoms of Perforation with GI ulcers

Back 38

board-like abdomen, absense of bowel sounds, diaphoresis, tachycardia, fever, tachypnea, pain

Front 39

Management of GI Ulcers

Back 39

SRMD-labs, aspiration pneumonia, enteral nutrition
Eradicate infection and protect gastric mucosa
Avoid local irritants

Front 40

Cholelithiasis: causes of

Back 40

1. impaired gallbladder motility + biliary stasis
2. High fat, High caloric diet
3. Estrogen therapy and drugs that lower serum cholesterol

Front 41

Cholelithiasis: CM

Back 41

Biliary Colic that starts 1 hr after a meal and lasts 1-5 hours
Indigestion
Fever, tachycardia, Hypotension

Front 42

Cholelithiasis- Management

Back 42

Cholecystectomy
Medications- to dissolve gallstones (Actigall, Chenix, Questran)
Cholecystostomy to drain GB

Front 43

Cholecystitis

Back 43

Obstruction of the cystic duct causing a buildup of bile, increasing pressure, causing inflammation, and eventually ischemia/necrosis/perforation

Front 44

Cholecystitis- Due to what?

Back 44

Presence of gallstones, severe illness, medical conditions, tumors of the gallbladder, alcohol abuse

Front 45

Cholecystitis- CM

Back 45

Biliary colic lasting more than 5 hours usually occuring at night
Anorexia, N/V
Fever and chills

Front 46

Cholecystitis- Management

Back 46

Cholecystostomy
Maintenance of fluid, bowel rest, pain control, medications to treat symptoms

Front 47

Intestinal Obstruction: CM

Back 47

cramping, colicky, abdominal pain, V, peristaltic waves on thin pts, failure to pass gas and stool, distended abdomen, tender abdomen, borboygmi on auscultation, absent bowel sounds, signs of fluid and electrolyte imbalance

Front 48

Intestinal Obstruction: small and large-bowel obstruction

Back 48

SBO- Functional or Mechanical
LBO- most often in sigmoid, CA most ocmmon

Front 49

Causes of functional small bowel obstruction(paralytic ileus)

Back 49

Abdominal surgery, medications, intraperitoneal infection, mesenteric ischemia, kidney/thoracic disease, metabolic disturbances, spinal cord injury

Front 50

Most common cause of paralytic ileus

Back 50

opioid therapy

Front 51

Diverticulitis

Back 51

inflammation in and around the diverticular sac, usually in the sigmoid colon. Undigested food and bacteria collect in diverticula forming a hard mass that impairs muscosal blood supply, allowing bacterial invasion

Front 52

Diverticulitis Management

Back 52

antibiotics against bowel flora(Flagyl, Septa, Bactrim, Cipro) and some -cillins
Pain medications
Caution- laxatives can further increase pressure and should be avoided
Surgery may be necessary-Hartmann procedure possibly

Front 53

Nutrition following treatment of diverticulitis

Back 53

Nothing-clear-high fiber, low fat