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Nurs 216 > elimination > Flashcards

elimination Flashcards

1
Q

what is elimination

A

excretion of waste products. Passage of stool through the intestinal tract & dispelling by intestinal smooth muscle contraction

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2
Q

h2 receptor antagonist function & suffix

A

h2 receptor found on parietal cells, receptors blocked and hcl production decreased
-dine

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3
Q

ranitidine

A

zantac, crosses BBB

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4
Q

cimitidine

A

tegamet

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5
Q

famotidine

A

pepcid

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6
Q

PPI

A

bind to H+ K+ ATPase to inhibit proton pumps, decreasing HCL secretion
more efficacy than H2 receptor blockers, longer half-life than H2 receptor blockers

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7
Q

omeprazole

A

losec

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8
Q

iansoprazole

A

prevacid

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9
Q

pantoprazole

A

pantaloc

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10
Q

antacids

A

alkaline agents which increase stomach PH

only use 2 hrs post/pre other PO meds

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11
Q

Aluminum hydroxide and s/e

A

amphojel

s/e: constipation

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12
Q

Magnesium hydroxide & s/e

A

milk of magnesium

s/e: diarrhea

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13
Q

Calcium carbonate

A

tums

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14
Q

small intestine fx & parts

A

fx: absorption of nutrients
parts: duodenum, jejunum, ileum (longest)

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15
Q

large intestine fx & parts

A

fx: reabsorption of water
parts: ascending colon, transverse colon, descending colon, sigmoid colon

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16
Q

protein absorption

A

happens in stomach and pancreas by gastric pepsin and pancreatic enzymes. creates amino acid chains (peptides)

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17
Q

Carbohydrate absorption

A

by amylase (mouth), pancreatic enzymes (pancreas), and brush border enzymes (small intestine)

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18
Q

fat absorption

A

by lingual lipase (mouth), bile (gall bladder), pancreatic lipase (pancreas)

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19
Q

diarrhea definition & causes

A

excessively frequent passage of loose or unformed stool
can be caused by: infectious organisms, food intolerances, intestinal disease, drugs
increased transition time, is a symptom

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20
Q

diarrhea complications

A

electrolyte imbalance, dehydration, malabsorption

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21
Q

Acute diarrhea types

A

inflammatory & non-inflammatory

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22
Q

Inflammatory diarrhea types

A

infectious & fever

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23
Q

infectious inflammatory diarrhea

A

caused by pathogenic invasion of intestinal cells, mostly affect colon

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24
Q

fever inflammatory diarrhea

A

causes urgency and tenesmus, left lower quadrant pain, can cause dehydration

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25
Q

non-inflammatory

A

watery stools, disruption of normal absorption secretory process.
periumbilical cramps, bloating, nausea & vomiting
can cause dehydration

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26
Q

travelers diarrhea

tx

A

infectious inflammatory diarrhea

must treat infection first (ciprofloxacin) & manage diarrhea symptoms as needed

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27
Q

ciprofloxacin (PO) - bioavailability, site of action, metabolism, excretion

A

70% bioavailable, binds directly to bacteria in GI, phase 1 metabolism produces active metabolites (less potent than drug) & cyp inhibition slowing metabolism, renal and some biliary excretion

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28
Q

is C.difficile gram + or -

A

gram +

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29
Q

C.difficile virulence factors

A

multiplies quickly, produces spores (must wash hands, not sanitize), release enterotoxin and cytotoxin

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30
Q

C.difficile how it affects body

A

destroys intestinal lining

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31
Q

C.difficile s&s

A

severe diarrhea, blood-pus in stool, fever, abdominal pain

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32
Q

C.difficile causes

A

nosocomial, long-term antibiotic tx, common in elderly

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33
Q

C.difficile tx

A

1st line- flagyl (PO)

2nd line- vancomycin (PO)

34
Q

probiotics

A

good bacteria in your body that restores and protects normal flora

35
Q

lactobacillus acidophilus fx

A
  • a probiotic

- destroys other bacteria by secreting toxic hydrogen peroxide, protects & restores normal flora

36
Q

best choice probiotics

A
  • BioK plus

- foods like yogurt

37
Q

antidiarrheals

A

combination of opioid + atropine

38
Q

how do opioids affect diarrhea

s/e

A

drugs bind to MU2 receptor in GI, decreasing peristalsis causing constipation
-s/e: CNS depression

39
Q

atropine

A

antimuscarinic- blocks parasympathetic system, stimulates sympathetic drive

40
Q

antidiarrheal meds

A
  • dyphenoxylate

- loperamide HCL

41
Q

dyphenoxylate

A

dypehnoxylate + atropine

brand name is lomotil

42
Q

loperamide HCL

A

meperidine (demerol) + atropine

brand name is imodium

43
Q

rehydration in hospital

A

isotonic IV solution. check serum sodium & sodium electrolytes

44
Q

rehydration at home

A 
rehydration solutions (gastrolyte, pedialyte)
or mixture of 1 L water + 80 mL glucose + 7 mL salt
45
Q

chronic diarrhea

A

associated w. chronic GI diseases (IBD, IBS, malabsorption syndrome, endocrine disorders, radiation colitis

46
Q

osmotic diarrhea

A

happens when water is pulled into bowel by hyperosmotic contents & colon is unable to absorb excess fluid

47
Q

secretory diarrhea

A

happens when cells lining the intestine secrete more fluid than they absorb

48
Q

IBS diarrhea s&s

A

abdominal cramps, bloating, diarrhea/constipation

49
Q

IBS diarrhea pathophysiology

triggers

A

CNS dysregulation of normal motility,

-stress, diet, menstruation, food intolerances

50
Q

constipation transition time

A

slow

51
Q

constipation dietary causes

A

due to fibre intake and decreased water

52
Q

constipation peristalsis causes

A

due to alterations in peristalsis or intestinal innervation impacting colonic motor function

53
Q

hirschsprung disease

A

occurs when parasympathetic ganglion in intestinal walls don’t develop before birth, affecting colonic motor function

54
Q

constipation tx

A

laxatives

55
Q

5 types of laxatives

A

bulk-forming, softeners, saline & osmotics, stimulants, & miscellaneous

56
Q

bulk-forming

A

pull water and add bulk into stool

57
Q

psyllium (metamucil) moa, onset, use

A

fiber pulls water and adds bulk to stool, 1-3 days onset, used in nursing homes

58
Q

softeners

A

pulls water and fat into stool

59
Q

docusate sodium (colace) fx, uses

A

promotes good renal function for excretion & decreased straining
post MI and post surgery

60
Q

saline & osmotic

onset

A

pull water into stool

potent, 1-3 hr onset

61
Q

milk of magnesium

A

saline & osmotic laxative, pulls water into stool, renally excreted

62
Q

lactulose

moa

A

doesn’t cure problem, improves mental state

decreases ammonia in blood

63
Q

stimulants

A

increase peristalsis NOT FIRST CHOICE

64
Q

miscellaneous

A

adjunct tx w/ constipation

65
Q

cathartic

A

enema

66
Q

enema

s/e

A

expansion of bowel, easy evacuation.
water & electrolyte combination
s/e can effect host flora so not used often.

67
Q

bloating

tx & ex

A

gas

tx: enzymes to increase carbohydrate digestion (gasex)

68
Q

vomiting pathophysiology

A

vomiting centre in medulla ( outside BBB) stimulated by abdominal muscles, GI tract, or ingested toxins, vestibular stimulants (equilibrium)

69
Q

reasons for N & V

tx

A

overeating, infection, medication, emotions & smells, pain

tx is specific to the trigger causing it

70
Q

N&V stimulus: motion induced (1)
target
MOA
Meds

A

target: H1 receptor (antagonist)
MOA: reduce vestibular excitiation
Meds: Dimenhyrdrinate (gravol), diclectin, ginger gravol

71
Q

Dimenhydrinate

A

gravol. used for motion induced nausea, reduces vestibular excitation

72
Q

ginger gravol

s/e

A

used for motion induced nausea. decreases peristalsis in intestines
s/e: OD can cause bleeding, CNS depression

73
Q

N&V stimulus: motion induced (2)
target
MOA
Meds

A

target: antimuscarinic anticholinergics
MOA: reduce vestibular excitation
Meds: scopolamine

74
Q

scopolamine

A

used for motion induced nausea. binds to receptors in parasympathetic NS and sometimes H1 receptors.
given transdermal, PO or IV

75
Q

N&V stimulus: GI pain
target
MOA
Med class & ex

A

targets: D2 receptor (antagonists)
MOA: increases GI motility (increase stomach empyting)
med class: phenothiazines
ex: metoclopramide, prochlorperazine

76
Q

N&V stimulus: drug induced & chemo tx; visceral pain
target
Meds
MOA

A

target: 5HT3 serotonin (antagonist)
Meds: ondansetron
MOA: blocks serotonin so stops vomiting and nausea

77
Q

metoclopramide

A

used for GI pain nausea. binds to D2 receptor and antagonizes causing increased GI motility

78
Q

prochlorperazine

s/e

A

used for GI pain nausea. binds to D2 receptors in brain increasing GI motility
s/e: sedation

79
Q

ondansetron

A

used for drug induced or chemotherapy induced nausea. drug binds to 5HT3 serotonin receptors blocking serotonin from binding and promoting nausea

80
Q

dronabinol

A

used for nausea caused by chemotherapy of chronic diseases. binds to receptor which stimulates GABA (makes action potential hard)

81
Q

nabilone

A

more potent than dronabinol

Nurs 216 (6 decks)

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