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GI Flashcards

Pancreatitis, Appendicitis, SBO, Celiac, Cholecystitis, Cirrhosis, Diverticulitis, Diverticulosis, Esophageal Varices, Gastroenteritis, GERD, Hepatitis, Peptic Ulcer

1
Q

Patho of pancreatitis

A

Inflammation of pancreas
Pancreatic duct obstruction and hypersecretion of pancreatic exocrine enzymes -> enzymes activated -> autodigestion
Impaired exocrine and endocrine fx

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2
Q

Risk factors of pancreatitis

A

Alcohol ingestion
Gallstones
Thiazide diuretics
Viral infx
Trauma

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3
Q

S+S of pancreatitis

A

Severe pain after eating
Pain located in epigastric region or LUQ
N+V
Elevated lipase and amylase levels

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4
Q

Complications of pancreatitis

A

Hypovolemic shock
ARDS
Retroperitoneal hemorrhage (Cullen sign)
Hypocalcemia
Hyperglycemia

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5
Q

Nursing interventions of pancreatitis

A

IV everything (opioids, fluids, antiemetics)
NPO
Alcohol cessation
Insulin

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6
Q

Nursing interventions for chronic pancreatitis

A

Alcohol cessation
Insulin
Small, bland, frequent meals that are low in fat
Administer pancreatic enzymes
Supplemental vitamins and minerals

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7
Q

S+S of Appendicitis

A

GRADE
Abdominal guarding
Rebound tenderness and RLQ pain
Anorexia and absent bowel sounds
Abdominal pain -> McBurne’s point
Elevated temp and WBCs

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8
Q

Nursing interventions of appendicitis

A

Assess bowel sounds
NPO
IV fluids and abx
Antiemetics and antipyretics
Semi-Fowler (no lying flat)
Avoid applying heat, cathartics, or enemas

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9
Q

1 fact about appendicitis

A

Avoid applying heat, cathartics, or enemas -> risk for appendix rupture

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10
Q

SBO complications

A

Peritonitis

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11
Q

S+S of SBO and labs

A

Colicky abdominal pain
Abdominal distention
Inability to pass flatus or stool
N+V (bile-stained)
Hypokalemia and metabolic alkalosis

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12
Q

Nursing interventions of SBO

A

NPO
Manage pain
AVOID opioids (may result in uncontrolled constipation)
NG tube
Antiemetics
IV fluids
Monitor: bowel sounds, abdominal distention, passage of gas/stool, signs of peritoneal irritation
Strict I+O

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13
Q

Peritoneal irritation S+S

A

Muscle guarding
Rebound pain
Pain if bed is shaken

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14
Q

Diet of celiac dz

A

Avoid BROW
Barley
Rye
Oats
Wheat
Diet high in calories and proteins

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15
Q

Nutritional deficiencies in celiac dz

A

Ferrous sulfate
Vitamins

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16
Q

Risk factors of cholecytitis

A

Female over 40 yo
Multiparous women
Obesity
Oral contraceptive use
Elevated serum cholesterol levels
Family hx

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17
Q

S+S of cholecystitis

A

Colicky pain in RUQ (can worsen after eating)
Murphy sign
Localized guarding
Fever and tachycardia
Leukocytosis
Perforation (peritonitis)
Prior hx of indigestion after eating fatty foods

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18
Q

Nursing interventions of cholecystitis

A

Prepare for cholecystectomy
Pain management
IV fluids and electrolytes
IV antiemetics
NPO -> low fat -> regular diet
IV abx

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19
Q

Cirrhosis is known as…

A

End stage of liver

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20
Q

Risk factors of cirrhosis

A

Chronic viral hepatitis
Chronic, excessive alcohol use
Non-alcoholic fatty liver dz

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21
Q

S+S of cirrhosis

A

Jaundice
Darkened urine
Pale stool
Ecchymosis
Edema
Build up of estrogen
Portal HTN (esophageal varices, ascites, splenomegaly)

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22
Q

Lab values of cirrhosis

A

Increased bilirubin, clotting times, ALT/AST, ammonia
Decreased albumin, platelets, WBC

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23
Q

Nursing interventions of cirrhosis

A

Elevate HOB
Diuretics
Manage ascites -> paracentesis
Daily weight and abdominal girth measurements
Sodium and fluid restrictions
Monitor for signs of bleeding and hepatic encephalopathy
Avoid sedatives and hepatotoxins

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24
Q

Hepatic encephalopathy S+S

A

Altered mental status
Asterixis
Confusion

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25
Paracentesis tx
Treat hypotension w/ colloid solution (25% albumin IV)
26
Complications of diverticulitis
Abscess formation Perforation -> peritonitis Hemorrhage Fistula formation
27
S+S of diverticulitis
Fever Prior constipation -> loose stools now Abdominal pain that worsens w/ strain N+V Tenderness and palpable mass Leukocytosis
28
Nursing interventions of diverticulitis
IV fluids, IV abx, pain management Clear liquid diet or NPO Surgery (bowel resection)
29
Teaching of diverticultitis
Routine exercise Fluid intake Diet modifications: high fiber Avoid straining during bowel mvts
30
Patho of diverticulosis
Occurs when sac-like pouches form in colon wall due to constipation, increased intraabdominal pressure
31
S+S of diverticulosis
Asymptomatic but diverticulitis and GI bleed
32
Nursing interventions of diverticulosis
High fiber diet Exercise Smoking cessation Avoid excess red meat
33
Esophageal varices (rupture) S+S
Vomiting bright red blood/clots Coffee-ground emesis or melena Hypotension Tachycardia Pale or cyanotic skin
34
Nursing interventions of esophageal varices
NPO Intubate if bleeding is massive IV fluids and RBCs Prepare for emergency EGD
35
Meds for esophageal varices
Octreotide infusion (vasoconstriction) PPI
36
S+S of gastroenteritis
Diarrhea (can be bloody) NV Fever Abdominal pain Hyperactive bowel sounds Abdominal tenderness during palpation
37
Complications of gastroenteritis
Dehydration and hypovolemia Electrolyte abnormalities
38
Nursing interventions for gastroenteritis
Monitor for dehydration: oral rehydration of IV fluids if severe Advance diet as tolerated Avoid carbonation Avoid fluids w/ high amts of sugar Strict I+O
39
Risk factors for GERD
Obesity Pregnancy Hiatal hernia Tobacco and alcohol consumption Foods: high fat diet, chocolate, peppermint Meds: anticholinergic meds or opioids
40
Complications of GERD
Esophageal ulcer -> bleeding Barret's -> esophageal cancer Scar -> stricture Worsening of respiratory conditions
41
S+S of GERD
Heartburn Epigastric pain Indigestion Dysphagia Regurgitation Hoarseness Respiratory symptoms S+S increased by bending, lying, eating, stooping
42
Pt teaching of GERD
Avoid dietary triggers: caffeine, chocolate, alcohol, carbonation, spicy, citrus Small, frequent meals Avoid lying down for 2-3 hrs after eating Elevate HOB
43
Meds for GERD
Antacids H2 receptor antagonists PPI
44
Hepatitis A
Fecal-oral route Sources: poor sanitation Crowded places
45
Hepatitis B and C
Bloodborne: sharing needles, hemodialysis, blood transfusion Sexual contact Perinatal
46
Acute hepatitis S+S
Fever Anorexia, nausea, malaise Pain Jaundice Pruritis Dark urine and pale stools
47
Nursing interventions for Hep B and C
Antivirals
48
Nursing interventions for Hep A
Hand hygiene precautions
49
Complications of Hep
Changes in neuro status Bleeding Fluid retention
50
Teaching for hepatitis
Avoid high fat diet Small and frequent meals Avoid liver toxins
51
Teaching for hepatitis A
Refrain from sharing utensils or drinking glasses Vaxx Proper hand hygiene
52
Teaching for Hep B and C
Refrain from sharing razors, needles, syringes Use condoms Hep B vaxx
53
Risk factors of peptic ulcer dz
H. pylori NSAIDs and corticosteroids Smoking Alcohol consumption Excess caffeine High levels of stress Trauma/critical illness
54
Complications of peptic ulcer
GI bleeding Perforation
55
Nursing interventions for non-bleeding peptic ulcer (meds)
Abx if H pylori present Oral PPI Sucralfate
56
Nursing interventions for bleeding peptic ulcer
NPO Anticipate endoscopy Monitor hemoglobin and hematocrit
57
Upper GI bleed S+S
Melena NSAID use Hematemesis Hx of H. pylori
58
Lower GI bleed S+S
Bright red stools Hx of diverticulosis
59
Liver dysfx lab values
Increased ammonia (hepatic encephalopathy), bilirubin, INR/prolonged PT (bruising, bleeding) Decreased albumin (fluid overload), platelets (petechiae)
60
Proper home care of an ascending colostomy
Clarify enteric-coated meds Identify foods that cause excess gas and odor Increased fluid intake
61
For colostomy irrigation, what locations is that for?
Descending/sigmoid
62
Hiatial hernia
Regurgitation of acid into esophagus b/c upper part of stomach herniates upward through diaphragm
63
BASICALLY Hiatal hernia =
gastric contents move in wrong direction at correct rate
64
S+S of Hiatal hernia
GERD when you lie down after you eat
65
Tx of Hiatal hernia
Want the stomach to empty faster High position High fluids High carbs Low protein
66
Dumping syndrome
Gastric contents dump too quickly into duodenum
67
BASICALLY dumping syndrome
gastric contents move in right direction at the wrong rate
68
S+S of dumping syndrome
Drunk + shock + abdominal distress
69
Tx of dumping syndrome
Want the stomach to empty slower Low position Low fluids Low carbs High protein
70
Acute ulcerative colitis exacerbation teaching
Avoid triggers Take vitamin and mineral supplements Use skin barrier cream 2000-3000 mL fluid daily Take sulfasalazine
71
Cholecystitis referred areas of pain
Right area of neck Back (right) - upper
72
Pancreatitis referred areas of pain
LUQ Left upper side of back
73
Appendicitis referred areas of pain
Umbilical area
74
Nephrolithiasis referred areas of pain
Left hip-groin Left hip (posterior)
75
Clay colored (gray) stool indicates
Biliary obstruction
76
Mucus or pus visible stool indicates
Ulcerative colitis
77
Greasy, foamy, foul-smelling, fatty stools indicates
Chronic pancreatitis
78
Ostomy bag should be changed every
5-10 days
79
High ALT/AST indicates...
Liver Hepatitis
80
High lipase indicates...
Pancreatitis
81
Liver cirrhosis S+S
Fatigue Jaundice Abdominal ascites Spider angiomas Palmar erythema Peripheral edema
82
Tx of cirrhosis (liver)
Diuretics Paracentesis Monitor for signs of hepatic encephalopathy Measure abdominal girth
83
Peptic ulcers S+S
Pain - mid-epigastric region Pain occurs 2-4 hrs after a meal or wakes up pt at night Relieved by antacids

NCLEX (40 decks)

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