GI/Hepatic/Pancreatic Flashcards
Peptic Ulcer
-History of:
NSAID
corticosteroid
H. Pylori
stress
smoking
alcohol
caffeine
type O blood
-Presentations:
Dyspepsia (indigestion)
worse on empty stomach
decreased hemoglobin and hematocrit
-Treatment:
avoid very hot or very cold foods
eat 3 regular meals a day
meds: PPI + antibiotics for first 14 days
Cholecystitis
- infalmmation of the gallbladder
- murphy’s sign
- Causes:
more common in females
obesity
high fat diet
older adults
type 2 diabetes
-Presentation:
abdominal pain that radiates to the right shoulder
-tachycardia (priority intervention)
- monitor for clay colored stools and dark urine, which indicates gallstone obstruction
- Cholelithiasis or gallstones are hardened deposits of digestive fluid that can form in your gallbladder
-Treatment:
- analgesics
- low fat diet (angel food cake, sherbet, and gelatin are ok for dessert)
- high fiber (bananas, apples, barley)
- avoid gas-producing foods such as broccoli and cabbage
- empty collection bag every 8 hours
report drainages more than 1,000mL
-after cholecystectomy: teach how to deep breathe and cough to split incision and reduce risk of respiratory complications
Peritonitis
-inflammation of abdominal wall
-rebound tenderness
-board-like abdomen
-tachycardic
-nausea and vomiting
-semi-fowlers or fowlers position (semi: 30-45, fowlers:45-60)
- elevated WBC count and neutrophils are sign of infection which is a manifestation of peritonitis
Ulcerative Colitis
- inflammation of the superficial mucosa of the colon
- caused by family and jewish history
- accutane use
- caucasian ethnicity
- low fiber diet can cause it
- presents as liquid bloody stools, low grade fever, abdominal distention along the colon, high pitched bowel sounds, left lower quadrant pain
Appendicitis
- inflammation of appendix
- Mcburny’s sign (rebound tenderness RLQ) and Rovsing’s sign (when you press on LLQ, pain is felt in RLQ)
- RLQ pain
- Nausea
- Low-grade fever
- Rebound pain/tenderness
- Ruptured appendix → peritonitis, abdominal distension, worsening condition
- sudden stop of pain means appendix ruptured
Assessment & Diagnostic Testing:
- History and physical
- CBC
- C-Reactive Protein (CRP is a protein level within the liver. Elevated = infection/inflammation)
- CT Scan
- Pregnancy test
Pancreatitis
- inflammation of pancreas
- turner and cullen’s sign
- caused by alcohol, gallstones, drugs, infection, trauma
- midepigastric or left upper quadrant pain
- pain gets worse with meals and when lying down
- N/V, weight loss
- elevated liver (ALS, AST) and pancreatic enzymes (amylase and lipase)
- monitor for hypocalcemia and hypomagnesium
Cirrhosis
- irreversible scarring of the liver that disrupts structure and function
- presents as enlarged liver, juandice, weight loss, splenomegaly, ascites, bleeding, esophageal varices, tea-colored urine
- treatment: weigh client daily, assess skin integrity, high calorie low protein, low fat, low sodium diet
- labs: low albumin, high ammonia, high bilirubin, prolonged PT
Hepatitis
- inflammation of liver caused by infectious organisms, chemicals, or toxins
- must be reported to local health department
- Hep. A = food/water, fecal-oral route, person to persom
- Hep. B/C = sex, blood products, sharing needles
Crohn’s Disease
- inflammation of GI tract that extends through all layers
- cobblestone appearance
- abdominal pain that does not resolve with defecation, gets worse when eating
- fistulas
- pain in right lower quadrant
- SLOW bleeding can occur (can cause anemia)
- bright red blood stools – not as much blood as ulcerative colitis
- decreased Hct, Hgb, elevated ESR
- diet: high calorie, high protein, low fiber, no dairy
- diarrhea
- meds: metronidazole
- for fecal occult blood test: do not eat red meat, raw veggies or fruits, or vitamin C 3 days before
Diverticulitis
-small sacs or pouch-like herniations in the wall of the colon
- can be caused by low fiber, high fat, and red meat
- constipation
- decreased hemaglobin and hematocrit due to chronic or severe bleeding
- tachycardia, nausea, and vomiting
- DO NOT GIVE MORPHINE (increases pressure in colon)
- LEFT LOWER QUADRANT PAIN
IBS
- do not drink fluids with meals
- smaller meals that are high calorie, high protein
- take psyllium in the evening for constipation IBS, and loperamide in the morning for diarrhea IBS
- causes: smoking, caffeine, Nsaids, stress, high fat diet, dairy products, alcohol, females
