GI & GU Emergencies

Question 1

Solid organs in abdominal cavity.

Answer 1

liver, spleen, pancreas, kidneys, and ovaries

Question 2

Which organs are retroperitoneal?

Answer 2

kidneys, ovaries, and pancreas

Question 3

An injury to a _____ organ can cause shock and bleeding due to the amount of blood vessels contained in the organs.

Answer 3

solid

Question 4

Main function of GI system is :

Answer 4

absorb and digest products to fuel cells.

Question 5

Portal viein

Answer 5

Transports venous blood from GI tract to liver for processing of nutrients that have been absorbed.

Question 6

What happens if blood flow through the liver slows?

Answer 6

The blood may back up throughout the GI system. Veins surrounding the stomach and esophagus dilate. Low pressure can cause leaking or rupture.

Question 7

Two main functions of urinary system:

Answer 7

Keeps track of electrolytes, water content, and acids in blood.
Removes metabolic wastes, drug metabolites, and excess fluids.

Question 8

Causes of peritonitis

Answer 8

Infection
Penetrating abd wound
Severe blunt injury
Many diseases

Question 9

Major clinical signs of peritonitis

Answer 9

Abd tenderness and distention

Question 10

Visceral peritoneum is only stimulated when :

Answer 10

distention or contraction of hollow abd organs active stretch receptors.

Question 11

Parietal peritoneum can perceive the same sensations as skin because

Answer 11

its supply be the same nerves from the spinal cord that supply the skin overlying the abdomen.

Question 12

What part of the nervous system supplies the visceral peritoneum?

Answer 12

Autonomic

Question 13

Visceral pain

Answer 13

Occurs when receptors in hollow structures are stimulated.

Question 14

Referred pain

Answer 14

Pain felt in an area of the body other than the area where the cause of pain is located.

Question 15

Why is the source of visceral pain difficult to pinpoint?

Answer 15

Only a few nerve fibers may be involved in pain transmission.

Question 16

Peritonitis typically causes ___.

Answer 16

Ileus - paralysis of muscular contractions.

Question 17

Location of pain with appendicitis.

Answer 17

Direct: RLQ
Referred: navel
Palpation: rebound tenderness

Question 18

Location of pain with cholecystitis.

Answer 18

Direct: RUQ
Referred: right shoulder

Question 19

Location of pain with ulcer.

Answer 19

Upper mid-abd or upper back

Question 20

Location of pain with diverticultitis.

Answer 20

LLQ

Question 21

Location of pain with AAA.

Answer 21

Lower back

Lower quadrants

Question 22

Location of pain with cystitis.

Answer 22

Retropubic

Question 23

Location of pain with pylonephritis.

Answer 23

Costovertebral angle.

Question 24

Location of pain with kidney stone.

Answer 24

Flank

Referred: radiating to genitalia

Question 25

Location of pain with PID.

Answer 25

Lower quadrants

Question 26

Location of pain with pancreatitis.

Answer 26

Upper abd | Back

Question 27

Location of pain with pnuemonia.

Answer 27

Referred to upper abd

Question 28

Conditions that may cause or lead to urinary retention.

Answer 28

``` Kidney stones BPH Urethral obstructions UTI Nerve damage ```

Question 29

Causes of acute abdomen.

Answer 29

``` GI hemorrhage Esophagitis GERD Peptic ulcer disease Mallory-Weiss tear Esophageal varices Hemorrhoids ```

Question 30

Acute abdomen

Answer 30

Sudden onset of abd pain that indicated irritation of peritoneum

Question 31

Causes of upper GI bleed.

Answer 31

``` Esophagitis Esophageal varices Mallory-Weiss tear Esophageal cancer Cirrhosis, lover disease GERD Stomach ulcers Stomach cancer Gastritis Duodenal ulcer (can cause lower) Small intestine cancer (can cause lower) IBS (can cause lower) ```

Question 32

Causes of lower GI bleed.

Answer 32

``` Duodenal ulcer (can cause upper) Small intestine cancer (can cause upper) IBS (can cause upper) Ulcerative colitis Colorectal polyps Colorectal cancer Diverticular disease Hemorrhoids ```

Question 33

s/s of upper GI bleed.

Answer 33

Melena | Hematemesis

Question 34

s/s of lower GI bleed.

Answer 34

Hematochezia

Question 35

Complications and adverse reactions of dialysis

Answer 35

``` Hypotension Muscle cramps N/V Hemorrhage, access site Infection at access site AMS LOC Air embolism Electrolyte imbalance Myocardial ischemia ```

Question 36

Why should you consider the possibility of cardiac dysrhythmias and ALS backup?

Answer 36

Dialysis changes the blood's chemistry which can lead to an electrolyte imbalance.

Question 37

What are some s/s if patient's missed their dialysis treatment?

Answer 37

Weakness, pulmonary edema or excess of electrolytes.

Question 38

How to manage a dialysis patient?

Answer 38

``` ABCDEs High-flow oxygen if indicated Manage bleeding from access site Position pt sitting upright in case of pulmonary edema. Supine if shock. Transport promptly. ```

Question 39

How do you manage an air embolism in a dialysis patient?

Answer 39

Disconnect from dialysis machine Supine Transport immediately

Question 40

s/s of air embolism

Answer 40

sudden dyspnea hypotension cyanosis

Question 41

s/s disequilibrium syndrom

Answer 41

N/V Headache Confusion

Question 42

What is the origin, description, and cause of visceral discomfort?

Answer 42

Origin : hollow organs Description : difficult to localize; described as burning, cramping, gnawing, or aching; usually superficially Cause : organ contracts too forcefully or is distended

Question 43

What is the origin, description, and cause of parietal pain/rebound pain?

Answer 43

Origin : peritoneum Description : steady, achy pain; easier to localize than visceral, increases with movement Cause : inflammation of the peritoneum secondary to bleeding or infection

Question 44

What is the origin, description, and cause of somatic pain?

Answer 44

Origin : peripheral nerve tracts Description : deep localized pain Cause : irritation of or injury to tissue causing activation of peripheral nerve tracts

Question 45

What is the origin, description, and cause of referred abd pain?

Answer 45

Origin : peripheral nerve tracts Description : pain originating in abd and causes perception of pain in distant locations; usually occurs after initial visceral, parietal, or somatic pain. Cause : similar paths for the peripheral nerves of the abd and the distant location

Question 46

What are pertinent negative you should obtain in your SAMPLE for GI or GU?

Answer 46

``` N/V Changes in bowel habits Urination Weight loss Belching or flatulence Pain Concurrent chest pain LNMP if female childbearing age Recent surgery or hospitalizations Ingested any substance that could cause the sxs ```

Question 47

Where should you start when palpating the abd?

Answer 47

Opposite from the site of pain rotating clockwise.

Question 48

Medical care prior to transport for GI/GU

Answer 48

1. Do not dx 2. Clear and maintain airway 3. Anticipate vomiting - recovery position or comfort 4. Administer 100% oxygen and anticipate ventilation 5. NPO 6. Document all pertinent info. 7. Establish IV 9. Keep patient comfortable. Conserve body heat. Provide gentle transport and constant psychological support. 10. Monitor vital signs.

Question 49

What fluids should be given for GI/GU emergencies?

Answer 49

Keep-vein-open rate Signs of hypovolemia: 20-mL/kg bolus of isotonic crystalloid UTI, kidney stone : bolus of fluid

Question 50

What GI/GU emergencies should be transported promptly?

Answer 50

``` PID Ectopic pregnancy Aneurysm Hernia AKI CKD ```