Final Exam GI Disorders

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JChristie20
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81092
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Final Exam GI Disorders
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2011-04-26 22:09:16
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GI disorders
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GI disorders
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  1. this can result from a loss of gastric HCL
    metabolic alkalosis
  2. this results from a loss of bicarb if the contents from the small intestine are vomitted
    metabolic acidosis
  3. this indicates a lower obstruction; below the level of the pylorus
    presence of fecal odor and bile
  4. vomit with a coffee ground appearance is an indication of
    gastric bleeding
  5. because drugs used to help N/V cause an anticholinergic affect which is not recommended for people with what disease
    • glaucoma
    • prostatic hyperplasia
    • pyloric or bladder neck obstruction
    • biliary obstruction
  6. a diet for N/V should include
    • high in carbs
    • low in fatty foods
  7. this type of hiatal hernia goes back into the stomach when the person is standing up
    sliding
  8. trauma, poor nutrition, and forced recumbant position are likely causes of what
    hiatal hernia
  9. this problem has similar symptoms to GERD
    hiatal hernia
  10. a simple an immediate way to help alleviate symptoms of hiatal hernia is to
    raise the HOB
  11. these medications lower LES pressure
    • nitrates
    • Ca channel blockers
    • antidepressants
  12. what is one of the primary factors of GERD
    incompetent LES
  13. this is the result of a decrease in pressure in the distal portion of the esophagus
    incompetent LES
  14. this is a common complaint of GERD
    hypersalivation (water bash)
  15. patients with GERD my also present with respiratory symptoms such as
    • wheezing
    • coughing
    • dyspnea
  16. this is a complication of GERD that is considered a precancerous lesion that increases the pts risk for esophageal cancer
    Barretts Syndrome
  17. S/S of Barretts syndrome include
    bleeding and perforation
  18. this is a hormone in the duodenum that decreases LES pressure; is stimulated by fatty foods
    cholecystokinin
  19. this is an anti-ulcer drug that my be used in patients with GERD for its cytoproductive properties
    sucralfate(carafate)
  20. with GERD a patient should have fluids when?
    between meals rather then with meals
  21. GI bleeding from an arterial source is
    profuse bright red bleeding
  22. vomitus with a coffee ground appearance is indicative of what?
    the blood has been in the stomach for some time
  23. this is a tear in the mucosa near the esophagogastric junction; likely due to chronic esophagitis
    Mallory-Weiss tear
  24. a Mallory-Weiss tear is most likely due to
    severe retching and vomiting
  25. most bleeding ulcers are related to the presence of what?
    H. Pylori bacteria
  26. this part of a urinalysis test should the patients hydrations status
    specific gravity
  27. these solutions are given in the event of a massive GI bleed
    • lactated ringers
    • whole blood
    • PRBCs
    • fresh frozen plasma
  28. for variceal bleeding this is used to produce vasoconstriction and is a posterior pituitary extract
    vasopressin (Pitressin)
  29. this occurs as the result of a breakdown in the normal gastric mucosal barrier
    gastritis
  30. these drugs are common causes of gastritis
    • aspirin
    • corticosteroids
    • NSAIDS
    • digitalis
    • fosamax
  31. this is a form of chronic gastritis that affects both the fundus and body of the stomach and is assoc. with ^ risk of stomach cancer
    autoimmune atrophic gastritis
  32. a loss of intrinsic factor is essential for the absorption of this and with gastritis it causes a deficiency
    B 12
  33. erosion of GI mucosa resulting from digestive action of HCL acid and pepsin
    PUD
  34. H. Pylori produces ______ which buffers the area around it thru the production of ammonia, protecting itself from destruction
    urease
  35. these lower the rate of mucosal cell renewal and protective effects so an counter-indicated for use of pts with PUD
    corticosteroids
  36. these are most commonly found onthe lesser curvature close to the antral junction
    gastric ulcer
  37. these ulcers are more likely to result in hemorrhage, perforation or obstruction
    gastric
  38. gastric ulcer are greater in ___
    duodenal ulcers are greater in ____
    • women
    • men
  39. the duodenal ulcers is associated with a high ______ secretion
    HCL acid
  40. therese an increase in duodenal ulcers with pts who have
    • COPD
    • cirrhosis
    • chronic pancreatitis
    • renal failure
    • Zollinger-Ellison syndrome
  41. clinical manifestations of gastric ulcers are
    • high in left epigastrium and back and upper abdomen
    • 1-2 hrs after meals
  42. clinical manifestations of duodenal ulcers are
    burning and cramping, pressure-like pain across midepigastric region and upper abdomen
  43. what are the 3 major complications of PUD
    • hemorrhage
    • perforation
    • gastric outlet obstruction
  44. this test is 90-95% sensitive to H. Pylori but will not distinguish between active or recently treated disease
    Immunoglobin G
  45. this test is widely used for PUD but not accurate for shallow superficial ulcers; used to diagnosis gastric outlet obstruction
    barium contrast studies
  46. the antibiotic therapy for H. Pylori usually lasts 7-14 days and includes
    • ranitidine bismuth citrate (tritec)
    • clarithromycin (biaxin)
  47. this is the adjunct therapy for PUD; ^ pH by neutralizing HCL acid
    antacids
  48. this is the best neutralizing food but it also stimulates gastric secretions
    protein
  49. these foods are least stimulating to HCL acid secretions but do not neutralize well
    carbs
  50. what are the tumor markers in blood for stomach cancer
    • carcinoembryonic antigen (CEA)
    • carbohydrate antigen 19-9
  51. this is caused by antibiotics that destroy the normal bowel flora, thereby allowing pathogenic organisms to flourish
    C diff
  52. c diff spores can live up to ____ days on inaminate objects
    70
  53. this is the 1st line treatment for C diff
    flagyl
  54. this can result from motor and sensory dysfunction
    fecal incontinence
  55. for fecal incontinence what is indicated
    dietary fiber and bulk forming laxatives
  56. this maneuver is contraindicated in many conditions including constipations
    valsalva
  57. for constipation you want to increase your pts
    dietary fiber and fluids
  58. obstruction of the lumen by fecalith, foreign bodies or tumor; causes periumbilical pain, anorexia, N/V, pain at McBurneys point with rebound tenderness
    appendicitis
  59. with appendicitis a patient will have a + ______ sign, which is pain where?
    • Rovsings
    • RLQ when LLQ is palpated
  60. this primarily occurs when blood borne organisms enter the peritoneal cavity or when abdonmial organs perforate or lead their contents into the peritoneum
    peritonitis
  61. with peritonitis the S/S are
    • pain
    • rebound tenderness
    • muscular rigidity
    • spasm
  62. S/S of a intestional obstruction are what type of bowel sounds
    high pitched over obstruction
  63. TX for hemorrhoids are
    • anti-inlammatories
    • stool softeners
    • sitz bath
    • bands
    • laser removal
  64. the most common cause of gall bladder disease
    E. choli
  65. stones that are primarily _____ are the most common
    cholesterol
  66. with gall bladder disease where will the tenderness be
    right upper quad
  67. what are symptoms of a total gall bladder obstruction
    • clay colored stools
    • steaorrhea(fatty stools)
    • jaundice
    • pruritis
  68. this may be given for pruritis; it binds the bile salts so they dont accumulate
    cholestyramine (questran)
  69. the diet modifications for after gall bladder surgery is what
    • low fat
    • avoid-dairy, fried foods, gravy nuts
  70. what are the three locations that a feeding tube can be placed
    • stomach
    • duodenum
    • jejunum
  71. theres a lower likelihood of regurgitation and aspiration when placed in the
    intestine
  72. these tubes are used for pts who need feeding for an extended period of time
    gastrostomy and jejunostomy
  73. using this, a gastrostomy tube is inserted through esophagus into stomach and then pulled thru a stab wound made in abdominal wall
    percutaneous endoscopic gastrostomy
  74. pt should be sitting with the HOB this high and for how long for intermittent feedings
    • 30-45 degrees
    • 30-60 min
  75. when should placement for a tube be checked
    • before and after feedings and meds
    • every 8 hrs for continuous
  76. feedings should be changed with they are hung for longer then _____ hours
    8 hr
  77. pump tubing should be changed every
    24 hr

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