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71 Cards in this Set
- Front
- Back
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Diverticulosis/itis most common in..
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sigmoid colon
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who presents with GERD?
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obese pts lying down
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IBS constipation and diarrhea
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deals with measl
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if pt is constipated where should palpate?
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LLQ
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most common GI symptom
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indigestion
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Gi prob from tobacco use
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esophageal reflux
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alcohol use problem
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cancers
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palpate each quad how long?
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5 min per quad
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distention feels ? and round feels?
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firm
soft |
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checks for inflamm and infection
leukodytosis GI bleed and obstruction High H&H |
CBC
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acute pancreatitis, cholycistitis, gallbladder attack, intestinal obstruction, and preforated ulcer check this
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serum amylas
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autoimmune disorders test..
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DNA
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upper GI test with..
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Xray using barium (PO)
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stomach, esophagus, and small bowel is
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upper gi
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prepare pts for upper gi (4)
before and after |
clear liquids day before, PO after midnight
hold PO meds adjust insulin increase fluids after for stool stim |
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barium enema, obeserve filled colon must tolerate bowel cleansing
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lower GI
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lower GI prep
food? think ahead what do you need the night before? after? |
low residue diet 1-2 days prior
clear liquid day before laxative night before NPO after MN high fluids after |
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pt must be able to do what for GI procedures
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change positions
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administer what before contrast CT?
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prednisone
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if renal pt and need CT or EUS give what first?
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Na bicarb and Mucomyst 1 hr prior and 6 hrs after
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helps diagnose gallstones, appendicitis, choley
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CT
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diagnose Barretts esophagus, pancreatitis, portal HTN
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EUS
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cant see diverticulosis on...
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CT
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use what to diagnose diverticulosis
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colonoscopy
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Endoscopic prep (3)
before look for what after |
NPO 8hrs prior
admin meds ordered NPO after until gag reflex back |
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prep for colonoscopy
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goLYTELY, bowel prep
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throat anesthetic before...
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EGD/ERCP
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S/S of perforation
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low grade temp
distended, rigid abdomen |
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MRI prep NPO, no what? ask what?
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NPO 6 hrs before, remove jewelry, claustrophobic?
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PET prep, what admin? whats unique?
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injection
no harm to body low radiation |
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radioactive isotope
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scintigraphy
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to gain GI motility prep.. what is it? do what after?
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radionuclide capsule: regular diet and activity
x rays q day for 4-5 days |
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manometry prep.. NPO, avoid what?
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NPO 8-12 hrs
avoid meds that affect motility |
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gastric analysis: NPO, no what? insert what? what is it? may cause?
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NPO 8-12 hrs
no smoking NG tube histamine injection may cause flushing |
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oscopy prep: what do you do and what do you monitor?
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warm tap water enema until clear
monitor rectal bleeding and perforation |
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obesity vs overnutrition
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obesity is a result of metabolism
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Bariatric BMI requirements
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> 40 without comorbidities
> 35 with comorbidities |
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decreases the stomach size to 30 ml or less, allows for normal digestion, can be reversed
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restrictive bariatric surgery
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bypasses portions of small intestine to reduce absorption of food.
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malabsorptive bariatric surgery
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rouxeny procedure, long term weight loss, less complications, rapid improvement of comorbidities
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combined procedures
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gold std bariatric surgery
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roux-en-y
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prevents absorption of fat holds 20-30 mL
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roux-en-y bypass
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complications of bariatric surgery (3)
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dehydration then increased HR
hypovolemic, edema (hoards fluid) |
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diverticulosis vs culitis?
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losis doesnt have inflammation, just herniations.
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manifestations of diverticulosis (3)
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chronic constipation
leukocytosis abd cramps |
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diet for diverticulosis
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low fiber, low fat
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treating diverticulosis..
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must be asymptomatic
3 flare ups- ressection start with antibiotic to stop infrection FIRST |
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inflammation of the peritoneum caused by a leakage of contents from abd organs into cavity
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peritonitis
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primary peritonitis
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fluid shifts into cavity and is a medium for bacteria
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secondary peritonitis
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perforation or rupture leading to a release of contents into the cavity.
chemical to bacterial to septic! |
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peritonitis may cause ___ within ___ hr
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septic shock within 6-12 hrs
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red stomach
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sign of peritonitis- DONT TOUCH
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peritonitis diagnosis of choice
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CT
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position pt with peritonitis
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side with knees flexed to relieve tension
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most common intestinal obstruction in the..
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small intestine
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cause of intestinal obstruction
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surgical adhesion
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paralytic ileus
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no bowel sounds
no peristalsis |
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inflammation during surgery causing tissues to bond together
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surgical adhesion
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ileus is normal post suregery until...
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3 days post
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treating paralytic ileus.. (3)
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NPO hydration= NG tube
stop opiates |
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too much fluid could keep accumulating in the abd cavity causing
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hypovolemic shock
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higher bowel obstruction- less absorption
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Hypokalemia
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lower bowel obstruction- absorbs more bc just sitting there
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hyperkalemia
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bowel obstuction treatment (3)
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consider K replacement
re establish blood flow NPO |
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use what type of meds with ileus
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NSAIDS
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bright red blood in stool, inflamm on inner lining. spreads from rectum upwards. exacerbations
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ulcerative colitis
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low H&H
Low albumin high WBC |
Ulcerative colitis
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all layers of bowel starting at top going downward fat in stool WEIGHT LOSS and nut. def.
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Crohn's Disease
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managing IBD (4 and med)
think diet |
oral hydration, low residue, high protein, high calorie
antidiarrheal |
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most crohn disease have what type of surgery?
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stricturoplasty
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cured by surgery
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ulcerative colitis
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