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nur 225 exam 2 > nur 226 gi and coagulaion > Flashcards

nur 226 gi and coagulaion Flashcards

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1
Q

Constipatio
n* Defined

A

small, infrequent,
or difficult BM
* Fewer than 3 BMs/week

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2
Q

Constipatio
n
* Causes

A

Diet (low in fiber)
* Lack of exercise
* Slowed peristalsis
* Pathologic conditions
* Obstruction or
diverticulitis

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3
Q

What is secretory diarrhea associated with?

Vibrio cholerae and Staph aureus can cause this type of diarrhea

A

infection

secretory

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4
Q

C Diff has what type of diarrhea?
a. acute
b. chronic
c. episodic
d. secretory
e. exudative

A

d

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5
Q

What disease causes an overgrowth of toxins that attack the GI tract?

A

C Diff

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6
Q

Causes of C Diff

A

antibiotics, chemotherapy, bowel surgerym direct contact

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7
Q

S/S of C Diff

A

secretory diarrhea (= 3 loose stools in 24
hrs), cramping, low grade fever, nausea, anorexia (decreased appetite), Mucus in stool

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8
Q

What is the complete or partial blockage of the SI or LI?

A

intestinal obstruction

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9
Q

SATA: Which of the following are functional intestinal obstructions?
a. hernia
b. feces
c. peritonitis (narcotics)
d. spinal fracture
e. hypokalemia
f. drugs
g. trauma

A

c, d, e, f, g

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10
Q

Impaction causes

A

Unrelieved constipation
* May lead to obstruction

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11
Q

s/s of impaction

A

May have continuous oozing or diarrhea
* Loss of appetite
* N/V
* Abdominal distention
* Cramping and

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12
Q

Diarrhea
* Defined:

A

increase in frequency and fluidity of bowel
movements

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13
Q

Diarrhea
* Define
acute, chronic and episodic

A

Acute
* Infection, emotional stress, some medications,
and liquid stool around an impaction

  • Chronic – lasting more than 4 weeks
  • Chronic GI infection
  • Alterations in motility or integrity
  • Malabsorption
  • Endocrine disorders
  • Episodic
  • Food allergy or irritant
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14
Q

Osmotic diarrhea

Secretory diarrhea

Exudative diarrhea

Related to motility
disturbances

A

Osmotic diarrhea Magnesium sulfate

Secretory diarrhea Vibrio cholerae &
Staphylococcus aureus

Exudative diarrhea Crohn disease & Ulcerative Colitis

Related to motility
disturbances Dumping syndrome & IBS

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15
Q

C. Diff
* Risk Factors

A

-Age > 65
* Antibiotic
therapy
* Immunocompromised
* Recent
hospitalization
* GI procedure
* Previous C. Diff
infection

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16
Q

C. Diff
* Treatment

A

-Vancomycin 125 mg, 4 times/day

  • Metronidazole
  • Probiotics
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17
Q

Irritable Bowel Syndrome
(IBS)
Defined

Possible causes

A

Defined by diarrhea
and/or constipation
with cramps and no
identified pathology

Possible causes
*Genetics
*Environment (stressors)
*Diet

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18
Q

IBS
* Manifestations

Pharmacotherapy

A

-Diarrhea, Constipation, Combination
of both
-Cramping abdominal pain
* Nausea
* Mucus in stool

Pharmacotherapy
* Antidiarrheals
* Anticholinergic/Antispasmotics
* Laxatives

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19
Q

Functional vs mechanical blockage

A

Mechanical obstruction occurs when there is a physical blockage in the intestine, such as a tumor, hernia, or adhesions.

Functional obstruction, on the other hand, is caused by a disruption in the normal muscle contractions that propel food through the intestines, often due to conditions like ileus or intestinal dysmotility.
Abdominal surgery,Severe trauma
* Spinal fracture
* Drugs (narcotics)

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20
Q

An intestinal obstruction can lead to…

A

increased fluid and gas, distention, water and electrolytes in lumen of SI, decreased perfusion, swelling, increased pressure, fluid in peritoneum

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21
Q

Complications of Intestinal Obstructions
a. vomiting
b. gangrenous tissue
c. hyperkalemia
d. ischemia to bowel
e. sepsis
f. shock (blood leakage)

A

b, d, e, f

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22
Q

What type of disorder is Dumping Syndrome?

Study These Flashcards
A

malabsorption

23
Q

Dumping
Syndrome

Study These Flashcards
A

(post GI surgery problem)

Dumping of stomach contents
into small intestine

food moves quickly from stomach to small intestine

24
Q

Dumping Syndrome
Manifestations

Study These Flashcards
A
  • Nausea
  • Weakness
  • Sweating
  • Diarrhea
25
Dumping Syndrome drug AE
* Octreotide (octupus) * Antidiarrheal * SE: nausea, vomiting and upset stomach
26
T/F: a treatment for Dumping Syndrome is to change your diet.
t
27
What is unreleived constipation called?
impaction
28
When do you see continuous oozing of diarrhea with abdominal distention and cramping?
impaction
29
What is commonly found in the stool with exudative diarrhea?
mucus
30
SATA: Which of the following are mechanical intestinal obstructions? a. hernia b. tumor c. feces d. trauma e. drugs f. intusseception g. hypokalemia
a, b, c, f
31
What is the treatment for an intestinal obstruction?
surgery, decompression of bowel, IV
32
Your patient Joe recently had a part of his SI removed and is coming into the ER with severe diarrhea. What condition does Joe have? How will you treat Joe?
Short Bowel Syndrome, IV fluids
33
Antidiarrheals * Used to treat * Different Groups
diarrhea * Adsorbants * Antimotility (anticholinergics and opiates) * Probiotics
34
Adsorbents name moa AE Caution
bismuth subsalicylate (Pepto-Bismol) * A form of aspirin coats the walls of the GI tract Constipation * Dark stools and darkening of tongue * Ringing in the ears (the constipated moth with black spots and headphones) * Caution in those with bleeding problems
35
Antimotility name moa ae
Atropine * loperamide Slow peristalsis * Drying effect* Urinary retention * Headache, dizziness, anxiety, drowsiness * Bradycardia, hypotension * Dry skin * Flushing
36
Probiotics
restores gut flora Lactobacillius- bacteria in gut Saccha -C-Diff
37
Laxatives * Different Groups
* Bulk-forming * Emollient * Hyperosmotic * Saline * Stimulant
38
Bulk-Forming name moa ae
psyllium similar to dietary fiber * Absorb water into the intestine, increasing bulk * Distends bowel to initiate reflex bowel activity and bowel movement * OK for long term use * Adverse Effects * Impaction above strictures * Fluid/electrolyte imbalance * Gas formation * Esophageal blockage
39
Emollient names * MOA * Adverse Effects
docusate sodium MOA: lubricates fecal material and walls, promotes fat Uses: prevent opioid-induced constipation mineral oil * MOA: lubricate intestines * Uses: fecal impactions Adverse Effects: skin rashes, decreased absorption of vitamins
40
Hyperosmotic names MOA use AE
Glycerin, lactulose and polyethylene glycol * MOA * Increasing water content in feces * Promotes distention, peristalsis, and evacuation * Uses * Evacuate bowels before diagnostics and surgical procedures * Adverse Effects * Abdominal bloating * Rectal irritation * Electrolyte imbalance
41
Saline names * MOA: * Adverse Effects
Saline * Magnesium Salts * magnesium citrate (Citroma) * magnesium hydroxide (Phillips Milk of Magnesia) * magnesium sulfate (epsom salts) * Sodium Salts * Fleet enema * MOA: increase osmotic pressure and draw water into colon * Adverse Effects * Magnesium toxicity * Electrolyte imbalance * Cramping, diarrhea
42
Stimulants names * Uses: * Adverse Effects *
Stimulants * bisacodyl (Ducolax) * senna (Senokot) * Uses: constipation or whole bowel evacuation * OTC * Adverse Effects * Nutrient malabsorption * Gastric irritation
43
most abundant number of proteins
Albumin & globulins * Albumin=57% of plasma protein
44
most plentiful clotting factor
Fibrinogen
45
what is plasma WITHOUT clotting factors
serum
46
Normal platelet count
150,000- 400,000
47
Thrombocytopenia=
<100,000
48
Additional platelets stored in the
spleeen
49
Excessive hemostasi causes
clot formation excessive or inappropriate
50
inadequate hemostasis causes
bleeding
51
Petechiae * Purpura * Ecchymosis * Telangiectasia * Menorrhagia * Epitaxis * Thrombosis *
Petechiae * flat, pinpoint, nonblanching red or purple- capillary hemorrhages in the skin or mucous membranes (<2 mm) * Purpura * petechiae in groups or patches (2 mm to 1 cm) * Ecchymosis * bruise- blood in the tissue (> l cm) * Telangiectasia * small, widened blood vessels on the skin * Menorrhagia * excessive menstruation * Epitaxis (nose bleeds) * nasal drainage Thrombosis * pathologic formation of clot (ex. DVT)
52
Hematoma * Hemarthrosis * Hematochezia or melena * Hematuria * Hematemesis * Hemoptysis
Hematoma * raised area of bleeding into the tissue * Hemarthrosis * bleeding into the joint * Hematochezia or melena * blood in feces * Hematuria * blood in urine * Hematemesis * blood in vomitus * Hemoptysis * blood in sputum
53

nur 225 exam 2 (3 decks)

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