GI test

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GI test
2013-12-10 19:20:50
GI test-7
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  1. inflammation, infection, or a symptom of disease, side effect of medicine- mouth
  2. Small white painful ulcers, on the inner cheek, lips, tongue, pharyns
    Can last several days to 2 weeks- usually heals w/o a scar
    Canker sore
  3. Cheesy white plaque that looks like milk curds when rubbed off
    Candidiasis- thrush (moniliasis)
  4. Risk factors for Herpes simplex 1
    Diabetes, antibiotic therapy, immunosupression- Opportunistic- may appear up to 20 days after exposure, treat with Acyclovir (antifungal)
  5. Cold sores, fever blisters, recur but will only last a few days, infectious, can be contagious, provoked by stress, fever, run down, no cure
    Herpes simplex 1
  6. Pts with _____ can tolerate solids more easily than liquids- teach "double-swallow) technique- 1 inhale, 2 put food in pharyns and swallow, 3 exhale, 4 swallow again
    pharyngeal weakness
  7. esophageal weakness is also called
    Cardiospasm or aperistalsis
  8. s/s of esophageal weakness
    gradual onset of dysphagia for both fluids and solids, loss of weight, substernal chest pain, regurgitation of esophageal contents onto pillow at night, progresses slowly-usually in the distal end- usually 40 years of age and over
  9. condition where the lining of the esophageal mucosa is altered, associated with GERD that is left untreated- can lead to precancerous cells in esophagus
    Barrett's esophagus
  10. Mucosal laceration at the gastroEsophageal junction- occurs in about 10% of cases, typically follows vomit, 90% of bleeding stops on it's own
    mallory- Weiss Tear
  11. Causes of narrowing of the lumen of the esophagus
    ingestion of corrosive substances, reflux esophagitis, prolonged NGT, irritation of the esophageal walls lead to formation of a stricture that the esophageal lumen and leads to dysphagia
  12. esophageal cancer affects more ____ and more ----
    men and african americans ages 50-60
  13. Primary s/s of esopheageal cancer
    difficulty swallowing
  14. _____ when you don't secrete enough intrinsic factor, therefore you have trouble absorbing enough B12 leading to pernicious anemia
    Chronic gastritis type A- autoimmune gastritis
  15. s/s of chronic gastritis
    may be asymptomatic except s/s of anemia, weakness, sore tongue, numbness, tingling- Treated with B12 injections
  16. Affects lower end of the stomach, antrum, and pylorus, near the duodenum- Freq. Assoc. with H. pylori, S/s poor appetite, heartburn after eating, belching, sour taste,
    Chronic gastritis type B
  17. Acute gastritis S/S
    abdominal discomfort, h/a, lassitude, nausea, vomiting, hiccuping
  18. s/s of chronic gastritis
    epigastric discomfort, anorexia, heartburn after eating, belching sour taste in mouth, nausea and vomiting, intolerance of some foods, may have vitamin deficiency
  19. Risk factors for peptic ulcer disease
    excessive secretion of stomach acid, dietary factors, chronic use of NSAIDs, alcohol, smoking and familial tendency-
  20. Choledococholithotomy
    incision of the common bile duct to remove stones
  21. Which ulcer is associated w/ extensive burns?
    Curlings- normally around 72 hours after
  22. What is the most prominant sign of inflammatory bowel disease?
    Intermittent pain
  23. peripheral veins used for ____
    Short term- very irritating to veins- soultion is weaker
  24. Which dietary modification is utilized for a pt dx w/ acute pancreatitis?
    Elimination of coffee- high- carb, low fat, low protein diet should be implimented
  25. An iliostomy resivior should be emptied...
    Every 2-4 hours
  26. Reddened circumscribed lesion that ulcerates and becomes crusted- primary lesion of syphilis
  27. What does TPN contain?
    animno acids, fats, vitamins, electrolytes, trace  elements, and water
  28. What is a protrusion of the intestine through a weakened area in the abdominal wall?
  29. Diet modification for a pt dx w/ IBS
    low residue diet
  30. When should you use TPN
    • Unable to tolerate liquids in GI tracts
    • Enteral feedings
    • disorders of GI tract
    • Surgical pts, trauma, healing
    • poor nutrition
    • weight loss
    • physician decides
  31. Which mouth condition is associated w/ HIV
    Kaposis sarcoma
  32. The presence of mucus and pus in stools suggest which condition?
    inflammatory colitis
  33. The primary source of microorganisms for cath-related infections are the skin and...
    cath hub
  34. Which surgical procedure for obesity utilizes a prosthetic device to restrict oral intake?
    Gastric banding
  35. To ensure patency of central venous line ports, diluted heparin flushes are used in which situation?
    Daily-when not in use
  36. A pt being treated for diverticulosis should...
    drink at least 8-10 glasses of H20 daily
  37. Fat soluable vitamins and fatty acids, glycerol absorbed into____
    lymph in lacteals
  38. Dysphagia
    difficulty swallowing
  39. odynaphagia
    Pain on swallowing
  40. dyspepsia
  41. What is the most common type of complain of a pt w/ pancreatitis?
    severe, radiating abdominal pain
  42. symptom of GERD which is characterized by burning sensation in the esophagus
  43. Clinical manifestations of cholelithiasis?
    "gallstones" clay-colored stools, excruciating URQ pain
  44. Initially, which diagnositic should be completed following placement of an NG tube?
  45. Which enzyme begins the digestion of starches?
  46. Which is caused by improper cath placement and inadvertent puncture of the pleura
  47. Borborygmus
    intestinal rumbling that accompanies diarrhea
  48. Which is an inaccurate clinical manifestation assoc. w/ hemorrhage?
  49. Mercury is typically used in placement of which tube?
  50. A pt w/ a sigmoid colostomy will have ____ feces?
  51. Which symptom would the nurse ovserve after an intestinal perforation?
    Sudden, sustained abdominal pain
  52. a pt w/ IBS is significantly at risk for
    osteoporosis due to decreased bone mineral desity
  53. Which is the major carb that tissue cells use as fuel
  54. The most significant complication r/t continuous tube feedings is _____
    The potential for aspiration
  55. Inflammation of the salivary glands
  56. Celiac spruce is an example of which category of malabsorption
    • Difficulty swallowing 
    • may also report chest pain secondary to pulmonary complications, may result f/ aspiration of gastric fluids
  57. What is a major cause of morbidity and mortality in pts with chronic pancreatitis
    pancreatic necrosis
  58. Blood flow to the GI tract is approx what % of total cardiac output?
  59. What is the most common symptom of colon cancer?
    change in bowel habits,-- fatigue, anorexia, and weight loss may occur but not most common
  60. Halitosis and a sour taste in the mouth are clinical manifestations associated w/
    esophageal diverticula
  61. post op care of a pt after esophageal surgery- nurse observes bloating- instruct to
    avoid foods like souffles and carbonated drinks
  62. Digestion in small intestine
    Water soluble nutrients- monosaccharides, amino acids, minerals, water soluble vitamins absorbed in blood in capillary networks
  63. A pt w/ duodenal ulcers would secrete ____ acid
    an excess amt
  64. Pts with gastric cancer would secrete____ acid
    little to no acid
  65. What is a gerontological consieration associated w/ the pancreas
    Increased fibrous material and some fatty deposits
  66. Bariatric surgical procedure optimal for long term weight loss
  67. What type of feeding should be given to a pt who is at risk for diarrhea due to hypertonic feeding solutions
    continuous feedings
  68. Amylase is an enzyme that helps digest____
  69. Major enzymes and secretions in the small instetine
    amylase, lipase, trypsin, bile
  70. Lipase and pepsin help digest _____
  71. using gastric analysis the nurse would expect a pt dx w/ peptic ulcer would secrete...
    some acid
  72. Serum amylase levels return to  normal....
    within 48-72 hours
  73. Primary sx of IBS
    diarrhea, constipation
  74. ____ is characterized by white patches, usually on the buccal mucosa
    • leukoplakia
    • scaling, crust formation and fissures
  75. A pt with an iliostomy should avoid...
    Enteric- coated products- could pass w/o being abosrbed
  76. Which enzyme aids in the digestion of protein?
  77. S/s of progressive gastric cancer include...
    Bloating after meals
  78. What is a clinical manifestation of abdominal perforation disease process?
    Hypotension- increased temp, tachycardia and elevated ESR
  79. A pt has undergone radial neck dissection. His skin graft is pale. This indicates which condition?
    Arterial thrombosis
  80. When gastric analysis testing reveals excess secretion of gastric acid, which med dx is supported?
    Duodenal ulcer
  81. semi-fowlers position is maintained for at least ____ following completion of an intermittent tube feeding
    1 hour
  82. Preprocedure for a pt scheduled for a proctosigmoidoscopy involving lower GI structures?
    follow dietary and fluid restrictions and bowel prep
  83. cancer of the ___+____ is the 2nd most common type of internal cancer in the US
    Colon and rectum
  84. A pt diagnosed w/ a duodenal ulcer will likely experience _____
    pain 2-3 hours after a meal
  85. When shouldTPN be used cautiously
    when a pt can't tolerate high-glucose concentration
  86. For a pt with a disorder of GI system, what history should the nurse assess?
    work history for exposure to environmental toxic wastes or radioactive material
  87. Major enzymes in the mouth
    saliva, salivary amylase
  88. Possible indications for TPN by central lines
    • extensive small bowel resection 
    • radiation and inflammation
    • sever diarrhea, IBD
    • intractible vomiting
    • GI obstruction
    • Sever nausea, vomiting w/ pregnancy
  89. Clusters of ulcers that take on a cobblestone appearance associated w/ which disease?
    Chron's Pain in LRQ
  90. Peptic ulcers disease occurs more frequently in which blood type?
  91. Hickman and Groshong are examples of which type of central venous access devices?
    Tunneled central caths
  92. Problems ingesting necessary nutrients- difficulty swallowing
  93. Post operatively, a pt with a radical neck dissection should be placed in which position
  94. causes of dysphagia
    • pharyngeal muscle weakness
    • esophageal disorders
  95. Enzymes and secretions in the stomach
    hydrocloric acid, pepsin, intrinsic factor
  96. dysphagia- tolerate solids better than liquids
  97. Following acute gallbladder inflammation a pt should avoid which food
    Cheese, eggs, cream and fried foods
  98. Which type of diarrhea is caused by increased production and secretion of H20, electrolytes by intestinal mucosa into intestinal lumen
  99. S/s of Achalasia (cardiospasm, aperistalisis)
    • Gradual onset of dysphagia
    • Weight loss
    • Substernal chest pain
    • regurgitation of esophageal content
    • little or no food in stomach
  100. Rebound hypoglycemia is a complication of parental nutrition caused by____
    feedings stopped too abruptly
  101. most common cause of diarrhea
    contaminated food
  102. causes of esophageal strictures
    • Ingestion of corrosive substances
    • Reflux esophagitis
    • Prolonged NGT
  103. When irrigating a colostomy the nurse lubricates the cath and inserts into the stoma no more than ____ inches
  104. A nontunneled cath can be used for no more than _____
    30 days
  105. Transmural thickening usualy is an early pathologic sign of _____
    chron's later results in deep, penetrating granulomas
  106. Typical s/s of appendicitis
    • Nausea, pain in RLQ
    • Rebound tenderness, or pain felt when pressure to abdomen is released
    • Low-grade fever
  107. S/s of esophageal cancer
    • Dysphagia- prime symptom
    • foul breath
    • full feeling
  108. Causes of acute gastritis
    • injury of the protective mucosal barrier by drugs, chemicals
    • alcohol, 
    • steroids-prednisone
    • bacterial infections
    • NSAIDs
    • extreme stress
    • excess coffee, tea, pepper, spices
    • severe trauma
  109. The most common s/s of esophageal disease
  110. Erosion of a mucous membrane forms an excavation in the stomach, pylorus, duodenum, or esophagus
    Peptic ulcer disease
  111. Risk factors for PUD
    excessive secretion of stomach acid, dietary factors, chronic use of NSAIDs, alcohol, smoking and familial tendency
  112. Manifestations of PUD
    dull gnawing pain or burning in the mid-epigastrium; heartburn and vomiting may occur
  113. A sharply defined break or ulceration in the protectice mucosal lining of the lower esophagus, stomach or duodenum which may involve submucosa and muscular layers- may expose the submucosal layers to gastric acid secretions and pepsin and cause autodigestion
    Peptic ulcer
  114. ____ ulcers extend throught he muscularis mucosa and damage blood vessels, causing bleeding or may lead to perforation of the GIT wall
  115. Pain, buringin and gnawing pain in the high left epigastric region
    Gastric acid secreted in parietal cells of fundus of the stomach
    Peptic ulcer
  116. Predisposing factors for Peptic ulcers
    excessive use of asprin, non-steroidal anti-inflammatory drugs (NSAIDs) cigarette smoking, genetic, dietary, severe stress, alcohol abuse, infection, caffeine, chemotherapy drugs
  117. Increased back diffusion of gastric acid into the tissues/mucosa of the stomach causes
    histamine release, inflammatory reactions, tissue damage, bleeding and ulcerations in the gastric wall
  118. The most common site for peptic ulcer formation is in the
  119. ____ ulcers are associated with weight loss, burning left epigastric area, food frequently aggraves pain, no pain at bedtime
  120. ____ ulcers- right epigastric pain at bedtime,
    burning, cramping, mid epigastric pain
    pain 2-4 hours after a meal, eating decreases pain, weight gain, melena in elderly, Stress/Drug induced
    Duodenal Ulcers
  121. Disorder of altered intestinal motility in which the colon does not contract in a normal pattern, hereditary tendency- s/s gas, bloating, constipation, diarrhea,
  122. Cluster of symptoms that occur despite the avsence of a disease process (motility disorder primarily affecting colon)- fluctuating instestinal motility
  123. metabolic disorder- inability to metabolize peptides (protein)
    Celiac disease
  124. Bacterial infection of intestines (protein malabsorption and other nutrients)
    Tropical spruce
  125. Frequent loose, bulky, foul, fatty stools, gray in color, float-
    specific for spruce, tropical or celiac
  126. s/s of appendicitis
    pain, fever, increased WBC, anorexia, nausea, vomiting, rebound tenderness, pain within iliac
  127. rovsings sign
    pain in RLQ when LLQ is palapted
  128. Complications of appendicitis
    perforation, abcess of appendix, peritonitis, severe pain, temp 100
  129. Presence of puches of mucosa and submucos that protrudes or herniate through the circular muscles of the intestinal wall- most common in the sigmoid colon
  130. Inflammation of the peritoneum and abdominal cavity from trauma, ischemia, tumor perforation, leakage of organ contents into pertoneal cavity- Complication of bacterial infection from perforated pepptic ulcer, ruptured appendix, also complication of CAPD
  131. A disease that causes inflammation in the small intestine, but it may affect any part of the GI tract
    Chron's disease- IBD
  132. S/S of Chron's
    Crampy Abd. pain, distention, tenderness in lower quadrents of the abdomen, esp. R/ side Hx of chronic diarrhea and fatigue, also skin lesions, inflammation of the eyes and abnormalities with liver, arthritis
  133. S/S: patho/etiology: epithelial lining of colon is shed, multiple ulcerations exact cause unknown; triggered poss. Infection, allergy, emotional stress- generally starts in the rectum, as a rule no healthy tissue appears between inflammed areas
    ulcerative colitis
  134. A collection of pus in the perianal area
    Anorectal Abscess
  135. S/Sx of anorectal Abscess
    Pain, redness and swelling of the area, drainage and fever
  136. Inflammation of the liver from exposure to infectious microorganism, hepatotoxic chemicals or drugs
  137. s/s of hepatitis
    fatigue, abdominal tenderness, color of skin and eyes, vleeding- prolonged prothrombin- vital signs- low grade fever
  138. Liver cells are infiltrated with fat and WBCs, then replaced with fibrotic tissue changing obstruction of hepatic blood flow and normal liver function- Decr. absorp.and utilization of fat soluble vitamins such as ADEK
  139. _____ hepatitis can lead to cirrhosis, chronic hepatitis or even death
  140. Type __ viral hepatitis- contaminated food, water, milk, through feces incubation period- 3-7 weeks
  141. Type __ viral hepatitis- Serum hepatits- blood transfusions, mucous membrane, incubation period- 2-5 months
  142. Type __ hepatitis-blood transfusions, needle sticks, a cause of acute and chronic hepatitis/world- incubation period 1 week- months
  143. Type __ hepatitis- a coinfection with HBV- transmitted
    Type D
  144. Type __ hepatitis- usuallyu contaminated water, similar to HAV seen in poor contries, inadequate sanitation, incubation period 2-9 weeks
  145. Chronic, progressive disease characterized by inflammation, fibrosis, and degeneration of liver parenchymal cells
  146. S/S of Chronic liver failure
    malaise, anorexia, indigestion, nausea, weight loss, diarrhea or constipation, and dull aching RUQ pain. Liver may be enlarged, firm, and tender. Bruising of the skin, bleeding gums, anemia, and maybe jaundice (known and icterus) may have sever pruritus
  147. pathophys of liver failure
    dilated blood vessels in the esophagus, develops from portal HTN (pressure rises in the portal vein from blocked blood flow in the liver) -DX- endoscopy
  148. S/S of acute pancreatitis
    usually intense pain, rigid abdomen, pain in midline below sternum, pain radiating to spine, shoulders, low back, low-grade fever, dry mucous membranes, tachycardia, if biliary, nausea, vomiting, jaundice- increased amylase, liver enzymes and bilirubin
  149. A progressive inflammatory disorder with destruction of the pancreas. Cells are replaced by fibrous tissue, and pressure within the pancrease increases.
    chronic pancreatitis
  150. Etiology of chronic pancreatitis
    alcohol consumption, gallstones blocking the pancreatic duct, trauma to the abdomen, or infection
  151. A progressive disease, irreversible, normal pancreatic tissue is replaced by connective tissue, enzyme production decreases, pancreas becomes small and hardened- usual age 45-60, then live 25 years
    Chronic pancreatitis
  152. Functions of the liver
    • Carbohydrate metabolism
    • Amino Acid metabolism
    • Lipid metabolism
    • Synthesis of Plasma Proteins
    • Phagocytosis by Kapffer Cells
    • Synthesizes albumin
    • Formation of Bilirubin
    • Storage of minerals, iron and Copper, stores vitamins A,D,E,K
    • Detoxification
    • Activation of Vitamin D
  153. Pancreas enzymes
    • Amylase
    • Starch to Maltose
    • Lipase
    • Trypsin
    • Emulsified fats to fatty acids/monoglycerides
    • Polypeptides to Peptides
    • Bicarbonate juice