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PERSONAL VOCATIONAL RELATIONSHIPS > GASTROINTESTINAL I > Flashcards

GASTROINTESTINAL I Flashcards

1
Q

BILE

A

product of liver, emulsifies fat

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2
Q

stomach

A

food resevoir

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3
Q

small intestine

A

absorption, digestion

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4
Q

large intestine

A

A.K.A. the colon..it is wider than sm. intestine, H2O absorption

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5
Q

food goes from mouth to anus using

A

peristalsis

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6
Q

What effect does aging have on the GI system?

A

tooth enamel gets harder/brittle, taste sensation decreases, decreased stomach motility, slower fat absorption, decreased rectal wall elasticity, faulty vitamini absorption>gallstones

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7
Q

frequency of stools is the most important data to determine GI function

A

false…consistency is most reliable

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8
Q

fresh colored blood is usually coming from

A

lower GI tract

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9
Q

Low CBC levels could indicate

A

internal bleeding

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10
Q

an occult blood test finds

A

blood not visible to the naked eye

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11
Q

clay colored feces could result from

A

barium or bile

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12
Q

TRUE OR FALSE

barium is not the usual medium contrast for GI diagnostics

A

false, it is

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13
Q

what must happen to barium post-study?

A

it must be eliminated

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14
Q

PT reports they ate some toast and drank extra pulp orange juice the morning of their colonoscopy, the nurse recognizes this is a problem because

A

a clear liquid diet should be followed 24 hours pre-op…eating could cause vizualization issues with scope

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15
Q

left side knee up for

A

endoscopy

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16
Q

A PT has difficulty eating 6 hours post EGD and presents a 101.2 degree fever. The nurse should report this to the HCP but why?

A

these are signs of perforation post EGD, which is a esophogus/stomach scope

*other S/S: Hypotension, tachycardia, n/v, rapid HR

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17
Q

An expected outcome of EGD could be PT reporting

A

scratchy, itchy throat

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18
Q

TRUE OR FALSE

A PT with acute kidney issues is contraindicated in ERCP

A

TRUE

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19
Q

left side position for

A

colonoscopy

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20
Q

PTs should avoid what colored drinks

A

orange and red

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21
Q

A PT reports cramping 3 hours post colonoscopy. The nurse should
1. administer a narcotic
2. reassure PT this is normal post-procedure
3. Supply a laxative

A

2

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22
Q

the LPN should make sure PT avoids ________ prior to basal secretion test

A

antacids

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23
Q

PT education for valvular disorders (MVP, stenosis etc) should include
1.Be consistent with leafy greens consumption if perscribed warfarin
2. avoiding salt/sodium intake
3. Don’t take NSAIDs and ASAs (ibuprofen, aspirin)

A

all

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24
Q

A PT on ACE inhibitors should monitor their

A

BP…it is an afterload reducing med

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25
Q

Liver, gallbladder, pancreas are

A

Accessory organs of digestion produce or store digestive secretion

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26
Q

Liver

A

Hepatic portal circulation

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27
Q

Páncreas

A

•amylase—starch>maltose
•lipase—emulsified fats>fatty acids/monoglycerides
•trypsin—polypeptides to peptides
•bicarbonate juices

28
Q

S/S of GI Alterations

A

•abdominal pain
•nausea/vomiting
•diarrhea
•constipation

29
Q

Abdominal pain (etiology & assessment)

A

•common
•reasons: obstruction, peritonitis, altered motility, stress, lesions etc
•assess: onset, character, location, severity, interventions etc

30
Q

Náusea & vomiting & prevention

A

•náusea—gotta vomit…drooling, weakness, hyper/hypotension, sweats
•vomit—emesis, stimulated by CTZ, rids body of harmful stuff
•hematemesis- bloody vomit, breath may smelly poopy
•prevent aspiration, monitor /correct fluid balances

31
Q

Diarrhea

A

•reasons: meds, anxiety, infection, diet, laxative, malnutrition
•assess duration, amount, character, etc, fever present(?)
•maintain skin hygiene, anti-poop meds, fluid balance

32
Q

Constipation (RAPDISS)

A

•Reason: meds, need fiber, need fluids, gastric stasis, immobility etc
•assess: bowel patterns, diet, lax use…treat with diet change/meds
•prevention: exercise, high fiber diet, fluids
•S/S—bloated abd., indigestion, rectal pressure, incomplete poop, hard poop, rumbling
•issues: impaction, ulcer, heart rupture from straining, megacolon
•dx: history & physical
•solutions: prevention, exercise, softeners

33
Q

Physical assessment

A

•Ht./Wt.
•BMI (18.5-24.9)
•mouth (loose teeth)
•abdomen—look for jaundice etc, listen, feel (girth), tap (Dr.),

34
Q

Diagnostic Testing

A

CBC, electrolytes, CEA (cancer), billirubin, liver/pancreatic enzymes

35
Q

Stool Testing color

A

•tarry-upper GI bleed
•frank–near rectum
•occult —least invasive blood in poo test

36
Q

Occult &Parasite Exam

A

•Occult–3 tests, meat free 72 hours pre exam…bleeding gums, food, meds can cause false +
•ova/parasite–3 tests, finds pathogens/bacteria, no urine allowed, specimen fresh & warm

37
Q

Fecal fat/Stool Cultures

A

•fecal fat–24 hr collection, test for malabsorption, crohn’s, pancreas issue
•stool culture—finds pathogens

38
Q

Barium Swallow

A

•aka upper GI series …view of esophagus, stomach, duo/jejunum with barium
•NPO 6-8 hrs pre midnight, laxative post test, poop watched for barium, monitor for constipation, drink 12 8 oz water post study
•test takes hours

39
Q

Barium Enema

A

•aka low GI series … looks at where/how full/ is colon
•unclear bowels=cancel study
•contraindicated with colon disease/perforation/obstruction
•finds polyps, hernias, motility, tumors, stenosis, colitis, diverticula
•same stool watch as UGI..PT should report bloating /constipation/bleeding
•test takes 15 minutes

40
Q

Endoscopy (pathophysiology)

A

•invasive, requires consent, direct visual/ ability to biopsy
•cauterize bleeding, remove polyps

41
Q

Esophagogastroduodenoscopy

A

•see esophagus, stomach, duodenum
•finds cancer, bleeding, infection, biopsy/cyto specimens can be taken
•watch V.S., prevent aspiration
•RUQ pain, fever, chills—infection

42
Q

Proctosigmoidoscopy

A

•lower GI scope…looks at colon, rectum , anus
•finds ulcers, punctures, hemorrhoids, polyps, can get specimens
•laxative pre, enema post

43
Q

Colonoscopy (Pathophysiology)

A

•Can see the Lg intestine
•watch for hemorrhaging, severe pain
•blood in poop normal if stool specimen taken

44
Q

Gastric analysis

A

•stomach secretion measurement
•finds duodenal ulcer, gastric carcinoma, pyloric or duodenal obstruction, pernicious anemia
•2 types of GA: Basal cell, gastric acid stimulation

45
Q

Basal cell secretion test

A

•NPO post-midnight pre-test
•stomach contents collected 4x/hr
•GI acid tested for amount/acid
•too much hydrochloric acid=maybe peptic ulcer, too little=cancer or pernicious anemia

46
Q

Gastric acid test

A

Measures amt of gastric acid for HR after SQ injection of a histamine

47
Q

A PT with DVT post op is started in IV heparin. Which lab test will the nurse monitor?

  1. Prothrombin time
  2. International normalized ratio
  3. Partial thromboplastin time
A

3

48
Q

Percutaneous Liver Biopsy

A
  • identifies cancer, cirrhosis, hepatitis
  • small sample from liver extracted by needle
  • risk for bleeding
  • CBC/ coagulation study pre-biopsy
  • NPO 6-8 pre-biopsy
  • AVOID COUGHING/STRAINING POST-BIOPSY
49
Q

NG vs EG, G tube, and J tube

A

Ng is shorter term, the rest are longer-term use

50
Q

Why would PT need a GI tube

A
  1. remove gas/fluid in stomach
  2. diagnose GI motility/sample for testing
  3. relieve/treat obstruction or bleeding
  4. nutrition, hydration, medication
  5. promote post-op healing
  6. remove toxic substances
51
Q

if you pull back 100 mLs after a feeding, what should you do next

A

PT isnt getting full feed, STOP THE FEED, call dr

52
Q

Enteral nutrition

A
  • supplies PT with nutrition
  • delivered into jejunum/duodenum
  • free water needs can be calculated by a dietician
53
Q

Gastro decompression

A

NG tube usually used, suction applied

54
Q

parenteral nutrition/periphreal para.

A
  • feed goes thru IV
  • due to high dextrose lvl, accuchecks should be taken
  • imporves nutrition, promotes healing, wt. gain
  • PPN-used <10 days
55
Q

Gastrointestinal Intubation

A

•tube for therapy/diagnostics
•gas & fluid removal
•diagnoses GI motility & gastric
secretion analysis
•relieves/treats obstructions or bleeding in tract
•provides nutrition, hydration, medication
•remove toxins (lavage)

56
Q

salem sump

A
  • most common
  • vents, prevents excess suction
  • do NOT plug off air vent
  • used for decompression, lavages
    •weighted, flexible feeding tube with stylets
57
Q

Nasoenteric

A
  • PT repositioned side to side for passage
  • used to decompress sm. bowel in Un-operable PTs
58
Q

nursing management for GI tube PT

A
  • nare care, check mouth (lose teeth), elevate HOB, educated PT pre/post-op
  • fluid balance, peristalsis presence
59
Q

possible complication of GI tube

A

PERFORATION

60
Q

What should a PT with GERD avoid?

A

eating large meals, lying down after eating, caffeine

61
Q

why are antidepressants given for IBS PTs?

A

for hypercontractions

62
Q

Liver needle biopsy summary

A

Watch for bleeding, limit movement, apply pressure, Pt should avoid coughing

63
Q

True or false : NG tubes are usually permanent or long term

A

False, it is short term and temporary

64
Q

Percutaneous Liver Biopsy

A

•needle used to get specimen to identify cancer, cirrhosis, hepatitis
•NPO 6-8 hours before test
•risk for bleeding

65
Q

Endoscopic Retrograde Cholangiopancreatography

A

•ERCP allows visual of liver, gallbladder, & pancreas
•removes stone/tumor removal, bile duct stent placement can be used
•NPO 8 hrs pre-op
•Monitor for hypotension, tachy, high HR, rapid RUQ pain, n/v—these are perforation/pancreatitis signs
•call Dr

PERSONAL VOCATIONAL RELATIONSHIPS (8 decks)

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