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GI Flashcards

(85 cards)

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1
Q

Dysphagia: Definition

A

difficulty swallowing

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2
Q

Dysphagia: clinical manifestions

A
  • c/o of difficulty swallowing
  • drooling/ leaking while eating or drinking
  • coughing or choking while eating or drinking
  • recurrent pneumonia or chest congestion
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3
Q

Dysphagia: Nursing Diagnosis

A
  • risk for aspiration

- altered comfort with pain on swallowing

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4
Q

Dysphagia: Nursing Management

A
  • upright for meals
  • thick liquids
  • not feeding while drowsy
  • assisting in cutting food
  • encourage chin tunk
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5
Q

Dumping Syndrome: definition

A

-rapid empty of stomach contents into jejunum

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6
Q

Dumping Syndrome: clinical manifestations

A
  • N/V/D
  • abdominal cramping
  • feelings of fullness
  • palpitations
  • tachycardia/ hypotension
  • diaphoresis
  • weakness/ dizziness/ dehydration
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7
Q

Dumping Syndrome: patient teaching

A
  • low carb and high protein diet
  • avoid: fruit juices, sweet, candies, soda, fried foods, fatty food
  • eat 6 evenly spaced meals without drinking
  • reclining after meals
  • antispasmodic/sedative can delay gastric empty
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8
Q

Appendicitis: definition

A
  • incomplete emptying of appendix cause infection and inflammation
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9
Q

Appendicitis: clinical manifestations

A
  • epigastric pain
  • Mcbrunner’s tenderness: peri umbilical tendered in RLQ
  • Rovsing sign: if LLQ palpated pain is felt in RLQ
  • rebound tenderness
  • nausea/ vomiting
  • fever
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10
Q

Appendicitis: diagnosis

A
  • elevated WBC

- CT scan

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11
Q

Appendicitis: treatment

A

appendectomy

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12
Q

Appendicitis: complications

A
  • rupture of appendix
  • peritonitis
  • abscess formation
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13
Q

Hiatal Hernia: definition

A
  • upper stomach goes through stretched esophageal sphincter and into the esophagus
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14
Q

Hiatal Hernia: Types

A
  • sliding: moved up and down

- paraesophageal: stay in place and risk for strangulations

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15
Q

Hiatal Hernia: clinical manifestations

A
  • pyrosis
  • regurgitation, belching, vomiting
  • dysphagia
  • feelings of fullness
  • most cases asymptomatic
  • abdominal distention and recline make symptoms worse
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16
Q

Hiatal Hernia: diagnosis

A

Barium swallow

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17
Q

Hiatal Hernia: Treatment

A

goal: reduce gastric distention and maintain function gastroesophageal sphincter
- weight loss
- small stomach volume: smaller more frequent meals, less fluid in stomach
- eat upright, upright for an hour, no bending post meal
- sleep HOB 4-8 inches

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18
Q

Hiatal Hernia and GERD fundoplication

A
  • for high risk of aspiration and severe chronic reflux

- wrap stomach around to make sphincter GE smaller

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19
Q

Barium swallow things to note

A
  • NPO before test

- laxative after

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20
Q

Hiatal Hernia and GERD medications

A
  • prokinetic agents: accelerate gastric emptying
  • antacids: neutralize acid
  • H2 receptor antagonist: decrease acid production
  • PPI: decrease gastric acid production
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21
Q

GERD: definition

A

reflux of gastric contents into esophagus

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22
Q

GERD: causes

A
  • decreased lower esophageal sphincter tone
  • increased intra-abdominal pressure
  • pyloric stenosis
  • Hiatal Hernia
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23
Q

GERD: caused of decreased LES tone

A
  • nicotine
  • caffeine
  • ETOH
  • milk
  • chocolate
  • fatty food
  • medications
  • peppermint/spearmint
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24
Q

GERD: clinical manifestation

A
  • pyrosis
  • dyspepsia
  • pain on swallowing
  • regurgitation of stomach contents
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25
GERD: diagnosis
barium swallow
26
GERD: treatment
goal: relieve symptoms and heal mucosa - med: H2 blockers, PPI, antacids - eat 2-3 hours before bed - sleep with HOB up - weight loss - avoid irritants
27
gastritis: Definition
-inflamamtion of gastric mucosa
28
gastritis: acute clinical manifestations
- headache - N/V - hiccuping - fatigue - sometimes bleeding
29
gastritis: chronic clinical manifestations
- epigastric discomfort - pyrosis - N/V - belching - anorexia - sour taste - intolerance to some food - vitamin deficiency
30
gastritis: non-erosive
usually caused by H pylori
31
gastritis: diagnosis
- H pylori test | - UGI x ray
32
gastritis: treatment
- treat H pylori - NPO while symptomatic - avoid caffeine, nicotine, ETOH - meds: H2 blockers or PPI
33
gastritis: erosive
caused by - over use of ASA, NSAIDs, alcohol - bile reflux - radiation therapy
34
Peptic Ulcers: definition
- excavation in mucosal wall caused by overproduction of acid or by mucosal damage
35
Peptic Ulcers: causes
- Stress - Med: ASA, NSAIDS - Smoking - ETOH - gastritis - H pylori
36
Peptic Ulcers: gastric ulcers: clinical manifestations
- associated with cancer - dull, gnawing epigastric pain 1/2-1 hr after meal - no pain at night - eating make it worse - hemorrhage more likely - hematemesis and melena
37
Peptic Ulcers: duodenal ulcer: clinical manifestations
- 2-3 hour after meal - pain at night - eating can relieve - Melena and red bloody stool
38
Peptic Ulcers: treatment
- treat H. pylori - NPO when symptomatic - avoid nicotine, ETOH, caffeine - Meds: H2 blocker or PPI - Avoid ASA and NSAIDS
39
Peptic Ulcers: Complications
- hemorrhage - perforation - pyloric obstruction
40
Peptic Ulcers: surgical procedures
- vagotomy: cut off part of vagus nerve stop sending message to make acid - antrectomy: cut off part of stomach that makes acid - pyloroplasty: enlarging opening to let stomach contents flow more feely
41
H pylori treatment
-triple or quadruple therapy
42
Bowel Obstruction: definition
anything that blocks forward movement of intestinal content
43
Bowel Obstruction: Types
- Mechanical: pressure exerted on wall prevent forward movement - functional: paralytic ileus: lack of innervation or decreased muscle tone - herination, adhesion, intussciption, voluvus
44
Bowel Obstruction: early obstruction
- BS sounds tinkle need obstruction; and silent after - short, intermittent pain - bilious vomit
45
Bowel Obstruction: late obstruction
- BS silent - distention - vomit has fecal odor - shock
46
Bowel Obstruction: other clinical manifestations
- cramp - nausea - diarrhea - constipation - fever and tachycardia: late finding, strangulation
47
Bowel Obstruction: Acute
- fever - tachycardia - peritoneal signs
48
Bowel Obstruction: Management
- NPO: gastric decompression - IV hydration - monitor fluid electrolyte balance - fever - pain relief - assess for return of bowel sounds and flatus - measure abdominal girth
49
Peritonitis: defintion
inflammation of peritoneal cavity lining
50
Peritonitis: clinical manifestations
- abdominal pain/ rigidness - worsening/ unexplained encephalopathy - diarrhea - worsening/new renal failure - ascites that does not resolve with diuretics - fever and chills - ileus
51
Peritonitis: diagnosis
- labs - x ray - CT scan
52
Peritonitis: Treatment
- IV hydration - antibiotics - surgery
53
Peritonitis: complications
-sepsis
54
Peritonitis: nursing diagnosis
- risk for infection - fluid volume deficit - anxiety/fear - knowledge deficit - imbalanced nutrition
55
Fecal Diversion: indications
- cancer - Inflammatory bowel disorders - temporary: protect anastomosis
56
Fecal Diversion:patient implication
- body iamge - attitude toward body function - appliance and self care ability
57
Fecal Diversion: types
colostomy: large intestine redirected to abd. wall ileostomy: small intestine redirected to abd. wall
58
Fecal Diversion: colostomy: indications
- colon/rectum cancer - chron's disease - ulcerive colitis - trauma - diverticular disease
59
Fecal Diversion: preoperative care
- pain management - OOB in 8 hours - assess for return of peristalsis can take up to 3 days - NGT may be placed for flatus - If ileostomy: drink 2-3L of water - wound assessment - prevent infection, respiratory/thromboembolic complications - avoid foods that cause odor - appliance care - teach self care and emotional need
60
Irritable Bowel Syndrome: definition
- unknown cause | - functional problem with intestinal motility
61
Irritable Bowel Syndrome: factors related to
- smoking - stress - women - high fat diet - depression
62
Irritable Bowel Syndrome: diagnosis
r/o pathophysiology
63
Irritable Bowel Syndrome: treatment
- identify irritants | - promote regularity of BM: exercise, probiotics, fiber
64
IBD: Chron's: definition
inflammation of bowel from esophagus to sigmoid colon in patches
65
IBD: Chron's: clinical manifestations that are different than UC
- RLQ pain post meal - minimal bleeding - N/V/D - systemic: joint pain, skin lesions, conjunctivitis, oral ulcers - malabsorption, anemia, weight loss, diarrhea
66
IBD: Chron's: diagnosis
- UGI barium - stool steatorrhea - occult blood test - blood test: albumin, total nutritional assessment, electrolytes, CBC, ESR
67
IBD: Ulcerative Colitis: definition
inflammation of sigmoid colon
68
IBD: Ulcerative Colitis: clinical manifestations different than Chron's
- LLQ pain - bleeding, dehydration - fever - fatigue - loss of appetite - urgent BM - anemia, wight loss, malabsorption, diarrhea
69
IBD: Ulcerative Colitis: diagnosis
- colonoscopy: not in acute: risk for bleeding - bloody stool - blood test: anemia (hemoglobin and hematocrit), total nutritional assessment, electrolytes
70
IBD: treatment and Management
- in acute exacerbation: Bowel rest: NPO/ gastric decompression - IV fluids - TPN - Meds - malnutrition: low residue, high protein, high calories - prevent worsening of inflammation
71
diverticular disease: definition
- disease of diverticulum
72
diverticulitis: definition
-inflammation and infection of diverticula
73
diverticulitis: clinical manifestation
- abd. pain (LLQ) - constipation/diarrhea - fever - N/V
74
diverticulitis: complications
- perforation - peritonitis - abscess formation - bleeding - colonic obstruction
75
diverticulitis: diagnosis
- abd. x ray | - abd CT: contrast test
76
diverticulitis: treatment of mild
- oral antibiotics | - liquid diet w/ low fiber foods and progress
77
diverticulitis: treatment of moderate to severe
- NPO/ NGT (gastric decompression) - broad spectrum - surgical intervention - drainage of access/ collection of pus - remove affect section of colon
78
diverticulosis: definition
weak muscle tone causes formation of diverticula
79
diverticulosis: causes
- congenital wall weakening - low fiber intake - straining on defectation - age
80
diverticulosis: clinical manifestation
- ongoing bowel irregularites - constipation/diarrhea - Nausea - bloating - anorexia - abd. distention
81
diverticulosis: diagnosis
colonoscopy
82
diverticulosis: treatment and teaching
- high fiber diet - bulk laxatives - avoid nut, corn, - exercise - permanent but manageable - teach signs of diverticulitis
83
Nutrition Feeding: Nasogastric diagnostic indications
- evaluate UGI bleeding - aspiration of gastric content - Identify esophagus and stomach on chest x ray - administer radiograph contest to GI track
84
Nutrition Feeding: Nasogastric therapeutic indications
- gastric decomposition - relive small bowel obstruction symptoms - bowel rest - aspiration - medication administration - feeding - check placed before use
85
Nutrition Feeding: parenteral:TPN indications
- oral intake is insufficient - pt unwilling to ingest adequate nutrients - pre/post operative - Chron's - can ingest orally or by tube

Adults 1 (3 decks)

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