GI Flashcards
(132 cards)
1
Q
auto digestion of the pancreas
A
pancreatitis
2
Q
endocrine function of the pancreas
A
insulin
3
Q
exocrine function of the pancreas
A
digestive enzymes
4
Q
1 cause of acute pancreatitis
A
alcohol
5
Q
2 cause of acute pancreatitis
A
gallbladder disease
6
Q
1 cause of chronic pancreatitis
A
alcohol
7
Q
sx of pancreatitis
A
pain ascites abdominal mass rigid abdomen culler's sign fever N/V jaundice hypotension
8
Q
bruising around umbilical area
A
cullen’s sign
9
Q
bruising around flank area
A
grey-turner’s sign
10
Q
how do you diagnose pancreatitis
A
elevated liver enzymes
elevated WBCs
increased blood sugar
increased serum bilirubin
11
Q
with pancreatitis the PT and aPTT is _____.
A
longer
12
Q
normal amylase
A
30-220
13
Q
normal lipase
A
0-110
14
Q
normal AST
A
8-40
15
Q
normal ALT
A
10-30
16
Q
treatment for pancreatitis
A
control pain
steroids
anticholinergics
GI protectants
17
Q
with pancreatitis we want the stomach ____ and _____
A
empty and dry
18
Q
male hemoglobin levels
A
14-18
19
Q
female hemoglobin levels
A
12-16
20
Q
male Hct levels
A
42-52%
21
Q
female Hct levels
A
37-47%
22
Q
why do we give anticholinergics with pancreatitis?
A
dry up secretions
23
Q
examples of anticholinergics
A
benztropine
atropine
24
Q
examples of GI protectants
A
pantoprazole
ranitifidine
famotidine
antacids
25
since we want the stomach empty and dry the client with pancreatitis needs
NPO
NGT to suction
bedrest
26
why will pancreatitis patients need insulin?
pancreas is sick
steroid use
TPN
27
4 major functions of the liver
detoxifying the body
helps blood clot
breaks down drugs
synthesizes albumin
28
with cirrhosis of the liver, liver cells are destroyed and replaced with scar tissue with alters the circulation within the liver, which in turn makes the BP in the liver go up....this is called?
portal HTN
29
if your liver is sick ____ is your #1 concern
bleeding
30
if your liver is sick ___ the dose of meds
decrease
31
never give ___ to people with liver problems
tylenol
32
antidote for tylenol
acetylcysteine (mucomyst)
33
sx of cirrhosis
```
firm, nodular liver
abdominal pain
chronic dyspepsia
change in bowel habits
ascites
splenomegaly
```
34
serum albumin with cirrhosis
decreased
| 3rd spacing
35
ALT and AST in cirrhosis
increased
36
when the spleen is enlarged, the _____ system is involved
immune
37
dx of cirrhosis by?
liver biopsy
CT/MRI
ultrasound
38
which labs need to be viewed prior to liver biopsy
PT, INR, aPTT
39
how do you position client for liver biopsy
supine with R arm behind head
40
post liver biopsy position?
lie on R side
41
treatment for cirrhosis
antacids, vitamins, diuretics
no more alcohol
I/Os, daily weights
measure abdominal girth
42
removal of fluid from the peritoneal cavity
paracentesis
43
have the client ____ before paracentesis
void
44
position for paracentesis
sitting up
45
with "shocky" clients, the BP goes ____ and the pulse goes ____
down
| up
46
anytime you are pulling fluids you can throw them into ____
shock
47
avoid ____ because the liver can't metabolize drugs well when it's sick
narcotics
48
if you give a liver client narcotics, it's the same thing as doing what to them?
double dosing them
49
diet for cirrhosis
decrease protein
| low sodium diet
50
protein breaks down to _____
ammonia
51
the liver converts ammonia to ____
urea
52
the kidneys excrete the ____
urea
53
when the liver is impaired, it can't make the conversion to urea and _____ builds up in the blood
ammonia
54
what does the increase in ammonia do?
decrease LOC
55
ammonia acts as a ____
sedative
56
sx of hepatic coma
```
mental changes
difficult to awake
asterixis
slow EEG
fector
```
57
what is fector?
breath smells like ammonia
58
treatment for hepatic coma
lactulose
cleansing enema
decrease protein in the diet
59
lactulose decreases serum _____
ammonia
60
high BP in the liver known as ____ ___ forces collateral circulation to form
portal HTN
61
the collateral circulation forms in 3 different places?
stomach
esophagus
rectum
62
when you see an alcoholic client that is GI bleeding it is usually _____ _____
esophageal varices
63
esophageal varices are usually no problem until they _____
rupture
64
treatment for esophageal varices
replace blood
VS
CVP
Oxygen
65
_______ medication helps with esophageal varices by lowering BP in the liver
octreotide (sandostatin)
66
an infrequently used emergency procedure that may be used to stabilize clients with severe hemorrhage with esophageal varices
balloon tamponade
67
balloon tamponade should not be used more than _____ hrs
12
68
purpose of balloon tamponade
hold pressure on bleeding varices
69
common cause of GI bleeding
peptic ulcers
70
peptic ulcers are most common in ?
males
71
sx of Peptic ulcers
burning pain
| heartburn
72
dx of peptic ulcers
gastroscopy
| Upper GI
73
what's important about gastroscopy
NPO before
| they're sedated
74
watch for perforation with gastroscopy by watching for what 3 things?
pain
bleeding
trouble swallowing
75
looks at the stomach with dye
upper GI study
76
NPO for how long for upper GI
NPO past midnight
77
education before upper GI
no smoking, gum, or mints
| no smoking/nicotine patches
78
treatment of peptic ulcers
antacids
PPIs
H2 antagonist
79
client teaching with peptic ulcers
decrease stress
stop smoking
avoid spicy foods
80
malnourished
pani is usually half hour to 1 hr after meals
food doesn't help, vomiting does
vomit blood
gastric ulcers
81
well-nourished
night time pain and 2-3 hrs after meals
eating helps
blood in stools
duodenal ulcers
82
when the hole in the diaphragm is too large so the stomach moves up into the thoracic cavity
hiatal hernia
83
main cause of hiatal hernia
large abdomen
84
other causes of hiatal hernia
congenital abnormalities
trauma
straining
85
sx of hiatal hernia
heartburn
fullness after eating
regurgitation
dysphagia
86
tx of hiatal hernia
small freq meals
sit up 1 hr after meals
elevate HOB
surgery
87
when the stomach empties too quickly after eating and the client experiences many uncomfortable to severe side effects...usually secondary to gastric bypass, gastrectomy, or gallbladder disease
dumping syndrome
88
sx of dumping syndrome
```
fullness
weakness
palpitations
cramping
faintness
diarrhea
```
89
left side lying=
leaves it in
90
right side lying=
releases it
91
tx of dumping syndrome
```
semi-recumbent with meals
lie down after meals
no fluids with meals
small freq. meals
avoid food high in carbs and electrolytes
```
92
ulcerative inflammatory bowel disease
| only in lg. intestine
ulcerative colitis
93
inflammation and erosion of the ileum but can be found anywhere in the small or large intestine
chron's disease
94
sx of ulcerative colitis and chron's disease
```
diarrhea
rectal bleeding
weight loss
vomiting
cramping
dehydration
blood in stools
anemia
rebound tenderness
fever
```
95
what does rebound tenderness indicate?
peritoneal inflammation
96
dx of ulcerative colitis and chron's disease
CT
colonoscopy
barium enema
97
clear liquids __-__hrs before colonoscopy
12-24
98
NPO __-__hrs before colonoscopy
6-8
99
they drink go-lytely before the colonoscopy. the other name for this is?
sodium polystyrene sulfonate
100
to help your client drink a colon prep more easily, get it _____
ice cold
101
post op colonoscopy watch for?
perforation
102
sx of perforation after colonoscopy
pain/unusual discomfort
103
treatment for ulcerative colitis and chron's disease
diet
meds
surgery
104
diet for ulcerative colitis and chron's disease
low fiber diet
| avoid cold foods, hot foods, and smoking
105
meds for ulcerative colitis and chron's disease
antidiarrheals
ATBs
steroids
106
surgery for ulcerative colitis
total colectomy
| kock's illeostomy
107
a kock's pouch hav a nipple valve that opens and closes to ____ the intestines
empty
108
the J pouch procedure removes the colon and attaches the ____ to the ____
illeum to the rectum
109
with chron's they try not to do ____
surgery
110
an ostomy in the ileum is called an ___
ileostomy
111
an ostomy in the colon is called a _____
colostomy
112
an ileostomy is going to drain _____ all the time
liquid
113
do you have to irrigate ileostomy?
NO
114
ileostomy patients are always at risk for ___ ___ because they are always a little dehydrated
kidney stones
115
a colostomy in the ascending and transverse colon have what type of stools
semi liquid
116
colostomy in the descending or sigmoid colon have what type of stools?
semi-formed or formed
117
which ostomys do you irrigate?
descending and sigmoid
118
sx of appendicitis
pain at mcburney's point
rebound tenderness
N/V
anorexia
119
dx of appendicitis
increased WBCs
ultrasound
CT
120
do not give ___ or ___ with appendicitis because we are worried about perforation
enemas or laxatives
121
treatment for appendicitis
surgery
122
after appendectomy what position should they be in?
HOB up
123
keep TPN refrigerated but ___ for administration
warm
124
what 2 things are needed for TPN
filter and central line
125
BG monitoring q ___ hrs with TPN
6 hrs
126
TPN can only be hung for ___ hrs
24
127
check urine for ___ and ____ with TPN
glucose and ketones
128
position to put in a central ine
trendelenburg
129
if air gets in the central line what position do you put them in?
left side trendelenburg
130
when changing the tubing for central line, how do you avoid getting air in the line?
clamp it off
valsalva
take a deep breath and HUM
131
why is x-ray done post insertion of central line?
placement
| and to make sure they don't have pneumothorax
132
central lines go into the ___ ___
RA
