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Illness and Patho 1 > GI > Flashcards

GI Flashcards

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1
Q

Acute inflammation of the vermiform appendix

A

Appendicitis

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2
Q

Where do patients with appendicitis have pain?

A

In the epigastic or periumbilical area

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3
Q

When do patients with appendicitis have nausea and vomiting?

A

After the abdominal pain

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4
Q

What are the signs of appendicitis?

A

Pain at McBurney’s point and rebound tenderness

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5
Q

Why is appendicitis very difficult to diagnose?

A

Because it is a diagnosis of exclusion

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6
Q

Why should patients with appendicitis not be given laxatives?

A

They can cause perforation of the appendix

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7
Q

Why should patients with appendicitis not use heat for the pain?

A

Because heat causes the circulation in the appendix to increase, leading to inflammation and perforation

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8
Q

How should patients with appendicitis be positioned?

A

Semi-fowlers

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9
Q

What are the priorities when a patient comes into the ER with appendicitis?

A

Make that patient NPO and give IV fluids and electrolytes

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10
Q

How many mL of sterile fluid are normally in the peritoneal cavity to prevent friction?

A

50

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11
Q

Life threatening acute inflammation of visceral/parietal peritoneum and endothelial lining of abdominal cavity, or peritoneum

A

Peritonitis

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12
Q

What does primary peritonitis indicate?

A

Peritoneum is infected via the bloodstream

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13
Q

What does secondary peritonitis indicate?

A

Contamination of the peritoneal cavity by bacteria or chemicals

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14
Q

Why does peritonitis have to be treated immediately?

A

To stop the shunting of blood to the area of inflammation and causing third spacing and hypovolemic shock

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15
Q

What are the signs of peritonitis?

A

Rigid, board like abdomen, pain, distention, high fever, tachycardia, dehydration, low urine output, hiccups, compromised respiratory status, nausea, vomiting, diminished bowel sounds, inability to pass flatus or feces, and anorexia

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16
Q

Why do hiccups occur with peritonitis?

A

Diaphragmatic irritation and increased white blood cells

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17
Q

How is peritonitis diagnosed?

A

Peritoneal lavage

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18
Q

How is peritonitis managed?

A

IV fluids, antibiotics, NG suctioning

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19
Q

What position do patients with peritonitis need to be in?

A

Semi-Fowlers

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20
Q

Widespread inflammation of mail the rectum and rectosigmoid colon, associated with periodic remissions and exacerbations

A

Ulcerative Colitis

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21
Q

Unpleasant and urgent senstation to deficate

A

Tenesmus

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22
Q

What is the poop of a patient with ulcerative colitis like?

A

10-20 bloody stools daily

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23
Q

What would the labs of a patient with ulcerative colitis be?

A

Decreased H&H, increased WBCs, c-reactive protein, increased erythrocyte sed, decreased electrolytes

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24
Q

What is the most definitive test for ulcerative colitis?

A

Colonoscopy

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25
What are the drugs used to treat ulcerative colitis?
Glucocorticoid, antidiarrheal drugs, and Humira
26
What are the side effects of antidiarrheal drugs?
Colon dilation and toxic megacolon
27
What needs to be taught with Humira?
Watch for signs and symptoms of infection
28
What should patients with ulcerative colitis avoid?
Caffeine, pepper, alcohol, and smoking
29
What do patients with ostomies need to be taught?
Don't leave supplies in the car
30
What should a stoma look like?
Pinkish to cherry red
31
What are the nursing interventions for patients with ostomies?
Skin protection, monitor blood and fluid loss, and psychological care
32
Inflammatory disease of the small intestine and colon causing thickening of the bowel wall with deep ulcerations and fistulas
Crohn's Disease
33
What causes Crohn's?
Possibly genetic, immune, or environmental factors
34
What do patients with ulcerative colitis look like?
Very sickly
35
What is the poop of a Crohn's patient like?
5-6 loose stools daily
36
How do obstructions occur in Crohn's patients?
Inflammation and scarring from the fistulas cause a narrowing of the intestines
37
What is the priority for patients with fistulas with Crohn's disease?
Always protect the skin
38
What is the criteria for patients to have a wound vac?
They must be in a positive nitrogen balance
39
What would the bowel sounds of a patient with Crohn's be?
Hyperactive in all four quadrants
40
Where is the pain for patients with Crohn's?
Right lower quadrant
41
Why would patients with Crohn's be anemic?
Because they can't absorb intrinsic factor
42
What drugs can be used to treat Crohn's?
Flagyl, methotrexate, remicade and Humira
43
What does Flagyl do?
Fights infection in deep, dark places
44
What teaching needs to accompany taking Flagyl?
Don't drink
45
What does Methotrexate do?
It is an immunosuppressant that kills rapidly dividing cells
46
What does Humira do?
Immunosuppressant
47
What teaching needs to accompany Humira?
Stay away from crowds and report signs of infection
48
What is the priority for patients with Crohn's?
Nutritional management
49
What is the diagnostic test for Crohn's?
Biopsy
50
The presence of many abnormal pouch like herniation in the wall of the intestine
Diverticulitis
51
Where do patients with diverticulitis have pain?
Left lower quadrant
52
What are the signs of diverticulitis?
Abdominal distension, guarding, rebound tenderness, decreased BP, hypovolemia, low grade fever, and nausea
53
How is diverticulitis diagnosed?
Barium show
54
What are the primary interventions for patients with diverticulitis?
Drug therapy, nutritional therapy, and rest
55
What drugs are used for patients with diverticulitis?
Flagyl, cipro, anticholinergics, and analgesics
56
What needs to be avoided for patients with diverticulitis?
Avoid laxatives and enemas
57
What does a bowel prep do?
Cleansing and then neomycin
58
A lack of desire to eat despite physiologic stimuli that would normally produce hunger?
Anorexia
59
The forceful emptying of the stomach and intestinal contents through the mouth
Vomiting
60
What are the most common symptoms of nausea?
Hypersalivation and tachycardia
61
Nonproductive vomiting
Retching
62
What is projectile vomiting associated with?
Head injuries and and structural deficits
63
What elevated electrolyte causes constipation?
Calcium
64
A reflux of chyme from the stomach to the esophagus
GER
65
What is GERD caused by?
A loose lower esophageal sphincter
66
What is the hallmark of GERD?
Abdominal pain within 1 hour of eating
67
What cells heal erosions called by GERD?
Barrett's epithelium
68
How can GERD be treated?
Avoid food that irritates stomach, eat slowly, lose weight, sleep on right side
69
Name the protein pump inhibitors
Prilosec, pantoprazole, and Nexium
70
What is Nissen Fundiplication?
Using laproscopic surgery to reinforce the lower esophageal sphincter
71
What is the post op care for patients with nissen fundiplication?
Avoid foods and beverages that cause gas, NG tube
72
Chronic GI disorder characterized by chronic or recurrent diarrhea, constipation, and/or abdominal pain and bloating
Irritable Bowel Syndrome
73
What are the clinical manifestations of IBS?
Abdominal pain relieved by defication or sleep with the sensation of incomplete bowel emptying
74
Where is the pain associated with IBS?
Left lower quadrant
75
What would the assessment of IBS patients reveal?
Normal weight, normal nutrition, normal fluid and electrolytes, and normal bowel sounds
76
What do patients with IBS need to be taught?
Don't abuse laxatives, don't delay the urge to deficate, increase fluids
77
What drugs are used to treat IBS?
Bulk forming laxatives, Bentyl, Ditropan, antidiarrheals, and Elavil
78
What teaching accompanies bulk forming laxatives?
Take at mealtimes with a glass of water
79
What is Bentyl used for?
Relieves cramps caused by smooth muscle spasms
80
What are the side effects of Bentyl?
Blurred vision, SOB, headache, drowsiness, and lack of sweatin
81
What is Ditropan used for?
It stops urge urinary incontinence
82
What is Elavil used for?
Relieves cramping
83
What are the side effects of Elavil?
Turns urine blue-green, constipation, dry mouth, and orthostatics
84
Unnaturally swollen or distended veins in the anorectal region
Hemorrhoids
85
How are hemorrhoids treated?
Preparation H, Rubber band treatment, diet high in fiber and fluids
86
What is the complications for hemorrhoids?
Bleeding
87
What is a nonmechanical intestine obstruction?
Paralytic Ileus
88
In what kind of obstruction are there borborygmi?
Mechanical Obstruction
89
In what kind of obstruction are there no bowel sounds?
Nonmechanical Obstruction
90
What is the hallmark of colorectal cancer?
Weight loss
91
Where is the most common place for colorectal cancer to occur?
In the exit of the rectum
92
What diet modifications can treat colorectal cancer?
Low fat, low carbs, high fiber
93
What is the most common sign of colorectal cancer?
Rectal bleeding
94
What is the diagnostic test for colorectal cancer?
Colonoscopy
95
What speeds up the return of bowel sounds and flatulence?
Ambulation
96
When can food be given post GI surgery?
After the gag reflex, bowel sounds, and flatulence returns
97
When do colostomy pouches need emptied?
When they are 1/3 - 1/2 full
98
Small growths in the intestinal tract that are covered with mucosa and are attached to the surface of the intestine
Polyps
99
What can polyps cause?
Bleeding, intestinal obstruction, and intussusception
100
What are 99% of peptic ulcers caused by?
H. Pylori
101
Ulcers characterized by high gastric acid secretion in the duodenum
Duodenal Ulcers
102
Break in the mucosa of the stomach
Gastric Ulcer
103
When do gastric ulcers cause pain?
Pain with an empty stomach
104
What causes stress ulcers?
Trauma, burns, head injuries, shock, or sepsis
105
What is the hallmark of stress ulcers?
Upper GI hemorrhage
106
When a patient is in shock, what can be done to prevent stress ulcers?
Start on tube feeds
107
What are Curling's ulcers caused by?
Burns
108
What are Cushing's ulcers caused by?
Head injury
109
What causes PUD?
NSAIDs, smoking, caffeine, Theophlylline and alcohol
110
How does Theophlylline cause ulcers?
It stimulates the HCL production
111
Where is the pain from gastric ulcers located?
Right upper quadrant
112
What is the most serious complication of ulcers?
Bleeding
113
What tests diagnose ulcers?
CBC and H&H, EGD
114
If a patient is hemorrhaging from an ulcer, what do you do?
Treat and prevent dehydration, stop the bleeding
115
What drug can be given to stop hemorrhaging?
Vasopressin
116
What are the three major complications that can occur from an ulcer?
Hemorrhage, Gastric Perforation, and Obstruction
117
What is the pharmacological treatment for ulcers?
Two antibiotics and a PPI
118
What does Carafate do?
Forms a viscid and stick gel and adheres to ulcer surfaces, forming a protective barrier
119
What teaching do patients on Carafate need?
Give on an empty stomach one hour before meals and at bed time
120
What surgical intervention can be used to treat PUD?
Vagotomy, antrectomy, or gastrectomy
121
What does a vagotomy do?
Eliminates the acid secreting stimulus to gastric cells and eliminates pain
122
What are the gastrectomy options?
Billroth 1 and 2
123
Patients with gastrectomy will develop what kind of anemia?
Pernicious or Folic Acid deficiency
124
What surgery is dumping syndrome associated with ?
Billroth 2
125
What is dumping syndrome?
Feeling like you will die after eating
126
How can dumping syndrome be avoided?
High protein, high fat and low carb diet, eat in recumbent position, avoid fluids, lie down after meals
127
What are the manifestations of a gastrojsjunocolic fistula?
Fecal vomiting
128
Why are protonix given to a patient experiencing a hemorrhage from PUD?
To protect the blood clot over the ulcer
129
What are the nursing interventions for PUD?
Pain, altered nutrition, and fluid volume deficit

Illness and Patho 1 (12 decks)

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