Gastrointestinal hurst

Question 1

signs of pancreatitis

Answer 1

pain increases with eating
abdominal distension/ascites
abdominal mass (swollen pancreas)
rigid birdlike abdomen with guarding (bleeding that cal lead to peritonitis)
cullens sign
grey turner sign
fever
inflammation
nausea
vomiting
aundice
hypotension (bleeding, ascites)

Question 2

Diagnosis of pancreatitis

Answer 2

increase serum lipase and amylase
increased WBC
increased Blood sugar
increased liver enzymes
PT, aPTT longer
serum bilirubin increase

Question 3

What happens with H/H with pancreatits

Answer 3

increased with concentration/dehydration
decreased with bleeding

Question 4

treatment of pancreatits

Answer 4

pain control
anticholinergics
GI protectants
maintain fluid electrolyte balance
maintain nutritional status >ease into a diet
keep stomach empty and dry
insulin
daily weights
eliminate alcohol

Question 5

lab values for amylase

Answer 5

30-330

Question 6

lab values for lipase

Answer 6

0-160

Question 7

lab values for AST

Answer 7

0-35

Question 8

lab values for ALT

Answer 8

10-36

Question 9

lab values for hemoglobin

Answer 9

male 14-18
female 12-16

Question 10

hematocrit lab values

Answer 10

male 42%-52%
female 37%-47%

Question 11

what are the 4 major functions of the liver

Answer 11

detoxify the body
help blood to clot
help metabolize drugs
synthesizes albumin

Question 12

cirrhosis pathophysiology

Answer 12

liver cells are destroyed and are replaced with connective/scar tissue alters the circulation within the liver> the bp in the liver goes up called portal hypertension

Question 13

signs of cirrhosis

Answer 13

firm, nodular liver, jaundice
abdominal pain
chronic dyspepsia
change in bowel habits
ascites
spenomegaly
fatigue
peripheral edema
anemia
can proggress to hepatic coma

Question 14

diagnosis of cirrhosis

Answer 14

decreased serum albumin
increase ALT and SLT
ultrasound
CT, MRI
liver biopsy

Question 15

positioning for liver biopsy

Answer 15

supine with right arm behind head
exhale and hold 3-5 seconds to get diaphragm out of the way
light on right side after procedure to hold pressure
monitor for bleeding

Question 16

treatment of cirrhosis

Answer 16

antacids, vitamins, diuretics
no more alcohol
I&O and daily weight
rest
prevent bleeding
measure abdominal girth
paracentesis (monitor for shock)
monitor for jaundice
avoid narcotics
decrease protein
low sodium diet

Question 17

peptic ulcers signs

Answer 17

burning pain
heartburn

Question 18

peptic ulcer diagnosis

Answer 18

gastroscopy
upper GI

Question 19

gastroscopy considerations

Answer 19

NPO pre procedure and until gag reflex returns
sedated
watch for perforation by watching for pain, bleeding, or if they are having trouble swallowing

Question 20

what does an upper GI do

Answer 20

looks at the esophagus and stomach with die

Question 21

considerations for upper GI

Answer 21

no smoking, chewing gum, or mints remove any nicotine patches

Question 22

why is smoking bad near upper GI

Answer 22

it increases stomach motility which will affect test
increases stomach secretions which will increase the chance of aspiration

Question 23

medications for peptic ulcers

Answer 23

liquid antacids
proton pump inhibitors
h2 antagonists
ABX (h pylori)
sucralfate

Question 24

client teaching or peptic ulcers

Answer 24

decrease stress
stop smoking
avoid temperature extremes in food and caffeine
follow up

Question 25

what is a hiatal hernia

Answer 25

hole in the diaphragm is too large so stomach move up into the thoracic cavity

Question 26

causes of hiatal hernia

Answer 26

large abdomen, congenital trauma and straining

Question 27

signs of hiatal hernia

Answer 27

heartburn regurgitation dysphagia

Question 28

treatment of hiatal hernia

Answer 28

small frequent meals sit up 1 hour after eating elevate HOB surgery lifestyle changes

Question 29

what is dumping sundrome

Answer 29

stomach empties too quickly after eating

Question 30

common causes of dumping syndrome

Answer 30

gastric bypass gastrectomy gallbladder disease

Question 31

signs of dumping syndrome

Answer 31

fullness weakness palpitations cramping faintness diarrhea

Question 32

treatment of dumping syndrome

Answer 32

semi-recumbent with meals lie down after meals on left no fluid with meals small frequent meals avoid foods high in carbs and electrolytes (empty fast)

Question 33

hey do you lay on your left with dumping syndrome

Answer 33

left side leaves it in right side releases it

Question 34

what conditions are included in IBD

Answer 34

churns and ulcerative colitis

Question 35

signs of IBD

Answer 35

diarrhea rectal bleeding vomiting weight loss cramping dehydration blood in stools anemia rebound tenderness fever

Question 36

colonoscopy considerations

Answer 36

clear liquid diet 12-24 Hours prior NPO 6-8 hours prior avoid NSAIDS for several days laxatives or enema until clear polyethylene glycol colon prep helps if icy and cold sedated monitor for perforation post

Question 37

diet for IBD

Answer 37

low residue diet avoid cold foods and smoking (they increase motility)

Question 38

ileostomy post op care

Answer 38

It will drain fluid all the time (dont have to irrigate) avoid foods hard to digest and rough food gatorade in summer at risk for kidney stones (always dehydrated)

Question 39

colostomy care

Answer 39

ascending and transverse semi liquid stools descending or sigmoid semi formed or formed irrigate descending and sigmoid for regularity

Question 40

when is the best time to irrigate colostomy

Answer 40

same time everyday after a meal