Wk 6, 7 GI - PowerPoint/2

Question 1

GI bleed s/s

5

Answer 1

1. rigid abdomen
2. hyperactive to diminished bowel sounds
3. rebound tenderness
4. melena
5. hematemesis
6. tachycardia
7. low BP

Question 2

primary etiologic factors for acute pancreatitis

2

Answer 2

1. biliary tract disease (most common in women)

2. alcoholism (most common in men)

Question 3

two classifications of pancreatits

Answer 3

1. mild - edematous or interstitial

2. severe - necrotizing, leaking out fluid

Question 4

pancreas puts out digestive enzymes

2

Answer 4

1. lipase

2. amylase

Question 5

not relieved by vomiting

Answer 5

pancreatitis

Question 6

pancreatitis abd pain location and s/s

4

Answer 6

left upper quad or epigastric

1. not relieved by vomiting
2. worse when laying down
3. may radiate to left shoulder, back or flank

Question 7

pancreatitis s/s

9

Answer 7

1. pain in LUQ
2. pain in epigastric
3. not relieved by vomiting
4. worse when laying down
5. may radiate
6. NV
7. hypotension
8. tachycardia
9. jaundice

Question 8

pancreatitis seepage of blood into tissues causes

Answer 8

1. ecchymosis on the flanks - Turner’s sign

2. bluish discoloration of the periumbilical area - Cullen’s sign

Question 9

pancreatitis - tetany caused by

Answer 9

hypocalcemia - this is caused by fat necrosis from enzymes

Question 10

pancreatitis - hypocalcemia signs

3

Answer 10

1. trusseau’s sign
2. chvostek’s sign
3. twitching of fingers, spasms

Question 11

pancreatitis lab results

7

Answer 11

1. lipase - rises slower than amalyse but lasts 2 weeks
2. amalyse
3. increased WBC count
4. decreased calcium and magnesium
5. may have elevated LFTs and elevated bilirubin
6. elevated glucose
7. CT scan

Question 12

pancreatitis best lab marker

Answer 12

lipase - rises slower than amalyse but lasts 2 weeks

Question 13

pancreatitis lab result - amalyse up in __ , lasts for ___

Answer 13

up in 12 hours, lasts for 4 days

Question 14

why do lab results for pancreatitis show decreased calcium and magnesium

Answer 14

due to fat necrosis

Question 15

best dx test for pancreatitis

Answer 15

CT scan

Question 16

what to check before CT scan with dye

3

Answer 16

1. allergies to iodine
2. on metformin
3. kidney function

Question 17

Two significant local complications of acute pancreatitis are:

Answer 17

1. pseudocyst - abscess along pancreas

2. abscess

Question 18

pancreatitis nursing care

Answer 18

1. NPO
2. antiemetic
3. pain management
4. TPN
5. limit stress, smoking, etoh

Question 19

ERCP stands for

Answer 19

endoscopic retrograde cholangiopancreatography

Question 20

rx for pancreatitis

Answer 20

1. antibiotics
2. anticholinergic dicyclomine/Bentyl
3. H2 blockers and PPIs
4. pancreatic enzyme called pancreatin or pancrelipase - aids in fat digestion

Question 21

Bentyle function

Answer 21

decreases spasm and peristalsis that can cause pain in pancreatitis

Question 22

calcium during pancreatitis

Answer 22

decreases

Question 23

cholecysitis

Answer 23

inflammation of the gallbladder wall

Question 24

cholelithiasis

Answer 24

stones in gall bladder

Question 25

gallbladder issues risk factors | 9

Answer 25

1. >40 yo 2. female 3. fat 4. genes 5. older than 60 6. DMI 1 7. high protein, low calorie diets 8. weight loss - increases cholesterol 9. fertile

Question 26

murphy's sign is to

Answer 26

cholecystitis

Question 27

dyspepsia, belching, flatulence is to

Answer 27

cholecystitis

Question 28

what is murphy's sign

Answer 28

pain with palp RUQ under ribs

Question 29

itching is to

Answer 29

cholecystitis

Question 30

clay colored stool

Answer 30

cholecystitis

Question 31

main test for cholecystitis

Answer 31

x ray

Question 32

stool and urine for bile flow problems

Answer 32

clay colored stools | tea colored urine/ dark

Question 33

cholecystitis labs | 5

Answer 33

1. increased WBC shift to left 2. direct indirect and total serum bili increase 3. amalyse and lipase may be elevated if pancreas involved 4. abnormal LFT 5. increased total cholesterol

Question 34

HIDA scan looks at what

Answer 34

gallbladder ducts

Question 35

ERCP puts what

Answer 35

scope into abdomen

Question 36

what analgesic you don't give - cholecystitis

Answer 36

demerol may cause spasms in spincture of oddi causing pain, give morphine instead

Question 37

cholecy. - meds to decrease spasms

Answer 37

dicyclomine/bentyl

Question 38

main dx tool for sepsis is

Answer 38

lactate levels

Question 39

post op cholecy. diet | 3

Answer 39

low fat low fried avoid chocolate