365 CH Upper GI
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| malabsorption syndrome | impaired absorption of nutrients from the GI tract; decreased enzymes, decreased bowel surface area
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| malabsorption syndrome symptom | fever; increased basal metabolic rate and use of protein stores
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| enteral nutrition | directly into the GI tract; patient can eat but can not meet all nutritional needs
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| reasons to be enterally fed | anorexia, facial fractures, head and neck cancer, extensive burns, critical illness
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| contraindications to enteral feedings | GI obstruction, prolonged ileus, severe diarrhea, vomiting, enterocutaneous fistula
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| oro gastric tube | temporary, goes in mouth and sits in stomach
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| nasogastric tube | temporary, in nose to the stomach; used for aspiration precautions
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| nasoduodenal tube | into intestine
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| gastrostomy, percutaneous endoscopic gastrostomy | long lasting, directly into stomach through the abdomen
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| aspiration risk | HOB 30 - 45
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| parenteral | directly into the bloodstream
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| parenteral nutrition | intravenous administration; accu check every 4 - 6 hours
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| parenteral feed | dextrose, fat emulsions, protein and electrolytes, trace elements; solution is only good for 24 hours
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| parenteral nutrition indications | GI tract is unable to be used, complicated surgery, GI obstruction, fistula, severe malabsorption
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| if parenteral feed is unavailable | hang 10 to 20% dextrose
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| refeeding syndrom | insulin takes glucose into cells, hypophosphetemia
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| refeeding symptoms | weakness, shallow respirations, confusion and seizure
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| medical management of obesity | lose 1 -2 pounds per week, healthy balanced diet
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| bariatric restrictive | make stomach smaller
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| bariatric malabsorptive | bypass part of the intestines
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| preoperative risks of bariatric | thromboembolism, pulmonary complications
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| gastric restriction | banding, minimally invasive and reversible; restricts stomach and makes smaller
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| vertical sleeve gastroplasty | removed portion of stomach
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| biliopancreatic diversion | 80% of stomach is removed; remained attached to bottom of small intestine
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| gastric bypass | stomach is smaller, duodenum, part of jejumun bypassed; less nutrients are absorbed; weight loss is longer lasting
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| mobilization prevents | deep vein thrombosis, hypostatic pneumonia
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| anastomotic leaks | breakdown suture line and leak gastric contents
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| dumping syndrome | food enters undigested into the small intestine
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| signs of dumping syndrome | N/V, diarrhea, tachycardia, faintness
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| postprandial hypoglycemia | uncontrolled gastric emptying, insulin release
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| vitamin replacement in bariatric | may not absorb B12 leading to anemia
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| anemia | lethargic, numbness, tingling
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| metabolic syndrome | obesity, hyperlipidemia, hyperglycemia, increased waist circumference, hypertension
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| metabolic syndrome managment | reduce LDL and cholesterol, stop smoking, lower BP
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| testing GI content | assess for placement of a GI tube
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| pH | less than 5.5 in the stomach
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