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GI test Flashcards

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1
Q

Major Functions of the GI Tract

A

-Breakdown of food particles into molecular form for digestion.
-Absorption into bloodstream of small nutrient molecules produced by digestion.
-Elimination of undigested unabsorbed food stuffs and other waste products.

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2
Q

Enzymes that digest Carbohydrates

A

Amylase
Ptyalin, Maltase, Sucrase, and Lactase

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3
Q

Enzymes/Secretion that digest Proteins

A

Trypsin
Pepsin, Aminopeptidase, Dipeptidase, and Hydrochloric acid

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4
Q

Enzymes/Secretions that digest Fats

A

Pharyngeal lipase
Steapsin, Pancreatic Lipase, and bile

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5
Q

What could a removed or partially removed stomach lead to

A

no stomach no B12 absorbed. B12 leads to paraniscious (sp) anemia. Look at hg/hct

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6
Q

intrinsic factor does what

A

promotes B12 absorption

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7
Q

small intestine function

A

Secretion of mucous
Absorption of nutrients
Movement of nutrients into the bloodstream

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8
Q

barium swallow teaching

A

teach the patient after the barium swallow to increase fluids to facilitate evacuation of stool and barium (check for fluid restrictions first)

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9
Q

CEA and CA 19-9 test looks for

A

cancer markers

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10
Q

Xerostomia

A

dry mouth

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11
Q

signs of aging on GI system

A

Xerostomia – dry mouth
* Decreased appetite
* Decreased ability to taste
* Delayed emptying of the esophagus
* Decreased HCl acid secretion
Constipation
* Liver size decreased
* Gallbladder disease
* Risk for decreased food intake

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12
Q

Gastrointestinal Intubation Reasons

A

Decompress the stomach
Lavage the stomach
Diagnose GI disorders
Administer medications and feeding
To compress a bleeding site
To aspirate gastric contents for analysis
To remove gas and toxins from the stomach, to diagnose GI motility disorders

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13
Q

what to do with a moist PEG tube

A

If pt has a Peg tube and its all moist around the area be sure to call the doc and get an order for antifungal medication

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14
Q

Signs of aspiration

A

Increased respiration, decreased pulse ox, crackles in lungs. STOP tube feeding and call doc

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15
Q

Indication for PN

A

malabsorption. 7 days unable to eat
Assess for hypoglycemia

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16
Q

why to not slow PN rates

A

rebound hypoglycemia

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17
Q

Parotitis

A

inflammation of parotid gland

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18
Q

Sialadenitis

A

inflammation of the salivary glands

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19
Q

Sialolithiasis

A

inflammation of the salivary stones

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20
Q

Oral and Laryngeal Cancers risk factors

A

Tobacco
Alcohol
HPV
History of head and neck cancer
Being a man
May occur in any area, but lips, lateral tongue, and floor of the mouth are most frequently affected
Over age of 60

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21
Q

Radical Neck Dissection Surgery nursing shit

A

ABCs > bleeding > patient’s ability to communicate
Preform Allen Test (test ulnar artery to ensure the radial artery will be sufficient)
Normal output is 80-100 mL output- watch for large clots, milky white fluid (infection/Chyle fistula) and excessive bleeding

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22
Q

Chyle fistula

A

can lead to dehydration, third spacing, poor wound healing. Call doc

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23
Q

Nursing Care of the Patient With a Radical Neck Dissection

A

Assess vitals every 1-2 hours, unless critical then it becomes every 15
Bed of head at 30 degrees, avoid Vlasova maneuver
May need suction, do not suction near suture line.
If they get a muscle removed assess grip and blood flow (pale, dusky, cool)

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24
Q

GERD meal recommendation

A

small and frequent

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25
Esophageal Varices
true medical emergency Risk factors – alcoholism, fatty liver, cirrhosis Signs & Symptoms – vomiting blood, black and tarry stools
26
Bilirubin
product of red blood cell breakdown
27
liver function tests
AST, ALT, GGT, GGTP, LDH
28
Alanine aminotransferase (ALT)
levels increase primarily in liver disorders; used to monitor the course of hepatitis, cirrhosis, the effects of treatments that may be toxic to the liver
29
Aspartate aminotransferase (AST)
not specific to liver diseases however levels of AST may be increased in cirrhosis, hepatitis, and liver cancer
30
Gamma-glutamyl transferase (GGT)
levels are associated with cholestasis; alcoholic liver disease
31
Fatty liver disease
Nonalcoholic fatty liver disease (NAFLD) Nonalcoholic steatohepatitis (NASH)
32
Manifestations of Liver Disease
Jaundice Portal hypertension Ascites and varices Hepatic encephalopathy or coma Nutritional deficiencies
33
Pruritus
very itchy skin
34
s/s Hepatocellular jaundice
Mild or severely ill Lack of appetite, nausea or vomiting, weight loss Malaise, fatigue, weakness Headache, chills, fever, infection
35
s/s Obstructive jaundice
Dark orange-brown urine, clay-colored stools Dyspepsia and intolerance of fats, impaired digestion Pruritus – very itchy
36
Portal Hypertension
Obstructed blood flow through the liver results in increased pressure throughout the portal venous system Results in Ascites and Esophageal varices
37
Treatment of Ascites
Low-sodium diet Diuretics Bed rest Paracentesis Administration of salt-poor albumin Transjugular intrahepatic portosystemic shunt (TIPS) Other methods: peritoneovenous shunt
38
goal with lactulose
3 soft bowel movements a day (actually super bad diarrhea)
39
Medical Management of Hepatic Encephalopathy
Discontinue sedatives, analgesics, and tranquilizers. HIGH RISK for safety issues Eliminate precipitating cause Lactulose to reduce serum ammonia levels IV glucose to minimize protein catabolism Protein restriction Reduction of ammonia from GI tract by gastric suction, enemas, oral antibiotics
40
Nursing Management of Esophageal Varices
Maintain safe environment; prevent injury, bleeding and infection
41
Hepatitis A and E route s
oral fecal
42
Hepatitis B and C routes
blood
43
Hepatitis D risk factors
only people with B are in danger
44
Nonviral Hepatitis
drug induced
45
Manifestations Hep A
mild flu-like symptoms, low-grade fever, anorexia, later jaundice and dark urine, indigestion and epigastric distress, enlargement of liver and spleen
46
Hepatitis A prevention
Good handwashing, safe water, and proper sewage disposal Vaccine Immunoglobulin for contacts to provide passive immunity
47
Management of Hepatitis B
Vaccine: for persons at high risk, routine vaccination of infants Passive immunization for those exposed Standard precautions and infection control measures Screening of blood and blood products
48
Cholelithiasis
gallstones
49
Medical Management of Cholelithiasis
ERCP - remove or break up Dietary management Medications: ursodeoxycholic acid and chenodeoxycholic acid Laparoscopic cholecystectomy Nonsurgical removal - Intracorporeal or extracorporeal lithotripsy
50
Acute Pancreatitis can lead to
Autodigestion from premature activation of enzymes Primary factors: Biliary tract disease EtOH
51
s/s pancreatitis
Sharp mid to LUQ pain, N/V, hypotension, tachycardia, jaundice, absent bowel sounds, low grade fever, tetany Turner’s and Cullen’s Sign
52
Pancreatoduodenectomy (Whipple Procedure)
Removes gall bladder, part of stomach and part of common bile duct and duodenum
53
Erosive Gastritis
Mucosa isn’t just damaged, it is going almost down to the sub mucosa Radiation therapy, meds, alcohol could be the cause
54
Manifestations of acute Gastritis
epigastric pain, dyspepsia, anorexia, hiccups, nausea, vomiting. Erosive gastritis can lead to melena, hematemesis, or hematochezia
55
Manifestations of chronic Gastritis
fatigue, pyrosis, belching, sour taste in the mouth, halitosis, early satiety, anorexia, nausea, and vomiting. May have pernicious anemia due to malabsorption of B12. Some are asymptomatic
56
Medical Management of Gastritis
Acute Refrain from alcohol and food until symptoms subside Supportive therapy: IV fluids, nasogastric intubation, antacids, histamine-2 receptor antagonists, proton pump inhibitors Chronic Modify diet, promote rest, reduce stress, avoid alcohol and NSAIDs Pharmacologic therapy
57
Peptic Ulcer Disease is associated with what infection?
H. Pylori
58
risk factors for peptic ulcer disease
Risk factors include excessive secretion of stomach acid, dietary factors, chronic use of NSAIDs, alcohol, stress, smoking, and familial tendency
59
rates of duodenal ulcers
Duodenal ulcers account for about 80% of all peptic ulcers. H. Pylori found in 90-95% of duodenal ulcers.
60
what to monitor for with peptic ulcer disease
Hemorrhage – look for vs changes Perforation and penetration – sudden very hard and rigid abdomen (surgical emergency) s/s shock Gastric outlet obstruction
61
perforation and penetration s/s
sudden hard and rigid abdomen
62
dumping syndrome
malabsorption of vitamins and minerals, might need supplemental vit b12 for dumping syndrome avoid fluid with meals, avoid high carb high sugar diets can cause hyper then sudden hypoglycemia
63
what can perforation lead to
peritonitis (inflammation of abdominal lining)
64
dumping syndrome management
To delay stomach emptying and dumping syndrome, assume low Fowler position after meals; lie down for 20 to 30 minutes Take antispasmodics as prescribed Avoid fluid with meals
65
Gastroparesis causes
Problems with vagus nerve (cranial nerve X) Nerve damage secondary to diabetes Drugs that decrease gastric motility
66
constipation causes
medications, chronic laxative use, weakness, immobility, fatigue, inability to increase intra-abdominal pressure, diet, ignoring urge to defecate, and lack of regular exercise
67
complications of constipation
Decreased cardiac output – straining increases interthorasic pressure Fecal impaction Hemorrhoids Fissures Rectal prolapse Megacolon
68
diarrhea causes
infections, medications, tube feeding formulas, malabsorption, metabolic and endocrine disorders, and various disease processes
69
diarrhea complications
Fluid and electrolyte imbalances Dehydration Cardiac dysrhythmias **Chronic diarrhea can result in skin care issues related to irritant dermatitis**
70
c-diff
Patients receiving clindamycin, ampicillin, amoxacillin, cephalosporins are susceptable. **Clostridium Difficile – can be transmitted nosocomially (highly contagious) – private room Contact Precautions Metronidazole (Flagyl), Vancomycin (PO) Handwashing Fecal Transplant – ew
71
Clinical Manifestations of Malabsorption
Hallmark finding is diarrhea or frequent, loose, bulky, foul-smelling stools, high-fat content and often grayish Symptoms similar to irritable bowel syndrome Manifested by weight loss and vitamin and mineral deficiency
72
Diverticular Disease
Diverticular disease increases with age and is associated with a low-fiber diet Diverticulum: sac-like herniation of the lining of the bowel that extends through a defect in the muscle layer May occur anywhere in the intestine but most common in the sigmoid colon Diverticulosis: multiple diverticula without inflammation Diverticulitis: infection and inflammation of diverticula
73
Crohn's disease
subacute chronic inflammation of the GI tract. Can have remission and exacerbation. Can have bits inflamed, cobblestone pattern. Very rarely have bloody stools
74
Ulcerative colitis
can have exacerbation and remission. Have abd cramps, bloody diarrhea, starts in the rectum and spreads up the colon.
75
Ulcerative colitis location
begins in rectum and spreads toward the cecum
76
crohn's disease location
most often in the terminal ilium with patchy involvement through all layers of the bowel
77
ulcerative colitis peak incidence at age
15-25 yr and 55-65 yr
78
crohn's disease peak incidence at age
15-40
79
ulcerative colitis number of stools
10-20 liquid bloody stools per day
80
crohn's disease number of stools
5-6 soft, loose stools per day, non-bloody
81
complications of ulcerative colitis
hemorrhage, nutritional deficiencies
82
crohn's disease complications
fistulas (common), nutritional deficiencies
83
ulcerative colitis need for surgery?
infrequent
84
crohn's disease need for surgery?
frequent

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