ATI-MedSurge-GASTROINTESTINAL
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| When do duodenal ulcer pain usually occur? | 1-1/2 to 3 hrs after meals, during the night
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| Dumping Syndrome | rapid emptying of gastric contents into the small intestine
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| Pancreatitis - first nursing priority | pain interventions
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| Pancreatitis - second nursing priority | auto digestion of the pancreas
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| What is? Cirrhosis | replacement of liver tissue with fibrotic, scar tissue
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| Spider angiomas |
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| Fetor hepaticus |
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| Cirrhosis - highest priority assessment | Blood stools
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| What is? Cholecystitis | inflammation of the wall of the gall bladder
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| Cholecystitis - foods to avoid | dairy, fried, chocolate, nuts, gravy, gas forming (beans, broccoli, cabbage...)
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| Ileostomy weight (gain / loss) is an expected finding? | gain
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| Ileostomy stoma is reddish-purple color, what should nurse do? | report to HCP, this is sign of bowel ischemia
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| Pancreatitis - _______ levels are increased | amylase
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| For a positive amylase result, levels must be? | 2 to 3 times normal value
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| For a positive lipase result, levels must be? | 3 to 5 times normal value
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| What does a Colonoscopy do? | allows visualization of anus, rectum, colon
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| Colonoscopy - dietary prep | - drink liquids 24-hr prior
- NPO 6-8 hrs prior
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| Appendicitis - most often seen in what age range / group? | 10 - 30 yrs / peak: males 20 - 30
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| What is the location of McBurney's Point? | lower right quadrant, halfway bet. umbilicus and anterior iliac spine
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| Appendicitis symptoms | abdominal pain (first), N/V
low-grade fever
tense posturing / guarding
mild elevation, left shift in WBC 10K - 18K
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| What is? Ulcerative Colitis | edema and inflammation of the rectum (may expand length of colon)
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| What is? Crohn's Disease | inflammation and ulceration of the GI tract (at distal ileum)
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| What is? Diverticulitis | inflammation of the intestinal wall (in the colon) due to trapped fecal matter
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| Ulcerative Colitis - nursing care | - teach relaxation techniques
- allow for daily rest periods
- restrict intake of caffeine
- monitor I/O, potassium
- eat high protein (calorie), low fibers
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| Lactulose (Cephulac) | given to aid in secretion of ammonia via stool in Cirrhosis of the Liver
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| Lactulose (Cephulac) - pt. teaching | - expect 2 - 5 soft stools /day
- dietary: low protein/low sodium
- expect bloating
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| What are? Peptic Ulcers | erosion of the mucosal lining of the stomach or duodenum
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| Drugs that give false negative for H. pylori | bismuth, misoprostol, sulcralfate, histamine2 receptor antagonists
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| Sulcralfate - should be administered? | on an empty stomach 1-hr before meals
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| Peptic Ulcer - meals | eating frequent, small meals and bedtime snacks stimulate gastric secretion and should be avoided
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| Symptom of peritonitis secondary to ulcer perforation? | Board-like abdomen
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| Colorectal cancer - expected lab findings | - increased CEA levels
- decreased Hct & Hbg
- positive fecal occult blood test
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| Metoclopramide Hydrochloride (Reglan), used to? | increases the motility of the esophagus and stomach
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| Metoclopramide Hydrochloride (Reglan), monitor for? | extrapyramidial side effects
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| Hepatitic C patients - pt. teaching | - avoid alcohol
- avoid acetaminophen
- no special diets required
- may need to decrease med dosages
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| What is? Ascites | an abnormal accumulation of fluid in the abdomen
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| Paracentesis | a procedure during which fluid from the abdomen is removed through a needle to analyze it or relieve pressure
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| Paracentesis - symptom of effective treatment | decreased shortness of breath
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| Bismuth subsalicylate (Pepto-Bismol), used for? | destroys the cell wall of H. pylori, does not affect gastric acid secretion
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| Rantidine (Zantac), used for? | an H2 receptor antagonist, used to decrease gastric-acid production
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| Aluminum hydroxide (Amphojel), used for? | antacid that neutralizes gastric acid
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| Sucralfate (Carafate), used for? | to form a protective coating over a gastric ulcer
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| Foods that can help prevent flatus? | Yogurt
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| Foods that can cause odor | fish, eggs, dairy, carbonated beverages, garlic, beans, dark veges
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| Acute Hepatitis B, expected assessments? | - arthralgia / myalgia
- headache
- fatigue
- pruritus
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| Portal-systemic shunt, used to? | decrease amount of ascites, measuring abdominal girth daily will determine this
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| Portal-systemic encephalopathy, complication? | clients with poor liver function, unable to convert ammonia & other waste products to less toxic form
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| Portal-systemic encephalopathy, monitor? | - serum ammonia and potassium levels
- L.O.C.
- asterixis
- fetor hepaticus
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| What is? asterixis | flapping of the hands
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| What is? fetor hepaticus | liver breath
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| Carcinoembryonic antigen (CEA) level... | will decrease if chemotherapy is being effective in controlling growth of cancer cells
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| Post-OP gastroectomy - nursing priority | nasogastric tube patency, to reduce risk of retention of gastric secretions, that can lead to gastric dilation
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| Cirrhosis pt. with elevated ____ should be reported to the HCP? | Ammonia, elevated may indicate portal-systemic encephalopathy
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| GERD - best sleeping position | left side, with head elevated 6 inches
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| Oxybutynin (Ditropan), used for? | alleviate pain with neurogenic or overactive bladder - avoid with GERD
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| Diphenoxylate (Lomotil), used for? | decrease gastrointestinal motility
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| 0.45% sodium chloride IV, used for? | fluid replacement, dehydration
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| Ciprofloxacin (Cipro), used for? | bacterial gastroenteritis
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| 5% dextrose water, used for? | acute gastroenteritis; fluid replacement, dehydration
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