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Acute Care > GI > Flashcards

GI Flashcards

1
Q

What is included in the upper GI?

A 
mouth
pharynx
esophagus
stomach
duodenum
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2
Q

What is included in the lower GI?

A

small intestine
large intestine
rectum/anus

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3
Q

What are the accessory organs of the GI system?

A 
teeth
tongue
salivary glands
liver
gall bladder
pancreas
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4
Q

List the diagnostic studies for GI, hepatic, biliary, pancreatic, and splenic systems (7)

A 
Laparoscopy
Barium swallow
Modified barium swallow study
Endoscopy
Endoscopic retrograde cholangiopancreatography (ERCP)
GI bleeding scan (scintigraphy)
Upper GI series
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5
Q

Describe a laparoscopy and what it is used for

A
  • insertion of a laparoscope into the abdominal cavity
  • uses a small incision and local anesthetic
  • can be diagnostic or therapeutic
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6
Q

Describe a barium swallow study and what it is used for

A
  • patient swallows barium liquid while XR and fluoroscopic images examine swallowing and peristalsis of esophagus
  • used to ID pathologic conditions of the esophagus (propulsion of liquid through esophagus into stomach)
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7
Q

Describe a modified barium swallow study and what it is used for

A
  • used to diagnose dysphagia

- analyzes oral, pharyngeal, and upper esophagus

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8
Q

Describe endoscopy

A

insertion of endoscope into digestive tract (esophagus, stomach, small intestines)

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9
Q

Describe ERCP and what it is used for

A

Endoscopic retrograde cholangiopancreatography

- uses endoscopy and fluoroscopy to diagnose and treat gall bladder, biliary system, pancreas, and liver problems

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10
Q

Describe what GI bleeding scans (scintigraphy) are used for

A

to determine the presence/source of GI bleeding

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11
Q

Describe what an upper GI series is used for

A

to identify the disorder of the esophagus, stomach, and duodenum

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12
Q

What is a small bowel series used for?

A

to visualize the jejunum and ileum

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13
Q

What are the common lab values associated with the liver?

A 
ALT
ALP
AST
albumin
bilirubin
ammonia
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14
Q

What are the common lab values associated with pancreatic function?

A

lipase
amylase
sweat test

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15
Q

Name the different health conditions that affect the GI system (15)

A
  • Dysphagia
  • GERD
  • PUD
  • Dumping syndrome
  • Upper GI bleed
  • Lower GI bleed
  • Diverticular disease
  • Hiatal hernia
  • Abdominal hernia
  • Crohn’s disease
  • Ulcerative colitis
  • Morbid obesity
  • Encephalopathy
  • Cholecystitis
  • Cholelithiasis
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16
Q

Describe dysphagia, its causes, diagnosis, and treatment

A 
difficulty swallowing (oropharyngeal or esophageal)
Dx:
- MBSS
- endoscopy
- CT
- MRI
Causes:
- neurological conditions (stroke/TBI)
- dementia
- myasthenia gravis
Tx:
- airway protection
- nutritional support
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17
Q

Describe GERD, its SxS and treatment

A 
backflow of gastric acid into the esophagus
SxS:
- heartburn
- regurgitation
Tx:
- diet modification
- weight loss
- PPIs
- H2 blockers
- Nissen fundoplication
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18
Q

Describe PUD, its causes, SxS, and Tx

A 
ulceration in the stomach or duodenum
Cause:
- H. pylori infection
- NSAIDs
SxS:
- hunger-like sensation
- nocturnal pain
Tx:
- lifestyle modifications
- PPIs
- antibiotics
- no NSAIDs/aspirin
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19
Q

Describe Dumping Syndrome, its causes, the types, and treatment

A 
enhances gastric emptying and interrupts normal digestive sequence
Causes:
- GI surgeries (gastrectomy, gastric bypass surgery, PUD surgery, Nissen fundoplication)
Types:
- early DS
- late DS
Tx:
- dietary changes
- medication
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20
Q

Describe Early Dumping Syndrome

A 
occurs within 30 minutes of a meal
SxS:
- palpitations
- tachycardia
- flushing
- diaphroesis
- syncope
- abdominal symptoms like cramping and bloating
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21
Q

Describe Late Dumping Syndrome

A

occurs 1-3hrs after a meal
SxS:
- consistent with hypoglycemia

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22
Q

Describe upper GI bleed and its causes

A 
bleeding that occurs in the stomach, esophagus, or duodenum
Causes:
- ulcers
- gastric erosion
- gastric/esophageal varices
23
Q

Describe a lower GI bleed and its causes

A 
a bleed that occurs in the colon and anorectum
Causes:
- IBS (diverticulitis)
- ischemic colitis
- anal and rectal lesions (hemorrhoids)
- ulcerate polyps
- colorectal cancer
24
Q

What are the SxS of a GI bleed?

A
  • hematemesis
  • hematochezia
  • melena
25
Q

How is a GI bleed treated?

A
  • IV fluids
  • blood transfusions
  • management of causative factors
26
Q

Describe the SxS and treatment for diverticular disease

A 
SxS:
- LLQ pain
- polyuria
- fever
- elevated WBCs
- constipation
- NV
Tx:
- diet modification
- clear liquids
- IV fluids
- pain meds
- antibiotics
- surgery (abscess drainage, colectomy)
27
Q

Describe a hiatal hernia, its SxS, and treatment

A 
a protrusion of abdominal structures upward through the esophageal hiatus
SxS:
- heartburn-like pain
- dysphagia
- chest pain
- dyspnea
- hoarsness
Tx:
- behavior modifications
- eating small/frequent meals
- bland food with high fiber
- acid-reducing medications
- laparoscopic repair
28
Q

Describe an abdominal hernia, its SxS and treatment

A 
a protrusion of bowel that is classified by location of protrusion
SxS:
- abdominal distension
- NV
- position changes with increased abdominal pressure (laughing, coughing)
- pain
- paresthesia
Tx:
- monitor asymptomatic cases
- symptomatic --> surgical repair
- possible temporary colostomy
29
Q

Describe Crohn’s disease

A

an idiopathic inflammatory bowel disease that can occur anywhere in the GI system
- most common in the terminal ileum and proximal colon

30
Q

What are the causes of Crohn’s disease?

A
  • genetics
  • immune dysregulation
  • infectious agents
  • psychological issues
  • environmental factors
31
Q

What are the SxS of Crohn’s disease?

A
  • abdominal cramping
  • RLQ pain/mass
  • diarrhea
  • weight loss
  • fatigue
  • low grade fever
32
Q

What are the treatments for Crohn’s disease?

A
  • corticosteroids
  • antibiotics
  • immunosuppressants
  • nutritional support
33
Q

What are some complications that may occur due to Crohn’s disease?

A
  • intestinal obstruction
  • inflammation of membranes
  • arthritis
  • ankylosing spondylitis
  • gallstones
  • vitamin B12 deficiency
  • thromboembolism
34
Q

Describe Ulcerative colitis and its causes

A

an idiopathic inflammatory bowel disease that occurs in the mucosal layer of the rectum and proximal colon
Causes:
- not well known but appear similar to crohn’s disease (genetics, immune dysregulation, infectious agents, psychological issues, environmental factors)

35
Q

What are the SxS of ulcerative colitis?

A
  • lower abdominal pain relieved by defecation
  • bloody stools
  • diarrhea
  • incontinence
  • nocturnal defecation
  • fatigue
  • weight loss
  • dehydration
36
Q

What are the treatments for ulcerative colitis?

A
  • anti-inflammatory meds
  • immunosuppressants
  • biologics
  • diet modification
  • surgery
  • monitoring for colon cancer
37
Q

Describe morbid obesity and what should be monitored

A

a chronic disease characterized by excessive body fat and BMI of 30 or higher.
- many comorbidities are linked with morbid obesity
Monitor:
- exercise tolerance (BP, HR, RR)
- skin inspection
- weight limits for equipment

38
Q

What are the different treatments for morbid obesity?

A 
Conservative tx:
- weight loss (goal: 10% reduction)
- diet modification
- medication
- behavior management
- increased physical activity (better outcomes)
Surgical Tx: (BMI>40)
- gastric bypass
- gastric banding
- gastroplasty
- gastrectomy
39
Q

Describe encephalopathy, its causes, symptoms, and treatment

A 
Causes:
- acute/chronic liver disease
SxS:
- impaired mental status and NM dysfunction that occurs over hours to days
- altered consciousness (mild to coma)
- ammonia intoxication
- changes in cerebral blood flow
Tx:
- reduce ammonia levels
- correct electrolyte imbalance
- antibiotics
- nutritional support
- liver transplant
40
Q

Describe cholecystitis, its symptoms, and treatment

A

acute or chronic inflammation of the gall bladder
SxS:
- RUQ pain that may radiate to R shoulder
- abdominal rebound tenderness (Murphy’s sign)
- jaundice
- NV
- fever
Tx:
- laparoscopic cholecystectomy

41
Q

What is the only difference between cholecystitis and cholelithiasis?

A

Cholelithiasis is gallstone formation
and
cholecystitis is inflammation of the gall bladder

42
Q

List the GI surgical procedures (8)

A
  • laparotomy
  • laparoscopy
  • appendectomy
  • cholecystectomy
  • colectomy
  • gastrectomy
  • splenectomy
  • colostomy
43
Q

Describe a laparotomy

A 
an open surgery of the abdomen to explore and repair tissues
Standard incision: midline
Used for:
- situations involving multiple dense adhesions
- grossly distended intestines
- massive ascites
- severe bleeding
- blunt and penetrating trauma
44
Q

Describe a laparoscopy

A
  • a short, narrow tube is inserted into the abdomen through a small (<1cm) incision (trochar)
  • surgical tools are inserted through the trochar to perform surgery
  • high resolution provide visual area of interest
  • less invasive, faster recovery time, shows better QOL outcomes
45
Q

What is an appendectomy?

A

removal of the appendix

46
Q

What is a cholecystectomy?

A

removal of the gall bladder

47
Q

What is a colectomy?

A

resection of a portion of the colon

- usually involves a colostomy or ileostomy

48
Q

What is a gastrectomy?

A

removal of whole or part of the stomach

49
Q

What is a splenectomy?

A

removal of the spleen

50
Q

What is a colostomy?

A

a procedure that reroutes stool from diseased colon to an external bag

51
Q

What are the types of colostomy?

A
  • end colostomy
  • double barreled colostomy
  • loop colostomy
52
Q

What should be checked when working with a patient with a colostomy bag?

A
  • make sure it is securely closed before interventions
  • keep covered for pt dignity
  • empty bag if full
53
Q

What are PT considerations for GI issues?

A
  • patient positioning for comfort
  • increased fatigue is likely
  • be aware of dietary restrictions
  • Avoid Valsalva. (varices may rupture with increased abdominal pressure)
  • ascites hinders effective coughing and restricts adequate ventilation
54
Q

List the important positioning tips/techniques

A
  • sidelying decreases tension on surgical site
  • have pt flx knees while lowering HOB to decrease tension on abdomen
  • supine may aggravate dysphagia and GERD
  • splinting should be done during mobility/coughing

Acute Care (11 decks)

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