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Gastrointestinal 2 Flashcards

1
Q

Discomfort in epigastric & back of throat with conscious desire to vomit

A

Nausea

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2
Q

Powerful ejection of gastric contents through mouth

A

Vomiting

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3
Q

N&V related to a disease

A

Pathogenic

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4
Q

N&V stemming from a disease treatment

Ex. Chemo

A

iatrogenic

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5
Q

N&V resulting from psychological state

A

psychogenic

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6
Q

vomiting is caused by what?

A

the stimulation the chemo-receptor trigger which stimulates the vomiting center in the medulla by some type of stimulus

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7
Q

vomiting can cause what kind of imbalance

A

metabolic alkalosis

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8
Q

diahrrea can cause what kind of imbalance

A

metabolic acidosis

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9
Q

what kind of nursing management should you do for a pt with N&V?

A

NPO until able to tolerate oral intake (once vomiting has stopped), HOB elevated to prevent aspiration, replace fluids/electrolytes, NG tube, mouth care, clean enviornment

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10
Q

what kind of electrolyte imbalance will happen with vomiting

A

hypokalemia

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11
Q

when is it best to give antiemetics

A

before vomiting starts

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12
Q

what kind of diet shuold be given to a pt with N&V

A

NPO, then effervescent fluids, bland foods, avoid fats

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13
Q

if a pt is post op what should you check for if your pt is vomiting

A

wound dehiscence

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14
Q

Rx’s for N&V are?

A

zofran, phenergan, reglan, CNS depressents

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15
Q

Reglan Rx does what

A

increases gastric emptying

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16
Q

Zofran and phenergan Rx does what

A

given to prevent nausea

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17
Q

inflammation in gastric mucosa

A

gastritis

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18
Q

hematoemesis

A

blood in vomit

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19
Q

how is gastritis diagnosed

A

H. Pylori testing & EGD

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20
Q

S/Sx of gastritis

A

malaise, N&V, hematemesis, epigastric pain, dyspepsia

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21
Q

recurrent inflammation of gastric mucosa, chief & parietal cells malfunction & disappear

A

chronic gastritis

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22
Q

what is associated with gastric cancer

A

chronic gastritis

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23
Q

S/Sx of chronic gastritis

A

N&V, indigestion, epigastric pain not relieved with antacids

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24
Q

Tx for chronic gastritis

A

avoid irritants, bland diet, B12 injections for pernicious anemia

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25
Q

if you have bright red blood in vomit it is from what

A

arterial

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26
Q

if you have slower oozing, dark emesis it is from what

A

venous or capillary

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27
Q

melena

A

tarry stools, slow bleeding from UGI

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28
Q

how long after the bleeding stops can you have blood in your stools

A

2-3 days

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29
Q

hematochezia

A

bright red blood in stool

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30
Q

how long after bleeding stops can you have a positive quiac test

A

8 days

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31
Q

possible causes of upper GI bleeding

A

NSAIDS, asa, steroids, esophageal varices, ulcers, cancer, clotting disorders, leukemia

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32
Q

what test can you do to show active bleeding

A

bleeding scan

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33
Q

what diagnositc test can you have for an upper GI bleed

A

endoscopy, barium swallow, CT, bleeding scan

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34
Q

Mallory Weiss tear

A

tear in mucosa near esopagogastric junction, from severe vomiting

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35
Q

a pt with a dupdenal ulcer may exhibit what?

A

melena

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36
Q

what treatment would you provide for a pt with an active upper GI bleed

A

VS for shock, IV fluids (LR, blood), foley cath, NG tube (saline lavage to clear out blood), O2

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37
Q

what Rx’s will help with a GI bleed

A

vasopressin, sandostatin, antacids, H2 blockers

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38
Q

an erosion of the GI mucosa resulting from digestive action of HCl and pepsin

A

peptic ulcer disease

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39
Q

where can peptic ulcer disease occur

A

any area of the GI tract but mostly inthe duodenum and stomach

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40
Q

difference between acute and chronic peptic ulcer disease

A

acute: superficial erosision minimal inflammation
chronic: erosiion through muscular layer, fibrosis & scar tissue form

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41
Q

peptic ulclers only develop in the presence of what

A

an acid enviornment and/or pepsin (begins the digestion of proteins) release

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42
Q

normal or increased acid secretinos/bile reflux duodenum

A

gastric ulcer

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43
Q

increased acid secretion from incrase parietal cell mass, hypersecretion occurs at unusually times (between meals & at night)

A

duodenal ulcer

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44
Q

S/Sx of peptic ulcer

A

burning/dnawing pain, pain worse on empty stomach, relieved by food but recurs within 3-4 hours, pain awakens patient at night (bc hypersecretion of acid)

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45
Q

Tx for peptic ulcer

A

physical and emotional rest, Rx, aviod stressors, nutritional therapy

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46
Q

what Rx neutralizes gastric acid

A

antacids

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47
Q

when should antacids be given

A

1-3 hours after meals & at bedtime

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48
Q

what Rx reduces HCl acid secretions by blocking the action of histamine on H2 blockers

A

H2 receptor antagonists (pepcid, zantac)

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49
Q

what Rx stops the secretion of HCl acid to raise pH of the stomach

A

proton pump inhibitor (protonix, prevacid, prilosec)

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50
Q

what Rx inhibits gastric secretions and decreases gastric motility (slows PNS)

A

anticholinergics

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51
Q

what is a side effect of anticholinergics

A

dry mouth, urinary retention

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52
Q

what Rx forms an adherent that covers the ulcer and protects from erosion

A

carafate

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53
Q

what Rx increases gastric motility & emptying (acid doest stay in contact with stomach as long)

A

reglan

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54
Q

Teaching for peptic ulcers

A

bland food, calm enviornment, no alcohol, ASA, stop smoking

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55
Q

what is the most common comlication of peptic ulcer disease

A

hemorrhage

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56
Q

what is the first sign of hemorrhage in peptic ulcer disease

A

hematemesis or melena

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57
Q

what is the most serious complication of peptic ulcer disease

A

perforation (hole)

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58
Q

involves spilling of gastroduodenal contents into peritoneal cavity causing peritonitis & septicemia

A

perforation of peptic ulcer

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59
Q

S/Sx of perforation

A

sudden onset of severe upper abdominal pain, rigid abd, absent bowel sounds, increase RR

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60
Q

Tx of performation

A

sugery, post op antibiotics

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61
Q

pt has ulcer located close to the pylorus, causes edema

A

gastric outlet obstruction

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62
Q

S/Sx of gastric outlet obstruction

A

abd pain which is releived by belching or self induced vomiting, vomit often contains food particles from days before

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63
Q

Tx for gastric outlet obstruction

A

surgery

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64
Q

Pronton pump inhibitors

A

reduce gastric acid secretions and promote ulcer healing

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65
Q

removal of 2/3rds of stomach and anastomosis of duodenum

A

billroth I

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66
Q

removal of 2/3rds of stomach and anastomosis of jejunum

A

billroth II

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67
Q

vagotomy

A

severing of vagus nerve, decreases gastric acid secretion

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68
Q

pyloroplasty

A

surgical enlargment of pyloric sphinctor to help with passage of contents from stomach to intestine

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69
Q

Post op gastric surgeries

A

DO NOT irrigate NG tube after surgery unless you have an order

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70
Q

how long post op of gastric surgery will you have bright red drainage

A

1-12 hours, return to mornal yellow green in 36 hours

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71
Q

rapid emptying of gastric contents into small intestines, occurs 15-30 minutes after meals

A

dumping syndrome

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72
Q

S/Sx of dumping syndrome

A

weakness, syncope, sweating, dizziness, cramps, diarrhea

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73
Q

Tx for dumping syndrome

A

small frequent meals, no fluids with meals (fluids will wash food through stomach quicker), no carbs

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74
Q

your pt has a loss of intrinsic factor

A

pernicious anemia

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75
Q

if your pt has pernicious anemia, what do they need

A

B12 shots once a month for life

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76
Q

what can occur after surgery on pylorus

A

alkaline reflux gastritis

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77
Q

what can be a side effect of dumping syndrome

A

postprndial hypoglycemia, due to release of excessive amounts of insulin into circulation

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78
Q

ulcer caused by generalized stress response resulting in decreased production of mucus and increased gastric acid secretions

A

curlings ulcer

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79
Q

gastric ulcer thats linked to intracranial pressure, stimulates vagal nerve, and increases gastric acid production, caused by trauma, operations or strokes

A

cushings ulcer

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80
Q

multiple small erosions caused by severe stress or trauma (burn pts)

A

stress ulcers

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81
Q

1st sign of stress ulcer

A

bleeding

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82
Q

Tx of stress ulcer

A

cautery or laser, if unable to control bleeding then surgery

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83
Q

what disease has severe peptic ulceration, gastric acid hypersecretion, elevated serum gastrin levels, and gastrinoma of pancreas or duodenum

A

Zollinger-Ellison syndrome

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84
Q

how is zollinger-ellison syndrome diagnosed

A

high serum gastrin levels, steatorrhea

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85
Q

Tx for zollinger-ellison

A

pancreatectomy (remove tumor), total or partial gastrectomy, H2 receptor antagonist

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86
Q

impairment of forward flow of intestinal contents caused by blockage

A

intestinal obstruction

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87
Q

where does intestinal obstruction mostly occur

A

ileum (narrowest part of small bowel)

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88
Q

what is the most common cause of small bowel obstruction

A

hernia

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89
Q

intestinal loop protrudes thru a weak segment of the abdominal wall

A

hernia

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90
Q

the slipping of one part of the intestine into another part just below it

A

intussusception

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91
Q

can hernias be life threatening?

A

yes they can cause necrosis of intestine

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92
Q

twisting of bowel on its self, twisted loop beomes strangulated

A

volvulus, EMERGENCY can occur within 6-12 hours

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93
Q

bezoar

A

foreign object stuck in bowel

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94
Q

what is key to prevent paralytic ileus 9neurogenic obstruction)

A

ambulation

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95
Q

in vascular obstruction what happens

A

occurs when the blood supply to bowel is disrupted, peristalsis stops and ischemia occurs quickly-its an EMERGENCY

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96
Q

S/Sx of obstruction

A

pain, abd distention, n&V

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97
Q

if you have a partial obstruction in your bowel what kind of stool will you have

A

liquid stool

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98
Q

if you have a complete obstruction in your bowel what kind of stool will you have

A

no stools

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99
Q

borborygmi

A

high pitched, tinkling sounds

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100
Q

during an intestinal obstruction what do your bowel sounds sound like

A

usually increase proximal to obstruction, within few hours, bowel becomes flassid & bowel sounds decrease

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101
Q

Dx of intestinal obstructions

A

increase of H&H, BUN (related to dehydration), decrease electrolytes, increase WBC

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102
Q

Tx of intestinal obstruction

A

surgical emergency, NPO, NG tube to relieve abd distention, fluid/electrolyte replacement, high mortality rate if not treated in 24 hours

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103
Q

what Rx do you want to avoid with a pt that has intestinal obstruction

A

morphine, bc causes spasms in large intestine

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104
Q

administration of nutrition thru tube inserted through stomach or small intestine (duodenum/jejunum)

A

enteral nutrition

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105
Q

who can not have enteral feedings

A

IBS, diverticulitis, bowel obstruction, GI hemmorhage

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106
Q

PEG tube is placed where

A

into the stomach

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107
Q

PEJ tube is placed where

A

jejunum (intraenteric)

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108
Q

are enteral feeding tubes prone to obstruction

A

yes when oral Rxs are not thoroughly crushed and dissolved in water

109
Q

which feeding tube is used for an extended time period

A

PEG

110
Q

when can feedings start

A

when bowel sounds are present

111
Q

Aspiration precautions for enteral feeding tubes

A

assess placement of tube Q4hr & b4 meals by aspirating, assess for residual volumes b4 meals & Q4hrs, maintain semi fowlers 30-45 minutes after feeding, irrigate tube with H2O after feeding,

112
Q

how is placement of enteral tubes checked

A

x ray

113
Q

continous drip (enteral feedings)

A

16-24 hours/day
use pump for constant flow
less regurgitation
increase absorption, nutrients

114
Q

intermittent drip (enteral feedings)

A

250-400 mL over 20-40 min 5-8 times/day
gravity or pump
allows freedom btwn meals

115
Q

bolus (enteral feedings)

A

rapid administration
similar to 2-3 meals/day
250-400mL given over a few minutes
poorly tolerated

116
Q

how long is a ready to hang set good for

enteral feedings

A

48 hours bc its a closed system

117
Q

how long is a top fil set good for

enteral feedings

A

24 hours (bc its an open system)

118
Q

what do you label with the enteral feedings

A

date and time when bag is hung

119
Q

perititis

A

inflammation of salivary gland

120
Q

when doing enteral feedings that else should you do for your pt

A

daily weights
I&O
frequent oral hygine to prevent perititis

121
Q

what are NG tubes used for

A 
decompress stomach or small intestine
admin of Rx or feedings
Tx of obstruction or bleeding site
obtain gastric contents for analysis
diagnose gastrointestinal motility or disease process
122
Q

which NG tube is only to be used on intermittent suction

A

levine or single lumen

123
Q

which NG tube decreases the chance of decompression of stomach and can be used on constant suction

A

salem, double lumen

124
Q

how do you check the patency of a NG tube

A

aspiration or irrigation with saline

125
Q

when irrigating an NG tube can you use water

A

NO saline only

126
Q

how do you measure for an NG tube

A

nose to ear to xiphoid process

127
Q

what should you lubricate the NG tube with

A

water soluble gel

128
Q

when the NG tube reaches the nasopharynx what shouldyou instruct the pt to do

A

lower head slightly to close trachea and open esophagus, have pt swallow water to aid with tube advancing

129
Q

what is the best way to confirm placement of NG tube

A

x ray

130
Q

when removing NG tube what should you ask the pt to do

A

hold breath to close epiglottis, gently and steadily withdraw the tube

131
Q

decompression of intestines in bowel obstruction

A

intestinal or nasoenteric tubes

132
Q

who does the insertion of intestinal tubes

A

MD

133
Q

when the MD has inserted an intestinal tube what must you instruct the pt to do

A

pt lie on right side for 2 hours, then supine with head elevated for 2 huors, then on left side for 2 hours, the tube is carried to the intstine by paristalsis

134
Q

with the removal of the intestinal tube, what should you do

A

remove 1-2 inches at a time, if the tube has reached the ileocecal valve, cut tube at nose and it will be removed by peristalsis via the rectum (poop it out)

135
Q

is irrigation of NG/intestinal tube included in I&O

A

yes

136
Q

when gastic surgery can you irrigate without a MD order or manipulate the tube

A

NO

137
Q

can you use lemon or glycerine swabs for oral care

A

NO

138
Q

what labs are for dehydration

A

BUN

139
Q

passage of frequent, loose, unformed stool

A

diarrhea

140
Q

large volume diarrhea

A

excess fecal water

141
Q

small volume diarrhea

A

without excess fecal water

142
Q

chronic diarrhea

A

at least 4 weeks, can be life threatening from dehydration/electrolyte imbalance

143
Q

Tx for diarrhea

A

replace fluid/electrolytes

Rxs to decrease motility

144
Q

BRAT diet

A

banana, rice, apple sauce, toast

145
Q

destroys bowels normal flora, permits overgrowth of c, diff

A

antibiotic related diarrhea

146
Q

found in some pts who are taking antibiotics, whitish membrane form over damaged areas of bowel

A

pseudomembranous colitis

147
Q

Dx of antibiotic related diarrhea

A

stool culture for c-diff

148
Q

tx of antibiotic related diarrhea

A

dc antibiotics, admin intestinal flora modifiers (yogurt, buttermilk), Rx (vanc, flagyl

149
Q

relaxation of external sphincter resulting in involuntary passage of stools

A

fecal incontinence

150
Q

what fluid replaces body fluids

A

saline 0.9%, isotonic

151
Q

what fluid has glucose, has few calories

A

dextrose, 170 calories

152
Q

what fluid has electrolyte replacement, has no dextrose so has no calories

A

LR

153
Q

what kind of diet should you give a pt with fecal incontinence

A

high fiber, high fluid diet

154
Q

retention or delay of fecal material in colon results in dry, hard stools

A

constipation

155
Q

What kind of diet should you give a pt with constipation

A

high fiber and increase fluids, avoid laxatives or enemas

156
Q

bulk forming agents-laxitive

A

absorb water, stimulates peristalsis
metamucil, benefiber
24 hours

157
Q

stimulant-laxitive

A

irritates colin wall to increase peristalsis
ex lax, correctol
12 hours

158
Q

stool softeners-laxative

A

lubricates intestinal tract and softens stoll
colace, mineral oil
8-72 hours

159
Q

saline and electrolytes-laxative

A

causes retention of fluid in intestinal lumen
golytely
15-30 minutes

160
Q

which laxative is the most abused

A

stimulants

ex lax, correcctol

161
Q

which laxative can cause kidney problems

A

saline and electrolytes

golytely

162
Q

a sympton associated with tissue injury

ex. abscess or rupture in abd, bowel obstruction, peritonitis, ovarian cyst rupture

A

acute abdominal pain

163
Q

TX of acute abd pain

A

ID & Tx cause

CT/ultrasound

164
Q

acute inflammation of vermiform appendix of cecum

A

appendicitis

165
Q

fecalith

A

stool is compacted in appendix

166
Q

if you have a pt with RUQ pain, and positive mcBurneys point what might your pt have

A

appendicitis

167
Q

pain felt when release of palpation

A

rebound tenderness

168
Q

tenderness between umbilicus & right anteriosuperior spine

A

McBurneys point

169
Q

when you suspect appendicitis what should you never do

A

apply heat to the abdomen (can cause rupture of appendix)

170
Q

if your pt has appendicitis what should you monitor for

A

symptoms of peritonitis

171
Q

inflammation of all or part of the surfaces of the abd cavity

A

peritonitis

172
Q

peritonitis

A

when you have drainage fromperforated or infected area that leaks into abd cavity

173
Q

S/Sx of peritonitis

A

increase RR, pain, rebound tenderness, muscle rigidity, abd distention, absent bowel sounds, fever, WBC elevated, hiccups (r/t irritated diaphragm)

174
Q

what should be your focus with peritonitis

A

fluid and electrolyte balance

175
Q

if you have a pt that is vomiting what shuold you do

A

NPO until vomiting has stopped

176
Q

inflammaiton of stomach and intestinal tract (small bowel)

A

gastroenteritis

177
Q

what are causes of gastroenteritis

A

bacteria, virus, parasite, food poisoning

transmitted by fecal-oral route

178
Q

what things can cause gastroenteritis

A

not washing hands, shellfish

179
Q

gastroenteritis of large bowel

A

dysentery

180
Q

what should you consider with gastroenteritis

A

contact precautions, fluid electrolyte imbalance

181
Q

chronic non infectious irritation caused by spasms of colon, no pathophysiologic changes in bowel

A

IBS (irritable bowel syndrome)

182
Q

mannings criteria for IBS

A

abd pain relieved by defecation
abd pain associated with stool changes
abd distention
presence of mucus with stool passage

183
Q

what is the most common symptom of IBS

A

intermittent crampy abd pain (lower quadrants)

due to spasms

184
Q

what is the most common digestive disorder seen in clinical practice

A

IBS

185
Q

what Rx is used to relieve pain in IBS

A

steroids

186
Q

Nursing care for IBS

A

low residue diet, steroids, mild relaxants (valium, xanax), anticholinergics (bentyl)

187
Q

anticholinergics

A

helps reduce spasms/cramping

Bentyl

188
Q

Ulcerative colitis

A

slow progressive lesion, starts in rectum and progresses to sigmooid colon to descending colon.

189
Q

S/Sx of ulcerative colitis

A

bloody, mucus diarrhea, LLQ colicky abd pain, fever, weakness, anemia
pt will have exacerbations and remisions

190
Q

toxic megacolon

A

bowel becomes inflammed & distended (transverse colon)

191
Q

fistulas

A

opening from one organ to another, one that is not supposed to be there
(usually with uterus, bladder or vagina. urine will look like stool in color)

192
Q

Tx for ulcerative colitis

A

bowel rest, combat infection, correct dyhydration

193
Q

diet for ulcerative colitis

A

high calorie, high protein, low reside, vit supplements

194
Q

can surgery cure ulcerative colitis

A

yes

195
Q

removal of entire colon and rectum with permanent ileostomy

A

proctocolectomy (for ulcerative colitis)

196
Q

crohns disease

A

chronic, inflammatory area seperated by normal tissue (skip lesions), can affect all areas of GI tract, thickened cowel wall, cobblestone apperance

197
Q

S/Sx of crohns disease

A

not often bloody, more pus and mucus, low grade fever, fistulas, intermittent diarrhea, crampy abd pain

198
Q

Rx for crohns disease

A

steriods, nutritional management

199
Q

is surgery curative for crohns disease

A

no, bc recurrence can occur in any area of bowel

200
Q

projection of mucosal surface of the bowel lumen

A

polyps (are pre cancerous)

201
Q

what type of polyp attaches to intestinal wall by stalk or stem

A

pedunculated

202
Q

what type of polyp attaches directly to wall, flat , broad based

A

sessile

203
Q

what type of polyp is larger, bleeds easily, premalignant

A

villous

204
Q

how do we diagnose cancer in polyps

A

colonoscopy with biopsy

205
Q

cancer of colon and rectum

A

3rd most common cancer, usually asymptomatic, metastasized to liver first, can have cancer for 8-10 years prior to diagnosis

206
Q

if you have a left sided tumor to colon, what kind of symptoms will you have

A

obstruct flow of solid stool, have ribbon like stool, constipation, rectal bleeding, diarrhea alternating with constipation

207
Q

hematachezia

A

rectal bleeding

208
Q

if you have a right sided tumor to the colon what kind of symptoms will you have

A

less change in bowel habits, melena, dull abd pain, anorexia, malaise, pain is late sign

209
Q

what is CT scan used for in cancer

A

staging

210
Q

what blood test is able to detect cancer/tumors

A

CEA (carcinoembryonic antigen)

protein secreted by tumor cells measured in blood

211
Q

resection or laparoscopic bowel resection

A

incision is made & proximal sigmoid is brought through abd wall as permenent colostomy

212
Q

radiation is used for what

A

shrink tumor

213
Q

chemotherapy is used for what

A

for control or palliation

214
Q

pouchlike protrusions of intestinal mucosa

A

diverticulum

215
Q

multiple diverticula exist

A

diverticulosis

216
Q

inflammation of diverticulum

A

diverticulitis

217
Q

diverticulitis results from what

A

obstruction of diverticula by a fecalith`

218
Q

fecalith

A

hard stoney mass made of feces

219
Q

S/Sx of diverticulitis

A

may be asymptomatic
LLQ pain,
N/V, occult bleeding, fever, WBC elevated

220
Q

Dx of diverticulitis

A

barium enema, colonoscopy

no colonoscopy during an acute flair can cause peritonitis

221
Q

Rx used for diverticulitis

A

anti cholinergic

222
Q

abnormal protrusion of an organ, tissue or part of an organ through a structure that normally contains it.

A

hernia

223
Q

reducible hernia is

A

can be pushed back in

224
Q

irreducible (incarcerated) hernia

A

needs surgery, can decrease blood flow = tissue death

225
Q

weakness in abd wall in inguinal canal, where spermatic cord or round ligament emerge

A

inguinal hernia

226
Q

protrusion through femoral ring into femoral canal

A

fermoral hernia

strangulates easily

227
Q

occurs due to weakness of rectus muscle or failure of umniliacl opening to close

A

umbilical hernia

228
Q

occurs due to weakness in abd wall at site of prevous surgeries

A

incisional or ventral hernia

229
Q

how do you assess for a hernia

A

have pt lay in supine position and ask pt to raise shoulders and head

230
Q

Tx for hernias

A

conservative: wear external support
surgery: prevent strangulation or if it has alreay occured

231
Q

herniorrhapy

A

hernia repair

232
Q

hernioplasty

A

weak area reinforced with mesh, wire, facscia

233
Q

Post op hernia repair

A

no coughing, avoid lifting or straining, watch for difficulty voiding, I&O

234
Q

impaired uptake of essential nutrients leads to malnutrition and weight loss

A

malabsorption syndrome

ex. celiac disease, tropical sprue, nontropical sprue

235
Q

what do villi do

A

increase surface area, increase absorption of nutrtients

236
Q

anemia

A

due to decrease of absorption of neutrients (iron)

237
Q

Tx for malabsorption syndrome

A

gluten free diet

no rye, barley, oats, wheat

238
Q

deficiency in intestinal lactase results inhigh concentration of intra-luminal lactose

A

lactose intolerance

239
Q

what OTC Rx helps with lactose intolerance

A

Lactaid

240
Q

dilated varicose vein of rectum and anus

A

hemorrhoids

241
Q

do internal hemorrhoids have pain

A

no pain

242
Q

do external hemorrhoids have pain

A

very painful

243
Q

causes of hemorrhoids

A

obesity, pregnance, portal HTN

244
Q

Tx for hemorrhoids

A

I&D, ointments, sitx baths

245
Q

post op hemorrhoids

A

watch for constipation, pain control, bleeding

246
Q

thin tear or crack in anal mucosa

A

anal fissure

247
Q

S/Sx of anal fissure

A

bleeding on defecation, pain, burning

248
Q

inflammation of ano-rectum with localized infection & pus accumulation

A

ano-rectal abcess

249
Q

S/Sx of ano-rectal abcess

A

throbbing pain when sitting

250
Q

Tx of ano-rectal abcess

A

I&D with packing

251
Q

hallow tract that leads from anal canal or rectum to perinanal skin, usually following a gland tract

A

ano-rectal fistula

252
Q

S/Sx of ano-rectal fistula

A

pruritis, pain, odor

253
Q

Tx for ano-rectal fistula

A

surgical repair

fistulectomy, fistulotomy

254
Q

fistulectomy

A

surgery for superficial fistulas

255
Q

fistulotomy

A

surgery for depper fistulas

area is opened & packed, heals by granulation

256
Q

small tract under skin at saceral area

A

pilonidal sinus

257
Q

pilonidal sinus

A

congenital, common in yound men, movement of buttock causes hair to penetrate skin=pilonidal cyst or abcess forms

258
Q

Tx for pilonidal sinus

A

I&D, packing, wound left open to heal

259
Q

Resulting from psychological state

A

Psychogenic

260
Q

Vomiting is caused by?

A

Stimulation of CTZ which stimulates the vomiting center in medulla

261
Q

Vomiting can cause?

A

Hypokalemia & metabolic alkalosis

262
Q

Antiemetics work best when

A

Prior to vomiting

263
Q

Inflammation of gastric mucosa

A

Gastritis

264
Q

Rovsing sign

A

Palpation of LLQ causing pain to be felt in the RLQ

265
Q

Pt with abd pain N&V, pt has bowel obstruction & abd mass. When listening to abd what would you hear

A

High pitched and hyperactive above area of obstruction

266
Q

Side effect of reglan

A

Tremors

267
Q

Pepcid is working correctly when what symptom is relieved

A

Epigastric pain

268
Q

Phenergran has a side effect of

A

Dry mouth

269
Q

What lab value would be used to indicate acute pancreatitis

A

Amylase

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