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GI

QuestionAnswer
routes of nutritional supplements 1. liquid whole food/ by mouth 2. feeding tube 3. tpn or ppn
types of feeding tubes nasogastric, esophogostomy, gastrostomy, jejunostomy nasoduodenal, nasojejunal, Dobnoff
can you check residual in jujuneum? no
NSAIDS interfere with prostiglandins
why does aspirin irritate the stomach? first it works in the blood and then it works by interefering with prostiglandins.
how do prostiglandins affect the stomach? protect the mucous lining of the stomach and cut down on acid
effects of aging on th GI tract mouth, digestive enzymes (HCI acid, IF, Pepsin, Lipase, Trypsinogen, Amylase, Bile and sucrase), motility, musculoskeletal, socio-economic.
What potential effects does NSAIDS have on the body? GI upset and bleeding
coated aspirin has no benefit
x-ray looking for free air, shows if system has a leak, this is normally a medical emergency
complication of barium studies constipation, may need MOM to get rid of barium
Nursing implications for upper GI study 1. Keep pt NPO for 8-12 hrs. before procedure 2. prevent contrast mediums impaction
Nursing implications for Barium 1.administer laxatives & enemas untill colon is clear 2. cl diet evening before procedure
Nursing implications for upper GI Endoscopy 1.NPO for 8 hrs 2. make sure consent is signed
Nursing implications for colonoscopy bowel prep, sedation will be given, cl 1-3 days before procedure,will inject air tell pt it will be uncomfortable and to pass the air.
Nursing implications for proctosigmoidoscopy 1. enema evening before & morning of procedure 2. explain that knee-chest position may br necessary
Nursing implications for gastric analysis 1. NPO for 8-12 hrs. 2. ensure no smoking day of procedure
Nursing implications for stool hemoccult 1. place smear of stool on both areas of card2. apply 2 drops of developer to each area and the control area 3. avoid NSAIDS, red meat, broccili for 3 days (could effect the results)
Nursing implications for liver biopsy 1. check coagulation status 2. ensure informed consent is signed.
Nursing implications for abd ultrasound schedule test before upper GI or brium enemas 2. client may need bowel cleansing
Nursing implications for liver/ spleen scan 1. explain non-invasive nature of test with only a trace of radio-activity 2.explain client will lie still while camera moves over abd.
Nursing implications for MRI npo for 6 hrs. before procedure. 2 metal and pregnancy contrindicated
Nursing implications for oral cholecystogram 1. assess for iodine allergy 2. npo after dye
pepsin enzyme that breaks down protein in the stomach
lipase pancreatic enzyme that breaks down fats into fatty acids and glycerol
cystokinin hormone that stimulates bile flow into the duodenum
stomach where fat digestion begins
ptyalin enzyme in the mouth that breaks down starches
mouth where carb break down begins
amylase enzyme that breaks down maltose, lactose, and sucrose
gingivitis inflammation of the gums
dysphagia difficulty swallowing
hematemesis vomiting blood
emesis vomiting
hepatomegly liver enlargement
ascites fluid within abd cavity
candidiasis white, curd like fungal lesions
hemorrhoids thrombosed veins in rectum and anus
melena black, tarry stool
leukoplakia thickened white patches
dyspepsia heartburn, indigestion
rebound tenderness sudden pain when fingers withdraw from abdominal palpation
the majority of blood supply to the liver is from the portal vein
purpose of procedure: oral cholecystogram x-ray of gallbladder after contrast medium allows visualization of gallbladder and duct system
purpose of procedure: barium swallow fluoroscopy with contrast medium to diagnos structural sbnormalities of esophagus, stomach,duodenal bulb
purpose of procedure: colonoscopy allows direct visualization of colon up to ileocecal valve.
purpose of procedure: ultrasound use of high frequency sound waves to detect viruses, stones, tumors
purpose of procedure: fecal analysis specimen analyzed of fat, blood, parasites
purpose of procedure: liver/spleen scan injection of radionuclide to record distributionin liver and spleen.
purpose of procedure: serum amylase blood tested for pancreatic enzyme
purpose of procedure: CT scan x-ray of gallbladder exposures at different depths to detect biliary tract, liver, pancreatic disorders.
Why do you need to be NPO for ultrasound? keep gallbladder from contracting
types of contrast iv and oral
nursing implications for contrast check allergies to shellfish and iodine, check orders for contrast or no contrast, check BUN and creatine (can kidneys clear this contrast)
Nursing implications for EGD pt must sign permit, npo for 8 hrs, concerned about gag reflex returning, VS every 15 mins, wait 1 hr to eat
best test for colon cancer colonoscopy
how do you get colon cancer genetic: you make the polyp because you have the gene to make it.
who should tell the pt when to have a colonoscopy? only the dr
colorectal canser risks 1. genetic predispostion 2. african americans 3. family hx 4.H/O CA 5. Age 6. bowel disease 7. diet 8. medications 9. lifestyle
GI Drugs Antacids, H2 blockers, PPI (stop production of acid)
antacids Rolaids, Tums, MOM
H2 Blockers Pepsid, Tagament
PIP Nexium, Previcid, Prilosec
S/S of polyp caliber of stool change, occult blood, CEA lab
GERD acid and pepsin reflux
factors of GERD esophageal motility, defective mucousal barrier, gastric emptying, stomach contents move up,
prediposing factors for GERD Age, poor nutrition,obestiy,ascites, tumors,heavey lifting, forced recumbant position.
GERD S/S heartburn, pain, dyspepsia, hoarsness, microaspiration
GERD treatment Anti-secretory, antacids, cytorotective, prokinetic
GERD lifestyle changes HOB on 6 in blocks, diet, decrease intra-abd pressure
complications of GERD severe reflux esophagitis ( inflammation, erosion, fibrosis) and pre-cancerous metaplasia ( lining starts to change to be more like that of the stomach)
GERD surgical unterventions fundiplication (wrap top of stomach and suture it creating a false sphinter) and stretta procedure (creates more scar tissue to tighten up the sphincter)
Gastritis causes 1. drugs 2. lifestyle 3. H. Pylori (know to cause stomach cancer
S/S of Gastritis Anorexia, N&V, Epigastric tenderness, fullness, Macrocytic anemia
Gastritis diagnosis endoscopy, IF testing. CBC, Electrolytes, Liver profile. Urine and stool sample
Peptic ulcer: Gatric S/S 1-2 hrs PC pressure and pain, burning gaseous
Peptic ulcer: Duodenal 2-4 hrs PC Sleep disturbance, pressure and pain, Burning, cramp like back pain
80% of ulcers are in? duodenum
complication of ulcers hemorrhage, perforation
Bleed from upper GI? black
Bleed from lower GI? red
treatment for perforation surgery, emergent
Gastroduodenostomy Billroth I- removal of distal 2/3 stomch w/ anastomosis to duodenum
gastrojejunostomy Billroth II- removal of distal 2/3 stomach w/ anastomosis to jejunum
Vagotomy selective ligation of vagus nerve eliminates stimulus for HCI
Dumping sydrome occurs after surgery, goes away on it's own, a sudden decrease in plasma volume occuring after eating. S/S sweating , palpation, pain, abd cramps
Blood that has begun to be digested by gastric secretions willl appear? coffee ground
Feosol (iron) will turn stools black.
S/S of GI hemorrage or perforation Hypotension, tachycardia, tachypnea
fluid movement in the dumping syndrome is a function of osmosis
Most common surgery Appendectomy
Appendisitis S/S Pain RLQ, Starts at periumbilical and then moves to McBurney's point (RLQ at hip line), positive Rovsing's sign, N&V, Anorexia, decreased motility, Neutrophilia, and fever
Rovsing's sign pressure on the L and feels pain on the right
Hernia protrusion of organ or structure through an opening or defect or weak spot
types of hernias hiatus, ventral, umbilical, inguinal, femoral
direct inguinal hernia from normal stressures of life
indirect inguinal hernia canal didn't close
strangulated hernia blood supply is cut off, emergency surgery situation
incarcerated hernia is trapped outside peritoneal cavity
reducible hernia hernia moves vack into peritoneal cavity
diverticulosis S/S generally on the left side, caused by constipation and straining. asymptomatic, cramp-like pain, alternating BM, bloating
diverticulosis diagnosis CT, CBC, FOBT, BE, Colonscopy
diverticulosis treatment diet hydrtion, medication (bulk laxative, anticholinergics), decreased intra-abdominal pressure.
diverticulitis S/S pain on l side, guarding, LLQ Mass, inflammatory response,
diverticulitis complications abcess, peritonitis, fistula. obstruction, bleeding,
diverticulitis treatment NGT, IVF, Antibiotics, Analgesics, progressive diet and ambulation; surgery (bowel resection)
types of bowel obstruction: adhesion, strangulated, ilialsecal intussusception , Intussusception from polyp,mesenteric occlusion, neoplam (tumor), volvulus of sigmoid colon (twisting, paralytic
Created by: gemjema
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