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112 Cards in this Set
- Front
- Back
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Endoscopic procedures:
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-allow direct visulatization of body cavities, tissues and organs
-performed for diagnostic and therapeutic purposes |
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Scope procedures:
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-involve use of flexible tube that is inserted into a body cavity or orifice to allow visualization, biopsy, removal of abnormal tissue and minor surgery
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Arthroscopy:
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-allows visulatzation of joint
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Broncoscopy:
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-allows visualization of the larynx, trachea, bronchi, and alveoli
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Colonoscopy:
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-allows visulzation of anus, rectum, and colon
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Cystocopy:
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-allows visualization of urethra, bladder, prostate and ureters
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Esophagogastrodudodenoscopy (EGD):
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-allows visualization of liver, gallbladder, and bile ducts
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Sigmodioscopy:
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-allows vitalization of anus, rectum, and sigmoid colon
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Ostomy:
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-create an opening form the inside of the body to the outside
-may be permanent or temporary |
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Stoma:
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-artificial opening from inside to outside of body created during ostomy surgery
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Perisotmal skin:
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-skin surrounding the stoma
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Ileostomy:
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-surgical opening into the ileum to drain stool
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Colostomy
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-surgical opening into the L intestine to drain stool
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Urostomy:
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-surgical opening to drain urine
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Ascites:
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-abnormal accumulation of protein-rich fluid in the abdominal cavity
-caused by cirrhosis of the liver (most common) |
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Paracentesis:
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-performed by inserting needle or trocar thought the abdominal wall into the peritoneal cavity and withdrawing ascitic flud for diagnostic purposes
-up to 1L of ascitic fluid can be withdrawn in order to relieve abdominal pressure |
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Where can paracentesis be performed?
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-In a physician's office, outpatient center or acute care setting
-at bedside or radiology dept using ultrasound to ensure correct placement of needle |
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Overall determining factor of paracentesis treatment in the treatment of ascites is?
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-Respiratory distress
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Albumin normal range?
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- 3.1 to 4.3 g/dL
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Protein normal range?
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- 6 - 8 g/dL
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Glucose normal range?
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-80 - 120 mg/dL
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Amylase normal range?
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- 53 - 123 units/L
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BUN normal range?
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- 8 - 25 mg/dL
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Creatinine normal range?
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- 0.6 - 1.5 mg/dL
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Gastroesophagela refulx disease (GERD):
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-characterized by gastric content and enzyme leakage into esophages
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Chief stymptom of GERD?
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-proglonge restorsternal heart burn (dyspepsia)
-regurgiation (acid reflux) in realationship to eating or activies -chronic cough, dysphage, belching (erucatation), faltulence (gas), atypical chest pain, asthma exacerbatoins |
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Untreated GERD leads to?
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-inflammation, breakdown, and long-term complications
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Primary treatment of GERD is?
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-lifestyle changes & diet
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Contributing factors of GERD?
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-Fatty and fried foods
-chocolate -caffeinated beverages coffee -peppermint -spicy foods -tomatoes -citrus foods -alcohol |
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S/S of GERD:
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-Dyspepsia, after eating
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Glucose normal range?
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-80 - 120 mg/dL
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Amylase normal range?
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- 53 - 123 units/L
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BUN normal range?
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- 8 - 25 mg/dL
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Creatinine normal range?
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- 0.6 - 1.5 mg/dL
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Gastroesophagela refulx disease (GERD):
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-characterized by gastric content and enzyme leakage into esophages
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Chief stymptom of GERD?
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-proglonge restorsternal heart burn (dyspepsia)
-regurgiation (acid reflux) in realationship to eating or activies -chronic cough, dysphage, belching (erucatation), faltulence (gas), atypical chest pain, asthma exacerbatoins |
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Untreated GERD leads to?
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-inflammation, breakdown, and long-term complications
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Primary treatment of GERD is?
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-lifestyle changes & diet
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Contributing factors of GERD?
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-Fatty and fried foods
-chocolate -caffeinated beverages coffee -peppermint -spicy foods -tomatoes -citrus foods -alcohol |
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S/S of GERD:
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-Dyspepsia, after eating
-throat irritation -chronic cough -hypersalvaitoin -eructation -flatulence -atypical chest pain -dysphagia |
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Esophageal varices:
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-swollen, fragile blood vessels in the esophagus
-liver damage, flood blood flow through liver is restriced and diverer to other vessels like the esophagus -increased blood flow (portal hyptertension) causes swllling and varcies result -MED EMERGENCY assoc. with high mortatliy rates |
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Esophageal varices complicatoins:
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-hypovolemic shock and complications of anemia
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Primary RF of esophageal varices?
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-Portal hypertension
-Conditions of PH include -Alcholic cirrhosis -viral hepatitis |
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S/S of bleeding esophageal varices:
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-Hematermesis
-Melena -Hypotension -Tachcardia |
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Meds for esophageal varcies:
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-beat blocker (propanolol [inderal])
-vasoconstricotrs (vasopressin [desmopressin] ) if PT bleeding admin IV access for possible blood transfusions |
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Peptic Ulcer:
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are of erosion involving the muscosal lining of the stomach or duodenum
-mucosa can become eroded to the point that the epithelium is expose to gastric acid and pepsin which can precipitate bleeding and perforation |
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Causes of pepic ulcers include?
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-Heliobater pylori infection
-NSAID use -Severe stress -Hypersecretory states |
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Heliobacter pylori testing:
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-Gastric samples: endoscopy test & medication history imporatant cerrtain can cause false reading
-Urea breath testing: clinet exhale into collection container, drinking carbon enriched urea solution asked to exhale again into collection container --- if present solution will break down and carbon dioxide will be released -IgG serologic testing: documents the presecnt of Heli. pylori anased on antibody assays -Stool Sample: test for presecent of Heli. pylori antigen -EGD |
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S/S of pepic ulcer:
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Dyspepsia (heartburn, blaoting and nausea) uncomfortable fullness or hunger
-Pain |
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Gastic Ulcer:
Pain |
-30 - 60 min after meal
-Rarely occurs at night -Pain woreses with food ingestion |
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Duodenal Ulcer:
Pain |
-1.5 to 3 hr after meal
-Often occurs at night -Pain relieved by food ingestion |
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Perforation:
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-severe epigastric pain spreading across abdomen
-abdomen is rigid, board like, hyperactive to diminished bowel sounds, had rebound tenderness -MED emergency |
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GI bleeding:
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-constist of hematermsis, melena, hyportension, tachycardia, dizziness, confusion, decreased hemoglobin
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Gastroectomy:
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-all or part of the stomach is removed
-may be performed with laparoscopy or open surgery |
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Antrectomy:
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-antrum portion of the stomach removed
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Gastrojejunostomy (Billroth II procedure):
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-lower portion of stomach is excised and remaining stomach is anastomased to the jejunum and remaining duodenum is surgically closed
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Vagostomy:
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-branches of vagus nerve that supply stomach are cut to disrupt acid production
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Pyloroplasy:
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-opening between stomach and small intestine is enlarged to increase rate of gastric emptying
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Indications for gastric surgery include?
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-Peptic ulcer disease
-Emergency surgical intervention of Perforation and hemorrhage -Surgical removal/reduction of gastric cancer |
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Pernicius Anemia:
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-due to deficiency of intrinsic factor normally secreted by the gastric mucosa
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S/S Pernicius Anemia :
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-Pallor
-Glossitis -Fatigue -Parethesias |
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Dumping Syndrome:
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-Consists of vasomotor symptoms occur in responsone to food ingestion
-rapdi emptying of gastric contents into small intestine - |
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Early symptoms of vasomotor symptoms?
Onset: Cause: Symptoms: |
Onset; within 30 min of eating
Cause: Rapid emptying Symptoms: Vertigo, syncope, pallor diaphores, tachycardia, palpitations |
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Late symptoms of vasomotor symptoms?
Onset: Cause: Symptoms: |
Onset: 90 min to 3hr after eating
Cause: Excessive insulin release Symptoms: abdominal distension adn cramping, borborygmi, nausea, dizziness, diaphroesis, confusion |
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Constipation:
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-defined as bowel movements that are infrequent, hard or dry and difficult to pass
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Diarrhea
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-defined as increased number of loose, liquid stools
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Causes of constipation?
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-frequent use of laxatives
-advanced age -inadequate fluid intake -inadequate fiber intake -immobilization due to injury -sedentary lifestyle |
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Causes of diarrhea?
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-viral gastoenteritis
-overuse of laxatives -use of certain antibitoics -IBS -Inflam. bowl disease -food-borne pathogens |
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S/S of constipation:
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-abdominal bloating
-abdominal cramping -straining at defecation |
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S/S of diarrhea:
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-S/S of dehydration
-Frequent loose stools -abdominal cramping |
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Fecal occult blood test:
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-obtained using a medical aseptic technique and wearing disposable gloves
-Peform a Hemocult slide teast adn record results -Certain foods (raw meat, raw vegetables) and mediation (aspirin, NSAIDS) can cause false positives -Bleeding can be sign of cancer, contribuiting factor to constipation |
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Digital rectal exam:
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-checks for impaction
-PT postitioned on L side w/knee flexed -lubricant index finger gently insert into rectal wall -Clients VS and resonse should be monitored |
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Stool Cultures:
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-Specimen should be labeled and sent to lab
-Intrestinal bacteria can be contributing factor to diarrhea |
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Intestinal obstruction can result from?
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-mechanical or nonmechanical causes
-mech obstruction requires surgery |
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Higher-level Intestinal obstruction?
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-have colickly, intermittent pain and profuse vomiting
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Lower-level obstruction?
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-have vague, diffused, constant pain and significant abdomian distension
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Bowel sounds when intestinal obstruction present?
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-will be hyperactive above obstruction and hypoactive below
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Most common obstructions are where?
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-in the small intestine
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Treatment of intestinal obstructions include?
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-focus on fluid and electrolyte balance, decompressing the bowl and relief/removal of the obstruction
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Mechanical obstructions are the result of?
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-90% of all obstructions
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Appendicitis:
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-results from obstruction, inflammation, and infection of the apendix
-leads to hypoxia, which can result in gangrene and perforation of appendix -Perforation can result in formation of abccess and peritonitis |
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Appendicitis is the common cause of?
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-Right lower quadrant inflammation and emergency abdominal surgery
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Incidence of appendicitis is prevalent in?
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-among adolescent males and individuals between 20 and 30 yrs old
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Appendicitis WBC and differntial?
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-MIld to moderate elevation of 10,000 to 18,000/mm3 (cubed) with left shift
-greater than 20,000 = peritonitis |
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Surgical management of Appendicitis is?
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-Appendectomy
-using a laparoscope (several small incisions and endoscopoe) -or open approach (requiring larger abdominal incision) |
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S/S of Appendicitis:
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-Mild or cramping, epigastric or periumbilical pain (inital)
-Constant, intense R lower quadrant pain (later) -N/V, anorexia -Rebound tenderness (pain after deep pressure applied and released over MCBurney's point (distance halfway between umbiliicus and anterior iliac spine) -Pain decreases with a decrease in right hip flexion or increases with coughing and movement may indciate peforation with peritonitis -Muscle rigidity, tense positioning, gaurding may indicate perforation w/peritioinits -Normal to low garden temp (higher suggests peritonitis) |
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Inflammatory bowel disease (IBD):
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-chronic inflammatory GI disease: ulceatrive colitis and Crohn's disease
-characterized by diarrhea (up to 20 stools during acute exacerbation), carmpy abdomial pain, exacerbations (flare ups)remission |
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Ulcertative colitis:
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-edematious, inflamed mucose with multple abscesses, begining in the rectum and moving upward through Large intestine
-changes from chronic nature increases cancer risk |
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Crohn's Disease:
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-intermittent involvement throughout the entire GI tract, common in the small intestine and terminal ileum.
-typically disease extends through all layers of the bowel |
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Diverticulitis:
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-acute inflammation of the diverticulum
-occurs in abdomial lower left quadrant where stoll is sold consistency -involves deep longitudinal discountious ulcertions taht involve all layers of the bowel |
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Acute treatment for all IBD:
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-fluids and bowel rest
-medications -potential surgery - |
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Long term treatment for all IBD:
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-low fiber (low residue) diet
-medication -long term treatment for diverticulitis involved high fiber diet!!!! |
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Ulcerative colitis etiology:
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-toxic megacolon: dilation an paralysis of colon
-risk for perforation |
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Crohn's Disease etiology:
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-Fistulas (1/3 of clients will develop), to their organs of abdomen (bladder, anal fissures, perianall abscesses, perilabial)
-Massive or repteaed bowel resections resuiln in short bowel syndrome and permenat depned on total parenteral nutrition -Risk for cholelthias (poor absorption of bile salts in terminal ileum) -Risk for pancreatitis (form treating drugs or impaired pancreatic drainage) |
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IBD primarily disease of?
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-younger people
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Diverticulits primarily disease of?
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-older people
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Colorectal cancer (CRC):
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-most common cancer
-2nd leading cause of death by cancer in W.Countries |
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Most CRCs are?
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-Adenocarcinomas (colon epithelium)
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CRC grows?
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-slowly
-many times client is asymptomatic -occult blood discovered in stool during rectal exam |
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CRC can metastasizethrough?
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-blood or lmyp to the the liver (most common), lungs, brain, or bones
-Spread can also occur as result of periotoneal seeding (example during surgical resection of tumor) |
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CRC can be cured by?
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-with early early detection
-regular colorectal screening recommended for individuals older than 50 and family history of CRC |
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Risk factors of CRC:
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-adeonmatous colon polyps
-famiily history of CRC -IBD (ulcertavive colitis, Crohn's disease) -High-fat, low fiber diet -Older than 50 yrs of age |
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Tests for CRC:
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-Fecal Occult blood test (FOBT): two stool samples, 3 consecutive days,
-Carcinoembyronic Antigen (CEA) serum test: CEA lvls elevated in most individuals w/CRC -Sigmoidoscopy/Colonscopy: provides definitve diagnosis of CRC -Barium enema: CT cans of abdomen pelvis lungs and liver chest xray live scans done to further identify specific location of cancer and identifies of metastases |
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S/S of CRC:
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-fatigue due to occult blood loss
-change in bowel habits -visible blood in stool -mass on digital rectal exam -partial bowel obstruction (high pitched tingling bowel sounds) -complete bowel obstruction (no bowel sounds in 5 mins) |
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Cholecystitis:
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-inflammation of the gallbladder wall
-"attack" subsides in 2 to 3 days |
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Cholecystitis is most often caused by?
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-gallstones (cholelithiasis) obstructing the cystic or common bile duct (bile flow from gallbladder to duodenum)
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What is bile used for?
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-digestion of fats
-produced in liver and stored in gall bladder |
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Cholecystitis can be?
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-acute or chronic
-can also obstruct pancreatic duct |
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Risk factors for Cholecystitis?
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-Female
-High-fat diet -Obesity (impaired fat metabolism; high cholesterol lvls) -Genetic predisposition -Older than 60 yrs of age (more likely to develop gallstones) -Individuals w/type 1 diabetes mellitus (high triglycerdies) -Low calorie, liquid protein diets -Rapid weight loss (increases cholesterol) |
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Triggering factors of Cholecystitis?
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-Trauma
-Surgery -Coronary events -Diabets -Fasting -Immobility -Hormone replacement Thereapy (HRT) -Pregnancy |
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Cholecystectomy?
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-removal of gallbladder w/laproscopic or open approach
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Attack of cholecystitis "gallbladder attack" characteristics?
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-Sharp pain in R upper quadrant of abdomen often radiating to right shoulder
-Pain with deep inspiration -Intense pain (increased HR, pallor, diaphoresis) after ingestion of high fat food -Rebound tenderness -Nausea, Anorexia, vomiting -Dyspepsia, eructaion (belching), flatulence -Fever -Jaundice, clay colored stools dark urine, stetorrhea (fatty stools), prutitus (accumulation of bile salts in skin) maybe be seen in cholectysitis due to bilary obstruction |
