Exam 3 Gi/gu

Front 1

Three classifications of Diarrhea

Back 1

Decreased Fluid Absorption
Increased Fluid Secretion
Motility Disturbances

Front 2

A patient is having an issue with decreased fluid absorption and is experience diarreah, why?

Back 2

The pt. large intestine is not reabsorbing fluids. The lg. intestine's job is to reabsorb fluids.

Front 3

A patient has experience food poision from eating at a local restrurant and is experience diarrhea, why?

Back 3

The patient is having a motility disturbance-increase in peristalsis to push out the bad.

Front 4

A patient comes into the doctors office with compliants of increased stress and anxiety and recent diarrhea why is this pt. experience diarrhea?

Back 4

The pt. is having an increase in peristalsis. Motility disturbance.

Front 5

An acute bout of diarreah is either

Back 5

bacterial and viral and is self-limiting

Front 6

A pt. is having a bout of chronic diarrhea (lasts 2 or more weeks and reoccurs) what type of complications can this pt. have

Back 6

dehydration and electrolyte imbalances.

Front 7

A pt. reports to the doctors office and reports recent diarreah what may the nurse want to know about this patient? (Assessment)

Back 7

History of travel, diet, medication use, previous surgery (dumping syndrome), family history and personal contacts.

Front 8

What diagnostic tests are done for diarrhea?

Back 8

CBC, LFT's, iron/folate levels, O&P, Endoscopy, GI series with barium swallows.

Front 9

Why would the doctor want to do LFT's on a pt. with complaints of diarrhea?

Back 9

The liver produces bile that emuisifies fat and if there is a metabolism issue then fats will be in stool and will give the pt. diarrhea.

Front 10

True or False Laxative abuse can cause diarrhea?

Back 10

True

Front 11

Causes of Decreased fluid absorption diarreah?

Back 11

Laxative abuse, mucosal damage: Crohn's disease, radiation, Ulcerative colitis (UC), ischemic bowel disease (IBD)

Front 12

Causes of Increased fluid secretion diarreha?

Back 12

infectious bacterial endotoxins, antibiotics, foods containing sorbitol, hormonal (adenoma of pancreas)

Front 13

Antibiotics can cause?

Back 13

C-diff-pt. will be put into isolation. C-diff is an intestinal bacteria that is kept in check by normal intestinal flora and when normal flora is destroyed the C-diff is now free to cause problems.

Front 14

Motility Disturbances of diarrhea

Back 14

IBS (Irritable bowel syndrome); gastroectomy (dumping syndrome).

Front 15

A 38 year old patient with a spinal cord injury can have fecal incontinence due to a

Back 15

neruo-muscular issue (sensory problem)

Front 16

If the muscles of the anus become flacid and cannot contract the patient may become

Back 16

fecal incontinent

Front 17

What sensory problems are common with fecal incontinence?

Back 17

MS, Parkensons, ALS, stroke, spinal cord injury, dementia

Front 18

When there is a fecal impaction what is commonly seen

Back 18

seepage (liquid stools) that are able to get around the impaction due to an increase in fluid secreations.

Front 19

Diagnostics of Fecal Incontinence are

Back 19

rectal exam, abdominal X-Ray's, sigmoidoscopy

Front 20

Managment of fecal incontinence

Back 20

antidiarrheal meds if non infections cause (Immodium), bowel and bladder training programs, suppositories to reestablish regularity, high fiber diet and increased fluid intake, and exercise (if non-neruo/muscular).

Front 21

When assessing a pt. for constipation what is important for the nurse to know?

Back 21

What is the normal bowel movement pattern for this patient? If the patient only goes on a regular basis every 3 days then they will most likley not be constiptated.

Front 22

Signs and symptoms of constipation are?

Back 22

adbominal pain, distention, bloating, headache, nausea, flatulence, palpable mass, decrease in frequency of bowel movements.

Front 23

True or False an anticholinergic will not cause a pt. to become constipated?

Back 23

False. Anticholinergics cause the bowel and bladder to slow. They can cause constipation.

Front 24

True or False Hypothyroidism is a cause of constipation

Back 24

True

Front 25

True or False Diabetes is not a cause of constipation

Back 25

False, it is a causative factor

Front 26

True or False a Megacolon is not a cause of constipation

Back 26

False, it is a cause

Front 27

T/F: Scleroderma (a Collagen Vascular issue) is a cause of constipation?

Back 27

True

Front 28

T/F IBS can cause constipation?

Back 28

True

Front 29

Why is the Valsalva maneuver and syncope an issue with constipation?

Back 29

This is due to straining. When you push you stimulate the vagus nerve (CN 10-goes all way down to anus) when stimulated it decreased heartrate, blood profusion to brain and one can then pass out (syncope-faint).

Front 30

Complications of Constipation are

Back 30

Valsalva maneuver and syncope, diverticulosis, obstipation (fecal impaction) secondary to constipation may cause bowel perforation.

Front 31

Aviod what type of enema for constipation?

Back 31

Soap sud enema should be avoided

Front 32

What type of enema can be used to alleviate constipation?

Back 32

oil retenion to soften feces

Front 33

True or False Laxatives can be used without caution for constipation?

Back 33

FALSE

Front 34

T/F the fluid intake of the pt. should be increased to 3000mL/day when constipated?

Back 34

TRUE

Front 35

Types of fiber

Back 35

Insoluble fiber-whole wheat, bran
Soluble fiber-oat bran, fruits, vegetables

Front 36

Etiology of Appendicitis

Back 36

obstruction in the lumen caused by feces, foreign bodies (ex. poppy seeds), tumors.

Front 37

Where is the pain felt for appendicitis?

Back 37

RLQ pain to the umbilicius area

Front 38

Pt. reports to the ER nurse that his RLQ pain has suddenly subsided and the nurse notes that his abdomen is distended, hard and rigid-what does this tell the nurse?

Back 38

That the appendix has perforated (this is bad b/c the fecal matter is no longer in the bowel and this causes massive infection-peritonitis).

Front 39

What is McBirney's point?

Back 39

half way between the umbilicus/right illiac crest-this is where the appendicitis pain localizes.

Front 40

What is rebound tenderness

Back 40

press down on the part of the body where it hurts and pain stops, release and the pain is felt again.

Front 41

A pt. comes to the ER with RLQ pain, muscle guarding of the abdomen, rebound tenderness of RLQ and a positive Rovsing's sing what might this patient have?

Back 41

Appendicitis

Front 42

Why does the nurse perform a urine analysis for a pt. that is suspected of having appendicitis?

Back 42

The doctor wants to make sure there is no issue with the urters as there is one in the RLQ as well)

Front 43

Diagnostic for appendicitis

Back 43

history and physical, CBC (to check for elevated WBC) and urine analysis.

Front 44

Surgery for appendicitis is MOSTLY performed when (though sometimes if this does not happen surgery is performed)

Back 44

perforation occurred

Front 45

The pt. is NPO, ice bag to the RLQ, IV fluids are given and pt. is on antibiotics what might this pt. have?

Back 45

Appendicitis

Front 46

All GI problems (except one) are given pain meds only when?

Back 46

A diagnosis is made b/c pain meds can mask symptoms.

Front 47

An inflammatory process in the peritonium that results in extracellular fluid shifts are

Back 47

Peritonitis

Front 48

What can cause peritonitis?

Back 48

blood born infections, cirrhosis of the liver, pancreatitis, peritoneal dialysis, abdominal surgery, perforations/ruptures of the bowel, appendix.

Front 49

Does Renae Hate GI/GU True or False

Back 49

TRUE

Front 50

S/S of peritonitis are

Back 50

high fever (101.0 and above), tachycardia, tachypena, nausea, vomiting, abdominal pain, tenderness, distention, rigidity, alteration in bowel sounds.

Front 51

Diagnostic studies for peritonitis

Back 51

CBC, serum electrolytes, abdominal x-ray, CAT scan, ultrasound, abdominal paracentesis

Front 52

SHOCK is inadequate

Back 52

profusion of organs, lactic acid builds up in the blood, cells of body die. Several causes-cardiac, hypovolumic shock etc...)

Front 53

iron deficiency anemia is closely corr. with

Back 53

ascending colon cancer

Front 54

Bowel Disorder Diagnostics

Back 54

CBC, Serum electrolytes, occult blood in stool, pus, and mucous, stool culture to r/o infection, sigmoidoscope/colonscopy/biopsy, barium enema

Front 55

Ulcerative Colitis involves the

Back 55

mucosa and submucos of rectum, sigmoid colon and upper colon-ulcers in the bowel.

Front 56

T/F pseudopopls and shortening of the colon are a result of UC

Back 56

TRUE

Front 57

A pt comes in with the following s/s: fluid and electrolyte imbalances, protein loss and multiple abscess/ulcerations, fever, tachycardia, weight loss, and lower abdominal pain, bleeding and diarrhea-what could be the cause

Back 57

UC (Ulcerative Colitis)

Front 58

True/False: Sulfa drugs are not used to treat UC?

Back 58

False, they are used to treat UC (sulfasalazine-Azulfidine)

Front 59

What microbal is used often to tx. UC?

Back 59

Rowasa (mesalamine)

Front 60

Can a pt. with UC get Kayopectate?

Back 60

NO!! it is not absorbed well.