Pelicano Module 4 Digestive Flashcards
(252 cards)
1
Q
A complication after gastric surgery that is RAPID GASTRIC EMPTYING causing distention of duodenum & jejunum
A
Dumping Syndrome
2
Q
Define Gastrectomy
A
Removal of the stomach, most of the time they do not remove all of the stomach
3
Q
What are the two s&s of Dumping Syndrome
A
Epigastric Pain
Explosive Diarrhea
4
Q
Nursing Care of Dumping Syndrome includes (5)
A
Monitor NG tube for decompression
Measure drainage and replace with IV fluids
6 small meals/day
Avoid fluid during meals
Recline for 1 hour after meals
5
Q
When checking drainage in patients with Dumping syndrome it is important to check for ________
A
blood, coffee grounds
6
Q
The primary purpose of the electrolyte solution called GoLytely
A
Stools become clear liquid, clean out the bowel
7
Q
aching or gnawing pain in right epigastrium relieved by eating, however pain 2-4 hours after meals , and pain causing you to wake up are s&s of
A
Duodenal Ulcer
8
Q
In order to make good RBCs patient needs an adequate amount of
A
Vitamin b12
9
Q
After a gastrectomy, because the stomach is now smaller, _______ and ______ can occur
A
Diarrhea and Pain
10
Q
What are the 3 most important things related to eating, about DUMPING SYNDROME
A
Eat small frequent meals
Lay down after meal
No fluid during meal
11
Q
After gastric surgery patients are at high risk for ________ deficiency causing ___________. Doctor may prescribe ________
A
Vitamin b12 deficiency
Pernicious anemia
Vitamin b12 IM
12
Q
Mets stands for
A
Metastatic disease
13
Q
Usually an adenocarcinoma in the pyloric area; mets to the lymph nodes, liver, spleen or pancreas
A
Cancer or the stomach
14
Q
Cancer of the stomach is caused by
A
Unknown, however pylori may be a factor
15
Q
s&s of Cancer of the stomach includes (5)
A
asymptomatic early
epigastric discomfort
anorexia
weakness
weight loss
16
Q
What are the 3 treatments for Cancers of the stomach
A
Gastrectomy
Chemo
Radiation
17
Q
Best scenario for cancer of the stomach is that we ……. most times we get it confused with ……
A
Diagnose it early
confused with normal gastric distress
18
Q
Post op Nursing interventions include (5)
A
Maintain NGT
Monitor drainage
Check bowel sounds
Start diet as ordered
Monitor nutritional status
19
Q
Most intestinal disorders come from
A
Infections
20
Q
Top two ways to get infections in the intestines is by
A
eating contaminated food
Fecal-oral route poor hand washing after elimination
21
Q
3 things that produce toxins causing mucosal cells to secrete water & electrolytes
A
Clostridia
Salmonella
Shigella
22
Q
Allowing Clostridia, Salmonella, and Shigella to get into the body causes
A
imbalance & diarrhea from mucosal cells secreting water & electrolytes
23
Q
This results from inhibition of normal flora
A
C-difficile
24
Q
What are the 4 main s&s of Intestinal Disorders
A
Diarrhea, cramps, fever, vomiting
25
Nursing interventions for Intestinal Disorders (5)
Fluid and electrolyte replacement
INTAKE AND OUTPUT
NO antidiarrheals
Give pepto bismol or Kaopectate
Contact precautions
26
IBS stands for
Irritable Bowel Syndrome
27
Motility disorder where CNS regulation of the motor & sensory functions of the bowel are altered
Irritable Bowel Syndrome
28
What are four factors that can affect intestinal motility
Eating , Stress, Hormones, and Drugs
29
IBS can cause sense of incomplete evacuation called
Tenesmus
30
s&s of IBS (5)
Abdominal pain and tenderness relieved by defecation
stool may have mucus
Tenesmus
Bloating and Flatulence
Alternating Constipation & Diarrhea
31
Treatment for IBS includes (4)
Provide Bulking agents (Fiber)
Anticholinergics
Drugs for Anxiety/Depression
Diet Management
32
After any G.I. Surgery patient will be (2) and we need to
NPO + NG tube
take all fluid out, then put the IV fluid in (check for bowel sounds) looking for blood in drainage (dumping syndrome)
33
Raw Clams are a big cause of Intestinal Disorder Infections because
They have feces in the water they are in
34
We can diagnose Infections of Intestines by
Sending stool for culture
35
Treatment for C-difficile includes
Antibiotics
36
With infections of intestinal disorders patient should be on .... precautions where nurse should have on
Enteric
| Gown and Gloves
37
We cannot give any ...... to patients with Intestinal Disorders, Infections because .......
Anti Diarreheals
We want stool to come out
38
Tenesmus is the
feeling of having to move bowels when there is nothing
39
We diagnose IBS by
ruling out any other diseases
40
IBS is successfully managed by
Having HIGH FIBER diet
41
TWO MAIN symptoms of IBS are
cramping and diarrhea
42
IBD stands for
Inflammatory Bowel Disease
43
Effects mucosa and submucosa of colon, usually extends upward from rectum, 2x more common than crohns disease
Ulcerative Colitis
44
Tiny abscesses form which grow & produce purulent drainage and sloughing of mucosa with ulcerations, capillaries bleed causing diarrhea containing mucous, pus and blood, Colon loses elasticity and ability to absorb
Ulcerative Colitis
45
In Ulcerative Colitis the stool is
BLOODY
46
Ulcerative Colitis means there is
Inflammation of the Colon that have ulcers in it
47
Ulcerative Colitis is more common in people that (4)
teens - 30s
Chronic disease
Women
Jewish
48
S&S of UC (5)
Diarrhea 15-20 day
Stool contains blood, pus, mucous
Toxic Megacolon
Anorexia
Abdominal Cramps
49
Toxic Megacolon is
When Colon becomes DISTENDED wall gets thin and is at risk for bursting
50
People who have been diagnosed with UC are at risk for
Colon Cancer
51
In UC Colon loses elasticity causing
Malnutrition
52
We can diagnose UC by (5)
Stool Specimen
CBC
Sigmoidoscopy
Colonoscopy
BE (Barium Enema) for an x-ray
53
3 medications most common for people with UC
Anti inflammatories
Steroids
Anti diarrheals
54
What should the diet be for someone with UC
Exclude Fiber, Caffeine, Spicy, Milk products,
Increase protein, Calories
55
What surgeries can be done for someone with UC (3)
Colon resection, ileostomy, Kock's continent
56
In a patient with UC we want to get symptoms under control and we do that by
Getting patient into remission
57
In UC TWO MOST COMMON TESTS TO DIAGNOSE ARE
Stool culture
Sigmoidoscopy
58
If patient with UC cannot follow diet we can put them on ..... or we can put them on ...... just to ......
TPN or we can put them on TPN to rest the bowels for a bit
59
When patient is on TPN we must monitor
Blood sugar levels
60
Surgery is preferred in people with UC when the ....
Colon becomes damaged
61
When ileostomy has been done no more .....
stool through anus
62
Stoma on abdomen should be ..... in color and have ......
Pinkish/ Reddish
| Watery stool
63
Nursing interventions for UC people that have just had ileostomy include (3)
Prevent skin breakdown
Empty bag frequently
Keep stoma clean and dry
64
UC usually starts in
Sigmoid colon
65
Nursing care for people with UC include (3)
Check bowel elimination
Maintain hydration
Maintain diet that helps them the most
66
When Ostomy bag has bad circulation (Stoma) the color is
Dusky
67
Pre-op care for UC (2)
Bowel Prep GoLytely
68
Post-op care for UC (3)
Check bowel sounds
Monitor drainage
Check color of ostomy
69
Crohns disease is a (2)
Inflammatory Bowel Disease
| Chronic Disease
70
UC is a
Inflammatory Bowel Disease
71
Not as common as ulcerative colitis, affects people 15-30, Autoimmune, Can occur anywhere in GI tract. Can lead to Fistulas and Fissures
Crohns Disease
72
abnormal tunnels that connects parts of the body
Fistulas
73
Cracks in body where stool can come out
Fissures
74
Autoimmune disease basically ATTACKING YOU OWN BILE
Crohns Disease
75
Main goal of patient care of Crohns disease is too
prevent them from getting FISTULAS
76
Crohns disease is not just in the colon it is .....
always in the ileum when it occurs, but can find it anywhere else in the g.i.tract
77
The ileum is located in the
RLQ
78
s&s of Crohns disease (4)
abdominal cramps
K, Na, b12 malabsorption
steatorrhea
RLQ pain
79
Excess fat in feces is called
Steatorrhea
80
Some Crohns disease patient can have symptoms ....... the g.i. tract
Outside
81
Treatment for patients with Crohn's disease includes (4)
Pre-digestive foods (elemental foods)
Immunosuppressants
Folic Acid
Increased protein
82
Elemental foods are also called
Pre-digestive foods
83
Crohns disease patients with fistulas will have
IV immunosuppressants
84
Surgery for Crohn's disease patients include (2)
Resection
Bypass
85
Nursing care for patients with Crohn's disease includes (3)
MONITOR FLUID AND ELECTROLYTE BALANCE,
Check anal region for excoriation
give emotional support
86
Similarity of Crohn's and UC is that they both have
Ulcers
87
When patient begins to vomit bright red blood after a total gastrectomy, priority action is to
Place patient on side
88
In patients with IBS the diet should be
High Fiber, low gas forming foods
89
In patients with Dumping Syndrome the diet should be
decreasing fluid during meals
90
Patients with UC should avoid (diet)
Fresh Fruit
91
Medical term for black, tarry stool
Melena
92
Test for stool to look for hidden blood is called the
Guaiac test
93
Inflammation of the appendix is called
Appendicitis
94
Inflammation of the appendix can lead to
Perforation and Peritonitis
95
Perforation is when Appendix
Bursts
96
Peritonitis is when Appendix
has a major infection
97
Appendicitis is common in
Males and teenagers
98
s&s of Appendicitis includes
Constant pain in RLQ, REBOUND TENDERNESS, anorexia, and low grade fever
99
Where is the Appendix located
RLQ
Very bottom of ascending colon
100
Surgery for Appendix is called
Appendectomy
101
When hand pressing is suddenly release and there is pain this is called
Rebound tenderness
102
What is a huge risk factor of Appendicitis
Constipation
103
Nursing care for Appendicitis includes (3)
No narcotics pre-op
ice bag for pain
NO HEAT
104
We give no Narcotics pre-op because we don't want to
Mask pain
105
Giving heat to patient with Appendicitis can cause it to
rupture
106
what happens to WBC count with appendicitis
goes up
107
Inflammation of the abdominal peritoneum
Peritonitis
108
Usually comes from feces bacterial contamination
Peritonitis
109
S&S of Peritonitis include (5)
Severe abdominal pain
Board like rigidity
leukocytosis
increased pulse
decreased BP
110
Treatment for Peritonitis includes (4)
NGT for decompression
Antibiotics x3 !!!!!
Surgery
NPO
111
Nursing care for patients with Peritonitis includes (3)
place patient in semi-fowlers
Surgical asepsis
No heavy lifting
112
Perforation or anything that bursts in your abdomen can cause
Peritonitis
113
If Peritonitis is left untreated patient can go into
Septic Shock
114
Better to ...... Peritonitis than .......
Prevent than treat
115
Diverticulosis is the ...... while Diverticulitis is the ........
Disease
Inflammation
116
pouch-like herniations through the muscle layer of colon
Diverticulosis
117
inflammation of one or more diverticula
Diverticulitis
118
When you have Diverticulosis your main goal is to
prevent Diverticulitis
119
Diverticulitis is usually located in
Descending colon
120
When fecal matter enters diverticula ...... occurs
inflammation and abscess
121
Perforation and Peritonitis lead to
obstruction of colon
122
Obstruction of colon leads to
hemorrhage
123
Risk factor for Diverticulosis / itis (3)
age > 50
low fiber diet
chronic constipation
124
S&S of Diverticulosis / itis (5)
```
PAIN IN LLQ
Fever
constipation
abdominal distention
blood in stool
```
125
We are naturally not supposed to have _______ in the muscle layer of colon
pouches
126
Diverticulosis / itis is MAINLY CAUSED BY
chronically constipated
127
Any complication that is low in Diverticulosis / itis there is
Blood in Stool
128
Treatment for Diverticulosis / itis is (3)
Prevent Constipation
SOFT FOOD HIGH IN FIBER
prevent gas and cramps (nuts and foods with small seeds)
Stool softeners
129
If person with Diverticulosis / itis is not following up with diet plan it can lead to need for
Bowel Surgery
130
Muscle weakness that results in a portion of the GI tract protruding through the muscle of the abdomen
Abdominal Hernia
131
When Abdominal Hernia can be pushed back into body cavity it is called
Reducible
132
When Abdominal Hernia cannot be pushed back it is called
Irreducible
133
When Abdominal Hernia had intestines that its peristaltic flow is obstructed it is called
Incarcerated
134
When Abdominal Hernia requires immediate surgery because blood flow is interrupted resulting in tissue necrosis it is called
Strangulated
135
Reducible Abdominal Hernia is not ...... and patient can ....
protruding
| patient can lie down
136
Irreducible Abdominal Hernia is more .... and .....
more protruding and may need operation
137
s&s of Abdominal hernia includes (3)
asymptomatic
protruding bulge at umbilicus
inguinal area
138
Treatment of Abdominal Hernia includes (3)
Herniorrhaphy, manual reduction, truss
139
Naturally we don't want a Herniorrhaphy so have patient
Not do any heavy lifting
140
Herniorrhaphy is
Repair
141
Binder that they put over hernia to keep it in place is called
A Truss
142
Teach patient after Herniorrhaphy to
NOT COUGH JUST DEEP BREATHE
143
We would like to perform a Herniorrhaphy before hernia becomes ...... where it becomes a .......
Strangulated
| Complication
144
Protrusion of stomach through an opening in the diaphragm into the lower portion of the thorax
Hiatal Hernia
145
Causes of Hiatal Hernia includes (4)
Coughing
Straining at stool
Lifting heavy objects
Obesity
146
s&s of Hiatal Hernia includes
GE Reflux, Heartburn, Feeling of fullness
147
GE in GE Reflux stands for
Gastroesophageal
148
Treatment of Hiatal Hernia includes (6)
Antacids
Small Frequent Meals
Avoid citrus, spicy, fatty foods, alcohol, smoking
Sit up after meals
Raise HOB
Lose the weight
149
When intestinal contents cannot pass through G.I. tract it is called
Intestinal Obstruction
150
Causes of Intestinal Obstruction include (5)
adhesions, impacted feces, intussusception, volvulus, high fiber diet
151
A paralytic ileus can cause an
Intestinal Obstruction
152
s&s of Intestinal obstruction include (6)
```
high pitched tinkling bowel sounds
distention
vomiting
dehydration
hypovolemia
shock
```
153
Treatment for Intestinal Obstruction include (2)
NG ot NJ tube for decompression
Remove obstruction / Surgery
154
Colon Cancer is most common in
60 or older
155
Risk factors for Colon cancer include (3)
UC, Polyps, Family history
156
s&s of Colon cancer (5)
```
Change in bowel habits
Anemia
Rectal bleeding
Tenesmus
Cachexia
```
157
Treatment of Colon cancer includes (3)
Surgery
RT
Chemo
158
Varicose veins that occur outside the anal sphincter (external) or inside (internal)
Hemorrhoids
159
Factors of Hemorrhoids include (4)
constipation
diarrhea
pregnancy
prolonged sitting/standing
160
s&s of hemorrhoids include (2)
prolapse
| bleeding with BM
161
Treatment for Hemorrhoids (4)
Stool softeners, topical creams, sitz bath or surgery (hemorrhoidectomy)
162
Best treatment for Hemorrhoids
Sitz bath
163
Nursing care for Hemorrhoids (3)
Check for bleeding
Bulk forming foods
8-10 glasses fluid/day
164
After an appendectomy the Nurse should provide these 4 steps to prevent RESPIRATORY complications
Pain control
Early ambulation
Coughing, Deep breathing
Incentive Spirometer
165
Patient shows understanding when he says..... after a hernia repair
I will deep breathe every hour when awake not cough
166
A patient diagnosed with Hiatal Hernia should (diet)
avoid eating 2 hours before bedtime
167
For a patient with Small-bowel obstruction, that is NPO, what 5 important things should the nurse constantly collect
```
Intake and Output
Pain level
Bowel Sounds
Pulse rate
Temperature
```
168
It is very important to report a .......... regarding a new colostomy bag (stoma)
DUSKY COLOR
169
Chronic degenerative disease of the liver. Lobes are infiltrated with fat & fibrous tissue. Scar tissue restricts blood flow to liver.
Cirrhoisis
170
Cirrhosis is a
Liver disorder
171
Liver produces ...... and stores .... and manages ....
Bile
glucagon
blood coagulation
172
Veins in esophagus are called
Varices
173
Varices and Ascites is classified as
fluid back up
174
Obstruction of portal vein results in ....... and it is .......
portal HTN
| irreversible
175
Portal HTN causes (2)
Varices and Ascites
176
Varices is in the .... a while Ascites affects the ....
Esophagus
Rectum / Abdomen
177
In Cirrhosis the Liver cannot ..... causing ....
metabolize protein properly causing blood ammonia levels to rise
178
Blood ammonia levels rising will cause
Hepatic Encephalopathy
179
Hepatic Encephalopathy puts patient at risk for
seizures
180
Causes of Cirrhosis include (4)
Alcohol abuse, Drugs, Chemicals, Obstructed bile flow
181
In Cirrhosis we need to decrease ..... intake because .....
Sodium because it retains fluid
182
s&s of Cirrhosis (5)
Ascites, Jaundice, Varices, Hepatic Encephalopathy, dyspnea
183
Jaundice means bile levels have
increased
184
Treatment of Cirrhosis includes (4)
Have liver rest
Restrict proteins, fluids
No alcohol
Paracentesis
185
Paracentesis is
putting needle in stomach to remove fluid
186
When conducting a Paracentesis it is best for the patient to
sit up
187
Increased bile can cause
dry + itching under the skin
188
Nursing care for Cirrhosis include (5)
Semi fowlers
Manage Pruritus
monitor abdominal girth I/O
Check mental status
Blood transfusions
189
It is most important as a nurse to check patients ...... when patient has cirrhosis
Mental Status
190
Pruritus is the
itching
191
Hepatitis is a
Liver Disorder
192
Infection / Inflammation of Liver caused by a virus, alcohol, toxins, or GB disease, can be acute or chronic
Hepatitis
193
s&s of Hepatitis include (5)
Malaise
Jaundice
Dark amber urine
Clay colored stools
photophobia
194
Clay colored stools can be from patients with ..(3)
Hepatitis
Cirrhosis
GallBladder disorders
195
Treatment for patients with Hepatitis (3)
Rest
Maintain nutritional intake
Avoid alcohol
196
Nursing care for patients with Hepatitis (2)
Skin care
Prevent transmission
197
Presence of stones in Gall Bladder
Cholelithiass
198
Stones in Gall bladder block ..... stopping
bile stopping its flow
199
inflammation in the gall bladder
Cholecystitis
200
Causes of Cholecystitis include (3)
Obstruction
Gallstones
Tumors
201
Preventing bile from leaving Gall Bladder will cause .... and it may rupture or become
inflammation
| Gangrenous
202
Our MAIN GOAL with patients with Gallbladder Disorders is to
PREVENT RUPTURE
203
s&s of GallBladder disorder (6)
```
Colicky pain in RUQ
Elevated WBCs
Clay colored stools
Steatorrhea
Dark urine
Jaundice
```
204
The GallBladder is located in the
RUQ
205
Colicky pain is
Stabby pain
206
Steatorrhea is
Fat in stool
207
Treatment for Cholecystitis includes (5)
NGT to lower suction
Lithotripsy
Cholecystectomy
Laparoscopy
T-Tube
208
Shock waves given through water or cushion that breaks up stones
Lithotripsy
209
Where we wouldn't have to open up the abdomen, using a scope with knives
Laparoscopy
210
Goes into the common bile duct, to make sure it doesn't get occluded and to keep it open, allows for drainage until edema resolves
T-Tube
211
If patient refuses surgery for Gall Bladder stone surgery we can give
Oral bile Acids to dissolve stones
212
Nursing care for people with Cholecystitis (3)
Gradually incorporate fats, cold meals, low fats, small meals
NPO
Checking NGT
213
In hepatitis B,C,D virus is found in
Blood and Body Fluids
214
In hepatitis B,C,D we should use
Standard Precautions
215
In hepatitis A we should use
Enteric Precautions
216
Hepatitis A is from
contaminated food (clams)
217
Hepatitis C is the worst because it can
progress to death
218
Acute or chronic inflammation of the pancreas causes occlusion of pancreatic duct; pressure builds & duct ruptures releasing enzymes that digest in the pancreas
Pancreatitis
219
Pancreatitis is caused by
MAINLY ALCOHOL
220
Pancreatitis can be very
PAINFUL
221
s&s of Pancreatitis (5)
Abdominal pain, jaundice, anorexia, low grade fever, vomiting
222
Pancreatitis is diagnosed by
ABD CT & Ultrasound checking for Amalyse
223
Treatment of Pancreatitis (7)
```
BR
NPO
IVF
NGT
Pain meds
TPN
Antacids
```
224
What should the diet be for someone with Pancreatitis
Bland, low fat, high protein, no alcohol
225
Difficult to diagnose in early stages, occurs in middle age, cause unknown. Metastasizes to stomach, duodenum, colon, invades blood vessels, lymph system
Cancer of Pancreas
226
Cancer of Pancreas is usually inoperable however it is a
very long operation 8-9 hours
227
What deficiency puts a patient with Cirrhosis most at risk for bleeding
Low vitamin K
228
Why would we cautiously use sedatives in a patient with Cirrhosis
Sedatives are potentially toxic to the cirrhosis patient
229
Acute hepatitis A patients are most likely to express what s&s
Headache, Nausea, and Flu-like symptoms
230
Highest priority with patients with Pancreatitis is
Pain Control
231
After a Cholecystectomy what are 3 things we can do maintain effective breathing pattern
Provide analgesics for relief
Encourage coughing and deep breathing
Assist with splinting during coughing
232
Before we palpate we should
listen to bowel sounds
233
When patient is given a barium our priority is to
get it out
234
To get Barium out doctor may order (2)
Force Fluids laxatives
235
Amylase levels .... in Pancreatitis
increases
236
After Liver Biopsy, we should (2)
lay patient in right side for 2 hours to prevent bleeding, make sure they did not nick lung
237
Most carcinomas come from (2)
Alcohol and Smoking
238
Inflammation of esophagus will cause
trouble swallowing
239
More stool goes through colon more ...... it gets
formed
240
Patients with Ulcers avoid (diet) (7)
```
Beans
Carbonated Beverages
Milk
Certain vegetables
Peas
Onions
Gassy foods
```
241
What should we use to clean stoma
mild soap and water
242
We give bariums to test
G.I. tract for a contrast
243
Barium will come out in stool as a
chalky looking substance
244
Sigmoidoscopy goes into ..... and Colonoscopy goes into ....
1
| 3
245
Billy Rubin
Measures bile
246
High bilirubin level = ... = ....
Jaundice = High bile levels
247
Cancer in the mouth and esophagus is most common in
drinkers, smokers
248
Erosion of lining in the stomach or intestine, can come from medication, smoking, alcohol, stress
Peptic Ulcer
249
Hematemesis is
Blood in vomit / coffee ground like
250
When vomiting we want to
turn patient to side to prevent aspiration, get vital signs
251
Pain in duodenum is best relieved by a
antacid
252
Diet for Diverticulosis includes
HIGH FIBER, SOFT FOODS, INCREASE IT SLOWLY
