TEST 2 Flashcards by olivia mcnamara

digestion begins

MOUTH

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stores food mixes it with gastric secretions empties into…

stomach; small intestine

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digestion and absorption of nutrients

small intestine

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absorption of water and electrolytes, forms feces

large intestine

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what all is included in the biliary tract

gallbladder, liver, bile, bilirubin

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what is the liver connected to

gallbladder and the pancreas; ex. if you have a gallbladder issue you could have a liver and pancreas issue too

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aids in the digestion of fats

bile

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Pigment derived from the breakdown of hemoglobin-yellow color

bilirubin

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creates, transports, stores, and releases bile into the duodenum to help in digestion

biliary tract

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dry mouth

Xerostomia

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decreased appetite in the elderly is due to

medications, lose sense of smell..physiological and socioeconomic

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assessment of the gi system most people come in complaining of

abdominal pain

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why is it important to ask about past surgeries

because if that person had surgery on their appendix then the appendix cant be causing them pain because they dont have one

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antibiotics most likely lead to

diarrhea

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what meds to ask if a patient is on with abdominal pain

antibiotics, NSAIDs, opioids, taken anything for constipation or diarrhea

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asking for abdominal pain

have any nausea, vomiting, constipation, or diarrhea?

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PQRST

Provoking or precipitating or pattern- what were you doing when the pain started
Quality
Radiating/relieving factors- is it better when you lay on your side?
Severity- scale of 0-10 rate it
Timing- when did it start? How long have you had this pain?

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looking at the biliary tract with

Endoscopic retrograde cholangiopancreatography (ERCP)

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what is normal after an scopy procedure

white stools are the procedure is normal finding. diarrhea and constipation are not!! (barium turns it white)

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WBC, RBC, infection, anemia, etc

CBC

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BMP

basic metabolic panel

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what does BMP tell us

creatinine
BUN
electrolytes

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pancreatic enzymes to know

amylase and lipase

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albumin

protein- good estimate of nutritional status

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bilirubin

tells us how the liver is functioning

ammonia levels

tells us if the liver is impaired this level will be high

LDL and HDL tells us

good and bad cholesterol; lipoproteins (low and high)

specific liver function tests

(ALT, AST, GGT, ALP)

cbc, bmp, cholesterol, ldl, hdl

know ranges

11-16 seconds

total cholesterol

less than 200

platelets

150-400,000

wbc

4-12,000

hemoglobin male

13-18

hemoglobin female

12-16

hematocrit male

37-49

hematocrit female

36-46

found in plant based products-nuts, seeds and vegetable oils

unsaturated fats

what can unsaturated fats do

can decrease serum cholesterol levels

meats, seafood, skinned chicken, whole dilk dairy products

saturated fats

what can saturated fats do

increase the risk of cardiovascular disease

made by hydrogenation-heating liquid vegetable oil –fried foods

trans fat

what does total cholesterol levels include

triglycerides, LDL, HDL

optimal level of ldl

less than 100

optimal level of hdl

greater than 40

overtime what can high levels of ldl cause

atherosclerosis

optimal level of triglycerides

less than 150

Abnormal lipoprotein metabolism

dyslipidemia

medications for dyslipidemia

statins

side effects of statins

Muscle pain Risk of myopathy Liver toxicity

how to diagnose someone with malnutrition- what lab

serum albumin

diet that promotes healing

high calorie, high protein food

parenteral nutrition is given how

bloodstream; usually through a central line with the GI track is not good

normal bmi

18.5-24.9

overweight

25-29.9

obese

greater than 30

Android fat distributed over abdomen and upper body (neck, arms, shoulders)

apple shaped

Fat located primarily in upper legs | Muscular mass is less developed.

gynoid

complication of bariatric surgery

dumping syndrome - gastric contents empty too fast into small intestine

metabolic syndrome 5 risk factors

``` hypertension triglycerides abdominal obesity hdl cholesterol impaired fasting glucose ```

block neurochemicals that appear to trigger nausea and vomiting

Antiemetics

progressive hypovolemia

bp starts to drop

black tarry stools-longer the passage of blood through the intestines the darker the stool color

Melena

Herniation of a portion of the stomach into the esophagus through an opening or (Hiatus) in the diaphragm

hiatal hernia

hiatal hernia occurs

at night if meal is eaten then a person lies flat

chronic diarrhea lasts

at least 4 weeks

what treatment for diarrhea is contraindicated

antidiarrheal agents with infectious organisms

treatment for c diff

vancomycin and flagyl

risk factor for appendicitis

Diet low in fiber and high in refined sugars and carbs

sign of appendicitis

rovsings sign

what sign will you see in patients with peritonitis

guarding, rigid abdomen

rbc

3.5-5.5

ptt

21-35 seconds

creatinine

0.5-1.2

chloride

96-106

BUN

6-20 if its high you're dehydrated

patients with liver issues what is one lab value you're going to test them for

albumin 3-5

bilirubin

0.1-1.2

hepatic encephalopathy is treated with what med

lactulose

total cholesterol is

less than 200

patient who is NPO but is now progressing onto foods how do you give it to them

start with clear liquid diet, then give them high card food; avoid FATTY foods

med list

2:08

fullament hepatitis

hepatic encelopathy ; most severe hep

function of the liver

Carbohydrate metabolism glycogenesis, glycogenolysis Protein metabolism-synthesis of nonessential amino acids, clotting factors, urea formation Fat metabolism-synthesis of lipoproteins, synthesis of fatty acids, breakdown of cholesterol Detoxification drugs/harmful substances Steroid metabolism Bile production and excretion Storage- glucose in form of glycogen, minerals, vitamins Mononuclear phagocyte system break down of old RBC, WBC bacteria and other particles, breakdown of hemoglobin from old RBC’s to bilirubin

cullens sign

pancreatitis; bruising around the belly button

greys turner

pancreatitis; bruising on the side

BRAT diet and what is it for

bananas, rice, apple sauce, and toast; used for patients with vomiting and diarrhea issues

what meds do we avoid with gerd

anticholingerics; decreases gastric emptying

What are some drugs we may give to GERD patients?

Cimetidine, Zantac, Pepcid, Prilosec, Nexium, Prevacid

what kind of meds reduce HCl secretion?

cimetidine, zantac, and pepcid

what kind of meds reduce gastric acid secretions and promote ulcer healing?

PPI

refeeding syndrome

hypophosphatemia