11- GI And GU Flashcards
(69 cards)
1
Q
Define Digestion
A
Breaking down of large food particles into molecules
2
Q
Define absorption
A
Passage of molecules into blood and lymph
3
Q
Alimentary Canal parts (GI Tract) (7)
A
- Mouth
- Pharynx
- Esophagus
- Stomach
- Small intestine
- Large intestine
- Anus
4
Q
Accessory Organ parts (GI Tract) (6)
A
-Teeth
-Tongue
-Salivary glands
-Liver
Gall bladder
-Pancreas
5
Q
What 2 reasons are food important
A
Nutrients- Building and repairing damaged tissues
Energy- Glucose (food)+O2=Energy
6
Q
What are Gastoenterologists
A
Work on the Upper GI Tract
7
Q
What are Proctologist’s
A
Work on the Lower GI Tract
8
Q
Process of Digestion (6)
A
- Ingestion
- Secretion
- Mixing propulsion
- Mechanical and Chemical digestion
- Absorption
- Defecation
9
Q
Mechanical digestion types (3)
A
- Mastication (chewing)
- Peristalsis (contraction and relaxation)
- Churning (stomach and small intestine)
10
Q
Chemical digestion types (2)
A
- Series of catabolic reactions
- Bigger molecules break down into smaller molecules
11
Q
Layers of GI tract (Outer to Inner)
A
Mesentary Serosa Muscularis Submucosa Mucosa
12
Q
Role of the Peritoneum
A
Protect and encase organs
13
Q
Role of the salivary glands (2)
A
Produce saliva
Start digestion
14
Q
What system controls salivation
A
Autonomic nervous system
15
Q
What drug blocks salivation
A
Atropine
16
Q
Functions of the Esophagus
A
Pass food bolus to stomach by peristalsis
17
Q
What controls esophageal peristalsis
A
Medulla Oblongata
18
Q
How long does it take food to reach the stomach
A
4-8 seconds
19
Q
Functions of the stomach (4)
A
- Mixing and holding food
- Begin protein digestion
- Continue triglyceride digestion
- Convert food bolus to chyme
20
Q
Vomiting aka Emesiss
A
Forcible expulsion of Upper GI contents
21
Q
What 2 things stimulate emesis
A
- Irritation and distention of stomach
- Unpleasant nerve impulses
22
Q
What is a main function of the liver
A
Produce bile
23
Q
What are the 2 functions of Bile
A
- Decrease surface tension of fat
- Mies fat to increase surface area
24
Q
Function of the Gall Bladder
A
Stores and concentrates bile
25
What are 2 stool colors
Melena- Black (slow)
| Hematochezia- Red (rapid)
26
What constitutes a positive tilt test
20 bpm increase
| 10 BP decrease
27
Ominous GI assessment findings
- Abdominal distention
- Cullens sign
- Grey-Turners sign
28
General GI Treatment (2)
- Position of comfort
| - Manage pain/Nv
29
What is the drug of choice for abdominal pain
Meperidine (Demerol)
30
What are the 3 types of GI pain
Visceral
Somatic
Referred
31
What is Visceral pain and organ type
- Dull, not localized
- Hollow organs
- Ruptured hollow organs cause peritonitis
32
What is Somatic pain and organ type
- Sharp, localized
- Solid organs
- Ruptured solid organs cause bleeding
33
What is Referred pain
Pain that travels from the site of origin usually following peripheral nerves
34
What separates the Upper from Lower GI
Ligament of Treitz
35
Common causes of Upper GI bleeds
Esophageal vacancies
Gastroenteritis
Peptic Ulcers
36
Common causes of Lower GI bleeds
```
Colitis
Chrons Disease
Diverticulitis
Hemorrhoids
Bowel obstruction
```
37
What are peptic ulcers
Erosions caused by gastric acid
38
What is Gatritis
Pre-ulcerative state, stomach is inflamed, erosion has not yet occurred
39
What are the 2 types of Peptic Ulcers
Gastric
| Duodenal
40
Gastric Ulcer
| S/S
S/S
- LUQ pain
- Over 50 y/o
- Pain AFTER eating or AFTER physical activity
41
Duodenal Ulcer
| S/S
S/S
- LUQ pain
- 25 to 50 y/o
- Stomach pain RELIEVED by eating
- Pain can be caused by stress
42
What is a Peptic Ulcer and main causes (
Ulcers created due to erosion of stomach, esophagus or duodenum from excess gastric acid
Causes
- Helicobacter Pylori bacteria
- Chronic NSAID use
- Severe burns
- Trauma
43
What are Curlings ulcers
Ulcers as a result stress related to burns
44
What are Cushings ulcers
Ulcers caused by head injuries or brain tumors
45
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Acute Gastroenteritis
Explain
S/S
Causes
Treatment
```
Inflammation of the stomach and intestines
S/S- Rapid onset N/v, Fever, Diarrhea, Diffuse pain
Causes- Food allergies, Viruses, Bacteria, Parasites, Alcohol, Tobacco, NSAIDs
Treatment
- Antiemetics
- (Ortho)Vitals
- ECG
- Fluids if needed
46
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Esophageal Varices
Explain
S/S
Causes
Treatment
```
Pressure increase in blood vessels of esophagus and stomach
S/S- Upper GI bleed, Fatigue, Weight loss, Jaundice, other abd s/s, Chest pain
Causes- Portal HTN, Caustic ingestion, Hep C
Treatment
- ABC’s
- Suction
- Shock management
47
Mallory-Weiss Tear
S/S
Cause
Treatment
PARTIAL tear at the junction of the esophagus and stomach
S/S- Bleeding, epigastric pain, hematemesis, Melena
Cause- Prolonged vomiting causes severe increase in stomach pressure
Treatment
-Estimate blood loss
48
Boerhaave Syndrome
S/S
Cause
Treatment
Complete latitudinal tear through wall of esophagus, usually after large meal with alcohol consumption
S/S- SubCu emphysema, Resp distress, chest pain, fever
Cause-Forceful vomiting
Treatment
- Determine blood loss
- Auscultation
- Treat chest pain
49
Diverticulitis
S/S
Causes
Treatment
Inflammation of small pockets of the GI Tract
S/S- LLQ pain, Fever, Body Aches, N/v, Lower GI bleeding
Causes- Infection, Trapped food
Treatment
- Patient comfort
- Manage sepsis
- Supportive
50
Ulcerative Colitis
S/S
Causes
Treatment
Inflammation of the large intestine (colon), generalized, not in patches, damaging the lining
S/S- Lower quadrant cramp/spasm, Rectal mucous discharge, Rectal fullness (tenesmus)
Causes-Genetics, stress
Treatment
- Assess for shock
- Supportive
51
Hemorrhoids
S/S
Causes
Treatment
Swelling and inflammation of the vascular cushions surrounding the rectum, can result in lower GI bleeding, can be internal or external
S/S- Bright red blood with defecation, Itching, Small mass on rectum
Causes- Increased rectal pressure or Irritation, Straining stools, Chronic constipation, Anal sex, Diarrhea
Treatment
- Supportive
- Ensure hemodynamic stability
- Ortho static vitals
52
Appendicitis
Causes
S/S (3 stages)
Treatment
Inflammation of the veriform appendix from obstruction, usually in older kids or young adults, rupture can cause peritonitis
Causes- Fecal matter or other material accumulate in appendix
S/S
Early-Periumbilical pain, N/v, Loss of appetite
Ripe-McBurney point pain
Rupture-Decrease in pain/pressure, Rebound Tenderness
Treatment
- Assess for Septicemia/Septic Shock
- Fluid/Vasopressors as needed
- Manage pain and vomiting
53
Cholecystitis (+4 similar conditions)
Causes
S/S
Treatment
Inflammation of the Gall bladder
- Cholangitis; Bile duct
- Cholelithiaseis; Stones in gallbladder
- Choledocholithiases; Stone in common bile duct
- Acalculous Cholecystitis; Gall bladder inflammation w/o gallstone(s)
Causes-Decreased flow of biliary materials from Major Trauma, Sepsis, Sickle Cell, Prolonged fasting
S/S- RUQ PAIN AFTER FATTY/FRIED MEAL, Murphy Sign (Exhale, pressure intercostal RUQ, Inhale=Pain), N/v, Fever, JAUNDICE
Treatment
- Supportive
- Watch for vagal stimulation
- Manage pain, N/v
54
Pancreatitis
Causes
S/S
Treatment
Blocked tube that carries food breakdown enzymes, and they breakdown pancreas itself, causing inflammation
Causes- Excess alcohol, Medication reactions, Trauma, Cancer, High Triglycerides
S/S- Sharp/Severe epigastric pain, Distention, N/v, Fever, HypoT, Muscle spasms, Shock, Resp failure, Cullen Sign, Grey Turners sign
Treatment
- Assess for severe hemorrhage
- Treat for shock
- Watch and treat for respiratory failure
55
Hepatitis (A,B)
Causes (A,B,C,D,E)
S/S
Treatment
Inflammation or Viral infection of the liver
A- Enters liver, reproduces, leaves with feces, antibodies develop, immune for life
B- Highest fatality rate of Hep type, Greatest Hep risk to health care
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Causes-
A- Fecal to Oral
B- Injections or sexual contact
C- Through blood and bodily fluids
D- Type B first
E- Contaminated drinking water
```
S/S- JAUNDICE, Clay colored skin, Fever, N/v, Weak, Muscle pain, Dull RUQ tenderness, JVD, Ascites, Hepatomegaly
56
4 causes of Bowel Obstruction
- Hernia- Through abd wall
- Adhesion- Weblike bands of tissue (adhesions) contract diameter of intestine
- Intussusception- Intestine folds into itself reducing the lumen
- Volvulus- Torsion/knot of the intestine
57
Bowel obstruction
Causes
S/S
Treatment
Intestinal blockage inhibiting movement of contents in the intestine
Causes- Tumors, foreign body, previous surgery
S/S- VOMITING BOWEL, Absent bowel sounds, Abdominal distention, Feculent smelling breath, Diffuse pain, Shock
Treatment
- Supportive
- Fluids for dehydration
58
Anatomy of the urinary system (4)
- Kidneys
- Ureters
- Urinary bladder
- Urethra
59
Kidney filtration/Nephron steps (7)
- Afferent arteriole bings blood to Glomerulus
- Filtrates move to Bowmans capsule
- Travel down convoluted tubule
- Filtrate moves to descending loop of Henle into medulla (Water removal)
- Ascending loop of Henle and out of medulla (Na removal)
- Distal convoluted tubal, last big filtrates are removed
- Collecting ducts where last of water is removed
60
What is the cause of most renal emergencies
Changes in Glomerular Filtration Rate (GFR)
61
What do diuretics do
Make the medulla very salty
62
Renal Calculi
Causes
S/S
Treatment
Crystallized urinary salts held together by organic matter, form in urinary tract
Causes-HTN, UTI, Immobilization, HyperCa, Gout, Tumors
S/S- Moving pain from flank to groin, Worst pain ever, Painful/Frequent urination, Hematuria, Shock looking, TachyC, HyperT
Treatment
- ABC’s
- POC
- IV/Fluid
- Pain meds (Meperidine, Morphine)
63
Urinary Tract Infection (UTI)
Causes
S/S
Treatment
Normal flora bacteria enter urethra and grown, usually in sexually active females, can cause kidney infection (Pyelonephritis)
Causes- Listed above
S/S
Triad)1.PAINFUL urination, 2.FREQUENT urination, 3.DIFFICULTY urinating
Foul smelling urine, Restless, Changes in VS
Treatment
- ABC’s
- IV
- Consider analgesics
64
Acute Renal Failure
Causes
S/S
Treatment
Sudden decrease in filtration rate of glomeruli, and toxins accumulate
Causes- Reduced renal blood flow, Hypovolemia, Diabetes, Rhabdomyolysis, Chronic inflammation of interstitial nephron cells, Urine flow obstruction from kidneys
S/S- Impaired mentation, Edema, HyperK ecg, Shock like,
65
Urinary Rentention
Causes
S/S
Treatment
Inability to urinate
Causes: Benign prostate hypertrophy, Renal calculus, Narrowed ureter
S/S: Abd pain, Inability to urinate, Oliguria
Treatment: Supportive
66
Pyelonephritis
Causes
S/S
Treatment
Inflamed kidney parenchyma from microbial infection
(More common in women, pts w/ obstructive lesions along GI tract)
S/S: Flank pain, Fever, Chills, N/V
Treatment: Supportive, watch for sepsis
67
Chronic Renal Failure
Causes
S/S
Treatment
Permanent loss of nephrons, Irreversible
Causes: Congenital, Prolonged pyelonephritis, Diabetes, Hypertension
S/S: Uremic frost, Delirium, Muscle twitching, Thin extremities, GI problems, Altered LOC, Abnormal ABG’s
Treatment: IV kvo, ABC’s, Monitor, Vitals
68
Disequilibrium Syndrome (From Dialysis)
S/S
Treatment
Group of signs during or after dialysis
S/S: Usually mild can be severe
Treatment: Diazepam for seizures
69
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Air Embolism (From Dialysis)
Treatment
```
Negative pressure on venous side of tubing or malfunction can allow air embolism into blood stream
Treatment: High flow O2, Left lateral (Modified trendelenburg)
