T3 - GI Assessment (Josh) Flashcards

1
Q

The GI tract extends from the — to the — and is about — feet long.

A

mouth

anus

25

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2
Q

What are the four layers of the GI tract?

A

Mucosa (inner)

Submucosa

Serosa

Muscular (outer)

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3
Q

— is the largest organ of the body, except for skin, and has lots of blood supply (about — mL per min)

A

Liver

1500

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4
Q

What is the name of the Pancreatic Duct that empties pancreatic enzymes into the intestine?

A

Duct of Wirsung

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5
Q

What is the Sphincter of Oddi?

A

the sphincter that allows passage of bile and pancreatic enzymes into the intestines

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6
Q

What is the Accessory Duct of Santorini?

A

the duct that empties liver and gallbladder bile into the intestine

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7
Q

What is the name for the opening in the intestine that allows passage of bile and pancreatic enzymes?

(note: I’m not talking about the Sphincter of Oddi…this is after that)

A

Duodenal Papillae

ampulla of Vater

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8
Q

What changes in older adult happen in stomach and what should we suggest?

A

decreased hydrochloric acid

suggest bland foods

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9
Q

What changes in older adult happen in Large Intestine and what should we suggest?

A

decreased peristalsis and decreased sensation to defecate

Increase fiber and fluids and keep track of BMs

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10
Q

What changes in older adult happen in Pancreas and what should we suggest?

A

Decrease lipase production leading to steatorrhea (fatty stools)

eat more small, frequent meals to decrease fat in stools

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11
Q

What changes in older adult happen in Liver and what should we suggest?

A

decrease in hepatic funciton leading to decreased drug metabolism

keep accurate account of meds

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12
Q

What blood Lab studies are for GI system?

A

CBC

PT

Electroylytes

Albumin

AST

ALT

Amylase

Lipase

Bilirubin

Ammonia

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13
Q

What lab tests are done with stool?

A

Fecal Occult Blood Test (FOBT)

FIT (Fecal Immunochemical Test)

Stool DNA (sDNA)

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14
Q

Which blood tests is not very sensitive and gives lots of false positives?

A

FOBT

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15
Q

What should we educate client about FOBT?

A

Not very sensitive (false positives)

Be off anticoagulants for a week

Don’t eat anything that could dye the stool

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16
Q

Since FOBT is not very sensitive and gives false postives, what test is better to test for Fecal blood?

A

FIT (Fecal Immunochemical Test)

***more sensitive

***don’t have to worry about foods or meds you’re taking

17
Q

What labs are done with urine?

A

Amylase (test for pancreatic function)

Urobilingen (test for increased bilirubin)

18
Q

What are the Upper GI Series tests?

A

Barium Swallow

Small Bowel Follow Thru (SBFT)

  • **NPO x 8 hrs prior
  • **NO ANTICHOLINERGICS 24 hrs prior
  • **Drink fluids afterwards
19
Q

What are the Lower GI Series tests?

A

Bariium Enema

***drink lots of fluids to prevent constipation afterwards

20
Q

What is an EGD?

A

Esophagogastroduodenoscopy

***direct visualization of esophagus, stomach, duodenum

21
Q

What should we teach about EGD?

A

NPO 8 hrs prior

No anticoagulants

NPO after until gag reflex returns (1-2 hrs) because they were given meds to paralyze gag reflex during procedure

Monitor RR (capnography)

22
Q

What is PTC?

A

Percutaneous Transhepatic Cholangiography

***putting needle in hepatic vein and watching it thru xray

***not done much at all

23
Q

What is ERCP?

A

Endoscopic Retrograde Cholangiopancreatography

***like EGD but goes deeper

***looks at liver, GB, bile ducts, pancreas

24
Q

What should we teach about ERCP?

A

same as EGD

lasts around 2 hrs

dye can be used and the tilt patient back and forth to get dye to spread around

25
Q

What is the pill camera they swallow called?

A

Small Bowel Capsule Endoscopy

***identifies source of bleeding

***they’ll poop out the camera

26
Q

When should we get Colonoscopy if we have NO family history of colon cancer?

A

age 50 and every 10 years

27
Q

What should we teach about Colonoscopy?

A

NPO

Clean bowels out first

No anticoagulants

Mild sedation

Lay on left-lateral side when test is done to allow air to be expelled after procedure

28
Q

Because EGD and Colonoscopy require conscious sedation, what should we do?

A

Monitor RR

They can’t drive for 12 hrs afterwards

29
Q

What test measures Hydrochloric Acid and Pepsin?

A

Gastric Analysis

  • **NPO 12 hrs prior
  • **NGT to suction to collect samples
30
Q

An ultrasound is not invasive, but what is required for it to be accurate?

A

full bladder