Term
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Definition
| extends from the mouth to the anus, is responsible for receiving food, breaking it down into nutrients (a process called digestion), absorbing the nutrients into the bloodstream, and eliminating the indigestible parts of food from the body. |
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Term
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Definition
| muscular channel lined with mucous membranes—connects the throat with the stomach |
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Term
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Definition
| a large, bean-shaped, hollow muscular organ consisting of three regions: the cardia, the body (fundus), and the antrum |
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Term
| Mucus, Hydrochloric acid, and the precursor of Pepsin (pepsinogen) |
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Definition
| The cells lining the stomach secrete three important substances |
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Term
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Definition
| The stomach's high acidity also serves as a barrier against infection by killing most bacteria |
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Term
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Definition
| the only enzyme that digests collagen, which is a protein and a major constituent of meat. |
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Term
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Definition
| The folds of the duodenal lining are called? |
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Term
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Definition
| These increase the surface area of the duodenal lining, allowing for greater absorption of nutrients |
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Term
| Duodenum, Jejunum and the Ileum |
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Definition
| These parts of the small intestine are largely responsible for the absorption of fats and other nutrients |
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Term
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Definition
| Released by the intestinal wall; lubricates the intestinal contents, and water, which helps dissolve the digested fragments |
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Term
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Definition
| Another substance released by the intestinal wall. Responsible for digesting proteins, sugars, and fats |
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Term
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Definition
| absorbs most of the nutrients and all but about 1 liter of fluid before emptying into the large intestine. |
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Term
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Definition
| secretes digestive enzymes into the duodenum and hormones into the bloodstream |
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Term
| Amylase, lipase, and trypsin |
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Definition
| The digestive enzymes secreated by the pancreas but released by the cells of acini are called? |
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Term
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Definition
| Amylase digests __________? |
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Term
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Definition
| Lipase digests __________? |
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Term
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Definition
| Trypsin digests __________? |
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Term
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Definition
| Protects the duodenum by neutralizing the acid that comes from the stomach |
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Term
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Definition
| Two antagonist hormones produced by the pancreas are? |
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Term
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Definition
| Lowers the level of sugar (glucose) in the blood by moving sugar into cells |
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Term
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Definition
| Raises the level of sugar in the blood |
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Term
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Definition
| When stimulated in respose to "hungry cells" the liver to release its storage to feed starving cells. |
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Term
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Definition
| Manufactures about half of the body's cholesterol; the rest comes from food. About 80% of the cholesterol made here is used to make bile |
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Term
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Definition
| Bile is stored in this location |
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Term
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Definition
| It assists in the digestion and absorption of fats, and it is responsible for the elimination of certain waste products from the body—particularly hemoglobin from destroyed red blood cells and excess cholesterol |
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Term
Bacteria colonizes the colon (Protection) Ferments indigestible carbohydrates Produces gas Inhibits growth of pathogens Synthesis B Complex makes Vit K;clotting |
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Definition
| Name (5) Roles played by Bacterial Flora |
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Term
O- Onset. When did your pain start? P- Persistent. Constant or intermitent? Q- Quality. sharp, dull, burns, achy R- Regoin. Does it radiate or localized? S- Severity. Pain scale 0/10 T- Time. How long have you had pain? |
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Definition
| How would you Assess for pain? What should the Nurse do first? *HINT(O-PQRST) |
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Term
| Inspection, Auscultation, Percussion, Palpation |
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Definition
| What is the correct order to complete an abdominal assessment? |
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Term
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Definition
| upper abdominal discomfort; occurs in 25% of the adult population. Typically after ingesting fatty foods. |
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Term
| Diarrhea, Constipation, Color & Caliber (Diameter) |
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Definition
| What (4) areas do you assess for changes in bowel habits when interviewing a patient? |
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Term
| Wash you hands. (Besides, the spreading the germs) If your hands are cold your patient may tense which alter your examination. Areas which are soft and tender may seem firm and solid. |
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Definition
| What is the first thing you should do before starting an abdominal assessment? (you have already identified the patient) |
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Term
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Definition
| An assessment technique used to determine expansion or distention of the abdominal wall that might accompany abnormal growth, enlargement of an organ or asymmetry. |
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Term
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Definition
An assessment technique used to assess bowel sounds, character, location and frequency in peristalsis within the large intestine. |
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Term
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Definition
| An assessment technique used to assess the size and density of abdominal organs by tapping your fingers over the organs. Determines if an organ is dense/hollow or full/empty. |
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Term
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Definition
| An assessment technique used to feels for tenderness and any abnormal masses or enlarged organs by applying gentle pressure. |
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Term
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Definition
| Pain that is caused by gentle pressure on the abdomen and that is relieved when the pressure is released. |
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Term
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Definition
| Inflammation and sometimes infection of the lining of the abdominal cavity |
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Term
| Esophagogastroduodenoscopy (EGD) |
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Definition
| allows direst visualization of the upper GI tract via fiber optic camera; takes pictures, biopsies & removes legions (polyps) |
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Term
NPO 8+ hrs or more Pt receives local anesthetis & sedation Pt is placed in left lateral position Monitor VS Assess gag reflex before anything po Discharge Instructions w/Family member |
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Definition
| Identify Nursing Interventions for a EGD procedure. |
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Term
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Definition
| allows direct visualization of the large intestine via fiber optic colonoscope; biopies, removes polys & cauterizes. Women >50 / Men >40 should receive one. |
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Term
| The goal is to reach the ascending colon. |
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Definition
| What is the goal during the colonoscopy procedure? |
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Term
| Bowel Prep. (Patient Teaching: Encourage patients to drink the entire prep and DO NOT MIX with other beverages) |
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Definition
| A successful colonoscopy depends on a successful__________? |
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Term
Clear liquid diet 24h prior to procedure Bowel Prep (Go-Lytely Solution) May experience n/v, bloating w/ prep NPO 8h prior to procedure; NPO after 12a Sedation during procedure Prepare to have someone escort you home |
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Definition
| Identify Nursing Interventions for a Colonoscopy procedure. |
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Term
| Upper GI, Sm Bowel follow through (X-RAY) |
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Definition
| A contrast medium (Barium)that collects in abnormal areas, showing ulcers, tumors, obstructions, erosions, and enlarged, dilated esophageal veins. Multiple films obtained after 24h. |
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Term
Clear liquid diet; NPO after 12a No smoking or chewing gum (stimulates gastric secretions) Increase fluids post-procedure Take MOM as directed (excretes Barium) |
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Definition
| Identify Nursing Interventions for a Upper GI, Sm Bowel follow through procedure. |
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Term
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Definition
| Used to detect polyps, tumors, and lesions. Colon prep is needed and patient may feel cramping during instillation. Most experience diarrhea after procedure. |
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Term
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Definition
| If a perforation is suspected this contrast is contraindicated. |
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Term
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Definition
| high frequency sound waves (echoes); create pictures. Used to dx: pancreatitis, appendicitis, cholecystitis & ectopic pregnancy. |
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Term
NPO 8-12h prior to procedure *Gallbladder-fat free meals 24h prior Exams requiring contrast; Schedule after (contrast blocks soundwaves=bad pictures) |
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Definition
| Identiify Nursing Interventions for Abdominal Ultrasounds. |
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Term
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Definition
| cross-sectional images of organs and other structures. patient is given a contrast medium. Shellfish allergy and poor renal function are contraindicated. |
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Term
Shellfish/Contrast allergies are interchangeable.
Contrast used for CT scans are metabolized by the kidneys. |
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Definition
| Why are patients with shellfish allergies and/or poor renal function contraindicated for receiving a CT scan? |
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Term
| Check your patients Creatinine levels. (normal range = (0.5-2.0mg/dL) |
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Definition
| What is the best way to assess for healthy renal function? |
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Term
| Magnetic Resonance Imaging (MRI) |
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Definition
| magnetic and radio waves to produce images; may not be used for pstients with metal devices in the body. |
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Term
- NPO 6-8h prior to procedure - Patient's who are claustrophobic are not good candidates for this procedure - Warn paitents that the machine is very noisey (earplugs are available to minimize noise but will not eliminate) - Procedure takes 60-90mins. |
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Definition
| Identify Nursing Interventions used for patients receiving an MRI. |
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Term
| Gastrointestinal-GI Intubation |
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Definition
| Insertion of a tube into the stomach and beyond is called a _________? |
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Term
| Esophageal Nasogastric-ENG Tube |
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Definition
| A tube inserted into the mouth is called a __________? |
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Term
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Definition
| A tube inserted into the nose is called a __________? |
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Term
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Definition
| A tube inserted into the abdomen is called a _________? |
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Term
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Definition
| A non-vented, non-suctioning, single lumen tube, 14"-18"french (up to 50" length);used for feeding ONLY. Meds will clog tubing. |
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Term
| Gastric or Salem Sump Tube |
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Definition
| NG or PEG, double lumen tube used for long term feedings & stomach decompression. |
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Term
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Definition
| The smaller lumen on a Gastric (salem) Sump tube acts as a vent. Vent must be kept higher than the waiste. It's called a __________? |
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Term
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Definition
| The larger lumen on a Gastric (salem) Sump tube; used for __________? |
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Term
1 Place distal tip at the patients nose 2 Extend tube to the patients earlobe 3 Extend straight to xipoid process |
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Definition
| How do you measure a patient for a GI Intubation? (3-Steps) |
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Term
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Definition
| What position should your patient be in when measuring them for a GI Intubation? |
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Term
Place patient in High Fowlers position May use topical anesthetic (lidocaine gel) Tip head forward Advise patient to sip H20 (moist mucosal) Instruct patient to breath Insert behind nosopharynx into stomach Confirm Placement (use pH tape) |
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Definition
| Identify Nursing Interventions for a GI Intubation insertion. |
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Term
| You should aspirate GI secretion then dip pH take to confirm secretions are within a pH 1.5-3.5. |
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Definition
| How do you confirm placement of a GI , ENG or NG tube? |
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Term
Confirm Placement (Use permanent marker) Secure tube with tape (immobilize tubing) Monitor I/O Irrigate with H2O or NaCl Implement good Oral & Nasal hygiene Assure sphincter is open (aspiration) |
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Definition
| Identify Nursing Interventions for Care of a GI tube? |
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Term
Keep tubes patent (irrigate PRN) Monitor I/O |
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Definition
| What is the most important Nursing measure associated with caring for patients with any type of feeding, drainage or suctioning systems? (2) |
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Term
Nausea Heartburn/Indigestion Hiccups Abdominal Distention Pain Vomiting (around the tube) |
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Definition
| Identify patient s/sx of a clogged or poorly drained tube. |
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Term
Explain procedure to patient Wear protective clothing (if pt n/v) Check placement (pH tape) Irrigate suction port (20-30ml NaCl) Attempt to aspirate (document I/O) Irrigate vent port; 20ml air-clear valve Reconnect to suction Recheck and confirm Patentcy of tubing |
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Definition
| Identify Nursing Interventions for Suctioning & Irrigating an NG tube. |
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Term
| HOB 30-45 degreees elevated |
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Definition
| What postion should the patient be in when receiving a tube feed to prevent aspiration? |
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Term
1. Low cost 2. Well tolerated 3. Given at home & long term care 4. Maintains intestinal metabolism 5. Maintains insulin/glucagon rations |
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Definition
| Identify (5) benefite of GI Intubations. |
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Term
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Definition
| A Dobhoff tube is a small, non-suctioning, flexible tube; used to administer nourishment and medicine. Correct placement in the small intestine is confirmed by an x-ray. |
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Term
1. Check Placement & residual (>100ml HOLD-feeding) 2. HOB 45 degrees (prevent aspiration) 3. Equipment - change q24h 4. Solution - no longer than 4-6h 5. Assess Patient (feeding tolerable) |
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Definition
| Identify Nursing Interventions for administering feedings via Dobhoff tube; may be continuous or cylclic (bolus) |
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Term
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Definition
| Inserted directly through abdominal wall. Feedings may be continuous or cyclic. Inserted in surgery through abdominal wall; 1st day post-op pt received H20. |
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Term
| Skin Care (prevents infection) |
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Definition
| The most important intervention in caring for a person with a PEG or G-tube. |
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Term
1. Aspiration 2. Diarrhea 3. Hyperglycemia 4. Dumping Syndrome |
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Definition
| Identify (4) Tube feeding complications. |
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Term
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Definition
| A condition caused by high osmolarity, s/sx are fullness, n/v, diarrhea (rapid gastric emptying), dehydration (fluid shift), tachycardia, hypotention. |
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Term
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Definition
| Patients dx:Dumping Syndrome are at higher risk of ___________?(infection) |
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Term
1. Slow Rate (ml/hr)- MD Order 2. Admin feedings room temperature 3. Admin continuous feedings(NOT bolus) 4. Use minimal H2O for flush |
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Definition
| Identify Nursing Interventions to Prevent Dumping Syndrome. |
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Term
1. Improve Nutritional status 2. Establish Positive Nitrogen Balance 3. Maintain muscle mass 4. Weight maintenance 5. Enhance healing |
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Definition
| Identify (5) patient goals for Parenteral Nutrition. |
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Term
1. When a patient has a negative nitrogen balance. 2. When 10-15% of admission wt is loss 3. Patients with long recovery periods |
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Definition
| When are parenteral nutrition diets implemented?(3) |
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Term
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Definition
| How much Formula (parenteral nutritional supplement) does a patient receive within a 24h period? |
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Term
1. Insufficient intake to meet metabolic needs 2. Inability to ingest food arally or via tube feeding 3. Unwillingness to ingest food 4. Pre & Post Operative Surgery |
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Definition
| What s/sx would indicate needs for parenteral nutrition? (4) |
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Term
| Central Venous Access Device-CVAD |
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Definition
| Catheter inserted into a high flow, large blood vessel, usually subclavian vein (invasive procedure) |
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Term
1. Percutaneous 2. PICC 3. Tunneled catheter 4. Implanted port |
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Definition
| Identify (4) Central Venous Access Devices. |
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Term
1. Insufficient intake to meet metabolic needs 2. Inability to ingest food orally or via tube feeding 3. Unwillingness to ingest food 4. Pre & Post Operative Surgery |
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Definition
| What s/sx would indicate needs for parenteral nutrition? (4) |
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Term
1. Given through large vein (central) 2. MD order SPECIFIC solution; check bag 3. Given through fikter - 1.2 micron 4. Start slow 50ml/hr; advance per order 5. Dedicated port (feedings, NOT meds) 6. Infuse via pump (NEVER gravity) |
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Definition
| Identify Nursing Interventions for administering parenteral nutrition via CVAD catheter. |
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Term
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Definition
| The most common complication after a CVAD insertion. |
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Term
| Percutaneous Central Venous Tube |
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Definition
| Commonly referred to as a "tripple lumen" |
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Term
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Definition
| Peripherally inserted; single or double lumen, central catheter inserted at the bedside by specially trained nurse or MD. Inserted into cephalic or basilic vein |
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Term
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Definition
| A central catheter for immediate time frame of use, inserted at the bedside into the cephalic or basilic vein; placement confirmed by x-ray. Less risk for pneumothorax. |
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Term
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Definition
| A cather hat is inserted for long-term usage may stay in place for years. Inserted surgically into subclavian vein and placed under the skin; reduced risk of infection. |
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Term
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Definition
| A Tunneled Catheter is tunneled up through the 1.______ then sutured at the 2.______ |
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Term
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Definition
| Long-term ports used for Chemotherapy; placed in a subcutaneous pocket, minimal care provides freedom for the patient. The port does not exit the skin; accessed by a special non-coring needle. |
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Term
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Definition
| A special needle used to access Implanted ports. This needle is non-coring (does not damage) to the port. |
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Term
1. Check Placement & residual (>100ml HOLD-feeding) 2. HOB 45 degrees (prevent aspiration) 3. Equipment - change q24h 4. Solution - no longer than 4-6h 5. Assess Patient (feeding tolerable) |
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Definition
| Identify Nursing Interventions for administering feedings via Dobhoff tube; may be continuous or cylclic (bolus) |
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Term
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Definition
| A complication of CVAD which always occurs at the time of the catheter insertion. s/sx: dyspnes, angina, absent lung sounds |
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Term
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Definition
| A complication of CVAD which always occurs at the time of the catheter insertion. s/sx: dyspnes, angina, absent lung sounds |
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Term
1. Administer Non-Rebreather Mask (15L) 2. Prepare Patient for chest tube insertion while someone else notifies the SWAT team. *(MD will be present) 3. Have x-ray ready to verify placement 4. Monitor VS (focus on Airway) 5. Offer reassurance (*continue to pray...) |
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Definition
| Identify Nursing Interventions associated with a pneumothorax complication. |
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Term
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Definition
| Occurs when air is introduced into IV tubing; lodges into the heart and obstructs the pulmonic valve. s/sx: hypoxia, WHEEZING & "sucking" sound on inspiration; 50% die. |
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Term
1. Clamp the lumen that is leaking. 2. Administer O2 ;roll pt on left side (while someone else notifies MD) *(continue to pray...) |
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Definition
| Identify Nursing Interventions when responding to an Air Embolism emergency. |
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Term
1. Prevention 2. Valsalva Maneuver |
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Definition
| The best Nursing Intervention for Air Embolisms are 1.__________. When changing caps on IV tubing, risks of an air embolism can be reduced by teaching your patients the 2.________ __________. |
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Term
1. Infection 2. Sepsis 3. Tegaderm |
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Definition
| Poor sterile technique during dressing changes cause 1._______ or 2._______. A 3.______ dressing should be place over the CVAD; insertion site t allow for visibility & assessment. |
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Term
1. Wash hands (aseptic technique) 2. Stop infusion, Notify MD & Pharmacy 3. Change bag & tubing q24h 4. Change DSD q72h 5. No piggy bags, blood draws or administrations via port. |
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Definition
| Identify Nursing Interventions if an infection is suspected; when caring for a patient with a Implanted Port or CVAD. |
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Term
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Definition
| A condition developed or glucose intolerance induced as a result of administering a concentrated, parenteral supplement. |
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Term
| The Nurse should notify the Pharmacist regarding the new order. ONLY the pharmacist can add insulin to a bag of parenteral nutritional supplement. |
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Definition
| As a result of Parenteral Nutritional induced hyperglcemia, the doctor orders insulin to add to the mixture. What Nursing Intervention is necessary for administering insulin via parenteral nutrition? |
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Term
| Drug: omeprazole (PRILOSEC) |
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Definition
Class: (PPI) Proton Pump Inhibitors
Action: Inhibits bind to the gastric proton pump tx: prevent or decrease the release or amount of gastric acids from parietal cells.
Side Effects: headache, anxiety, dixzziness, abdominal pain, flatulence, dry mouth
NI: DO NOT CRUSH TABLETS OR CAPSULES PT: AVERAGE HEALING TIME 4-8 WKS.
ADVISE PT'S TO USE ANTACIDS FOR ACUTE HEART BURN RELIEF. |
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Term
| Drug: pantoprazole sodium (PROTONIX) |
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Definition
Class: (PPI) Proton Pump Inhibitors
Action: Inhibits daytime and nocturnal acid secretion. Long-term tx for healing & decrease amt of HCL acid in GI.
Side Effects: headache, anxiety, dixzziness, abdominal pain, flatulence, dry mouth
PT: MAY TAKE 1-4 DAYS FOR A PATIENT TO EXPEREIENCE RELIEF OF SYMPTOMS.
ADVISE PT's TO USE ANTACIDS FOR ACUTE HEART BURN RELIEF. |
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Term
| Drug: sucralfate (CARAFATE) |
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Definition
Class: (GI) Agents
Action: Does not secretion nor neutralize gastric acid. Binds to normal and ulcerated mucosa; forms protective barrier-"CHALK LIKE BARRIER"
Side Effects: headache, dixzziness, constipation, flatulence, dry mouth
NI: SHAKE SUSPENSION BEFORE POURING GIVE ON AN EMPTY STOMACH -1h before or 2h after meals SEPARATE DOSES OF ANTACIDS -30 min from administration *CAUTION WHEN USING W/ANTACIDS & H2 BLOCKERS |
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Term
| Drug: aluminum hydroxide (AMPHOJEL) |
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Definition
Class: Antacid
Action: Alkaine substances that neutralize HCL acids, increases pH & strengthens stomach mucosal barrier
Side Effects: constipation
NI: SHAKE WELL BEFORE DISPENSING
PT: TeaTEACH PT S/S OF GI BLEEDING NOTIFY MD IMMEDIATELY IF GI BLEED OCCUR |
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Term
Drug: aluminum hydroxide & magnesium simethicone (MYLANTA) |
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Definition
Class: Antacids, combos
Action: Alkaine substances that neutralize HCL acids & increases pH
Side Effects: diarrhea
NI: SHAKE WELL BEFORE DISPENSING CONTRAINDICATED IN PT's w/RENAL DX (pt's can't excrete magnesium)
PT: TEACH PT S/S OF GI BLEEDING NOTIFY MD IMMEDIATELY IF GI BLEED OCCUR |
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Term
| Drug: Cimetidine (TAGAMET) |
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Definition
Class: H2 Receptor Anagonist
Action: blocks H2 receptors of gastric parietal cell inhibiting gastric secretions.
Side Effects;(occur rarely with prolonged usage >1m)headache, diarrhea, gynecomastia, antiandrogen (males), confusion (elderly)
NI: DO NOT W/ANTACIDS (reduces absorption)
PT: ACUTE ULCERS-MAY TAKE 8 WK FOR HEALING |
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Term
| Drug: famotidine (PEPCID) |
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Definition
Class: H2 Receptor Anagonist
Action: blocks H2 receptors of gastric parietal cell inhibiting gastric secretions.
Side Effects;(occur rarely with prolonged usage >1m)headache, diarrhea, constipation, dizziness
NI: DON'T GIVE w/ANTACIDS reduce absorption MOST EFFECTIVE 30M PRIOR TO MEALS & HS MAY ENHANCE EFFECTS OF WARFARIN
PT: ACUTE ULCERS-MAY TAKE 8 WK FOR HEALING |
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Term
| Drug: ranitidine (ZANTAC) |
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Definition
Class: H2 Receptor Anagonist
Action: blocks H2 receptors of gastric parietal cell inhibiting gastric secretions.
Side Effects;(occur rarely with prolonged usage >1m)headache, diarrhea, constipation, dizziness
NI: DON'T GIVE w/ANTACIDS reduce absorption MOST EFFECTIVE 30M PRIOR TO MEALS & HS MAY ENHANCE EFFECTS OF WARFARIN=INCREASED INR=LOWER DOSE
PT: ACUTE ULCERS-MAY TAKE 8 WK FOR HEALING |
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Term
|
Definition
| Parietal cells in the stomach produce a substance that facilitates the absorption of vitamin B12. |
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Term
|
Definition
| In absence or deficiency of intrinsic factor Vitamin B12 can not be absorbed causing this condition. |
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Term
|
Definition
| Bruising around the umbilicus is a sign of intra-abdominal bleeding called? |
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Term
1. Monitor BG's cover w/sliding scale 2. Monitor I/O's 3.Assess s/s confusion,stupor,lethargy 4. Use pump & check infusion rate |
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Definition
| Identify Nursing Interventions for administering parenteral nutrition with insulin. |
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Term
Signs & Symptoms include; 1. Cramping (abd pain) 2. Dyspepsia (gas & bloating) 3. Isolation (stay home near BR) 4. Frequent/Urgent diarrhea 5. Nausea & Vommiting 6. Anal discomfort (use baby wipes) |
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Definition
| Patient Teaching: What should the Nurse incluse about the possible side effects of GoLYTELY bowl prep solution? |
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Term
s/s of GI Obstruction; 1. Bleeding 2. low BP 3. Hypoactive Bowel Sounds 4. Patient c/o abd pain 5. Inability to pass gas |
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Definition
| If your patient has a GI Obstruction what s/s would you expect to see? (5) |
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