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210 ch. 34
GI function
| Question | Answer |
|---|---|
| Where is the stomach located | left upper portion of abd under left lobe of liver and diaphragm overlaying most of pancreas |
| How much does the stomach hold | 1500ml |
| What are four anatomic regions of stomach? what are two sphincters | cardia(entrance), fundus, body, pylorus(outlet)... LES(lower esophageal) and pyloric |
| what is fx of sm int..21ft? what are three sections? | absorption is primary, then secretion Duodenum, jejunum(middle), ileum |
| What does the ileocecal valve do? | ileum terminates at valve and controls flow of digested material from ileum to cecal, prevent reflux |
| What is attached to cecum? | appendix |
| What empties into the duodenum at the ampulla of Vater? | common bile duct |
| what are parts of lg int...5-6ft | ascending, transverse, descending(left side of abd), sigmoid colon, rectum, anus |
| What are the five major veins that make up the vena portae that enters liver | sup mesenteric, inf mesenteric, gastric, splenic, cystic vv... |
| which vv supply O2 and nutriets to stomach and intestine | stomach: gastric intestine: mesenteric |
| Which part of the lg int has the most motility | transverse, it moves with expanding stomach |
| What two things are key to the elderly with hospitilzation and the GI | hydration bc low saliva, so help food intake excercise bc slower digestion |
| when assessing pt with GI issues what is important about meds, elimination, excercise, chief complaint | Some meds incr (cholinergics)/ decr(anticholinergics) GI fx look at color,smell,consistency normal excercise amount |
| How should you obtain physical exam of GI issue? | Inspection:bruise/lesions auscultation:4 quads percussion:high/solid/dull, low/gas/tympani palpation: can move things @ |
| What is fx of GI tract | digestion, absorption, elimination |
| What enzyme do chief cells secrete and what is fx | pepsin, protein digestion |
| What is intrinsic factor and where is it | secreted by parietal cells in gastric mucosa, combines w/ B12 so can be absorbed by ileum. If absent, get pernicious anemia. |
| What is pH of stomach vs sm int | pH of stomach can be as low as 1. Sm int is more alkaline, bicarbonate |
| what is difference and similarities of pepsin and trypsin | Both are digestive enzymes. Pepsin is in gastric mucosa. Trypsin is released from pancreas |
| What are two types of contractions in sm. int. | segmentation contractions: mixing waves, churning contents Intestinal peristalsis: propel to colon. Both stimulated by presence of chyme. |
| Discuss difference and similarities of absorption of nutrients vs fats/proteins/carbs/Na/chloride/B12/bile salts/Mg/Ph/K | Sm Int/Duodenum:nutrients Jejunum:fats/proteins/carbs/Na/Cl Ileum: B12/bile salts Sm Int: Mg/Ph/K |
| What are two types of colonic material added to residual material | electrolyte solution: bicarbonate and mucus to protect lining and help fecal adherence. |
| Where does the brown color of poop come from | breakdown of bile |
| What are age related changes to GI | loss of teeth, decr salivation, motility, HCL acid, peristalsis, tone in sphincters |
| what is dyspepsia | indigestion |
| Pain in upper right shoulder can indicate | liver probs |
| Appendicitis will show pain where | LLQ |
| Blood in stool presented from? black color in stool? bright/dk red blood in stool? Red streaked bloody stool? | black(melena): upper GI tract bright/dk red: lower GI streaked: lower rectal/anal |
| Other stool abnomalities: | bulky,greasy,foul smell clay colored, no bilirubin mucus threads or pus small, dry, rock-hard loose, watery |
| A large "V" formation with thin white coat on tongue, is this normal? | yes |
| What are 9 regions of stomach starting from LUQ to right | lft hypochondriac-epigastric-rt hypchondriac Lft lumbar-umbilical-rt lumbar lft inguinal-hypogastric-rt inguinal |
| what are four types of bowel sounds heard on auscultation | normal, hyperactive, hypoactive, absent(none for 3-5min) |
| Diagnostic serum tests for GI | CBC, PTT, triglycerides, liver fx, amylase, lipase, CEA(carcinoembryonic antigen) and CA(cancer antigen 19-9 for colon Ca |
| Stool tests | FOBT- early Ca detection, blue=blood..assess diet before: avoid red meat, aspirin, NSAIDs, turnips, horseradish, Vit C. Gather in dk stool area |
| How should you handle Ova/parasite stool samples? stools for lipids? | parasite: warm sample, 3 specimens lipid: put on ice, Crohn's dis test |
| What is breath test looking for in GI | overgrowth of bacteria in intestine and short bowel syndrome. Test for levels of hydrogen to test fot Hpylori bacteria |
| Ultrasonic testing for GI tests for | gallstones, enlarged ovary, enlarged gallbladder/pancreas, ectopic preg, appendicitis Nsg mgmt: NPO to lower gas |
| Upper GI radiologic tests Lower GI tests | swallow barium barium enema..always scheduled b4 upper GI tests and not for active inflammatory dis or perforations/obstructions |
| CT scans are suited for what body type? | thin, not much fat..schedule b4 barium |
| When is MRI contraindicated? | pt with pacemaker, artificial heart valves, defibrillators, insulin pumps, anxiety of closed spaces |
| What is most important nsg mgmt after endoscopy | check gag reflex with tongue blade from Versed. |
| What does "til clear" mean with barium enemas | run enemas three times till poop gone. Now Go-LYTELY, CoLyte) If bleeding, use Gastrografin contrast agent |
| What are nsg mgmt of endoscopy | Lay on left side to aid clearance of pulmonary secretions. Watch what you say, cause 8th cranial nerve(hearing) last to go |
| what is ERCP endoscopic retrograde cholangiopancreatography looking for | common bile duct and looking for gallstones |
| what concern is nsg looking for after colonoscopy? | bowel perforation, rectal bleeding, abd pain/distention, fever |
Created by:
palmerag
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