Flashcards in Gastrointestinal Deck (62)
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1
what does the GI system involve
oral cavity
esophagus
stomach
small intestines
large intestines
digestion
elimination
2
what three main problems happen within the esophagus
Dysphagia, achalasia, and GERD
3
difficulty swallowing
dysphagia
4
what diseases/occurrences cause dysphagia
parkinsons
multiple sclerosis
dementia
stroke
trauma
5
when people have dysphagia they tend to be
dehydrated, have weight loss, malnutrition, and aspiration
6
what are S/S of dysphagia
drooling, increased oral secretions
coughing or choking at meals
hoarseness or increased throat clearing
gurgling voice
7
for those who have difficulty swallowing and are at risk for aspiration pneumonia what are a few interventions we can help them
HOB raised for at least 30 minutes after meals
give them easier food to chew and thicken liquids
8
peristalsis lower 2/3 of the esophagus is absent (smooth muscle)
achalasia
9
what are symptoms of achalasia
might feel food sticking
foul breath
symptoms of GERD
belching
10
achalasia is a smooth muscle so it is a ______ problem
nerve
11
dysphagia is a ______ problem
mechanical
12
how do you manage esophageal problem
eat slow and lots of fluids
ccb and nitrates before meals
inject botox
pneumatic dilation
13
what is a problem of the stomach
peptic ulcer disease
14
what are risk factors of peptic ulcer disease
high stress life, large amount of caffeine, large amount of alcohol, long-term NSAID, H. Pylori
15
what is H. Pylori bacteria
it lives in the stomach and can live for a long time, some people may develop ulcers and some may not
16
what are the two clinical manifestations
gastric- 1-2 hr after meal burning
duodenal- 2-5 hr after meal burning/cpramping
17
where will gastric burning be located
higher in the stomach
18
where will duodenal burning/cramping be located
near small intestines
19
what are the 3 BIG complications of peptic ulcer
1. hemorrhage
2. perforation
3. gastric outlet obstruction
20
what are signs of hemorrhage
throwing up blood and poop in blood(melena)
21
what labs will be done to see how much blood is lost
H&H
22
ulcer has eaten a hole through the stomach and is perforated (can get septic)
perforation
23
things can not be dumped into small intestines because the inflammation at the end of the stomach
gastric outlet obstruction
24
what are nursing interventions for peptic ulcer disease
NPO
order to place NG tube
VS
Lab work
Pain meds
Antibiotics
25
why would a peptic ulcer pt be given antibiotics
because of H. Pylori and they will take it a full 14 days and need to FINISH the prescription
26
what is the main inflammatory intestinal disorder
diverticulitis
27
bulging pouches in the GI wall pushed the mucosal lining thru the surrounding muscle (sac like)
diverticulum
28
if theres not an inflammation of the diverticulum there is
not a problem
29
where is the diverticular disease most common
sigmoid colon
30
low _____ diet and ______ contributes to development and plays a major role in the development of _________
fiber; constipation; diverticulosis
31
sacklike herniation of the lining of the bowel (fine)
diverticulum
32
multiple diverticula present NO inflammation/systems (can have it but not an inflammation issue)
diverticulosis
33
infection/inflammation of the diverticulum (problems because now those little holes have inflammation because they are infected)
diverticulitis
34
undigested foods, especially seeds, mix with bacteria and accumulate in diverticula sac forming a hard mass
diverticulitis
35
when food gets caught in the sac and gets infected on the outside making it rupture (perforate) what happens to what is inside the intestines
it will dump into the gut and cause problems
36
what are clinical manifestations of diverticulitis
pain, fever, vomiting, WBC up, abd pain, X-ray shows air in the gut
37
peritonitis is due to ________
diverticulitis rupture
38
what are dx tests for peptic ulcer disease
barium enema
colonoscopy
39
if pt was going in for a barium enema what would you teach
liquid is white and chalky so the very first bm may be white and chalky
40
what type of surgery is done for diverticulitis
bowel resection to take out the perforation or the part that is sick
colostomy is done to give the bowel a break (temporary)
41
what are nursing interventions for diverticulitis
maintain I&Os, teach foods that trigger, increase fiber/soft diet, antibiotic, stool softener, ambulation
42
what are the 2 inflammatory bowel disease
crown's disease and ulcerative colitis
43
can start form the mouth tho the anus (goes all the way through)
crohn's disease
44
can infect multiple sections, skipping around
crohn's disease
45
what would the bowel look like on a scope of crohn's disease
cobble stoney
46
what are clinical manifestations of crohn's disease
family hx, anemic, chronic diarrhea, weight loss, malabsorption
47
what is the BIGGEST catch of crohn's disease
malabsorption
48
crohn's disease is ______ which means it goes all the way through the layers of the _______
transmural; intestines
49
so if there is another intestines on top of the transmural area it will
eat through that one as well
50
is crohn's disease curable
NOOOOO
51
what if the bowel is so bad due to crohn's disease
they remove it and give a colostomy or get a resection
52
where is ulcerative colitis typically located
the colon (large intestines)
53
what will ulcerative colitis look like inside by a scope
red and bloody
54
what are clinical manifestations of ulcerative colitis
NOT transmural, cramps, anema, fever, weight loss, chronic diarrhea (bloody)
55
what are severe symptoms of ulcerative colitis
tachycardia
hypotension (fluid loss)
tachypnea
dehydrated (lots of stool)
56
what labs would be done on ulcerative colitis pt
H&H, WBC, Lytes (potassium, sodium)
57
75% will have surgery- bowel resection (NOT A CURE) will have recurrence of the disease
crohn's disease
58
25% will have total colectomy (CURED but permanent colostomy)
ulcerative colitis
59
occurs when intestinal contents cannot pass through GI tract; requires prompt treatment
intestinal obstruction
60
what are the two types of intestinal obstruction and what do they mean
mechanical= occlusion or blockage of lumen from tumor or it gets twisted
nonmechanical= most often from a neuromuscular disorder (decrease in the peristalsis)
61
what intestinal obstruction will not be presented quickly and takes longer to realize
large bowel obstruction
62