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68WM6 Ph 2 GI2
Gastrointestinal System
| Question | Answer |
|---|---|
| this sphincter prevents reflux of gastric contents into the esophagus | cardiac (lower esophageal) sphincter |
| this sphincter regulates the rate of stomach emptying into the small intestin | pylorlic sphincter |
| the chief coenzyme of gastric juice which converts proteins into proteases and peptones | pepsin |
| necessary for the absorption of vitamin B12 | intrinsic factor |
| enzyme that controls gastric acidinty | gastrin |
| this part of the small intestine contains the openings of the bile and pancreatic ducts | duodenum |
| digests starch to maltose | amylase |
| reduces maltose to monosaccharide glucose | maltase |
| splits lactose into galactose and glucose | lactase |
| reduces sucrose to fructose and glucose | sucrase |
| splits nuclec acids to nucleotides | nucleose |
| activates trypsinogen to trypsin | enterokinase |
| these play a vital role in the synthesis of some B vitamins and vitamin K | intestinal bacteria |
| prevents contents of the large intestine from entering the ileum | ileocecal valve |
| this organ synthesizes glucose, amino acids, and fats | liver |
| this organ stores 200 to 400 mL of blood and also filters the blood | liver |
| stores and concentrates bile and contracts to force bile into the duodenum during the digestion of fates | gallbladder |
| the cystic duct joins the hepatic duct to form | common bile duct |
| the presence of fatty materials in the duodenum stimulates the liberation of this, which causes contraction of the gallbladder and relaxation of the sphincter of Oddi | cholecystokinin |
| secretes sodium bicarbonate to neutralize the acidity of the stomach contents that enter the duodenum | pancreas |
| examination of the upper GI tract under fluoroscopy after the patient drinks barium sulfate | barium swallow (upper GI seies) |
| after a barium swallow test, the client should be instructed to | increase po fluid until stools resume their normal color |
| a fluoroscopic and radiographic examination of the large intestine after the rectal instillation of barium sulfate | barium enema (lower GI series |
| the diet restrictions before a barium enema study include | low residue diet for 1-2 days, clear liquid diet day before and laxative the evening before, NPO after midnight |
| requires the passage of a NG tube into the stomach to aspirate gastric contents for analysis of acidity, appearance, and volume | gastric analysis |
| how long should a patient be NPO before gastric analysis | 8 to 12 hours |
| upper GI endoscopy is also known as | esophagogastroduodenoscopy(EGD) |
| following sedation, an endoscope is passed down the esophagus to view the gastric wall, sphincters, and duodenum | EGD |
| how long should a patient remain NPO following EGD | 1 to 2 hours |
| use of a rigid scope to examine the anal canal | anoscopy |
| before anoscopy, proctoscopy, and sigmoidoxcopy enemas are given until | returns are clear |
| a fiberoptic endoscopy study in which the lining of the large intestine is visually examined | colonoscopy |
| following endoscopic examinations, guarding of the abdomen, increased fever and chills, pallor, abdominal distensiona and pain, restlessness, tachycardia, and tachypnea are signs of | bowel perforation; peritonitis |
| performed with a fiberoptic laparoscope that allows direct visualization of organs and structures within the abdomen | laparoscopy (peritoneoscopy) |
| performed to detect gallstones and to assess the ability of the gallbladder to fill, concentrate its contents, contract, and empty | cholecystography |
| before colecystography, patient should be assessed for allergies to | iodine or seafood |
| examination of the hepatiobiliary system performed via a flexible endoscope inserted into the esophagus to the descending duodenum | endoscopic retrograde cholangiopancreatography (ERCP) |
| examination involving injection of dye directly into the biliary tree | percutaneous transhepatic cholangiography |
| transabdominal removal of fluid from the peritoneal cavity for analysis | paracentesis |
| why should a patient void before paracentesis is performed? | to move the bladder out of the way of the paracentesis needle |
| how is a patient positioned for parcentesis? | upright on edge of bed, or fowlers if bedridden |
| needle inserted through the abdominal wall to the liver to obtain a tissue sample for biopsy and microscopic evaluation | liver biopsy |
| these laboratory values should be checked before a liver biopsy is performed | PT, PTT, INR |
| patient should like on this side for this long after a liver biopsy | right side, two hours |
| urea breath test detects the presence of ________, which is the bacteria that causes perptic ulcer disease | heicobacter pylori |
| __________ is released during liver damage or biliary obstruction | alkaline phosphatase, (bilirubin is also an acceptable answer) |
| prothrombin time is _________ with liver damage | prolonged |
| _________________ assesses the ability of the liver to deanimate protein byproducts | serum ammonia |
| liver enzymes are ______________ with liver damage | elevated |
| an increase in _________ indicates pancreatitis or biliary obstruction | cholesterol |
| increased values of amylase and lipase indicate __________ | pancreatitis |
| normal bowel sounds occur every __ to ___ seconds | 5 to 15 |
| how long must you listen before assuming that bowel sounds are absent? | 5 minutes |
| backflow of gastric and duodenal contents into the esophagus | gastroesophageal reflux |
| causes of GERD | incompetent lower esophageal sphincter, pyloric stenosis, or motility disorders |
| also known as esophageal or diaphragmatic hernia | hiatal |
| inflammation of the stomach or gastric mucosa | gastritis |
| in chronic gastritis, a deficiency of this vitamin may develop | B12 |
| ulceration in the mucosal wall of the stomach, pylorus, duodenum, or esophagus | peptic ulcer |
| the proper order for performing an abdominal assessment | inspect, auscultate, percuss, palpate |
| chronic gastritis is distuinguished from acute gastritis by the following symptoms in addition to nausea, vomiting, and anorexia | belching, heartburn after eating, sour taste in mouth, vitamin B12 deficiency |
| ulcers are named according to their _____ | location |
| most common sites of peptic ulcers | stomach and duodenum |
| mucosal barrier protectants should be administered... | 1 hour before meals |
| pain with gastric ulcers is usually located in ___________ and occurs ________ after meals | mid or left epigastric, 30 to 60 minutes |
| pain with duodenal ulcers is usually located in ___________ and occurs _________ after meals | midepigastric, 1.5 to 3 hours |
| removal of the stomach with attachment of the esophagus to the jejunum or duodenum | total gastrectomy (esophagojejunostomy or esophagoduodenostomy) |
| surgical division of the vagus nerve to eliminate the vagal impulses that stimulate hydrochloric acid secretion in the stomach | vagotomy |
| removal of the lower halv of the stomach and usually includes a vagotomy | gastric resection or antrectomy |
| partial gastrectomy with the remaining segment anastomosed to the duodenum | billroth I, or gastroduodenostomy |
| partial gastrectomy with the remaining segment anastomosed to the jejunum | billroth II, or gastrojejunostomy |
| enlargement of the pylorus to prevent or decrease pyloric obstruction and enhance gastric emptying | pyloroplasty |
| should an NG tube be irrigated following gastric surgery? | no |
| rapid emptying of the gastric contents into the small intestine that occurs following gastric resection | dumping syndrome |
| loud gurgles indicating hyperperistalsis; stomach growling | borborygmi |
| results from a deficiency of intrinsic factor | pernicious anemia (vitamin B12 deficiency) |
| signs of pernicious anemia | smooth, beefy red tongue, parasthesias of hands and feet, gait a balance disturbances |
| to prevent dumping syndrome, this diet should be followed | high protein, high fat, low carbohydrate |
| foods that contain vitamin B12 | yeast, citrus fruits, dried beans, green leafy vegetables, liver, nuts, organ meats |
| following bariatric surgery, the patient is restricted to liquid and pureed food for how many weeks | 6 |
| dilated and tortuous veins in the submucosa of the esophagus | esophageal varices |
| esophageal varices are caused by ______ _________ | portal hypertension |
| how should a patient with esophageal varices be positioned? | head elevated |
| this medication is administered to induce vasoconstriction and reduce bleeding of esophageal varices | vasopressin |
| this medication is administered in conjunction with vasopressin to prevent vasoconstriction of the coronary arteries (in treatment of bleeding esophageal varices) | nitroglycerin |
| this should be avoided by a patient with esophageal varices | vasovagal responses |
| the injection of a sclerosing agent into and around bleeding varices | sclerotherapy or endoscopic injection |
| ligation of varices with an elastic rubber band | endoscopic variceal ligation |
| this type of ulcerative colitis results in vascular congestion, hemorrhage, edema, and ulceration of the bowel mucosa | acute |
| this type of ulcerative colitis causes muscular hypertrophy, fat deposits, and fibrous tissue with bowel shortening, thickening, and narrowing | chronic |
| key signs of ulcerative colitis | severe diarrhea with blood and mucus, dehydration and electrolyte imbalance, vitamin K deficiency |
| ulcerative colitis can be cured by | protocolectomy with permanent ileostomy |
| intraabdominal pouch that stores the feces constructed from the terminal ileum | kock pouch |
| before colostomy/ileostomy, intestinal antiseptics and antibiotics are administered to | decrease baceria in the colon |
| normal stoma color is | bright pink or red, and shiny |
| key signs of crohn's disease | crampy colicky pain after meals, semisolid diarrhea, dehydration, electrolyte imbalances |
| surgery for this inflammatory bowel disease is avoided because recurrence of the disease process is likely to occur | crohn's disease |
| outpouching or herniation of the intestinal mucosa | diverticulosis |
| inflammation of one or more diverticula | diverticulitis |
| a perforated diverticulum can progress to | peritonitis |
| key signs of diverticulosis/itis | LLQ pain that increases with coughing, straining or lifting, palpable, tender rectal mass, blood in stools |
| dilated varicose veins of the anal canal | hemorrhoids |
| _________ are caused by portal hypertension, straining, irritation, or increased venous or abdominal pressure | hemorrhoids |
| key sign of hemorrhoids | pain and bright red bleeding on defecation |
| how often should sitz baths be used | 3 to 4 times per day |
| key sign for appendicitis | abdominal pain most intense at McBurney's point, rebound tenderness |
| how will a patient with acute appendicitis usually position themselves? | side lying with abdominal guarding and knees flexed |
| inflammation of the peritoneum | peritonitis |
| following appendectomy with appendix rupture, how should a patient be positioned | right side lying or low to semi fowlers with legs flexed to facilitat drainage |
| chronic, progressive disease of the liver characterized by diffuse degeneration and destruction of hepatocytes | cirrhosis |
| cirrhosis that is alcohol induced, nutritional, or portal | laennec's |
| cirrhosis as a complication of acute viral hepatitis or exposure to hepatotoxins | postnecrotic |
| cirrhosis as a complication of chronic biliary obstruction, bile stasis, or obstructive jaundice | biliary |
| cirrhosis associated with severe right sided congestive heart failure | cardiac |
| persistent increase in pressure within the portal vein that develops as a result of obstruction to flow | portal hypertension |
| the accumulation of fluid within the peritoneal cavity that results from venous congestion of the hepatic capillaries | ascites |
| progressive renal failure associated with hepatic failure | hepatorenal syndrome |
| a patient with ascites would have a dietary restriction of | sodium and fluid |
| coarse tremor chacterized by rapid, nonrhythmic extension and flexion in the wrist and fingers | asterixis |
| fruity, musty breath odor of severe chronic liver disease | fetor hepaticus |
| this medication decreases the pH of the bowel, decreases production of ammonia by bacteria in the bowel, and facilitates the excretion of ammonia | lactulose (chronulac) |
| this mecications inhibits protein synthesis in bacteria and decreases the production of ammonia | neomycin; metronidazole (flagyl) |
| this type of cholecystitis results when inefficient bile emptying and gallbladder muscle wall disease cause a fibrotic and contracted gallbladder | chronic |
| this type of cholecystitis occurs in the absence of gallstones and is due to bacterial invasion via the lymphatic or vascular systems | acalucous |
| key signs of cholecystitis | epigastric pain 2 to 4 hours after eating fatty foods, pain in RUQ, Murphy's sign (inability to take a deep breath when the examiner's fingers are passed below the hepatic margin) |
| removal of the gallbladder | cholecystectomy |
| incision into the common bile duct to remove a stone | choledocholithectomy |
| these two activities should be encouraged following gallbladder surgery to avoid respiratory complications | coughing, deep breathing |
| acute or chronic inflammation of the pancreas with associated escape of pancreatic enzymes into surrounding tissue | pancreatitis |
| key signs of pancreatitis | midepigastric or LUQ pain that is aggravated by a fatty meal, alcohol, or lying in a recumbent position |
| discoloration of the abdomen and periumbilical area (pancreatitis) | cullen's sign |
| discoloration of the flanks (pancreatitis) | turner's sign |
| elevated serum lipase and amylase are indicators of | pancreatitis |
| signs of chronic pancreatitis | LUQ mass, seatorrhea and foul smelling stools, diabetes mellitus |
| the first stage of hepatitis preceding the appearance of jaundice; flu like symptoms | preicteric stage |
| the second stage of hepatitis which includes the appearance of jaundice and associated symptoms such as elevated bilirubin levels, dark urine, and clay colored stools | icteric stage |
| the convalexcent stage of hepatitis in which jaundice decreases and urine and stool color return to noromal | posticteric stage |
| how is hepatitis A most commonly transmitted | fecal-oral route |
| how is hepatitis B most commonly transmitted | parenterally |
| how is hepatitis C most commonly transmitted | parenterally |
| how is hepatitis D most commonly transmitted | parenterally, and only in conjunction with hepatitis B |
| How is hepatitis E most commonly transmitted | contaminated water |
| how is hepatitis G most commonly transmitted | parenterally |
Created by:
ewoff85
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