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Human Needs > Upper & Lower GI Disorders > Flashcards

Upper & Lower GI Disorders Flashcards

1
Q

Vomiting Characteristics Meaning

A
  • bright red: active bleeding
  • coffee look: old blood/lower GI bleeding
  • projectile: increased ICP, no nausea
  • Fecal odor: backflow of intestinal content; obstruction (lower GI)
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2
Q

N/V Acute Care

A
  • persistent vomiting: hospitalization, IVs, & NPO
  • start with clear liquids
  • NG may be necessary
  • I & O, VS, signs of dehydration
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3
Q

Nausea/Vomiting Non-Pharmacologic Interventions

A
  • quiet, well ventilated, & free of noxious odors
  • avoid sudden changes in position
  • relaxation
  • cleanse face/hands with cool cloth
  • mouth care
  • antiemetic (HCP prescribed)
  • raise head of bed`
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4
Q

Gastritis

A

gastric mucosal inflammation

  • due to gastric mucosal barrier breaking down
  • black tarry stools, bloating, pain, nausea, upset stomach, indigestion
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5
Q

Gastritis Assessment

A
  • health history (gastric irritant, smoking, stress, H. pylori, alcohol)
  • epigastric tenderness
  • GI discomfort (N/V, bloating, anorexia)
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6
Q

GERD

A

upper GI problem

-reflux of stomach acid into lower esophagus

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7
Q

GERD Management

A
  • elevate head 30 degrees
  • don’t lie patient down for 2-3 hrs after eating
  • stress & weight reduction
  • small, frequent meals
  • PPIs
  • risks: aspiration & ulcers
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8
Q

Laproscopic Nissen Fundoplication

A

restores the function of the LES

  • postop: prevent respiratory probs, maintain fluids/electrolytes, prevent infections
  • postop assess: pneumothorax (chest pain, dyspnea, cyanosis)
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9
Q

Peptic Ulcer Disease

A

GI mucosal erosion in any part of the GI tract

  • assess health history & med usage
  • heart burn, weight loss, epigastric tenderness, N/V, tar stools
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10
Q

Peptic Ulcer Disease Health Promotion

A
  • people taking ulcerogenic drugs have increased risk; take with food
  • teach patients to report symptoms r/t gastric irritation (epigastric pain)
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11
Q

Peptic Ulcer Disease Acute Care

A
  • NPO, NG tube, IV fluids
  • mouth care
  • cleaning/lubricating nares
  • analysis of gastric contents
  • VS initially & hourly to detect shock
  • I & O
  • physical/emotional rest
  • pain meds, sedation
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12
Q

Hemorrhage

A

Changes in VS & increase in the amount and redness of aspirate signals massive upper GI bleeding

-maintain the patentcy of the NG tube and prevent blood clot blockage. If the tube is blocked, distention results

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13
Q

Perforation

A

sudden, severe generalized abdominal pain and severe shoulder pain

  • rigid/boardlike abdomen
  • shallow, grunting respirations
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14
Q

Perforation Care

A
  • check VS every 15-30 min
  • stop all oral, NG feedings
  • IV fluids may be increased
  • provide pain meds
  • antibiotic therapy
  • surgical/laparoscopic closure
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15
Q

Gastric Outlet Obstruction Care

A
  • Constant NG aspiration
  • regularly irrigate tube & reposition the patient from side-to-side
  • clamp NG intermittently
  • I & O, IVs, electrolyte replacement
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16
Q

2 Most Common Types of IBDs

A

Crohn’s and Ulcerative Colitis

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17
Q

Crohn’s Disease

A
  • onset: 15-35 yrs & 55-70 yrs
  • symptoms: abdominal pain, diarrhea, weight loss, & fatigue
  • malnutrition common
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18
Q

Ulcerative Colitis

A
  • onset: 15-35 yrs & 55-70 yrs
  • symptoms: stool urgency, fatigue, increased bowel movements, mucous in stool, nocturnal bowel movements, abdominal pain
  • bloody stool common
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19
Q

IBD Care

A

Hemodynamic Stability

Fluid and Electrolyte Balance

Pain Control

Nutritional Support

Skin Integrity Maintenance

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20
Q

What do you monitor for hemodynamic stability?

A
  • labs (CBC)
  • VS
  • stools for blood
  • I & O
21
Q

IBD teaching

A
  • rest & diet management importance
  • perianal care
  • drug actions & side effects
  • symptoms of recurrence
  • when to seek medical care
  • ways to reduce stress
22
Q

Ulcerative Colitis Complications

A
  • perforation
  • peritonitis
  • increased risk of colon cancer after 10 yrs
23
Q

Crohn’s Disease Complications

A
  • fistula
  • fissure
  • abscess
  • perforation & peritonitis
  • nutritional deficiencies
24
Q

IBD Expected Outcomes

A
  • decreased # of diarrhea
  • freedom from pain & discomfort
  • use of coping strategies
  • body weight maintained
25
Q

Peritonitis Assessment

A
  • causes: abdominal surgery, ectopic pregnancy, or perforations
  • high WBC & shallow respirations
26
Q

Peritonitis Diagnoses

A
  • acute pain
  • fluid imbalance
  • impaired gas exchange
  • risk for infection
27
Q

Peritonitis Care

A
  • IV fluids & antibiotics
  • monitor for pain & response to analgesics
  • position patient with knees flexed
  • I & O, electrolyte status, VS
  • antiemetics, NPO, NG
  • low flow oxygen
28
Q

Intestinal Obstruction

A
  • high: severe vomiting, projectile, feces, cramping

- low: slow onset, foul smelling vomiting, colicky, constipation, abdominal distention

29
Q

Large Intestinal Obstruction

A
  • onset: gradual
  • vomiting: late/absent
  • pain: persistent, cramping
  • BM: obstipation
  • distention: increased
30
Q

Appendicitis Risk Factors

A
  • 10 to 30 yrs old

- obstruction of lumen opening to appendix

31
Q

Appendicitis Acute Findings

A
  • dull periumbilical pain, moves to RLQ
  • anorexia, nausea, vomiting
  • low grade fever
  • rebound tenderness
  • high WBC
  • sudden improvement of pain: rupture
32
Q

Constipation & Fecal incontinence Assessment

A
  • C: Crohn’s disease
  • F: perineum for breakdown, IAD, pressure injury

Both: health history, bowel habits/sensation, stool scale, diet, ADLs

33
Q

Percutaneous Transhepatic Cholangiography (PTC)

A

X-ray of liver and bile duct after dye is injected directly into liver

34
Q

Hepatobiliary Scintigraphy (HIDA)

A

scan of liver, gallblader, & bile ducts

35
Q

Hepatitis Types

A
  • A & E: bowel
  • B: body fluids
  • C: circulation
  • D: HBV for DNA replication
36
Q

Hepatitis Assessment

A
  • RUQ pain
  • weight loss
  • N/V
  • low grade fever
37
Q

Hepatitis A Health Promotion

A
  • person & environmental hygiene
  • hand-washing
  • vaccination
38
Q

Hepatitis B Health Promotion

A
  • screen for HBV
  • vaccination
  • hand-washing & gloves
  • condom use
39
Q

Hepatitis C Health Promotion

A
  • screening of blood, organ, & tissue donors
  • infection control precautions
  • modifying high-risk behaviors
  • screen if born in 1945-1965
40
Q

Cirrhosis

A
  • end stage of liver disease

- extensive degeneration & destruction of liver cells

41
Q

Cirrhosis Diagnoses

A
  • chronic confusion
  • fatigue
  • nausea
  • chronic pain
  • risk for bleeding, injury, impaired oral mucous membrane, impaired skin integrity
42
Q

Cirrhosis Implementation

A
  • abstain from alcohol
  • adequate nutrition
  • paracentesis & balloon tamponade
  • PSE
43
Q

Cholelithasis

A

gallstones

-risks: high cholesterol, bile/cholesterol balance upset, females/pregnancy, >40 yrs, obesity

44
Q

Cholecystitis Risk Factors

A
  • inflammation
  • E. coli infection
  • cancer
  • anesthesia
45
Q

Acute Pancreatitis Symptoms

A
  • hypotension
  • low grade fever
  • LUQ pain
  • tachycardia
  • vomiting
46
Q

Chronic Pancreatitis Symptoms

A
  • distention
  • LUQ burning/cramping pain
  • clay-colored stool
  • jaundice
  • weight loss
47
Q

Pancreatitis Risk Factors

A

Bile reflux due to biliary tract obstructive disease

Alcohol consumption

Smoking

Hyperlipidemia (HLD)

48
Q

Pancreatitis Complications

A
  • pseudocyst: accumulation of fluid, enzymes, debris, & exudates
  • abscess
49
Q

Pancreatitis Implementation

A
  • analgesics, opioids
  • rest
  • decrease pancreatic stimulus
  • small frequent meals
  • NPO or NG tube

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