Week 3 (GI Trauma, Hepatitis, Cirrhosis, Male Reproductive, & Female Reproductive (Part 1)) Flashcards
(101 cards)
Abdominal Assessments: which organs are associated with pain in each abdominal quadrant
GI - KNOW THIS!!!
RUQ = Liver
LUQ = spleen
RLQ = appendix
LLQ = UC & diverticulitis
When the following traumas occur, what areas are usually injured?
1.) Trauma to the lower rib cage
2.) Chest trauma
3.) Pelvic trauma
GI Trauma - KNOW THIS!!!
1.) Lower Rib Cage = spleen
2.)Chest Trauma = esophageal & gastric
3.)Pelvic Trauma = bladder & uterus
Signs & Symptoms / Patho of Abdominal Trauma
GI Trauma
- blood loss
- pain
- decreased peristalsis
What are Esophageal Varicies? What is the cause?
GI Trauma
Abnormal veins in the esophagus
Cause: portal hypertension or blockage of liver
What is the cause of esophageal varicies & what are common symptoms?
GI Trauma - KNOW THIS!!!
Cause: portal Hypertension (blockage of the liver)
Signs & Symptoms:
* Jaundice
* Hematemesis (vomiting blood)
* Melena
* Altered LOC (decreased consciousness)
* Shock
* Vomiting
* Bleeding
* Lightheadedness
Risk factors for esophageal varicies
GI Trauma
- Portal Hypertension
- Red marks on the varicies (seen on the EGD)
- Severe cirrhosis
- Liver failure
- Continued EtOH use
Signs & Symptoms of esophageal varicies
GI Trauma - KNOW THIS!!
- Hematemesis
- Melena
- Altered Consciousness
- Shock
- Jaundice
- bleeding
- lightheadedness
Treatment for Bleeding Varicies
GI Trauma - KNOW THIS!!!
- Treat for shock (administer O2)
- IV fluids, electrolytes, blood & blood products
- Vasopressin, somatostatin, octreotide to decrease bleeding
- Nitroglycerin + vasopressin to reduce coronary vasoconstriction
- Propranolol & nadolol (beta blockers) to reduce portal pressure
- Balloon tamponade
- TIPS (Trans jugular Intrahepatic Portosystemic Shunt)
What 2 medications are used to treat esophageal varicies & why are they used?
GI Trauma - KNOW THIS!!!
Propranolol & Nadolol
- beta-blockers; they decrease portal HTN
What is a balloon tamponade & when is it used?
GI Trauma - KNOW THIS!!!
Inflating a balloon inside the esophagus which puts pressure on varicies to stop the bleeding
- Used for esophageal varicies
Nursing Management of Esophageal Varicies
GI Trauma
- Safe environment (prevent injury, bleeding, & infection)
- Administer treatments
- Monitor for potential complications
- Encourage deep breathing & position changes
- Education & support
What are signs & symptoms of hepatic injury?
GI Trauma - KNOW THIS!!!
- RUQ pain
- Rebound tenderness
- Hypoactive / absent bowel sounds
- SIGNSN OF HEMORRHAGE OR SHOCK
- abdominal wall muscle rigidity, spasm, or involuntary guarding
Key Symptoms of Hepatic Injuries
GI Trauma - KNOW THIS!!!
- RUQ Pain
- Rigidity
- Guarding
- Signs of Shock or Hemorrhage
What type of abdominal trauma is associated with underlying damage to the spleen?
GI Trauma - KNOW THIS!!!
fractures of the 10th or 12th ribs
Signs & Symptoms of Splenic Injury
GI Trauma
- Signs of hemorrhage or shock
- Abdominal wall muscle rigidity, spasm, or involuntary guarding
- LUQ Tenderness
- Pain in the L Shoulder (KEHR’S SIGN)
Key Signs & Symptoms of Splenic Injury
GI Trauma - KNOW THIS!!!
- Kehr’s Sign (Radiating L shoulder pain)
- LUQ Pain
- S&S of shock or hemorrhage
Signs & Symptoms of Hollow Organ Injuries
GI Trauma - KNOW THIS!!!
- Peritoneal irritation
- Evisceration of small bowel or stomach
- Diagnostic peritoneal lavage may show presence of bile, feces, or food fibers
- Bruising
- Rigidity
What organs should you think of when you hear pelvic fracture?
GI Trauma - KNOW THIS!!!
Bladder & Urethra
If there is blood at the meatus or scrotum, what should you do?
GI Trauma - KNOW THIS!!!
Do NOT insert a catheter
Key Signs & Symptoms of Bladder Injury
GI Trauma - KNOW THIS!!!
- Blood at meatus and/or scrotum
- Urge to urinate but unable to urinate
Signs & Symptoms of Bladder & Urethral Injuries
GI Trauma - KNOW THIS!!!
- Suprapubic pain
- Urge, but unable to urinate
- Blood at meatus & in scrotum
- Rebound tenderness
- Displacement of prostate
- Abdominal wall muscle rigidity, spasm, or involuntary guarding
What is Cullen’s Sign & what does it indicate?
GI Trauma - KNOW THIS!!!!
Bluish / purplish bruising (ecchymosis) at or around the umbilicus (bellybutton)
Indicates: internal bleeding into the peritoneum
What is Kehr’s Sign & what does it indicate?
GI Trauma - KNOW THIS!!!
Radiating L shoulder pain
- Indicates splenic injury
What is Grey Turner’s Sign & what does it indicate?
GI Trauma - KNOW THIS!!!!
ecchymosis on the flank; one or both sides
Indicates: renal injury