Med Surg 2 Gastrointestional System

Front 1

Varicose veins of the esophagus

Back 1

Esophageal Varcies

Front 2

Seen with protal hypertension

Back 2

Esophageal Varcies

Front 3

Treatment of this disease includes: Vasopresin, assess the airway, Elevate the HOB, Vit K to promote clotting, transfusion, Surgery, Sengstaken-Blakemore and Minnesota NG Tubes

Back 3

Esophageal Varcies

Front 4

A symptom is hematemesis a emergency where patient vomits bright red blood

Back 4

Esophageal Varcies

Front 5

Has three ports, one for blowing up the gastric balloon, one for blowing up the esophageal balloon, and one for suctioning the stomach, can insert a second tube to suction above the esophageal balloon used for Esophageal Varcies

Back 5

Sengstaken-Blakemore NG Tube

Front 6

Has four ports, uses the same technique as the Sengstaken-Blakemore NG Tube except you use the fourth port to suction above the esophageal balloon, used for Esophageal Varcies

Back 6

Minnesota NG Tube

Front 7

Protrusion of a protion of the stomach upward through the diaphragm

Back 7

Hiatal Hernia

Front 8

Types include: Sliding: stomach slides into the chest when patient reclines and Paraesophageal (rolling) stomach herniates through the diaphragm

Back 8

Hiatal Hernia

Front 9

This disorder is caused by: Weakness in muscles, long term bed rest in reclining positon, increased abdominal pressure (ascites, abdominal cancer, obesity, pregnancy)

Back 9

Hiatal Hernia

Front 10

Diagnostics for this disorder include: CXR, Barium Swallow, Esophagoscopy

Back 10

Hiatal Hernia

Front 11

S/S of the disorder include: Indigestion, feeling full, belching (eructation), epigastric pain, worse when lying down

Back 11

Hiatal Hernia

Front 12

Internvetions for this disorder include: small frequent/bland meals to not upset the gastric, lose weight, elevate the head of bed, sit up after meals, antacids, Regalan (speeds up gastric emptying into the SI), Surgery

Back 12

Hiatal Hernia

Front 13

This type of surgery is used for Hiatal Hernia and it strengthens the LES by suturing the fundus of the stomach around the esophagus and anchoring it below the diaphragm

Back 13

Nissen Fundoplication

Front 14

This is used for Hiatal Hernia and is speeds up gastric emptying time into the SI

Back 14

Regalan

Front 15

This diagnostic test uses a Barium Swallow to detect abnormalities of the esophagus and stomach, patient needs to be NPO 6-8 hours before surgery, you need to monitor stools for two days to see the pass of white stools (barium is being eliminated) normal color of stool appears in 3 days

Back 15

UGI, Upper Gastric Intestional

Front 16

This diagnostic looks for blood, bile, pathogens, parasite eggs, it is not a sterile procedure, collect stool in clean cup and do NOT put bathroom tissue in sample, send to lab ASAP, tell patient to not eat red meant if testing for occult in stool, do not take salicylates, ascorbic acid, anticoagulants, steroids, if blood or mucus is in sample include it

Back 16

Stool Speciman

Front 17

For this diagnostic test there are two types, T-Tube and IV, T-Tube detects if bile ducts are open after gallbladder surgery, IV permits visualization of bile ducts they need to be NPO 4-6 hrs before they make take laxative, watch for signs of bleeding and RES distress, for both report allergic reaction

Back 17

Cholangiograph

Front 18

This diagnostic test visualizes the esophagus, stomach, duodenum, need to be NPO 6-8 hours before procedure, may sedate before, NPO until gag relfex returns, Nurse monitors for bleeding in throat and rectum, look for signs of perforation

Back 18

EGD, Esophagogastroduodenoscopy

Front 19

Abdominal distension, cramping, fever

Back 19

Signs of Perforation

Front 20

These two diagnostic tests look at colon and rectum, the patient needs to be NPO for 6-8 hours before exam, may have liquids the night before, may give laxatives, nurse needs to look for signs of perforation and rectal bleeding

Back 20

Colonoscopy and Proctoscopy

Front 21

This disease is cause by the H-pylori bacteria, through fecal and oral (bad handwashing)

Back 21

PUD, Peptic Ulcer Disease

Front 22

Risk factors for this disease include: hypertension of gastric juices, Alcohol, smoking, coffee, tea, spicy foods, over use of ASA-NSAIDs-Steroids, certain blood types

Back 22

PUD, Peptic Ulcer Disease

Front 23

Blood types: A and O

Back 23

PUD, Peptic Ulcer Disease

Front 24

Treatment for this disease include: antibiotics, avoid stimulants, small frequent feedings, stress management

Back 24

PUD, Peptic Ulcer Disease

Front 25

PUD meds to use: is used to heal the ulcer; it coats the ulcer

Back 25

Carafate

Front 26

Gastritis/PUD meds to use: used to reduce gastric secretions

Back 26

Tagamet

Front 27

PUD meds to use: used to stop gastric secretions

Back 27

Prilosec, Nexium, Prevacid, Protonix, Aciphex

Front 28

Surgery as a treatment for PUD:
Subtotal gastrectomy, part of the stomach is removed including the antrum and anastomosed to the duodenum

Back 28

Billroth I

Front 29

Surgery as a treatment for PUD:
Subtotal gastrectomy, part of the stomach is removed including the antrum and anastomosed to the jejunum

Back 29

Billroth II

Front 30

Complications of this disorder include, hemorrhage, perforation (rigid abdomen (perionitis), board like abdomen), obstruction, Dumping Syndrome, Pernicious Anemia

Back 30

PUD, Peptic Ulcer Disease

Front 31

This disorder is characterized when food empties to rapidly into the duodenum, often occurs after subtotal gastrectomy, occurs 30 minutes after meals

Back 31

Dumping Syndrome

Front 32

S/S of this disorder include: N/V, weakness, abdominal pain or feeling of fullness, distension, syncope, diaphoresis, increased pule, dizziness, and cold sweat

Back 32

Dumping Syndrome

Front 33

Treatment for this syndrome include: avoid large amounts of food/liquids/sweets, increase protein intake, use bentyl, use a resting position to slow down the movement of food through the GI tract

Back 33

Dumping Syndrome

Front 34

Cancer of the LI

Back 34

Colorectal Cancer

Front 35

Risk factors for this cancer include: increased fats in diet, decreased fiber in diet, obesity, smoking, alcohol, IBD, genes, polyps

Back 35

Colorectal Cancer

Front 36

Diagnostics for this cancer include: Rectal exam, CEA (has a specific tumor marker), colonoscopy beginninng at age 50

Back 36

Colorectal Cancer

Front 37

S/S of this cancer include: change in bowel habits, bright red blood in stool, pencillike stools, tumors grow slowly and may be asymptomatic

Back 37

Colorectal Cancer

Front 38

Treatment: coloectomy, chemo and radiation

Back 38

Colorectal Cancer

Front 39

Interventions for this cancer include: look for signs of inflammation, may get drain, measure fecal drainage, assess wounds for infection, TCDB, give analgesics

Back 39

Colorectal Cancer

Front 40

bleeding, fever, increased pain

Back 40

Signs of inflammation

Front 41

odor, swelling, purulent drainage

Back 41

Signs of Infection

Front 42

Inflammation of the lining of the stomach

Back 42

Gastritis

Front 43

Caused by: NSAIDs, stress, alcohol, toxins, smoking, bacterial/viral infections, food allergies, certain drugs that your are not suppose to crush

Back 43

Gastritis

Front 44

S/S of this disorder; N/V/D, epigastric pain, fever, anorexia

Back 44

Gastritis

Front 45

Interventions for this disorder: NPO then move to bland diet, monitor E-lytes, give: sedatives, antacids, antispasmotics, antiemetics, antibiotics, Tagamet-used to reduce gastric secretions

Back 45

Gastritis

Front 46

Sac like pouches in the intestional wall become inflammed and infected, mainly sigmoid colon

Back 46

Diverticulutis

Front 47

This disorder is caused by: a decrease in bulk in diet, seen in men 50 and older

Back 47

Diverticulutis

Front 48

Diagnostics for this disorder include: Barium Enema and Endoscopy

Back 48

Diverticulutis

Front 49

S/S of this disorder include: nagging/cramping pain, bloating, unrelieved constipation/diarrhea, fever, N/V, Chills, stools with increased mucus

Back 49

Diverticulutis

Front 50

Treatment for this disorder include: increase fiber, avoid seeds and nuts, bland diet, stool softners, antibiotics, bowel resection

Back 50

Diverticulutis

Front 51

Complications of this disorder include; Perforation and Peritonitis

Back 51

Diverticulutis

Front 52

Sac like pouch in the Esophagus

Back 52

Esophageal Diverticula

Front 53

S/S of this disorder include: feeling foreign body in throat, dysphagia, halitosis

Back 53

Esophageal Diverticula

Front 54

NI for this disorder include: bland diet with no spicy stuff, vitamins, antacids, antiemetics, semi fowlers position, possible surgery

Back 54

Esophageal Diverticula

Front 55

Inflammation and ulceration of the lining of the intestines

Back 55

IBD

Front 56

Two types: Crohns and Ulcer Colitis

Back 56

IBD

Front 57

Called Regional Enteritis, is autoimmune, deep ulcers in all layers of the bowel, terminal ileum, chronic, remissions and exacerbations, more severe than ulcerative colitis, affects any area of the GI tract, Attacks last several weeks or months, may be heredity

Back 57

Crohns

Front 58

Diagnostics for this disease: H/P, upper and lower GI, colonoscopy, CBC, H/H and PTT to bleeding, E-lyte will have an imbalance, ESR

Back 58

Crohns

Front 59

S/S of this disease: abdominal crampling, constant pain, diarrhea (constant irritation discharge and rectal irritation), tenderness, anorexia, anemia, fever, melena, perianal fissures

Back 59

Crohns

Front 60

Treatment for this disorder include; Antidiarrheals (except for sever colitis), anticholinergics (block never impulses, Antibiotics, Steroids, Immunosuppressants, Iron, and B12, Folic Acis, Remicade to block inflammatory process

Back 60

Crohns

Front 61

Interventions: Bland diet (increase protien/cal, decrease residue/fat), TPN, transfusions, manage stress, perianal care (sitz bath, topical cream, botox injections, hopefully it heals in 5 weeks because at week 6 it is chronic), emotional support, bowel resection and ileostomy

Back 61

Crohns

Front 62

Complications of this disorder: malabsorption syndroms, abscess, hemorrhage, peritonitis, peri-anal fissures, fistuals, systemic problems (arthritis, liver disease, gall and kidney stones)

Back 62

Crohns

Front 63

Part of colon (LI), could only be 1 attack, maybe genetic, increased incidence in women, ages 15-25 and again 50-80, less severe than Crohns, autoimmune

Back 63

Ulcerative Colitis

Front 64

Diagnostic for this disorder include: H/p, stool speciman, endoscopy, CBC, E-lytes, sigmoidoscopy

Back 64

Ulcerative Colitis

Front 65

S/S for this disease include: bloody diarrhea, recatl bleeding, abdominal bleeding, nausea, weight loss, cachexia, dehydration, anemia, tachycardia

Back 65

Ulcerative Colitis

Front 66

Treatment for this disorder include: antidiarrheals, sedation, antiinflammatories, seroids, anticholinergics, analgesics, vitamins, minerals, TPN, diet, Monitor stools, decrease stress, good perianal care, monitor v/s-labs-I-O, observes skin for breakdown, surgery, may need psychotherapy

Back 66

Ulcerative Colitis

Front 67

Complications for this disease include: colon cancer, perforation of colon, peritonitis, hemorrhage, abcess, strictures, malabsorption

Back 67

Ulcerative Colitis

Front 68

Protrusion of the intestine through the abdominal wall due to muscle wall weakness

Back 68

Hernia

Front 69

Caused by: lifiting heavy objects, straining and coughing

Back 69

Hernia

Front 70

Classes:
1. Reducible-slips back in with gental pressure when person lies down
2. Irreducible, Incarcerated-cant be pused back in and impair blood flow to that area and become gangernous (may)
3. Strangulated-trapped and deprived of blood

Back 70

Hernia

Front 71

S/S of this disorder: palpable mass, pressure, swelling, pain and inflammation

Back 71

Hernia

Front 72

Treatment:
1. Herniorrhaphy-repairs it by suturing hernia
2. Hernioplasty-uses mesh to reinforce the area

Back 72

Hernia

Front 73

Post Op care: Turn and deep breath-do not cough or sneeze, ice packs, monitor bowel sounds, and not activity for two weeks

Back 73

Hernia

Front 74

Inflammation of the blind pouch in the cecum, can be caused by bacteria/worms/parasites/ fecaliths

Back 74

Appendicitis

Front 75

Pain in LRQ, Blumbergs sign, and McBurneys Point

Back 75

Appendicitis

Front 76

Treatment includes; No heat or Laxative (can cause it to rupture), no analgesics, give ice, NPO in case of surgery, Elevate HOB, hip flexion they need to be in semi fowlers or side lying position

Back 76

Appendicitis

Front 77

Complications:
Perforation, Abcess, Peritonitis

Back 77

Appendicitis

Front 78

Rebound tenderness in abdomen

Back 78

Blumbergs Sign

Front 79

Pain is midway between the anterior illac crest and the belly button

Back 79

McBurneys Point

Front 80

Inflammation and infection of the peritoneum; fluid shifts out of blood to peritoneal cavity

Back 80

Peritionitis

Front 81

Varicose veins of the rectum can be external or internal

Back 81

Hemorrhoids

Front 82

Caused by: constipation, straining, lifiting, prolonged standing, pregnancy, obesity, pelvis tumors

Back 82

Hemorrhoids

Front 83

S/S : rectal pain, anal itching, bleeding, feeling of fullness in rectum

Back 83

Hemorrhoids

Front 84

Interventions: warm and cold compresses, sitz bath, exercise, increase fluids, stool softners

Back 84

Hemorrhoids

Front 85

Treatment:
1. Hemorrhoidectomy; tell dr. if you have a fever or bleeding, prevent reoccurance, use stool softners, high fiber diet, dont delay defacation, limit activities

Back 85

Hemorrhoids

Front 86

Ascultate for 2 min per quadrant, listen for 5 minutes for absence of bowel sounds

Back 86

Bowel Sounds

Front 87

Clicks and gurgles occur 5-30 times per minute, loud sounds are called: borborygmi

Back 87

Bowel Sounds

Front 88

Document as: present, absent, increased, decreased, high pitched, gurgling, tinkling, gushing

Back 88

Bowel Sounds

Front 89

Inspect, Ascultate, Percussion, Palpation
Ascultation before plapation because it can cause no sounds

Back 89

Steps to Assess the Abdomen

Front 90

Not indicated or goes against

Back 90

Contraindicated

Front 91

Uses Trocar and is inserted in the abdominal wall to drain fluid

Back 91

Paracentesis

Front 92

Indicated for ascites

Back 92

Paracentesis

Front 93

Get v/s, weight, abdominal girth, have pt void

Back 93

Paracentesis

Front 94

Remove fluid slowly, to rapid causes circulatory collapse

Back 94

Paracentesis

Front 95

Monitor v/s until stable, chekc for bleeding and blood in urine and send fluid drained to lab

Back 95

Paracentesis

Front 96

1. To deliver foods to stomach
2. Can be deivered by gravity or pump, for people who cant swallow,
3. Used to control bleeding (sengstaken-Blakemore)

Back 96

Purpose for NG tubes

Front 97

Herbal Laxative

Back 97

Senna

Front 98

Bulk Forming Agent

Back 98

Metamucil

Front 99

Infloding of skin in the midline above the coccyx, evidenced at birth by hairy dimple at sacrococcygeal area, also seen during puberty and in men, may contain hair

Back 99

Pilonidal Cyst

Front 100

Caused by bad hygiene, obesity, trauma

Back 100

Pilonidal Cyst

Front 101

S/S: pain, inflammation, swelling, redness, hard lesion

Back 101

Pilonidal Cyst

Front 102

NI: Warm compresses, antibiotics, analgesics, position on side, I/D, can reoccur and be chronic, surgery to remove

Back 102

Pilonidal Cyst

Front 103

Types:
Basal and Squamous Cell

Back 103

Oral Cancer

Front 104

Includes the lips and is less severe

Back 104

Basal Cell Oral Cancer

Front 105

Includes the lips bucca, gums, floor of mouth, tonsils, tongue and is worse

Back 105

Squamous CellOral Cancer

Front 106

Diagnostics: H/P, biopsy

Back 106

Oral Cancer

Front 107

Caused by: sun, wind, alcohol, poor nutrition, pipe smoking, chronic irritation

Back 107

Oral Cancer

Front 108

S/S pain in tongue-ear, leukoplakia, dysphagia, anorexia, weight loss, change in fit to dentures, hemoptysis, access the neck for movement and enlarged nodes

Back 108

Oral Cancer

Front 109

Treatment: chemo, radiation, surgery, do rectal and ear temps, monitor RES status (dyspnea, restlessness, tachycardia), analgesics, steroids, TPN, good hydration, surger, suction to remove secretions, good mouth care, emotional support, may need communication device, and swallowing/speech therapy

Back 109

Oral Cancer