GI PowerPoint Flashcards by Jade Ring

_____ uses a scope and camera to observe (esophagus, stomach and the first part of your small intestine).

_____ uses a scope to observe further down the intestine

Endoscopy

Enteroscopy

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An esophageal stricture is

narrowing of the esophagus, or throat, that can make it difficult to swallow

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_____ based fecal Occult blood test (gFOBT)

Guiac

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_____ is a minimally invasive medical procedure that examines the large intestine from the rectum
to the sigmoid colon, the part of the colon closest to the rectum.

sigmoidoscopy

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Steatorrhea is

Excess fat in feces. It can cause stools to be bulky, difficult to flush, pale, oily, and foul-smelling.

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Order of physical assessment for GI

Inspection
Ausculation
Percussion
Palpation

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Esophagogastroduodenoscopy (EGD), also known as an upper GI endoscopy, is a procedure that examines ….

the lining of the esophagus, stomach, and duodenum (first part of the small intestine

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Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that uses ….

To examine

an endoscope and X-rays

to examine and treat the bile and pancreatic ducts

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A small bowel capsule endoscopy…

Patient swallows a capsule containing a camera

noninvasive diagnostic procedure that allows a doctor to see inside the digestive tract

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A liver-spleen scan, also known as a liver scan is….

a nuclear medicine procedure that uses a small amount of radioactive material to check for abnormal areas in the liver or spleen

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Bulging pulsating abdominal mass or a bruit is heard during Ausculation

What can the cause be

Special precautions

Abdominal aortic aneurysm

DONT TOUCH

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Oncofetal antigens are

Antigens found in both fetuses and adult cancer patients

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Normal urine contains some urobilinogen.

Too much urobilinogen in urine may be a sign of a ….

Little or no urobilinogen may be a sign of other problems with your …..

liver disease, such as hepatitis or cirrhosis, or certain types of anemia.

liver, gallbladder, or bile ducts. Urobilinogen comes from bilirubin

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The fecal immunochemical test (FIT) is

Preformed yearly

a screening test for colon cancer that looks for blood in stool samples

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EGD Endoscopy

Prep

Hold….
NPO?
Remove….
IV needed?
Sedation?

Hold NSAIDS
NPO
Remove dentures
IV needed
Moderate Sedation

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EGD Endoscopy

Post

NPO?
VS?
Side rails up?
Monitor for?
No Driving?

NPO until gag reflex returns
VS Q 15 min
Side rails up
Monitor for Pain, Bleeding, Fever
No driving 12 - 18 hrs

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Priority care for Post EGD

Prevent aspiration

NPO until gag reflex returns

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Endoscopic Retrograde Cholangiopancreatography (ERCP)

PRE & POST Care same as EGD

Teach family to monitor for…

Cholecystitis or cholangitis

Gallbladder inflammation or infection

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Small Bowel Capsule Endoscopy

Prep

NPO?
When can they start to consume fluid and foods?

NPO 12 Hrs (includes fluids)
Remain NPO 2 hrs into test
Clear fluids after 2 hrs
Light lunch 4 hours into test

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Colonoscopy

Prep

Hold….

Anticoagulant/ NSAIDS

you know the rest of the prep

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Colonoscopy

POST

NPO?
VS?
Posistion?
Side rails up?
Monitor for (3)
Driver required?

NPO until Sedation wears off
VS Q 15 mins
Lie on left side
Monitor: Hemorrhage, Pain, Low BP
DRIVER REQUIRED

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Liver- Spleen Scan

Radioactive tracer given via IV
Eliminated in urine 24hrs
Avoid in which patient’s?
Teach?

Avoid in pregant

Teach: lie still in exam & wash hands carefully after toilet

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Vegan diets can predispose people to anemia from lack of…

Vitamin B12

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Ideal BMI range

18.6 - 24.9

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Underweight BMI

<18.5

Overweight BMI

25 - 29.9

Obese BMI

>30

Marasmus Kwashiorkor Starvation

3 forms of protein undernutrition

Marasmus is a

deficiency of all macronutrients: carbohydrates, fats, and protein

Kwashiorkor

Protein malnutrition is mostly found in people living in geographical areas that have limited food resources

Glossitis

Inflammation of the tongue

Stomatitis

A condition that causes painful swelling and sores inside the mouth

Unrecognized Dysphagia may cause these 3 problems in older adults

Undernutrition, dehydration, aspiration

Concern for weight loss % in a month % over 6 months

5 10

How long can a nasoenteric tube be inserted How long can a PEG/J Tube be inserted

<4 weeks Long term

How often to check PEG tube

It is proper to rotate a PEG tube 360° daily

True

How long of a supply do you add to a feeding tube? How often to change bag and line

4 hrs 24 hrs

Refeeding syndrome is

a potentially fatal condition, caused by rapid initiation of refeeding after a period of undernutrition.

To keep tube patent Flush with water, when?

Q 4h Before and after meals After interruption of enternal nutrition

If tube is clogged use

50mL piston syringe and 30 ML

Parenternal Nutrition is used for.. Who decides the formula

When GI tracts can't be used. Pharmacy

Give these solutions of TPN bag isn't available

D10W D20W

Does a TPN bag require a 2nd check by an RN

Yes

Liraglutide Naltrexone- bupropion Orlistat Phentermine-topiate

Drug therapy for Obese

Surgical management of Obesity If... BMI BMI or weight more than ____ % of ideal weight

BMI >40 BMI >35 with other health issues Greater than 100%

Priority for weight loss surgery is...

Airway management

Postoperative weight loss surgery Apply.... Monitor for....

Abdominal binder Dumping Syndrome

Postoperative weight loss surgery Clear liquids in ___ oz cups On discharge diet? When can they eat pureed, soft, & solid foods

1 Full liquids on discharge Puree 1 week Soft foods several weeks Solid foods 8 weeks

Dyspepsia

Indigestion

Atrophy of gastric mucous Lower hydrochloric acid levels Related disorders Malabsorption of which vitamins?

Malabsorption of Iron & Vita B12 Overgrowth bacteria Gastritis

Peristalsis slowed Dulled nerve impulse Relat3d disorders

Lower sensation for BM Constipation/ impaction

Lower number / size of hepatic cells Related disorder

Drugs not metabolized Lead to Toxic levels

A prothrombin time (PT) test measures ...

how long it takes for blood to clot. A high PT can indicate that there is serious liver damage or cirrhosis, and that there may be a higher risk of internal

A bilirubin test can help investigate issues with the gastrointestinal (GI) tract. These (2) organs What does a high or low value mean

Liver disease / gallbladder High bilirubin means liver is having a hard time converting bilirubin into bile

CBC Celiacs will have an increased number of _____

Antibodies due to perceiving gluten as a threat

CBC IBS will have an increased number of

WBC

Can ulcers be detected by a cbc

Yes H pylori can be detected in a cbc

CRP High levels of C-reactive protein can indicate these diseases

Crohn's, acute pancreatitis, IBS

Urine test measuring _____ are used for diagnosing pancreatitis

Amylase

Fecal fat test High levels of fat in the stoll can indicate these organs aren't functioning properly

Pancreas: lipase Liver: bile production

An ALT result of 100 IU/L or higher is a clear indicator of.... A mildly elevated ALT result (30–100 IU/l) may be due to: Medication, such as statins A lower than normal ALT result is uncommon and usually isn't a cause for concern. However, it could mean .....

serious liver disease. Vitamin B6 deficiency or chronic kidney disease

Low normal range serum amylase and/or lipase suggests this problem

chronic pancreatitis

A fecal immunochemical test (FIT) is a home test that looks for....

blood in stool samples, which can be an early sign of colon cancer

S / S Sudden, intense pain in the upper right abdomen Pain that spreads to the back or below the right shoulder blade Pain that worsens with deep breaths Tenderness over the abdomen when touched

Cholecystitis

RDN computes Enteral Nutrition formula Is a script needed by a HCP

Yes

Enterostomal feeding is the placement of a NG tube True or False

False Enterostomal feeding is the placement of a PEG/J tube

Tube Feeding care Check for residual volume How often

Q 6h

Flush tube with 30ml water and at least 30ml syringe every 4 hours If clogged...

Use 50 mL piston syringe and 30 mL water

Obesity Class 1,2,3 values

Class 1: 30 - 35 2: 35 - 40 3: >40

Liraglutide Anti-diabetic medication It can treat type 2 diabetes. It can also promote weight loss in certain patients. Which route is this drug available

Sub Q

Naltrexone Class of medications: Opiate Antagonists. Bupropion is in a class of medications called antidepressants.

Work together on two areas of the brain Hunger center and the reward system, to reduce appetite and help control cravings.

Orlistat Common brands: Alli, Xenical Action: Lipase inhibitor S/E...

oily stools, diarrhoea, abdominal pain and faecal spotting

Phentermine-topiramate Class/action: ....

Anorectics. It works by decreasing appetite

Most common bariatric surgery

Gastric Bypass Roux-en-Y

Anastomotic leaks most common serious side effect / cause of death after Gastric Bypass surgery Monitor for...

Back, shoulder, ab, Restlessness Tachycardia, oliguria