NURS122 > GI > Flashcards

GI Flashcards

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1
Q

what is considered upper abdominal issues

A
  • GERD
  • peptic ulcers
  • gastritis
  • gastroparesis
  • gallstones
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2
Q

what is considered lower abdominal issues

A
  • celiac disease
  • diverticular disease
  • IBS
  • inflammatory bowel disease
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3
Q

symptoms of upper GI issue

A
  • bleeding
  • anemia
  • early satiety
  • unexplained weight loss >10%
  • progressive dysphagia
  • odynophagia (pain or discomfort when swallowing)
  • persistent vomiting
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4
Q

what does C-reactive protein tell you

A

inflammation

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5
Q

causes of gastritis

A
  • H.pylori
  • excessive smoking or drinking
  • prolonged NSAID use
  • cocaine
  • weakened stomach lining (i.e. pernicious anemia)
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6
Q

most important system to check although it is GI issues

A

cardiac first - pulses, cap refill, O2 sat monitor

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7
Q

isolation precaution for gastritis

A

contact precautions

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8
Q

how often to take I/Os for at risk pt

A

q1hr

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9
Q

how often to check weight for at risk pt

A

q4hr

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10
Q

what type of IV fluid to give for gastritis

A

D5W w/ 0.9NS + 20KCl

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11
Q

nurse teaching for gastritis

A
  • perianal hygiene
  • food prep practices
  • vaccines
  • continued ORT (oral rehydration therapy) at home
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12
Q

what type of acid/base issue might vomiting and diarrhea lead to

A

hyperchloremic acidosis from loss of sodium bicarbonate

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13
Q

minimum of fluids for maintenance & how much fluid intake we should have per day

A

125-150mLs /hr
should have 2-3L per day

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14
Q

most common causes of appendicitis & age range for getting it

A
  • infection from stomach migrated to appendix
  • obstruction of stool

most common in teenage years

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15
Q

why is abx &IV fluids typically given to someone with appendicitis

A

prophylactic prevention in case it ruptures
IV fluids to avoid dehydration

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16
Q

what is GI bleed pt at risk for

A
  • hemorrhage
  • hypovolemic shock
  • aspiration
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17
Q

what’s the treatment for GI bleed

A
  • blood transfusion
  • NG tube for gastric lavage
  • stop bleed
  • meds: epinephrine, vasopressin
  • meds: octreotide
  • PPI: pantoprazole
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18
Q

why give vasopressin (ADH) for GI bleed

A

it constricts the GI blood vessels to slow bleed

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19
Q

what is a sign of a massive GI bleed

A

foul smelling, marron or purple color jelly stool

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20
Q

what can hyperperistalsis indicate

A

intestine issue such as obstruction

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21
Q

teaching for fluoroscopic x-rays

A
  • enemas need to be given
  • NPO for 8 hrs at least
  • lost of fluids & laxatives to expel the contrast
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22
Q

what position should the pt be in for endoscopy

A

left side with head bend forward

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23
Q

how does ERCP (endoscopic retrograde cholangiopancreatography) work

A

endoscopy into duodenum & inject contrast dye into common bile ducts to see gallstones, tumor, or biopsy

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24
Q

how does capsule endoscopy work

A

pt swallows small camera to see small bowel that wasn’t seen in regular endoscopy

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25
contraindications for barium swallow
pregnancy - since barium has radiation perforation of esophagus or intestines blockage or severe constipation severe issues with swallowing sensitivities
26
how does barium affect stool color
white or light color until clears
27
preparation for colonoscopy
clear liquids the day before Golytely night before (may cause ab cramping) - osmotic laxative to cleanse
28
when is colonoscopy recommended
pts over age 50
29
how is gastric contents analyzed
NG tube and see contents
30
gerontological considerations
- stomach produces less acid - less protection when taking NSAIDs - muscles can slow leading to acid reflux or constipation
31
S/S of diverticulitis
- gas, bloated, cramps, constipation - if inflamed: pain, cramps, fever, vomiting
32
what is Barrett's esophagus
if GERD is untreated and the acid affect the esophagus and leading to cancer
33
S/S of gastritis
- N&V - abd pain, cramps - indigestion, uncomfortable between meals or at night - hiccups - loss of appetite - black tarry stools
34
treatment for gastritis
- avoid gluten & dairy - avoid hot & spicy foods - take antacids prn - abx w/ acid blocking drug for H.pylori - vitB12 shots for pernicious anemia
35
S/S of appendicitis
- LRQ pain that radiates from naval - pain that worsens with movement - N&V - loss of appetite - fever - constipation or diarrhea - flatulence or bloating
36
where is McBurney's Point for appendicitis
abd wall between navel and LLQ that causes pain in LRQ
37
when do appendix typically burst from appendicitis
24-72 hrs
38
what is Rovsing's sign for appendicitis
palpation of LLQ that leads to pain in LRQ
39
Testing for appendicitis
- CBC (especially neutrophils 2,500-7,000) - CT, ultrasound - c-reactive protein for inflammation
40
laparotomy vs. laparoscopy
laparotomy is small incision in abdomen laparoscopy is inserting a small scope in
41
what position to place patient after appendix sx
high-fowler's to decrease tension in abdomen
42
what is octreotide used for
decrease HCl & decrease splanchnic blood flow IV bolus up to 5-6 days after bleed
43
MOA of PPI pantoprazole
inhibits pump that secretes HCl acid neutralizing effect lasts longer than antiacids can take up to 4 days before effect is seen
44
list HH2 receptor antagonist drugs
ranitidine cimetidine famotidine nizatidine -"tidine"
45
MOA of ranitidine
inhibit histamine at H2 receptors to decrease parietal cell acid secretion
46
when should pts take pantoprazole
before meals
47
when should pts take ranitidine
with or after meals before sleep
48
use HH2 receptor antagonists cautiously in which pts
kidney dx pts
49
what is small intestine adhesions
fibrous tissue that form after sx from extreme inflammation can lead to GI obstruction
50
what is small intestine volvulus
twisting of intestines that can lead to obstruction
51
what is small intestine intussusception
"telescoping" of one segment into the next section that can lead to obstruction
52
stricture of colon means
narrowing of colon caused by scarring of inflammation
53
causes of GI obstruction
- small intestine adhesion, volvulus, intussusception - birth defect - tumors - hernias - IBS (i.e. Crohn's) - swallowed objects in children
54
what can ileus lead to
gastroenteritis, appendicitis electrolyte imbalances
55
what is pseudo-obstruction
obstruction due to muscle or nerve issue
56
causes of pseudo-obstruction
Parkinson's, MS Hirschsprung's dx - lack of nerves in large intestine diabetes hypothyroidism
57
symptoms of obstruction
- severe bloating - pain - decreased appetite - N&V - constipation (complete) or diarrhea (partial block)
58
treatment for obstruction
- IV fluids - NG suction - surgery - colostomy, ileostomy, partial bowel removal
59
DC teaching after obstruction sx
- eat small meals throughout day - take sips of clear liquids throughout day - add new foods back to diet slowly - if constipation or discomfort avoid solid foods & clear liquid only - limit exercise for 4-6wks - ileostomy or colostomy care
60
list 3 antiemetics
ondansetron metoclopramide dimenhydrinate
61
what type of foods should pts with ileostomy restrict
- fiber - soda, nuts, peppers - limit smoking - dairy
62
change in pain when someone with duodenal ulcer vs. gastric ulcer ingests food
decrease in pain for duodenal ulcer increase in pain for gastric ulcer
63
use of magnesium hydroxide
known as "milk of magnesia" increases GI motility
64
how does vomiting and diarrhea affect electrolytes
decrease in electrolytes so should be monitored closely
65
what happens to the enzymes that the pancreas typically releases when the pt has pancreatitis
increase in enzymes due to poor modulation
66
what foods should a pt with colostomy eat
yogurt crackers toast to prevent flatus and odor
67
what foods can a pt with celiac dx eat and not eat
don't eat gluten eat more fiber foods - beans, nuts, fruits, veg
68
main symptom to look out for when a pt is taking metoclopramide
extrapyramidal symptoms i.e. ataxia
69
main symptom to look out for when a pt is taking ondansetron
monitor ECG for QT prolongation
70
main symptoms of dramamine (dimenhydrinate)
drowsiness, dry mouth, blurred vision
71
how should antiacids be taken
with a full glass of water when acid levels are highest so 1-3hrs post meal and before bedtime
72
how does changes in CEA (carcinoembryonic antigen) level change with cancer
increases with cancer
73
Hgb level for pt with colorectal cancer
decrease due to intestinal bleed
74
foods to eat vs. not eat to avoid dumping syndrome post gastrectomy
eat more protein eat less carbs or sugary foods & fluids
75
why would cirrhosis lead to bleeding of the esophageal varices
increased portal vein pressure that leads to enlarged veins of the esophagus
76
what type of foods should a pt with pancreatitis consume and not consume
low fat high protein diet
77
prolonged use of PPI can lead to what
fractures especially in elderly pneumonia or C.diff
78
list some antiacids
- aluminum hydroxide - magnesium hydroxide - calcium carbonate - sodium bicarbonate
79
what does metoclopramide do
antiemetic increased motility of stomach and esophagus
80
which antibiotics can eliminate H. pylori
- metronidazole - amoxicillin - clarithromycin - tetracycline
81
what is sucralfate used for
coats ulcer and protects it prevents H. pylori from binding to mucosal wall inhibits acid
82
expected effects of taking sucralfate
black stool
83
when to take sucralfate
1 hr before meals or bedtime
84
what drug not to take & adverse effect of sucralfate
don't take with aspirin, NSAIDs may cause constipation
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