GI System

Question 1

role of small intestine

Answer 1

receiving digestive enzymes from pancreas and liver

churn and mix food making it into chyme

absorb nutrients

move food into colon

Question 2

where is bile produced

Answer 2

liver

Question 3

where is bile stored

Answer 3

gallbladder

Question 4

what is the role of bile?

Answer 4

emulsifies lipids so they can be absorbed

Question 5

wha tare the digestive enzymes created by the pancrease

Answer 5

trypsin - break down proteins
amylase - break down carbs
lipase - break down lipids

Question 6

function of colon/large intestine (3)

Answer 6

absorbing water and electrolytes

producing and absorbing vitamins

forming and propelling feces towards rectum for elimination

Question 7

what are 3 things the liver produces

Answer 7

bile
albumin
cholesterol

Question 8

which organ converts ammonia to urea

Answer 8

liver

Question 9

what organ metabolizes bilirubin

Answer 9

liver

Question 10

if you run out of TPN, what do you give?

Answer 10

dextrose 10% at same rate as TPN

Question 11

what is docusate

Answer 11

stool softener

Question 12

what is polyethylene glycol

Answer 12

miralax
laxative

Question 13

3 antidiarrhelas

Answer 13

loperamide
diphenoxylate
bismuth subsalicylate (pepto bismol)

Question 14

3 antiemetics

Answer 14

ondansetron (zofran)
promethazine
meclizine

Question 15

how do you administer ondansetron and why?

Answer 15

administer slowly
fast push can cause QT prolongation and VT

Question 16

what kind of drug is famotidine

Answer 16

h2 receptor blocker
pepcid

Question 17

what kind of drug is omeprazole

Answer 17

ppi

Question 18

how do h2 receptor blockers work

Answer 18

block histamine binding with receptors in mucosal parietal cells –> decreases acid secretion

Question 19

can h2 receptors be taken with meals?

Answer 19

yes

Question 20

how do PPIs work

Answer 20

prevent transport of H ions into gastric lumen - bind to gastric parietal cells to decrease acid production

Question 21

what are 2 nursing considerations for omeprazole

Answer 21

take 30-60 mins before meals
report black, tarry stools

Question 22

what drug promotes healing of ulcers by providing a barrier over them

Answer 22

sucralfate

Question 23

how does sucralfate interact with other drugs

Answer 23

can decrease bioavailability of warfarin, digoxin, phenytoin, levothyroxine and some antibiotics
separate drugs for at least 2 hours!

Question 24

s/s of gastric ulcers

Answer 24

pain 1-2 hours after meal
aggravated by eating
vomiting
weight loss
hematemesis

Question 25

s/s of duodenal ulcers

Answer 25

pain 2-4 hours after meals food might relieve pain weight gain melena if hemorrhage occurs

Question 26

where is crohn's disease

Answer 26

ileum and anywhere throughout small and large intestines can occur anywhere from mouth to anus skip lesions

Question 27

where is ulcerative colitis

Answer 27

large intestine

Question 28

diverticula

Answer 28

herniation of mucosa through muscle layers of the colon wall

Question 29

diverticulosis

Answer 29

asymptomatic diverticular disease

Question 30

diverticulitis

Answer 30

inflammatory stage of diverticulosis

Question 31

possible causes of diverticular disease

Answer 31

decreased fiber abnormal neuromuscular function alterations in motility > 60 years

Question 32

what kind of diet do you want for diverticular, crohns and UC

Answer 32

low fiber avoid cold or hot foods no smoking

Question 33

what are bowel mvmts going to look like with ileostomy

Answer 33

very liquid

Question 34

what are bowel mvmts going to look like with colostomy

Answer 34

more solid going through colon, patient can absorb water

Question 35

what is mcburney's sign

Answer 35

pain during palpation to RLQ seen with appendicitis

Question 36

what position is comfortable for appendictis

Answer 36

position right side low fowlers

Question 37

what is the number 1 cause of pancreatitis

Answer 37

alcoholism

Question 38

pathophy of pancreatitis?

Answer 38

digestive enzymes activate inside pancreas and auto digestion starts

Question 39

s/s of pancreatitis

Answer 39

pain increased with eating distension ascites rigid abdomen Cullen's sign Grey turner's sign fever n/v jaundice hypotension

Question 40

nursing intervetnions for pancreatitis (PANCREAS)

Answer 40

pain control antispasmodics NPO/NGT - pancreatic rest calcium replacement d/t hypocalcemia replace fluids and electrolytes elevated enzymes (check amylase and lipase) antibiotics with fever steroids

Question 41

what are 2 causes of cholelithiasis

Answer 41

hyperlipidemia hyperbilirubinemia

Question 42

signs of cholelithiasis (gallstones)

Answer 42

RUQ sudden sharp pain that radiates to shoulder blades or right shoulder worse at night or after a fatty meal N/V

Question 43

which hepatitis are fecal oral

Answer 43

A & E *no risk of chronic infection

Question 44

which hepatitis are due to infected body fluids

Answer 44

B,C, & D

Question 45

which hepatitis is common with iv drug use or non-sterilized medical equipment

Answer 45

hep C

Question 46

which hepatitis is common with infected body fluids like blood or semen

Answer 46

hep B

Question 47

which hepatitis have vaccinations

Answer 47

A&B

Question 48

s/s of increasing ammonia

Answer 48

changes in LOC neuromuscular disturbances fetor (distinctive musty or sweet breath odor) sleep, mood and speech issues

Question 49

tx to decrease ammonia

Answer 49

lactulose antibiotics (neomycin or rifaximin) decrease protein in diet monitor serum ammonia decrease fluid retention (k sparing) avoid CNS depressants (benzos and opioids)

Question 50

5 s/s of cirrhosis

Answer 50

palpable firm liver ascites & edema d/t decrease albumin abdominal pain, bloating, poor appetite spider angiomas jaundice

Question 51

what would lab values look like with cirrhosis

Answer 51

decrease albumin increased AST and ALT

Question 52

what diet for pts with cirrhosis

Answer 52

low protein, low sodium