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Gastrointestinal Flashcards

(74 cards)

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1
Q

pyloric sphincter

A

closes to keep food in the stomach, and opens to send food into the small intestine

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2
Q

small intestines

A

receive digestive enzymes from pancreas and liver, make food into chyme and absorb nutrients

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3
Q

liver functions

A

produce bile, albumin, cholesterol, converts glucose to glycogen for storage, converts ammonia to urea, metabolizes bilirubin in the breakdowns of RBCs, metabolizes drugs and toxins, produces clotting factors and regulates blood clotting

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4
Q

gallbladder

A

stores and releases bladder into small intestine

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5
Q

pancreas

A

regulates blood sugar, and produces and releases digestive enzymes; trypsin, amylase, lipase (released into duodenum)

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6
Q

Large Intestine

A

absorbs water and electrolytes, produces and absorbs vitamins, forms and propels feces toward rectum for elimination

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7
Q

TPN

A

delivered intravenously, contains dextrose, amino acids, and electrolytes; central line is preferred

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8
Q

TPN complications

A

infection, fluid overload hypo/hyper-glycemia, embolism

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9
Q

if TPN runs out and you don’t have anymore what should you do

A

do not turn off suddenly, give dextrose 10% at same rate the TPN was running

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10
Q

TPN bag and tubing is changed every

A

24 hours

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11
Q

ondansetron nursing consideration

A

administer slowly, fast push can cause QT prolongation and VT

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12
Q

antiulcer agents include

A

H2 receptor blockers, PPIs, antacids, GI protectant

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13
Q

Famotidine

A

H2 receptor antagonist (antihistamine); blocks release of histamine which blocks acid secretion; separate this class from other medications as they are likely to interact

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14
Q

Famotidine use

A

short term tx of gastric and duodenal ulcers, GERD, hypersecretion of stomach acid conditions, chronic NSAID use

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15
Q

Omeprazole

A

PPI; GERD and ulcers, decreases gastric acid production; administer 30-60 minutes, report black, tarry stools

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16
Q

sucralfate

A

aluminum hyroxide and sucrose; promotes healing of ulcers by providing a barrier over them, short term tx of duodenal or gastric ulcers, peptic esophagitis, NSAID/ASA induced GI damage

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17
Q

surcralfate nursing considerations

A

take on empty stomach 1 hr before meals or 2 hours after and at bedtime (usually taken 4 times a day), don’t give within 30 min of antacids as it decreases effectiveness, monitor BG in diabetics as it contains sucrose

can decrease availability of warfarin, digoxin, phenytoin, levothyroxine and classes of abx - separate these drugs from sucralfate for at least 2 hrs

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18
Q

NG tube measurement

A

nose to ear to xiphoid process

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19
Q

blakemore tube

A

inserted through nose down esophagus and into stomach with balloons that can be inflated to stop bleeding esophageal varices

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20
Q

blakemore tube nursing consideration

A

must keep a pair of scissors at bedside in case of emergency; if inflate balloon becomes dislodged it can compress the trachea and cause respiratory arrest; if happens cut balloon port to let air escape

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21
Q

hold feeds if gastric residual is greater than

A

500ml

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22
Q

esophageal varices

A

dilated submucosal veins in esophagus, can burst and bleed; caused by liver disease and alcoholism tx: blakemore tube and surgery

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23
Q

GERD what is it and tx and complications

A

acid refluxes from stomach into esophagus causing esophagitis Tx: sit upright after eating, eat small frequent meals, H2 blockers and PPIs, complication: Barrett’s esophagus

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24
Q

Gastritis

A

inflammatory disorder of gastric mucosa; acute gastritis is associated with H.pylori and NSAID use

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25
gastritis S&S and tx
vague abdominal discomfort, epigastric tenderness, bleeding tx: healing occurs spontaneously within a few days, no NSAIDs, H2 receptor blockers, PPIs, abx if cause is H. pylori
26
Barrett's esophagus
reflux for extended period of time, acid has caused changes to cells of esophagus which are cancerous
27
Gastric ulcer S&S
pain 1-2 hrs after meals and gets worse when eating, abd pain aggravated by eating, vomiting, weight loss, hematemesis if hemorrhage occurs
28
Gastric ulcer tx
treat H.pylori infection with abx if this is the cause, reduce stomach acid with PPIs and H2 receptor blocks
29
duodenal ulcer S&S
pain 2-4 hrs after meals, food may relieve pain, weight gain, melena if hemorrhage occurs
30
duodenal ulcer tx
treat H.pylori infection with abx if this is the cause, reduce stomach acid with PPIs and H2 receptor blocks
31
primary action of PPIs is to
increase stomach pH or decrease amount of acid in the stomach
32
Crohn's disease
inflammation and erosion of the ileum and anywhere throughout the small and large intestines; affects any part of digestive tract from mouth to anus, skip lesions
33
ulcerative colitis
inflammation of large intestines, sigmoid colon and rectum, lesions are continuous (no skipped lesions) and are limited to the mucosa and are not transmural
34
Diverticula
herniation of mucosa through the muscle layers of the colon wall
35
diverticulosis
asymptomatic diverticular disease
36
diverticulitis
inflammatory stage of diverticulosis
37
possible causes of diverticular disease
decreased dietary fiber, abnormal neuromuscular function, alterations in intestinal motility, >60 yrs of age
38
diverticula disease S&S
rebound tenderness, cramping, diarrhea, vomiting, dehydration, weight loss, rectal bleeding, bloody stools, anemia, fever
39
diverticula disease tx
low fiber diet, avoid cold or hot foods, no smoking, antidiarrheals, abx, steroids, severe cases may require surgery and ostomy's
40
intestinal obstruction
any condition that prevents the flow of chyme through the intestinal lumen or failure of normal intestinal motility in the absence of an obstructing lesion
41
small intestine obstruction S&S
colicky pains cause by intestinal distention followed by n/v
42
large intestine obstruction S&S
hypogastric pain and abdominal pain
43
Appendicitis
inflammation of appendix, begins as a dull steady periumbilical pain, pain progresses an localizes to RLQ, sudden relief of pain may indicate rupture
44
Appendicitis S&S
RLQ pain, anorexia, increase temp and increased WBCs, nausea, McBurney's and Psoas sign
45
McBurney's sign
indicated when there is significant pain upon palpation of this area in the RLQ
46
Appendicitis tx
appendectomy; preop: no heat, position on right side low fowlers; postop: IV fluids, abx, pain management, NPO until return of bowel sounds, wound care
47
pancreatitis
inflammation of the pancreas, number one cause is alcoholism; digestive enzyme activation inside pancreas causes autodigestion of the pancreas
48
Pancreatitis S&S
pain (increases with eating), distention, ascites, abd mass, rigid abdomen, cullen's sign, Gray turner's sign, fever, n/v, jaundice, hypotension, increased WBCs and increase in serum lipase
49
cullen's sign
C shaped bruising above belly button
50
turner's sign
bruising along flank
51
cholelithiasis
gallstones, hardened deposits of bile in gallbladder caused by hyperlipidemia or hyperbilirubinemia
52
gallstone S&S and tx
sudden sharp RUQ pain, pain worsens and radiates to back and between shoulder blades, get worse at night or after fatty meal, n/v tx: cholecystectomy
53
cholecystitis
inflammation of gallbladder cause by infection, blocked bile duct, cholelithiasis
54
rupture of appendix can lead to
peritonitis
55
cholecystitis S&S and tx
fever, leukocytosis, rebound tenderness, and abdominal muscle guarding tx: pain management, fluids, fasting, abx if indicated
56
treatment for perforated gallbladder
immediate cholecystectomy
57
hepatitis
inflammation of liver that can lead to cirrhosis, caused by different viral infections and severe cases can lead to hepatic coma/encephalopathy
58
Hep A transmission, prevention, tx
contaminated food or water (fecal-oral) vaccination, hygiene, sanitation tx self limited
59
hep B
contact with infected body fluids (blood, semen, vaginal fluids) vaccination, blood screening, improved hygiene acute: supportive, chronic: antiviral therapy
60
hep C
contact with infected body fluids (IVDU, non sterilized medical equipment) screening, sanitary environment, sterile needles direct acting antivirals (DAAs)
61
hep D
contact with infected body fluids; can only get HDV if already infected with HBV blood screening, sanitary practices, HBV vaccine helps prevent HDV
62
hep E
contaminated food or water (fecal - oral) improved hand hygiene and sanitation supportive tx
63
chronic hepatitis includes
B, C, D
64
Hepatic coma/encephalopathy
increased ammonia levels due to inflammation of liver and it not being able to convert it to urea so it builds up
65
hepatic encephalopathy S&S
changes in LOC, neuromuscular disturbances, fetor (distinctive musty or sweet breath odor), sleep, mood, and speech problems
66
hepatic encephalopathy risk factors
high protein diet, infection, hypovolemia, hypokalemia, constipation, GI bleeding, drugs
67
hepatic encephalopathy tx
decrease ammonia - lactulose, abx, decrease protein in diet decrease fluid retention - potassium sparing diuretics avoid CNS depressants - can worse encephalopathy
68
cirrhosis
chronic disease of the liver marked by degeneration of cells, inflammation, and fibrous thickening of tissue, liver cells destroyed and replaced with scar tissue, this impairs blood flow to liver causing portal htn
69
causes of cirrhosis
alcoholism, hepatitis B, hepatitis C, diet
70
cirrhosis S&S
palpable firm liver, ascites, edmea, abd pain, bloating, dyspepsia, poor appetite, spider angiomas, jaundice, low serum albumin, high serum liver enzymes ALT and AST, anemia
71
anemia can occur in cirrhosis because
liver produces clotting factors, when not working properly becomes bleeding risk and bleeding/blood loss can lead to anemia
72
cirrhosis tx
paracentesis, strict I&Os, daily weights, be careful with drug doses (liver cannot metabolize as well; especially with narcotics and acetaminophen), antacids, vitamins, diuretics, low protein and sodium diet, bleeding precautions, skin care
73
avoid _____________ medication in liver pts
acetaminophen
74
___________________ drugs can worsen encephalopathy
benzodiazepines and opioids

NCLEX (23 decks)

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