Chapter 32

Front 1

gastrointestinal system consist of

Back 1

GI tract, liver,gallbladder, pancreas,appendix

Front 2

components of the upper GI

Back 2

mouth, esophagus, stomach, duodenun

Front 3

ligament of treite is

Back 3

a ligament that supports the duodenojejunal junction

Front 4

Major cause's of upper GI problems include

Back 4

peptic ulcers,gastritis, varix rupture,Mallory-weiss tear, esophagitis,duodenitis

Front 5

Mallory-Weiss Tear

Back 5

Esophageal laceration secondary to vomiting

Front 6

Hematemesis

Back 6

Bloody Vomit

Front 7

Melena

Back 7

Dark, smelly, tarry stool

Front 8

Coexisting illnesses that effects the upper GI bleeds include

Back 8

HTN, atherosclerosis, diabetes, substance abuse (includung abuse of meds)

Front 9

Upper GI bleeds

Back 9

May be light or brisk and life threatning

Front 10

Pt's with esophageal tears or varix in the gastric lining may

Back 10

Vomit copius amounts of blood

Front 11

S/S of serious GI problems will present with

Back 11

signs of shock, AMS, Tachycardia, peripheral vasoconstriction, diaphoresis, cool, pale, clamy skin, and hemodynamically unstable

Front 12

Vomit itself can comprimise

Back 12

airway resulting in impaired respirations, aspiration and ultimately respiratory arrest

Front 13

Pt's usually complain of _______ with upper GI problems

Back 13

Malaise, weakness, syncopal or non-syncopal episodes, dizzyness, tachycardia, palpatations and indegestion

Front 14

Findings upon Inspection and examination of pt's with upper GI issues

Back 14

Symmetric distention or bulging in one region of the abdomen. Ecchymosis may be present if large amount of blood loss into the abdominal cavity (bowel sounds may be absent if bleeding is severe or hyperactive if bleeding is minimal)

Front 15

Prehospital Treatment of upper GI issues

Back 15

Maintain airway, O2 therepy, circulation status. Place pt's in Left Lateral Recumbant position or high semi-fowlers to prevent aspiration if pt is actively vomiting

Front 16

Treatment of Upper GI continued

Back 16

two large bore IV's ( base fluid resuscitation on pt's condition and response to treatment) administer 20 cc/kg bolus to treat hemorrhagic hypovolemia if warranted

Front 17

Esophageal Varices

Back 17

swollen vein of the esophagus

Front 18

Upper GI diseases

Back 18

Esophageal varices
Acute Gastrointeritis
Chronic Gastrointeritis
Peptic Ulcers

Front 19

Causes of Esophageal varices

Back 19

Alcohol, and ingestion of caustic substances

Front 20

Alcohol consumption in massive amounts causes degenerative disease of the liver called

Back 20

Cirrhosis

Front 21

Pt's suffering from esophageal varices present with

Back 21

painless bleeding and are hemodynamically unstable due to blood loss.

Front 22

S/S esophageal varices

Back 22

Hemastasis with bright red blood, dysphagia, burning or tearing sensation, forceful and copius amounts of bloody vomit. Bleeding is severe. (clotting time increases because of high portal pressure). Signs of shock, increase pulse,increase respirations, cool, clammy, diaphoretic, AMS, And hypotention mat be present.

Front 23

Tx. Esophageal varices

Back 23

Aggressive airway managment, IV fluids, Rapid transport.
suction airway frequently if needed, orotracheal intubation may be needed, High flow O2, treat signs of shock, place in shock position. High fluid resuscitation.

Front 24

Acute Gastrointeritis

Back 24

inflammation of the stomach and intestines with sudden onset of vomiting and diarrhea. The pathologic inflammation causes hemmorrhage and erosion of the mucosal and submucosal layers of the GI tract, it can damage the villi which aborb water and nutrients

Front 25

Dehydration secondary to diarrhea is a common cause of

Back 25

Death

Front 26

Causes of Gastroenteritis

Back 26

Alcohol, tobacco, stress, chemotherapeutic agents, ingestion of acidotic or alkalotic agents

Front 27

Hematchezia

Back 27

Bright red (frank blood) from erosion of the lining of the lower GI tract

Front 28

S/S of Gastroenteritis

Back 28

Hematemesis, fever, n/v, general malaise, dehydration, hemorhage, hemodynamically unstable due to hypotention, tachy, pale, cool, clammy,restless, decreased mental status.( if dehydration is severe pt's may have chest pain, dysrythmias)Visible distention of the abd may be noted means gas has built up, tenderness through out the abd.

Front 29

Tx of gastroenteritis

Back 29

Supportive and pallitive care, clear airway of vomit or secretions, O2, rehydrate with IV fluids, consider antimetics such as compazine or phenergan, emtional support

Front 30

Chronic Gastroenteritis

Back 30

Inflammation of the gastroentestinal mucosa marked by long term mucosal changes or permanet mucosal damage. due to microbial infection

Front 31

Bacteria pathogens that cause gastroenteritis

Back 31

Escherichia coli-(E-coli)
Klebsiella
Enterbacter
Campylobacter jejuni

Front 32

Viral pathogens that cause gastroenteritis

Back 32

Norwalk
Rotavirus

Front 33

Parasitic pathogens that cause gastroenteritis

Back 33

Protozoa
Cryptosporidium
Cyclosporidium

Front 34

Bacterial, Viral and Parasitic causes of gastroenteritis is all transmitted by

Back 34

Fecal-oral route, or by infected food and water

Front 35

Pt Presentation with gastroenteritis

Back 35

N/V, fever, diarrhea, abd pain, cramping, anorexia, lethargy, in severe cases shock, (the intensity of the S/S reflects the degree of microbial contamination

Front 36

Tx for gastroenteritis

Back 36

Protest yourself, ABC's, transport, antibiotics and allowing the disease to run its normal path