Gastrointestinal & Urologic Emergencies Flashcards
1
Q
Solid organs of the GI and urinary systems
A
Liver, spleen, pancreas, kidneys, and ovaries
2
Q
Hollow organs of the GI and urinary systems
A
Gallbladder, stomach, small intestine, large intestine, and urinary bladder
3
Q
Sugars start to be absorbed while in the ___
A
Mouth
4
Q
Most digestion takes place in the ___
A
Stomach
5
Q
The liver secretes ___ aiding in the digestion of ___
A
- Bile
- Fats
6
Q
Hollow pouch located beneath the liver that acts as a reservoir for bile
A
Gallbladder
7
Q
Sections of the small intestine
A
- Duodenum
- Jejunum
- Ileum
8
Q
From the stomach, food travels to the ___
A
Small intestine
9
Q
Where digestive juices from the pancreas and liver mix together
A
Duodenum
10
Q
Secretes juice containing enzymes that help break down starches, fats, and proteins
A
Pancreas
11
Q
Breaks down starches into sugar
A
Amylase (enzyme produced in the pancreas)
12
Q
Produces bicarbonate, insulin, and glucagon
A
Pancreas
13
Q
Neutralizes the stomach acid in the duodenum
A
Bicarbonate
14
Q
Help regulate the levels of glucose in the bloodstream
A
Insulin and glucagon
15
Q
Plays a major role in the absorption of digestive products (small intestine)
A
Jejunum
16
Q
Absorbs the remaining nutrients. Absorbs bile acids and returns them to the liver for future use, and vitamin B12 for making nerve cells and red blood cells
A
Ileum
17
Q
A wavelike contraction of smooth muscle in the large intestine
A
Peristalsis
18
Q
The spleen in part of the ___
A
Lymphatic system
19
Q
Function of the spleen
A
Significant role with red blood cells and the immune system. Assists in the the filtration of blood, removes old red blood cells, recycles iron, and serves as a blood reservoir. Also produces antibodies to fight off infection
20
Q
Controls the discharge of certain waste materials filtered from the blood by the kidneys
A
Urinary system
21
Q
Play an important role in the regulation of the acid-base balance and blood pressure
A
Kidneys
22
Q
Kidney disease is a common cause of ___
A
Secondary hypertension
23
Q
Nearly ___ of the output of the blood from the heart passes through the kidneys each minute
A
20%
24
Q
Large vessels attach the kidneys directly to the ___
A
Aorta and inferior vena cava
25
The kidneys continuously concentrate this filtered urine by ___
Reabsorbing water as it passes through a system of specialized tubes within them
26
The tubes in the kidneys eventually unite to form the ___
Renal pelvis
27
Cone-shaped collecting area that connects the ureter and the kidney
Renal pelvis
28
Diameter of ureters
0.2"
29
___ occurs in the ureters to move urine to the bladder
Peristalsis
30
The urinary bladder is located ___
Immediately behind the pubic symphysis in the pelvic cavity
31
The ureters enter the bladder ___
Posteriorly at its base
32
Healthy adult amount of daily urine
1.5 to 2 liters
33
The bladder empties through the ___
Urethra
34
The abdominal cavity is lined with a membrane called the ___
Peritoneum
35
The parietal peritoneum lines the ___
Walls of the abdominal cavity
36
The visceral peritoneum covers the ___
Organs themselves
37
The abdominal space normally contains a small amount of ___ to bathe and lubricate organs in the abdominal cavity
Peritoneal fluid
38
Any foreign material can cause irritation of the peritoneum, called ___
Peritonitis
39
The sudden onset of abdominal pain
Acute abdomen
40
Peritonitis is usually associated with ___
The acute abdomen, vomiting, and nausea, loss of body fluids into the abdominal cavity
41
Peritonitis typically causes ___
Ileus
42
Paralysis of the muscular contractions that normally propel material through the intestine
Ileus
43
The retained gas and feces from ileum cause ___
Abdominal distention
44
The only way the stomach can empty itself with ileus
Emesis
45
Emesis
Vomiting
46
The fluid loss into the abdominal cavity during peritonitis can result in ___
Abnormal shifts of fluid from the bloodstream into body tissues, decreasing the volume of circulating blood and may lead to decreased BP or even shock. May present with tachycardia and hypotension
47
Inflammation in small pockets at weak areas in the muscle walls of the intestines
Diverticulitis
48
Inflammation of the gallbladder
Cholecystitis
49
Patients with diverticulitis or cholecystitis may have a ___
High fever
50
Patients with acute appendicitis may have a normal temperature until ___
The appendix ruptures and contaminates the peritoneal cavity
51
Abdominal pain can have different qualities because ___
Two different types of nerves supply the peritoneum
52
The parietal peritoneum and the skin of the abdomen can perceive ___
Much of the same sensations, and can easily ID and localize a point of irritation
53
The visceral peritoneum is supplied by the ___
Autonomic nervous system
54
The visceral peritoneum is stimulated when ___
Distention or contraction of the hollow abdominal organs activates the stretch receptors
55
Irritated visceral peritoneum pain perceived at a distant point on the surface of the body
Referred pain
56
The result of connections between the body's two separate nervous systems
Referred pain
57
Localization of pain for appendicitis
RLQ (direct); around naval (referred); rebound tenderness
58
Localization of pain for cholecystitis
RUQ (direct); right shoulder (referred)
59
Localization of pain for ulcer
Upper midabdomen or upper part of back
60
Localization of pain for diverticulitis
LLQ
61
Localization of pain for abdominal aortic aneurysm (ruptured or dissecting)
Low part of back and lower quadrants
62
Localization of pain for cystitis (inflammation of the bladder)
Lower midabdomen (retropubic)
63
Localization of pain for kidney infection
Costovertebral angle
64
Localization of pain for kidney stone
Right or left flank, radiating to genitalia
65
Localization of pain for pancreatitis
Upper abdomen (both quadrants); back
66
Localization of pain for hernia
Anywhere in the abdominal area
67
Localization of pain for peritonitis
Diffuse abdominal pain area
68
Prevents damage to the stomach and duodenum due to acids
Protective layers of mucus
69
The protective layer of mucus in the stomach and duodenum is eroded, allowing the acid to eat the organ itself
Peptic ulcer disease (PUD)
70
Most peptic ulcers are the result of ___
Infection of the stomach with Helicobacter pylori bacteria or chronic use of NSAIDs
71
Alcohol and smoking can affect the severity of PUD by ___
Increasing gastric acidity
72
Hematemesis
Vomiting blood
73
Melena
Black, tarry stools containing blood
74
Gallstones that cannot pass cause ___
Cholecystitis
75
Cholecystitis commonly produces symptoms about 30 minutes after ___
A particularly fatty meal and usually at night
76
Symptoms of cholecystitis
1. Constant severe pain in the right upper back, shoulder area, or flank
2. Nausea and vomiting
3. Indigestion
4. Bloating
5. Gas
6. Belching
77
People at a higher risk of developing cholecystitis
1. Women
2. Older adults
3. Obese people
4. People of Scandinavian, Native American, & Hispanic descent
78
___ may present without the normal symptoms of cholecystitis other than localized tenderness
Older adults
79
Pancreatitis may be caused by ___
An obstructing gallstone, alcohol abuse, and other diseases
80
Pain from pancreatitis may get ___ after eating
Worse
81
Symptoms of pancreatitis
1. Severe pain in the LUQ & RUQ, may radiate to back
2. Pain worse after eating
3. Nausea and vomiting
4. Abdominal distention
5. Tenderness
6. Fever or tachycardia if complications of sepsis or hemorrhage are present
82
A small recess in the large intestine
Appendix
83
Pain progression with appendicitis
Generalized, dull, and diffuse, may center in the umbilical area. Later localizes to the RLQ of the abdomen. May also caused referred pain. Rebound tenderness
84
Other symptoms of appendicitis
Nausea and vomiting, anorexia, fever, and chills.
85
Who may not have rebound tenderness with appendicitis?
Pregnant women
86
Appendicitis pain ___ when the patient's legs are straightened
Increases
87
A Mallory-Weiss tear results from ___
Excessive vomiting or retching
88
Hematemesis is frequently seen in patients with ___
Upper GI bleeding
89
Melena from upper GI bleeding is dark red due to the ___
Partial digestion of the blood
90
Bleeding in the lower GI tract shows up in stools as ___
Bright red or maroon colored
91
What causes esophagitis?
The lining of the esophagus being inflamed by infection or from acids in the stomach
92
GERD
Gastroesophageal reflux disease
93
A condition in which the sphincter between the esophagus and the stomach opens, allowing stomach acid to move up into the esophagus
GERD
94
GERD is also called ___
Acid reflux disease
95
Occur when the pressure within the blood vessels surrounding the esophagus increases
Esophageal varices
96
Esophageal varices is often the result of ___
Liver failure
97
Esophageal blood vessels eventually drain their blood into the ___
Liver
98
A tear in the junction between the esophagus and the stomach, causing severe bleeding and potentially death
Mallory-Weiss tear
99
Comprises a family of conditions revolving around a central theme of infection combined with diarrhea, nausea, and vomiting
Gastroenteritis
100
___ is the principal symptom in both infectious and noninfectious gastroenteritis
Diarrhea
101
Bleeding from diverticulitis is usually ___
Bright red and painless
102
The main symptom of diverticulitis
Abdominal pain
103
Created by swelling and inflammation of the blood vessels surrounding the rectum
Hemorrhoids
104
Hemorrhoids may result from ___
Conditions that increase pressure on the rectum or irritation of the rectum
105
Cystitis is generally caused by a ___
Bacterial infection
106
Cystitis is referred to as a ___
Urinary tract infection (UTI)
107
Cystitis can become a serious health problem if the infection spreads to the ___
Kidneys
108
The ___ play a major role in maintaining homeostasis
Kidneys
109
The kidneys preserve homeostasis by ___
Eliminating waste from the blood
110
Urea remains in the blood
Uremia
111
Renal calculi
Kidney stones
112
A sudden decrease in function of the kidney
Acute kidney injury (AKI)
113
AKI
Acute kidney injury
114
Irreversible failure of the kidney that develops over months and years
Chronic kidney disease (CKD)
115
CKD
Chronic kidney disease
116
CKD is often caused by ___
Diabetes or hypertension
117
Always consider that a woman with lower quadrant pain and tenderness may have a problem with her ___
Ovaries, Fallopian tubes, or uterus
118
AAA
Abdominal aortic aneurysm
119
The aorta lies immediately behind the ___
Peritoneum
120
If the AAA ruptures, the patient will present with ___
Signs of acute peritoneal irritation and hemorrhagic shock. May also report radiation of severe pain in addition to back pain
121
AAA pain may be described as ___
Tearing
122
A protrusion of an organ or tissue through a hole or opening into a body cavity where it does not belong
Hernia
123
A hernia that disappears back into the body cavity in which it belongs
Reducible
124
A hernia that cannot be pushed back into the body
Incarcerated
125
Complete obstruction of blood circulation in a given organ as a result of compression or entrapment
Strangulation
126
Strangulation can cause ___
Death of tissue
127
Signs and symptoms of a serious hernia problem
1. Reducible mass that is no longer reducible
2. Pain at the hernia site
3. Tenderness when the hernia is palpated
4. Red or blue skin discoloration over the hernia
128
What additional PPE should be considered for a GI issue?
Face shield, gown, and disposable shoe covers
129
Bruising around the umbilicus or on the flanks may indicate ___
Internal abdominal bleeding
130
During a GI emergency when asking about medication history, ask about ___
Alcohol, antibiotics, pain relievers
131
Specific questions to ask during a GI emergency
1. Nausea and vomiting
2. Changes in bowel habits
3. Urination
4. Weight loss
5. Belching or flatulence
6. Pain
7. Concurrent chest pain
8. Other symptoms that may be related
132
Involuntary muscle contractions of the abdominal wall; an effort to protect the inflamed abdomen
Guarding
133
Steps to assess the abdomen
1. Explain to the patient how you will assess the abdomen
2. Place the patient in a supine position with the legs drawn up and flexed at the knee to relax the abdominal muscles, unless there is trauma. Determine whether the patient is restless or quiet, and whether motion causes pain
3. Expose the abdomen and visually assess it
4. Ask where the pain is most intense. Palpate in a clockwise direction beginning with the quadrant after the one that is tender or painful
5. Palpate gently. If you see a pulsating mass, do not touch it
6. Palpate to determine if each quadrant is tense or soft when palpated
7. Note if pain is localized or diffuse
8. Palpate and wait for the patient to respond, do not ask if it hurts
9. Determine if there is rebound tenderness. This indicates peritonitis
10. Determine whether the patient can relax the abdominal wall on command. Guarding or rigidity may indicate peritonitis
134
High respiratory rate with a normal pulse rate and BP may indicate the patient is unable to ventilate properly because ___
Deep breathing causes pain
135
A high respiratory rate and pulse rate with signs of shock, such as pallor and diaphoresis, may indicate ___
Septic or hypovolemic shock
136
ESRD
End-stage renal disease
137
ESRD is also called ___
Chronic renal failure
138
ESRD is treated with ___
Peritoneal dialysis (PD) or hemodialysis
139
First series of conditions in a patient who misses a dialysis treatment
Weakness and pulmonary edema
