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139 Cards in this Set

  • Front
  • Back
Name the components of the GI tract.
Mouth to anus. Includes the pancreas and gallbladder.
List some radiologic diagnostic studies for the GI tract.
Barium Swallow, small bowel series, Barium enema oral cystogram (HIDA scan), cholangiography, ultrasound, nuclear imaging scans, CT, and MRI.
What are some endoscopic studies for GI assessment?
Capsule endoscopy, upper GI endoscopy, colonoscopy, proctosigmoidoscopy, ERCP, and laparoscopy.
What kind of procedure is a liver biopsy?
A needle procedure.
What is the post-procedure care for a liver biopsy?
Lay on the right side for 2 hours, take vitals frequently.
What are some potential complications from a liver biopsy?
Hemorrhage, shock, peritonitis, and pneumothorax.
What are the components of a liver function test?
Bilirubin, albumin, blood ammonia levels, PT, PTT, ALP, AST, ALT, and cholesterol.
What gives information on bile formation and secretion?
Bilirubin.
What gives information about protein metabolism?
Albumin and blood amonia levels.
What gives information about hemostatic functions?
PT and PTT.
List 3 serum enzyme tests.
ALP, AST, and ALT.
What gives information about lipid metabolism?
Cholesterol.
When assessing nutrition, what is a very important thing to think about?
Vitamin imbalances.
What are some forms of supplemental nutrition?
Oral supplements, Tube feedings, and TPN.
What are 4 types of tube feedings?
Nasogastric, nasointestinal, gastrostomy, and jejunostomy.
In what position should the head of the bed be when receiving a tube feeding?
At 30-45 degrees.
What is TPN?
Total perenteral nutrition.
What is the route for TPN?
IV - always central line or PICC.
What are some treatments for obesity?
Nutritional therapy, exercise, behavior-cognitive modification, drugs, and surgery.
What are the 2 types of ostomies?
Illeostomy and colostomy.
What is an ileostomy?
The ileum goes out through the abdominal wall and a stoma is created.
Is an ileostomy temporary or permanent?
Both.
For what conditions is an ileostomy used?
Colitis, Crohn's disease, familial polyposis, cancer, and trauma.
What is the appearance of the stool received from an ileostomy?
Liquid to sem-liquid.
What is a colostomy?
An opening between the colon and abdominal wall and a stoma is created.
Is a colostomy temporary?
It can be temporary or permanent.
For what conditions is a colostomy used?
Cancer, perforated diverticulum, and trauma.
What is the appearance of the stool received from a colostomy?
A formed stool.
For what kind of ostomy is irrigation used?
Colostomy.
What is GERD?
Gastro-esophageal Reflux Disease.
Is GERD a syndrome or a disease?
A syndrome.
Do children have GERD?
No, they have GER.
What is the etiology of GERD?
Reflux of gastric secreation into the esophagus.
What are the s/s of GERD?
Heartburn, N&V, and regurgitation.
If someone has GERD, what are they more at risk for?
Aspriation, pneumonia, or cancer.
What are the 4 phases of the treatment of GERD?
Lifestyle modifications, drugs, more intensive drug management, and surgery.
What is a hiatal hernia?
A portion of the stomach herniates into the esophagus.
What are the s/s of hiatal hernia?
Heartburn and dysphagia.
How is a hiatal hernia diagnosed?
A barium swallow or endoscopy.
What is the treatment for a hiatal hernia?
No ETOH, smoking, or large meals.
What are potential complications of a hiatal hernia?
GERD, hemorrhage, esophageal stenosis, strangulated hernia, and surgery may be needed.
What is gastritis?
Inflammation of gastric mucosa.
What is one of the most common stomach problems?
Gastritis.
How is gastritis diagnosed?
CBC and occult stool.
What is the treatment of acute gastritis?
NPO, IV, antiemetic, antacids, H2 blockers, PPI, and antibiotics.
What is PUD?
Peptic Ulcer Disease.
Is a PUD more often gastric or duodenal?
Duodenal.
What is the etiology of PUD?
Erosion of the GI mucosa resulting from the action of HCL and pepsin.
What causes PUD?
NSAIDS, steroids, smoking, ETOH, caffeine, stress, and H. Pylori.
What are the s/s of gastric PUD?
Epigastri burning or pain 1-2 hrs after a meal and food can aggrevate it.
What are the s/s of duodenal PUD?
Symptoms start 2-4 hrs after a meal, back pain and sometimes no pain, and may be no symptoms until hemorrhage or perforation.
What are 3 emergency complications of PUD?
Hemorrhage, perforation, and gastric outlet obstrution.
What is the most common emergent complication of PUD?
Hemorrhage.
What is the treatment for PUD?
Meds, antibiotics (if H. pylori), decrease stress, and avoid irritants.
What causes food poisoning?
Contaminated food.
How is food poisoning spread?
Person to person and by undercooked or improperly handled foods.
What are the s/s of food poisoning?
NV, diarrhea, and acute gastroenteritis.
What is the treatment for food poisoning?
Correct food prep and correct fluids/electrolytes prn.
What is new from the CDC concerning food poisoning?
Concern about overuse of antibiotics and increased resistant organisms.
Do you give imodium for food poisoning?
No.
Is diarrhea a symptom or a disease?
A symptom.
Should you always consider diarrhea to be infectious?
Yes, always considered infectious.
What is the main concern with infants and diarrhea?
Dehydration.
What is the treatment for diarrhea?
Goal is to decrease the number of stools; educate about handwashing and skin breakdown.
How do you treat a child with diarrhea?
Give them pedialyte/gatorade to replace lytes.
How often do normal bowel movements occur each day?
2-3.
What disease may be the cause for pediatric constipation?
Hirschsprung's Diease. (Part of the colon is not functioning.)
What may be the issue if an older adult is constipated?
Rectal stasis, rectal ulcers, and a tumor could be present.
What are some contributing factors to constipation?
Decreased fiber and fluid intake, decreased amount of exercise, depression, chronic stress, meds, ignoring the urge to defecate, environmental constraints, and socio-cultural beliefs.
What are some complications with constipation?
Unrelenting constipation, hemorrhoids, fecal impaction, and colon perforation.
What is very important when assessing chronic abdominal pain?
H & P.
Which is tougher to diagnose, acute or chronic abdominal pain?
Chronic.
How are some ways that abdominal pain is diagnosed?
CBC, UA, pregnancy test, x-ray, CT, MRI, pelvic/rectal exam, and EKG.
What med is not given when there is a GI problem?
Ibuprofen.
What can be given right away for abdominal pain?
Toradol.
Why can Toradol be given for abdominal pain?
It is less sedating. Sometimes the benefits outweigh the risks.
What is esophagitis?
Frequent complication of GERD.
What is Barrett's esophagus?
Esophageal metaplasia. And another complication of GERD.
How is Barrett's esophagus diagnosed?
By endoscopy and a biopsy every 1 - 3 years.
What is a complication of Barrett's esophagus?
It is precancerous.
In what patients is esophageal varices most often seen?
Patients with cirrhosis.
Is a GI bleed an emergency?
Yes, it is an emergency if it is acute.
What must a nurse assess for in a patient with a GI bleed?
Assess for symptoms of hypovolemic shock.
What is given to a patient with a GI bleed?
IV fluids, IV meds, and blood prn.
What does the blood look like if the GI bleed is a varicy?
It will be bright red.
What is the appearance of the blood if the GI bleed is in the stomach?
It will look like coffee grounds.
What is the appearance of the stool if the GI bleed is in the upper GI?
It will be a black tarry stool.
What will be the appearance of the stool if the GI bleed is in the lower GI?
The stool will be maroon.
What will the appearance of the stool be if the GI bleed is in the rectum?
There will be bright red blood in the stool.
What is acute pancreatitis?
Autodigestion of the pancrease. This is caused by a plugged duct so the enzymes sit in the pancreas and eat at it.
What causes acute pancreatitis?
ETOH use and GB disease.
What are the s/s of acute pancreatitis?
LUQ pain that radiates to the back, Cullens sign, and jaundice.
What is Cullen's sign?
Bluish-black discoloration around the umbilicus.
How is acute pancreatitis diagnosed?
An increase in serum amylase, and increase in serum lipase,and presence of urine amylase.
How is acute pancreatitis treated?
MS, NPO, NG, antibiotics, and prevent shock.
What is cirrhosis of the liver?
Chronic, progressive destruction of the liver.
What is the major cause of cirrhosis of the liver?
ETOH use.
What are the s/s of cirrhosis of the liver?
Pain, dull heavy feeling in RUQ, palpable liver, ascities, jaundice, edema, spider angiomas, and esophageal verices.
What is a major complication of cirrhosis of the liver?
Portal hypertension.
How is cirrhosis of the liver treated?
Weigh daily, need rest, no ibuprofen or asa.
What is ascites?
Accumulation of serous fluid in peritoneal/abdominal cavity.
In what instance would a paracentesis be perfromed?
If the patient is SOB.
What is the etiology of ascites?
BP increases liver proteins to go into lymph and the lymph cannot handle the fluid so it releases it into the cavities.
What is hepatic encephalopathy?
Terminal complication of liver disease. Ammonia enters the circulation without detoxification by the liver.
What are the s/s of hepatic encephalopathy?
Disorientation, increasing neuro symptoms, coma and death if left untreated.
What is the treatment for hepatic encephalopathy?
Low to no protein diet, Lactulose, and a liver transplant.
What does Lactulose do?
It binds ammonia.
What is another name for gall stones?
Cholelithiasis.
What are some s/s of gall stones?
Indigetsion, mod-sever pain in RUQ (may radiate to the R shoulder), fever, NV, and restlessness.
What drug will not affect the spincter of Odii?
Demarol.
How is gall bladder disease treated?
Dermerol, antibiotics, fluids, NG (if severe), anticholinergics, antispasmodics, fat-soluble vitamins, bile salts, and Cholestyramine.
What is Irritable Bowel Syndrome (IBS)?
Intermittent and recurrent abdominal pain; may also have excessive gas, urge to defecate, and distension.
What is the main symptom of IBS?
Diarrhea.
What is used to treat IBS?
Anticholinergics, antidiarrheals, tegaserod, relaxation therapy, acupuncture, and dietary changes.
What area of the bowel is effected in Crohn's disease?
Any area of the bowel can be affected.
What are the s/s of Crohn's disease?
Non-bloody diarrhea, intermittent severe abdominal pain, fever, fatigue, abdominal tenderness, wt loss, and malnutrition.
How is Crohn's disease diagnosed?
Barium studies and endoscopy.
What is the treatment for Crohn's disease?
Steroids (if small intestine is involved), sulfasalazine (if colon is involved), Flagyl (if peri-anal area is involved), dietary changes, may have surgery (but not cured by surgery).
Where does ulcerative colitis begin?
In the rectum and moves up the colon.
What is a risk with ulcerative colitis?
Cancer.
What are the s/s of ulcerative colitis?
Bleeding, diarrhea, and abdominal pain.
Where are polyps most common?
In the rectal-sigmoid area.
What is appendicitis?
An inflammed appendix.
What causes appendicits?
Accumulate feces obstructing lumen of cecum.
What are the s/s of appendicits?
RLQ pain, anorexia, NV, persistent continuous pain, rebound tenderness, and possible fever.
What is the treatment for appendicits?
Surgery.
What is diverticulosis?
A complication of constipation.
What is diverticulitis?
Inflamed diverticula.
How is diverticulitis diagnosed?
CT with oral contrast.
What is a hernia?
A protrusion of an organ through weak area in wall of cavity.
What is the most common complication of constipation?
Hemorrhoids.
How are hemorrhoids treated?
High fiber diet with increased fluids; prevent constipation and strain.
What is a cleft lip?
Failure of maxillary processes to fuse.
What is a cleft palate?
A midline fissure.
What is EATF?
Esophageal atresia with tracheoesophageal fistula.
What is the etiology of EATF?
Failure of esophagus and trachea to develop a continuous tube.
What is the treatment with EATF?
Thoracotomy, maintain airway, prevent aspiration, antibiotics, and have suction available.
What is pyloric stenosis?
Obstruction of circular muscle of pyloric canal.
What is intussusception?
Ileocolic telescoping of intestine.