Adult Health - Module 9

Question 1

Lack of Peristalsis

Answer 1

Absent bowel sounds for 5 minutes in each quadrant

Question 2

Sunken abdomen indicates

Answer 2

Malnutrition

Question 3

Rebound tenderness indicates

Answer 3

Peritoneal irritation

Question 4

RUQ pain indicates

Answer 4

Acute cholecystitis

Question 5

Upper middle pain indicates

Answer 5

Acute pancreatitis

Question 6

RLQ pain indicates

Answer 6

Acute appendicitis

Question 7

LLQ pain indicates

Answer 7

Acute diverticulitis

Question 8

GI Labs

Answer 8

CMP (Complete metabolic panel)
CBC
Liver Enzymes
Pancreatic Enzymes
Stool culture

Question 9

CMP

Answer 9

Complete metabolic panel. Check K+, Na+, Mg+, BUN, Creatinine.

Question 10

Liver Enzymes

Answer 10

AST, ALT, alkaline phosphatase

Question 11

Pancreatic enzymes

Answer 11

Amylase/Lipase

Question 12

Normal lab values for Liver Enzymes

Answer 12

AST: 0-35 units/L
ALT: 4-36 units/L
ALP: 30-120 units/L

Question 13

Normal lab values for Pancreatic Enzymes

Answer 13

Amylase: 6.6-35.2 units/kg
Lipase: 0-160 units/L

Question 14

Stool culture purpose

Answer 14

Assess blood, mucus, WBC, or parasites in feces.

Question 15

Which disease is diagnosed with stool sample?

Answer 15

C-dif.

Question 16

Upper GI diagnostic tests

Answer 16

Fluoroscopy and X-ray.

Interventions: Contrast Medium and patient should be NPO for 8 hours. Educate that stool may be white for 72 hours

Question 17

Lower GI diagnostic tests

Answer 17

Fluoroscopy of colon and X-ray to find polyps, tumors, and lesions.
Interventions: Uses Contrast medium and administer laxatives/Barium enemas to clear the bowels. Elderly/Immobile do not tolerate this type of test well.

Question 18

Abdominal Ultrasound

Answer 18

Identify size/configuration of organs, gallstones, and appendicitis.
Interventions: NPO for eight hours

Question 19

CT scan

Answer 19

Combo of X-ray machines/diff depth exposure.
Interventions: Iodine sensitivity and educate patient that contrast will make them warm and feel like they peed their pants.

Question 20

MRI

Answer 20

Noninvasive and uses radiofrequency and magnetic waves to detect metastasis, bleeding, and distinguish tumors.
Interventions: SCREEN FOR METAL. obtain screening form

Question 21

Endoscopy tests

Answer 21

EGD/Colonoscopy. Patients receive MAC

Question 22

EGD

Answer 22

Gives direct visualization of Esophagus Gastrium Duodenum (EGD).
Interventions: Signed consent, educate about anesthetic in throat/sedation to insert scope. After procedure, NPO until gag reflex returns and check vitals (sudden spike of temp indicates perforation which is LIFE THREATENING)

Question 23

Colonoscopy

Answer 23

Direct visualization of the colon.
Interventions: Laxatives/enemas, NPO, and educate about sedation with scope inserted in rectum. After procedure, Check rectal bleeding, perforation, and vitals.

Question 24

PUD

Answer 24

Peptic ulcer disease. Erosion of the mucosal surface and 80% are duodenal.

Question 25

PUD causes

Answer 25

H. Pyloria and NSAIDs-induced injury

Question 26

PUD assessment

Answer 26

Anxiety, tenderness, pain, N/V and possible bleeding

Question 27

PUD diagnosis

Answer 27

Endoscopy. CBC, Liver enzymes (amylase), stool studies

Question 28

PUD interventions

Answer 28

DO NOT TAKE ASPIRIN/NSAIDS

Question 29

PUD meds

Answer 29

Analgesics, H2 receptors, Antacids, Sulcralfate (short term use to protect stomach lining), and antibiotics (ONLY if caused by H. pylori)

Question 30

GERD symptoms

Answer 30

Dyspepsia, heartburn, hypersalivation, chest pain

Question 31

GERD diagnosis

Answer 31

Barium swallow, endoscopy

Question 32

GERD meds

Answer 32

Anti-ulcer, PPI/H2RA

Question 33

GERD diet

Answer 33

Avoid fatty foods, chocolate, alcohol, mints, and citrus.

Question 34

Nissen Fundoplication

Answer 34

Antireflux surgery in GERD to restructure the stomach. Uses fundus to wrap around.

Question 35

Hiatal hernia

Answer 35

Distorted intrathoracic pressure causing reflex

Question 36

Hiatal hernia diagnosis

Answer 36

Barium swalow, Upper GI X-ray (visualize lower esophagus). 90% are sliding hiatal hernias in which the stomach slides into the thoracic cavity.

Question 37

Hiatal hernia symptoms

Answer 37

similiar to GERD. Heartburn, pain

Question 38

Hiatal hernia meds

Answer 38

Antiulcer, PPI's, H2RA, and antacids (to remove ulcers).

Question 39

Hiatal hernia diet

Answer 39

Same as GERD. Avoid fatty foods, chocolate, alcohol, but adding on CAFFEINE.

Question 40

Upper GI bleed symptoms

Answer 40

Hematemesis (vomiting blood/coffee ground), Hematochezia (bright red stool with unstable VS) and Melena (black, tarry, foul-smelling stool).

Question 41

Upper GI bleed diagnosis

Answer 41

``` H/H not best indicator even though its bleeding. Instead, primary source is endoscopy occult blood stool testing, increased BUN (from blood digestion) CBC, PT/INR Serum electrolytes Liver Enzymes Type and Cross Match ```

Question 42

Upper GI bleed interventions

Answer 42

IV/blood products for volume loss, NG tube to monitor. Monitor I/O, ECG, and mucous membrane assessment. AVOID ASPIRIN/NSAIDS

Question 43

Rolling hernia

Answer 43

Fundus forms pocket/esophagus.

Question 44

Mechanical vs Nonmechanical Obstruction

Answer 44

Mechanical: Occlusion of intestinal lumen (hernia/tumor) Nonmechanical: Neuromuscular disorder (Paralytic illeus, peritonitis)

Question 45

Antibiotic meds for Small bowel obstruction

Answer 45

Flagyl/Cipro

Question 46

Small bowel obstruction Interventions

Answer 46

NPO, Ng tube to empty stomach, antibiotics (Flagyl/Cipro), Surgery, antiemetics, AMBULATION