Term
|
Definition
| Close perforations & remove damaged tissue |
|
|
Term
|
Definition
| Copious warm isotonic washings |
|
|
Term
|
Definition
Report fever, pain, bleeding
No heavy lifting 7 days
No fiber 1-2 days |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| pathogen, parasite, ova, worms |
|
|
Term
|
Definition
| Low - GI bleed/malnutrition Anemia |
|
|
Term
| Indirect hemagglutination assay tests for |
|
Definition
|
|
Term
| Side FX of Barium swallow study |
|
Definition
White stools 1-2 d.
Constipation |
|
|
Term
|
Definition
Pepto-Bismol (anti-biotic action)
Charcoal
Kaopectate |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Anti-cholinergics for diarrhea |
|
Definition
| Atropine, Belladone, Pro-banthine |
|
|
Term
| When do you use antidiarrheal drugs? |
|
Definition
| Cautiously and ONLY when cause is known. |
|
|
Term
| How long no food after diarrhea? |
|
Definition
|
|
Term
|
Definition
Risk for fluid volume deficit
Risk for impaired skin integrity - peri-anal area |
|
|
Term
| Peri-anal skin protectant |
|
Definition
| Zinc-oxide based creams/ointments |
|
|
Term
| How often do you check a patient if incontinent? |
|
Definition
|
|
Term
| How much drop in BP is + ortho hypotension? |
|
Definition
|
|
Term
| How much fluids can you give if fluid volume deficit r/t diarrhea? |
|
Definition
|
|
Term
| Constipation is defined as.. |
|
Definition
| <2 BM/wk and/or difficult passage of stools (hard/marble like) |
|
|
Term
| Stool softener & Instructions |
|
Definition
| Docusate (Miralax) - give 1 hr apart from other drugs with fluids |
|
|
Term
|
Definition
| Psyllium (mix in full glass cool liquid) |
|
|
Term
| Osmotic & Saline Laxatives |
|
Definition
Milk of Magnesia
Lactulose
Magnesium Citrate
Polyethylene Glycol
Take w/full glass liquid
Contraindicated if fluid deficit or Na+ restrictions |
|
|
Term
| Irritants/Stimulants for GI |
|
Definition
Bisacodyl
Senna
Take on empty stomach |
|
|
Term
|
Definition
Fluids
Fiber (prunes, bran)
Inc. activity
Narcotics only PRN |
|
|
Term
|
Definition
Digital exam
Enemas if Rxd |
|
|
Term
|
Definition
| Spastic bowel or functional colitis |
|
|
Term
|
Definition
| Abd. pain w/ constipation/diarrhea or both |
|
|
Term
| If constipation & diarrhea Rx? |
|
Definition
|
|
Term
| IBS constipation in women Rx? |
|
Definition
Tegaserod mesylate (Zelnorm)
lubiprostone (Amitiza) |
|
|
Term
| Nsg. Care fecal incontinence |
|
Definition
Check Q hr.
Consistent toilet time & place (AM post breakfast/coffee for gastrocolic reflex)
Privacy
Odor control
Caring & non-judgmental
Suppository before toileting |
|
|
Term
|
Definition
Simple - Inflamed but intact
Gangrenous - necrotic c microperforations
Perforated - Gross perforation with peritonitis |
|
|
Term
|
Definition
| Rebound tenderness @ McBurney's point @ beginning of ascending colon RLQ |
|
|
Term
|
Definition
^WBC & shift to left
Abd. US |
|
|
Term
|
Definition
IV fluids & Abx
Appendectomy |
|
|
Term
|
Definition
|
|
Term
|
Definition
Contamination (infection or enzyme irritant) of space between parietal and visceral layers
Most sign. complication of many acute abd. disorders. |
|
|
Term
|
Definition
Severe abd. pain (diffuse or local)
Guarding
Rapid, shallow breathing |
|
|
Term
| Mortality rate/cause Peritonitis |
|
Definition
40%
Septic/hypovolemic shock |
|
|
Term
|
Definition
WBC >20,000
Blood cultures (septicemia)
Liver and renal function studies
Abd. xtray
Perforation
Paracentesis |
|
|
Term
|
Definition
|
|
Term
|
Definition
Abx (broad then spec. after cultures)
Narcotics & sedatives PRN |
|
|
Term
| Drains used for peritoneal cavity |
|
Definition
|
|
Term
| How do wounds with drains heal? |
|
Definition
|
|
Term
| Nsg. care thru NG tube after surgery if intestinal decompression |
|
Definition
| Suction until motility returns |
|
|
Term
|
Definition
| Separation of wound c exposed bowel - EMERGENT |
|
|
Term
| How many days can a client not eat before we start to worry? |
|
Definition
|
|
Term
| Supportive care post-surgery (peritoneal) |
|
Definition
HOB ^ to improve respirations
O2 PRN
TPN if needed |
|
|
Term
| Nsg. care post peritoneal surgery Pain mgmt |
|
Definition
Check symptoms & amt pain relief from analgesics
HOB ^ and knees/feet bent to relieve muscle tension
Alternative pain relief measures |
|
|
Term
| Why is pain relief important post surgery? |
|
Definition
| Pain increases the stress response which impairs healing. |
|
|
Term
| Fluid volume deficit care post peritoneal surgery |
|
Definition
Check I & O (includes drain, suction)
Check H/H, urine SG, electrolytes
Check VS for shock
Report UO <30 ml/hr |
|
|
Term
| Nsg. action after peritoneal surgery NG |
|
Definition
| Replace cc for cc of NG suction - calculate in IV rate |
|
|
Term
| Importance/amt of good oral care post op |
|
Definition
| Q shift decreases ventilator related pneumonia 40-50% |
|
|
Term
| Altered Protection (wound and immune stress) Nsg. actions |
|
Definition
Strict handwashing
Assess infection
Check WBCs, albumin losses (healing)
Culture new purulent drainage
Strict asepsis
Maintain fluid balance & nutrition |
|
|
Term
|
Definition
| Inflammation of GI tract r/t Viral or bacterial infection usually w/acute diarrhea |
|
|
Term
|
Definition
| Contaminated food or water |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Undercooked beef, unpasteurized milk, apple juice or fecal-oral |
|
|
Term
|
Definition
|
|
Term
|
Definition
| raw or improperly cooked poultry, meat, eggs and dairy |
|
|
Term
|
Definition
| fecal-oral, vectors, objects |
|
|
Term
|
Definition
|
|
Term
| Tx Colitis, Cholera, shigella, salmonella |
|
Definition
Septra, Cipro, Ampicillin
Antidiarrheals for fluid loss |
|
|
Term
|
Definition
|
|
Term
|
Definition
Vancomycin
Linezolin (Zyvox) |
|
|
Term
|
Definition
|
|
Term
| When are probiotics useful? |
|
Definition
| Infectious & abx associated diarrhea if client not immunosuppressed or critically ill (good bacteria could become harmful) |
|
|
Term
|
Definition
| Harmful toxins & antigen/antibodies removed |
|
|
Term
| What two gastroenteritis causing organisms is plasmapheresis useful for? |
|
Definition
Botulism
Hemorrhagic E. coli |
|
|
Term
| Protozoal infections are caused by? |
|
Definition
Fecal-oral
Direct or sexual contact possible
eg. Giardiasis Amebiasis Cyptosporidiosis |
|
|
Term
| Tx Protozoal infection of bowel |
|
Definition
|
|
Term
| Helminthic infections include.... |
|
Definition
Nematodes - Round worms (eg <3 worms)
Trematodes - Flukes
Cestosodes - tapeworms |
|
|
Term
|
Definition
Pyrantel Pamoate (Antiminth)
Mebendazole (Vermox) |
|
|
Term
| Nsg. care helminthic infections |
|
Definition
Handwashing
Contact isolation
Disinfect objects, linens, toilets |
|
|
Term
| Nsg. teaching r/t helminthic infection |
|
Definition
Drink safe water
Peel or cook produce
Cook all meats & fish
No feces in fertilizer |
|
|
Term
| IBD includes which two diseases? |
|
Definition
Ulcerative Colitis
Crohn's Disease |
|
|
Term
| Who does UC primarily affect? |
|
Definition
15-40 year olds
Etiology unknown |
|
|
Term
| What is Ulcerative Colitis? |
|
Definition
| Inflammation of mucosa and submucosa of the rectum & colon (NOT small intestine) |
|
|
Term
|
Definition
rectum to colon
distal to proximal
Microscopic hemorrhage
Abcesses
Necrosis & sloughing |
|
|
Term
| Characteristics of rectal/colon mucosa with UC |
|
Definition
| Red, friable, bleeds easily |
|
|
Term
| What will pts with UC have in their diarrhea? |
|
Definition
|
|
Term
| What affect does chronic inflammation have on the bowel? |
|
Definition
Fibrosis
Decreases viability of colon
No H20 absorption or slow down |
|
|
Term
| What intervals are common for chronic intermittent colitis? |
|
Definition
|
|
Term
| How many BMs/day for mild and severe UC |
|
Definition
Mild <4
Severe 6-10 to 30-40 possible |
|
|
Term
|
Definition
| LLQ pain relieved by defecation |
|
|
Term
|
Definition
Colon Cancer
Arthritis
Uveitis |
|
|
Term
|
Definition
Anemia r/t blood loss
Perforation r/t friability
Toxic megacolon
Inc. risk for colon cancer |
|
|
Term
|
Definition
Colon paralysis and dilation within min to hrs.
Shock symptoms (life threatening)
Colon full of air or liquid
Massive hemorrhage (rare) |
|
|
Term
| What Sx do you report to provider for pt with UC? What is considered normal? |
|
Definition
Fever, Signs of infection, signs of perforation/peritonitis, shock symptoms
Normal - diarrhea and bloody stools, anorexia |
|
|
Term
|
Definition
Regional enteritis
Chronic and life long
Affects full thickness lining (fibrotic thickening, obstruction, ulceration, strictures)
"cobblestone" bowel
Can affects small intestine and therefore nutrient absorption |
|
|
Term
| What kind of malabsorption is common with Crohn's? |
|
Definition
| Vit. B, Fats (dec. bile salts absorption), absorption of fat soluble vitamins |
|
|
Term
| 90% of Crohn's patients have what? |
|
Definition
| Continuous or episodic diarrhea |
|
|
Term
| Characteristics of diarrhea in Crohn's. |
|
Definition
Liquid, loose, w/o blood usually
Steatorrhea (floating stools or fat ring around toilet) |
|
|
Term
| Sx/complications of Crohn's. |
|
Definition
Abd. pain & tenderness
Anorectal lesions
Abscesses and fistulas
Perforation -- Peritonitis |
|
|
Term
|
Definition
| Tract the body forms in order to drain abscess or get rid of an infection. Can be formed in inappropriate places. |
|
|
Term
| Dietary/Rx mgmt IBD acute phase |
|
Definition
|
|
Term
|
Definition
Low residue, low/no dairy, Inc. cal and protein, decrease fat and fiber.
Replace B12, Ca++, Iron
Check for ABGs (metabolic acidosis)
Check serum electrolytes (hypokalemia, hypomagnesemia)
Fluids |
|
|
Term
| Potent anti-inflammatories UC and Crohn's |
|
Definition
Sulfasalazine (Abx + potent NSAID 5-ASA)
Balsalazide
PO or PR |
|
|
Term
| Anti-inflammatories for small bowel in Crohn's |
|
Definition
|
|
Term
| Immunosuppressive drugs Crohn's |
|
Definition
Azathioprine
Mercaptopurine
Methotrexate (TNF alpha inhibitor for autoimmune issues) |
|
|
Term
| When can you give a UC pt. antidiarrheals |
|
Definition
|
|
Term
| What is the risk of giving an acute phase UC pt. antidiarrheals? |
|
Definition
|
|
Term
| Biologic Immunomodulators Crohn's |
|
Definition
| Infliximab (Remicade) IV q 2-3 months |
|
|
Term
| Abx, Antispasmodics, Antidiarrheals Crohn's |
|
Definition
Abx - Metronidazole & Cipro
Antispasmodics - Pro-banthine
Antidiarrheals - Lomotil, Immodium, codeine |
|
|
Term
| When/what surgery performed on Crohn's patients? |
|
Definition
Only if complications
Anastomosis (preferred to ostomies)
Reoccurence likely |
|
|
Term
|
Definition
Yes
Total colectomy
*disfiguring |
|
|
Term
| What is typically done for a pt. given total colectomy |
|
Definition
Ileoanal anastomosis
Ileostomy |
|
|
Term
|
Definition
Fluid volume deficit
Altered nutrition (less than body requirements)
Anxiety or disturbed body image
Fatigue r/t anemias (Crohn's) or blood/iron loss (UC)
Ineffective therapeutic regimen mgmt r/t sx, changes and multiple drugs |
|
|
Term
| Sprue is also known as what? |
|
Definition
|
|
Term
| What causes Celiac's disease? |
|
Definition
Gluten=antigen
Antibodies attack enteral mucosa when gluten present and cause inflammation and villi damage which leads to malabsorption
Tropical Sprue from infection (Et. unknown) |
|
|
Term
|
Definition
Sore tongue
Diarrhea
Wt. loss |
|
|
Term
| Common deficiencies Celiac's |
|
Definition
|
|
Term
| A Gluten free diet excludes what? What does it include? |
|
Definition
Wheat, rye, barley, oats
Low fat
Dec. milk
Inc. calories and protein
Folic acid, Iron
Rice, potatoes |
|
|
Term
| What pts more likely to have lactose intolerance? |
|
Definition
| Asians, American Indians, African Americans, Hispanics and Jewish Americans. |
|
|
Term
| Tx lactose intolerance/alternative sources of Ca++ |
|
Definition
Decrease milk products
Take lactase enzymes PRN
Leafy greens
Vit D/Ca++ fortified OJ/juices
Aged cheeses
Yogurt as tolerated
Soy products, Tofu |
|
|
Term
|
Definition
| Iatrogenic r/t significan bowel resections for Crohn's patients |
|
|
Term
| What part of the bowel does short bowel syndrome involve? Which part is more serious? Why? |
|
Definition
Small intestine
Proximal more serious than distal r/t malabsorption of nutrients |
|
|
Term
| What syndrome is common along with short bowel syndrome when the remaining bowel can no longer compensate? |
|
Definition
| Dumping syndrome -> diarrhea |
|
|
Term
| Tx of short bowel syndrome |
|
Definition
|
|
Term
|
Definition
| Protruding mass on bowel wall |
|
|
Term
|
Definition
|
|
Term
| What % polyps become cancerous? |
|
Definition
|
|
Term
| 3rd leading cause cancer deaths |
|
Definition
|
|
Term
| Long-term survival rate colon cancer |
|
Definition
|
|
Term
| What are colorectal adenocarcinomas from? Where are they most common? |
|
Definition
Polyps
Common in Sigmoid colon & rectum |
|
|
Term
| Risk factors colorectal cancer |
|
Definition
Daily alcohol consumption
C-Reactive Protein present (inflammation)
IBS or IBD |
|
|
Term
| Screening options/timing colorectal cancer |
|
Definition
After 50 or 45 if family hx/african american
Hemoccult (guaiac) or fecal (occult) test yearly
Flexible sigmoidoscopy or Barium enema q5yrs
Colonoscopy q 5-10 yrs or 3 yrs post polypectomy |
|
|
Term
| By the time Sx occur what has colorectal cancer progressed to? |
|
Definition
| Metastasized to adjacent abd. organs and liver |
|
|
Term
| Growth time colorectal cancer |
|
Definition
|
|
Term
|
Definition
Change in bowel patterns
Bleeding
Late Sx: pain, anorexia, wt loss |
|
|
Term
Lab value for colorectal prognosis, tx. progress and to check for reoccurence
(NOT for screening) |
|
Definition
| CEA (CarcinoEmbryonic Antigen) |
|
|
Term
|
Definition
Surgical resection w/ or w/o colostomy
Radiation therapy adjuvant pre or post op
Chemo - 5FU post-op c folinic acid
Laser photocoagulation (small tumors or palliative) |
|
|
Term
| Nsg teaching pre-OP Colorectal cancer |
|
Definition
| Bowel prep/Cathartics, talk about ostomy set up if applicable |
|
|
Term
| Nsg care post-op colorectal cancer |
|
Definition
| NG sxn, NPO, IV, wound care, ambulation, diet when peristalsis |
|
|
Term
| Rx post-op colorectal cancer surgery |
|
Definition
H2 receptor drugs PRN eg Zantac
(PPI) |
|
|
Term
| Nsg. Dxs post op colorectal cancer |
|
Definition
Risk for fluid volume deficit
Altered Nutrition (less than body requirements)
Altered body image r/t colostomy
Pain
Anticipatory Grieving
Risk for sexual dysfunction (genital nerve disruption r/t surgery)
Colostomy (sex) |
|
|
Term
| What is considered poor nursing care if you don't do it asap post-op? |
|
Definition
|
|
Term
|
Definition
| Protrusion of an organ through abdominal muscle wall defect |
|
|
Term
|
Definition
| Inguinal - Direct and Indirect |
|
|
Term
Hernias likely in women.
What do they often contain? |
|
Definition
|
|
Term
| Hernia related to prior surgeries |
|
Definition
|
|
Term
| Hernia that can be returne to abd. cavity manually or spontaneously |
|
Definition
|
|
Term
| Hernia c content that can't be returned to abd. cavity |
|
Definition
|
|
Term
| Hernia with contents cut off from blood supply at risk for necrosis |
|
Definition
|
|
Term
| Common etiologies mechanical (60%) intestinal obstruction |
|
Definition
| Hernia, scar tissue, fibrotic structures |
|
|
Term
| Common etiologies for functional (paralytic ileus) intestinal obstruction. |
|
Definition
Post. abdominal surgeries
Meds (opiates, anesthesia) |
|
|
Term
| Small bowel obstruction accounts for ____% of bowel obstruction whereas large bowel obstruction accounts for ___% |
|
Definition
|
|
Term
| Sx small bowel obstruction |
|
Definition
Borborygmi (hyperactive BS above obstruction early sx)
Cramps, N/V (severe)
Absent BS
Protuberant abdomen (taut and stretched)
Dehydration and electrolyte imbalance ->hypovolemic shock |
|
|
Term
| Complications small bowel obstruction |
|
Definition
Inc. distention and bacterial growth ->
Strangulation->
Gangrene ->
Perforation ->
Tissue death, peritonitis, death |
|
|
Term
| Large bowel obstruction is usually caused by what? |
|
Definition
| Cancer, obstipation, diverticulitis |
|
|
Term
| Sx large bowel obstruction |
|
Definition
N/V (early sx but later than in small bowel due to distal location)
Low-grade cramps
Feculent vomit
Distention, increased pressure, gangrene, perforation |
|
|
Term
| Bowel obstruction type common in kids and babies - telescoping |
|
Definition
|
|
Term
| Bowel obstruction when bowel gets twisted and strangulated (not hernial) |
|
Definition
|
|
Term
| Bowel obstruction where scar tissue forming between bowel segments r/t abdominal surgeries/IBD/ |
|
Definition
|
|
Term
| 4 types bowel obstructions |
|
Definition
Intussusception
Adhesion
Volvulus
Herniation |
|
|
Term
|
Definition
Let bowel rest & hope it will resume peristalsis
Intestinal tubes (advance ~6 in/hr until can't move further and suction) |
|
|
Term
| Rx functional bowel obstruction |
|
Definition
Metoclopromide (watch for extrapyramidal symptoms )
Dec. n/v and inc. peristalsis |
|
|
Term
| Pre-op Tx mechanical bowel obstructions |
|
Definition
NG sxn to stop vomiting and distention
Isotonic IV fluids and electrolytes
Prophylactic antibiotics (&probiotics)
Anastomoses usual in bowel obstruction surgery |
|
|
Term
| Post-op bowel obstruction care |
|
Definition
Deep breathing and coughing (no cough if hernia repair) Splinting
Ambulation asap ^ peristalsis |
|
|
Term
| Nsg interventions for Risk for Ineffective Breathing r/t distention pressure on diaphragm or possible aspiration (Bowel obstruction removal surgery) |
|
Definition
^HOB
C&DB (splint)
Pain meds
Incentive spirometer
NPO
GI sxn |
|
|
Term
| When do you stop GI sxn in a patient with bowel obstruction? |
|
Definition
| BS return and passing flatus |
|
|
Term
|
Definition
| sac-like projections of mucosa though colon muscle defects from increased pressure (Flabby/weak colon) |
|
|
Term
| What is the general etiology of diverticular disease? |
|
Definition
|
|
Term
| What are complication of diverticular disease? |
|
Definition
Muscle thickens ->
Lumen narrows ->
Possible obstruction or fistula formation |
|
|
Term
| What other disease can diverticular disease mimic? What % of pt with diverticular disease are asymptomatic? |
|
Definition
IBS (pain, n/v, low fever, bleeding)
~80% |
|
|
Term
|
Definition
| Inflammation of diverticula and gross or microscopic perforation usually in 1 spot |
|
|
Term
| Complications diverticulitis |
|
Definition
Infection and bleeding (trapped food in pouches)
Bacteria in pouches - abscess or peritonitis |
|
|
Term
|
Definition
Broad spectrum Abx.
Pentazocine (Talwin) for pain b/c dec. colonic pressure
Docusate (Miralax) |
|
|
Term
| What drug can you NOT give a pt. with diverticulitis? Why? |
|
Definition
Laxatives.
Increase colonic pressure |
|
|
Term
| Dietary mgmt durgin acute phase diverticulitis |
|
Definition
| NPO then gradual as recovering, bowel rest |
|
|
Term
| General dietary mgmt diverticulitis |
|
Definition
High fiber (work out bowel)
Avoid food with small seeds |
|
|
Term
| What % of diverticulitis pts get surgery and why? |
|
Definition
| ~25% if peritonitis or abscess |
|
|
Term
|
Definition
Methylcellulose
Psyllium
Polycarbophil
Act in small intestine and colon
Absorb water thereby softening and enlarging the fecal mass promoting peristalsis |
|
|
Term
|
Definition
Docusate sodium
Docusate calcium
Small intestine and colon
Sufactant action softens stool by facilitating penetration of water; also causes secretion sof water and electrolytes into intestine |
|
|
Term
|
Definition
Bisacodyl (colon)
Senna (colon)
Castor oil (small intestine)
Stimulate peristalsis
Bring water and electrolytes into colon and decrease water and electrolyte absorption |
|
|
Term
|
Definition
Magnesium hydroxide, sulfate and citrate
Sodium phosphate
Polyethylene glycol
Small intestine and colon
Osmotic action retains water and softens feces |
|
|
Term
|
Definition
Lubiprostone (Opens Cl- channels in intestinal epithelium and inc. motility and secretion of fluid into lumen)
Mineral oil (lubricates and reduces water absorption)
Glycerin suppository (lubricates and causes reflex rectal contractions)
Lactulose (similar to osmotic laxatives) |
|
|
Term
| Laxatives that produce watery stool in 2-6 hrs |
|
Definition
Osmotic laxatives (in high doses)
Castor oil |
|
|
Term
| Laxatives that produce semifluid stool in 6-12 hrs. |
|
Definition
Osmotic laxatives (low doses)
Bisacodyl (oral - suppositories work in 15 min)
Senna |
|
|
Term
| Laxatives that produce soft stool in 1-3 days |
|
Definition
Bulk-Forming Laxatives
Surfactant laxatives (docusate)
Lactulose
Lubiprostone |
|
|
Term
| Best thing to clean peri-anal area |
|
Definition
| H20, mild soap (Periwash) |
|
|
Term
Fasting blood glucose normal range
Albumin normal range
Cholesterol |
|
Definition
BS 70-110
Alb. 3.5-5.0
Chol <200 |
|
|
Term
| This type of obesity is more common in men and has a higher risk for HTN and stroke than the other form of obesity. |
|
Definition
|
|
Term
| This type of obesity is seen more commonly in women and is harder to treat |
|
Definition
|
|
Term
100% wt over ideal
___x higher risk of dying |
|
Definition
|
|
Term
Overcoming obesity stats:
BMI
Exercise
Loss
Diet
Cues |
|
Definition
BMI 18.5-24.9
Exercise 30 min/day 3-5x/wk
1-2 lbs/wk
1000-1500 kcal
Eat when hungry, not when presence of food or time of day |
|
|
Term
| Labs to assess on obese pt |
|
Definition
Thyroid profile
Glucose, cholesterol, lipid profiles |
|
|
Term
| Two types of gastric (bariatric) surgeries |
|
Definition
Gastric bypass
Gastroplasty (banded) or stapling |
|
|
Term
| Complications of gastric surgeries |
|
Definition
Vomiting
Dumping syndrome
Anastomosis leak -> peritonitis
Band breaks or slips
Nutrient deficiency |
|
|
Term
|
Definition
Inadequate nutrient intake
Impaired absoprtion
Nutrient loss (diarrhea, hemorrhage, renal failure, Inc. metabolic needs) |
|
|
Term
| What % of hospitalized clients are malnourished? |
|
Definition
|
|
Term
| When energy stores of glycogen are drained, what happens? How long does it take? |
|
Definition
|
|
Term
| When gluconeogensis occurs during stress response, PCM (protein-calorie malnutrition) |
|
Definition
|
|
Term
| How fast can protein be broken down by gluconeogenesis? |
|
Definition
| 1/2 protein stores can be broken down within 3 wks |
|
|
Term
| Nsg Dxs malnutrition - catabolism |
|
Definition
Impaired nutrient absorption
Impaired skin integrity
Subcutaneous fat and muscle proteins broken down
Impaired immune system
Impaired wound healing
Impaired mobility
Abdominal edema, diarrhea |
|
|
Term
| Increased complication rates, mortality, slower healing, rehospitalization and length of stay in hospital are all associated with what? |
|
Definition
|
|
Term
| Normal, mild, significant values for albumin. |
|
Definition
Normal 3.5-5.0
Mild 3.0-3.5
Significant <3.0 |
|
|
Term
|
Definition
Oncotic gate keeper
Binds electrolytes (ca++) and drugs |
|
|
Term
| What does hypoalbuminemia put a pt at major risk for? |
|
Definition
|
|
Term
| When do you test prealbumin? |
|
Definition
|
|
Term
| How long does it take to have an appreciable increase in Albumin levels? |
|
Definition
|
|
Term
| What serum electrolyte is reduced with severe malnutrition? |
|
Definition
|
|
Term
| What blood cell count is reduced with malnutrition |
|
Definition
|
|
Term
| Dietary mgmt malnutrition |
|
Definition
Replace K+, Mg+, Ca++
Re-introduce: protein, calories, vitamins and minerals
Fat and lactose introduced last
Gradual process |
|
|
Term
|
Definition
Corticosteroids (^Na+ retention also)
Megace
Marinol
Odor/presentation |
|
|
Term
| Standard Enteral tube feed |
|
Definition
Jevity 1cal/1mL
14% protein
60% CHO
25% Fat
c vitamins and minerals |
|
|
Term
| Enteral feedings complications |
|
Definition
Aspiration
Diarrhea
Gastric distress
Dehydration
Skin breakdown |
|
|
Term
| What degree should HOB be at for NG? |
|
Definition
|
|
Term
|
Definition
NG Tube
Corpack (weighted)
Tigertube (self-advancing to Jejunum)
Gastrostomy (G) tube
Jejunostomy (J) tube |
|
|
Term
|
Definition
Suctioning
Irrigation
Temp. feeding
Meds |
|
|
Term
| What do you need to check when using NG tube? |
|
Definition
Skin breakdown
Placement
Markings on tubing vs. baseline
HOB 30-45 |
|
|
Term
|
Definition
Benefits - less likely to aspirate, migrates to jejunum itself, wire to assist with placement
Risks - Clogs easily, bleeding/tissue damage |
|
|
Term
| What is the new safety measure for all tubes/catheters/etc? |
|
Definition
|
|
Term
|
Definition
50% Dextrose, 8.5% AA, hypertonic
Via Central line (includes PICC) |
|
|
Term
|
Definition
10% Dextrose, 3.5% AA, slightly hypertonic
Via Peripheral line |
|
|
Term
| What can't you do on the same arm as a PICC? |
|
Definition
|
|
Term
| Problems with central line insertion |
|
Definition
Air bolus
Pneumothorax
Check lungs if took more than one stick
Brachial plexus injury
Mal-positioning |
|
|
Term
| What do you need before you use a central line? |
|
Definition
|
|
Term
| How often must TPN orders be written? |
|
Definition
|
|
Term
| Nsg. assessment of central line care and TPN actions |
|
Definition
X-ray confirmation before usage
Check electrolytes - replacement via IV
Secure new orders daily
Change tubing Qday
Sterile site care q3d
glucose checks; SSI
VS Q4hr
I&O, Daily Wts
Diuretics per MD order |
|
|
Term
| How often must you check blood sugars with TPN? |
|
Definition
|
|
Term
| Do you have to have someone confirm the order for you when hanging TPN? |
|
Definition
|
|
Term
| Inflammation of the oral mucosa |
|
Definition
|
|
Term
|
Definition
>65 years age
Immune compromised
Chemo
O2 therapy
Steroids
Poor oral hygiene
ETOH abuse
Chronic renal or heart failure |
|
|
Term
|
Definition
Viral
Bacterial
Irritants
Mechanical trauma |
|
|
Term
|
Definition
Malnutrition
Electrolyte/fluid imbalances
Bacterial endocarditis
Sepsis |
|
|
Term
|
Definition
Topical oral anesthetics (Orajel, viscous lidocaine)
Fungal ("swish & swallow" Nystatin, Fluconazole)
Herpetic (Acyclovir)
Bacterial (Abx)
Mechanical (saline rinses, Gelcare analgesia)
Et cell stimulator (Palfermin) |
|
|
Term
| What kind of cancer is oral cancer? |
|
Definition
|
|
Term
| Where is oral cancer located? |
|
Definition
| Lips, tongue, mouth floor, head & neck |
|
|
Term
|
Definition
| Smoking, ETOH, chewing tobacco |
|
|
Term
| Early sign of mouth cancer |
|
Definition
| Painless oral ulceration or lesion that doesn't heal |
|
|
Term
|
Definition
Blood tinged sputum
Dysphagia
Difficulty speaking
Swollen lymph nodes |
|
|
Term
| Where does mouth cancer frequently metastasize to? |
|
Definition
|
|
Term
|
Definition
Risk for Ineffective Airway Clearance
Risk for Imbalanced Nutrition
Impaired Verbal communication
Disturbed body image |
|
|
Term
| GERD (Gastroesophageal reflux disease) |
|
Definition
| Backward flow of gastric contents into esophagus |
|
|
Term
|
Definition
| Incompetent lower esophageal sphincter or increased pressure in stomach |
|
|
Term
| Factors contributing to GERD |
|
Definition
Inc. gastric volume
Bending or lying down
Inc. gastric pressure eg obesity, tight clothing
Hiatal hernia |
|
|
Term
|
Definition
Dysphagia
Belching
Heartburn
Chest Pain |
|
|
Term
| What % adults are affected by GERD? |
|
Definition
|
|
Term
|
Definition
Esophageal strictures
Barrett's esophagus (cancer) |
|
|
Term
|
Definition
Barium Swallow
Upper endoscopy
24 hr ambulatory pH (check for regurgitation)
Esophageal manometry (sphincters pressure & peristalsis) |
|
|
Term
|
Definition
PPIs
H2 receptor blockers
Antacids
Promotility agents
Protectants/Anti-ulcer (sucralfate) |
|
|
Term
| What GERD medication do you need to stagger with other meds in order to prevent malabsorption? |
|
Definition
|
|
Term
| Who are antacids contraindicated in? |
|
Definition
|
|
Term
| What problems does using Sodium bicarb at home for GERD cause? |
|
Definition
Fluid retention - Edema/HTN/CHF aggravation
Metabolic alkalosis
Inc. intra-abd. pressure
Delays pt from seeking care |
|
|
Term
| What side FX do aluminum based antacids have? |
|
Definition
Constipation
Dec. effects of coumadin and digoxin
Inc. Sodium - CHF/HTN risk |
|
|
Term
| H2 receptor blockers (reduce acidity of gastric juices) Take HS even if Sx relieved |
|
Definition
Famotidine (Pepcid)
Ranitidine (Zantac) |
|
|
Term
|
Definition
Reduce acid secretions
Nexium, Protonix, Prevacid, Prilosec |
|
|
Term
|
Definition
Sulcralfate (Carafate)
Forms paste with gastric acid to adhere to damaged tissue |
|
|
Term
| Promotility agent Inc. peristalsis and gastric emptying |
|
Definition
Metoclopramide (Reglan) 30 min before meals
Watch for extrapyramidal SEs |
|
|
Term
| Lifestyle changes to prevent GERD |
|
Definition
Don't eat after 8pm
Sit up after eating
Take meds as Rxd
Avoid fats and alcohol & coffee |
|
|
Term
|
Definition
| Nissen fundoplication (tightens lower esophageal sphincter) |
|
|
Term
| Part of stomach protrudes through esophageal hiatus of diaphragm into thoracic cavity |
|
Definition
|
|
Term
|
Definition
Ba swallow
Upper endoscopy |
|
|
Term
|
Definition
|
|
Term
| Absence of peristalsis associated with scar tissue |
|
Definition
|
|
Term
|
Definition
| Balloon dilation of lower esophageal sphincter every 6 months |
|
|
Term
|
Definition
Dysphagia
Fullness in chest w/meals
Chest pain @ rest
Night time cough and hoarseness |
|
|
Term
| May result from untreated GERD |
|
Definition
|
|
Term
| What type of cancer is Barrett's Esophagus? |
|
Definition
Squamous cell
Adenocarcinoma |
|
|
Term
| Risk factors Barrett's Esophagus |
|
Definition
|
|
Term
| Manifestations Barrett's Esophagus |
|
Definition
Hoarse voice
Progressive dysphagia with pain while swallowing
Choking, coughing
Anorexia
Weight loss |
|
|
Term
| Late manifestation Barrett's Esophagus |
|
Definition
| Tracheoesophageal fistulas |
|
|
Term
|
Definition
Surgical Resection
Palliative |
|
|
Term
| Complications of radiation to esophagus |
|
Definition
Perforation
Strictures
Hemorrhage |
|
|
Term
|
Definition
Barium Swallow
Esophagoscopy
CXR, CT, MRI
Albumin |
|
|
Term
| Altered Nutrition Interventions for Esophageal cancer |
|
Definition
Pain control
TF PRN
Check labs (albumin, electrolytes)
Check I & O
Daily weights
Swallowing |
|
|
Term
| Risk for Ineffective airway clearance and aspiration r/t Esophageal Cancer Nsg. Interventions |
|
Definition
HOB 30-45
C&DB Q2hrs
Monitor vitals, LOC
Check TF placement |
|
|
Term
| Disorders that affect digestion |
|
Definition
N/V
Stomach cancer
Peptic Ulcer Disease
Gastritis |
|
|
Term
| What is the gastric mucosal barrier composed of? |
|
Definition
Impermeable lipid layer
Bicarb ion secretion
Mucus gel |
|
|
Term
| What interrupts the protective mucosal barrier? |
|
Definition
|
|
Term
|
Definition
Anorexia
Pallor
Sweating
Tachycardia
Vagal stim - dizziness & ortho HoTN |
|
|
Term
|
Definition
Dehydration
Hypokalemia
Metabolic alkalosis
Aspiration -> Pneumonia
Rupture or teat esophagus |
|
|
Term
|
Definition
Serotonin receptor antagonists (Zofran)
Dopamine antagonists (Compazine)
Antihistamines (Vistaril)
Cannabinoids (Marinol)
BDZs (Ativan)
Corticosteroids (Decadron) |
|
|
Term
| How low does Hg have to be before you start having major problems? |
|
Definition
|
|
Term
|
Definition
CBC
H/H (Iron deficiency, pernicious anemia)
Vit B12
Electrolytes
Coag studies (INR, PT, PTT)
Upper endoscopy (EGD - Esophagogastroduodenoscopy |
|
|
Term
| When the gastric mucosa is not working properly, Vit B12 is not absorbed due to the lack of intrinsic factor secreted by gastric mucosa. What dos lack of Vit B12 produce? |
|
Definition
| Abnormal large RBCs fragile with limited O2 carrying capacity (Anemia) |
|
|
Term
|
Definition
Whole blood infusion
Gastric lavage (Ice to constrict)
IV fluids - NS
Upper endoscopy-sclerosing agent |
|
|
Term
| Pt. teaching r/t GI bleed |
|
Definition
NSAID, ASA use
ETOH use
Food choices
Meds |
|
|
Term
|
Definition
|
|
Term
| Black tarry stools associated with upper GI bleed |
|
Definition
|
|
Term
| Bright red blood in stools associated with lower GI bleed |
|
Definition
|
|
Term
| How high does the MAP have to be in order to adequately perfuse the kidney? |
|
Definition
|
|
Term
| Three types of Upper GI bleeds |
|
Definition
Gastritis
PUD
Esophageal Varices |
|
|
Term
| Gastritis due to ASA, NSAIDS, steroids, ETOH, caffeine or H. Pylori |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Inflammation and atrophy gastric tissue gastritis |
|
Definition
|
|
Term
|
Definition
| Inflammation of the stomach lining & mucosal irritation |
|
|
Term
| Why are most hospitalized pts on PPIs? |
|
Definition
Risk for Erosive (stress) Gastritis
When going into the hospital
1. BS Increases
2. Catabolism
3. Inc. HCl production r/t stress |
|
|
Term
| Manifestations Acute Gastritis |
|
Definition
N/V
Anorexia
Hematemesis, Melena
Abd. pain
If perforation: BLEEDING, shock & acute abd pain |
|
|
Term
|
Definition
NPO 6-12 hrs
Clear liquids -> full->solids
If n/v persist = IV fluids c electrolytes |
|
|
Term
|
Definition
PPIs
H2 receptor blockers
Sucralfate |
|
|
Term
| Prevention erosive gastritis |
|
Definition
PPI
H2 receptor blocker
Sucralfate
Avoid stress, alternative relaxation measures |
|
|
Term
| Manifestations Erosive Gastritis |
|
Definition
Not associated with pain
Bleeding occurs 2 or more days after stress event
Risk for perforation - watch for s/s peritonitis |
|
|
Term
| Chronic gastritis risk factors |
|
Definition
|
|
Term
| Etiology Chronic Gastritis |
|
Definition
Autoimmune
H. Pylorus
Beginning w/ superficial inflammation and leading to atrophy of gastric tissue |
|
|
Term
| Manifestations Chronic Gastritis |
|
Definition
Vague gastric distress
Epigastric heaviness not relieved by antacids
Fatigue r/t anemia |
|
|
Term
|
Definition
Metronidazole
Clarithromycin
PPI
Pepto Bismol |
|
|
Term
| How is H. Pylori transmitted? |
|
Definition
|
|
Term
|
Definition
| Bacteria irritate mucus gel and produce enzymes that decrease the efficacy of the mucus gel in protecting the gastric mucosa |
|
|
Term
|
Definition
Gnawing
Burning
Hunger-like pains
Aching |
|
|
Term
| A break in the mucous lining of GI tract that comes in contact w/gastric juice |
|
Definition
| Peptic Ulcer Disease (PUD) |
|
|
Term
|
Definition
|
|
Term
|
Definition
H. Pylori
Drinking
Smoking
NSAIDs and ASA |
|
|
Term
|
Definition
Hemorrhage
Perforation
Outlet obstruction |
|
|
Term
| Most commonly affected areas by PUD |
|
Definition
Duodenum (most common)
Esophagus
Stomach |
|
|
Term
|
Definition
Maintain Circ
IV Fluids
Gastroscopy-laser to seal bleeding vessels
NPO
PPI (IV)
Blood products PRBCs |
|
|
Term
| Tx Perforation hemorrhage |
|
Definition
|
|
Term
| Tx Gastric Outlet obstruction |
|
Definition
Balloon to dilate
NPO
NG decompression
NS + K+
H2 receptor blockers IV
Surgery last resort |
|
|
Term
|
Definition
Upper GI series c Barium
Gastroscopy |
|
|
Term
|
Definition
NPO 6-8 hrs before
No dentures, eyewear
No eating after until gag reflex |
|
|
Term
|
Definition
Pepto (inc. mucosal bicarb and prostaglandin to heal ulcer + abx activity)
H2 receptor blockers (HS)
PPIs (before meal) |
|
|
Term
| Adenocarcinoma with few Sxs; advanced when Dx'd. |
|
Definition
|
|
Term
| Risk factors stomach cancer |
|
Definition
Nitrates
Smoked meats
H. Pylori
Gastric polyps |
|
|
Term
|
Definition
|
|
Term
|
Definition
Hypertonic food bolus ->
Empties quickly into intestine ->
Hypertonic food brings lots of water in from surrounding tissues ->
Increases peristalsis ->
Causes swelling of intestine, cramping, and borborygmi ->
Blood volume decreased due to water being pulled in ->
Decreased blood volume & orthostatic hypotension |
|
|
Term
| What should patients do if they are experiencing dumping syndrome? |
|
Definition
|
|
Term
|
Definition
Faintness
Sweating
Palpitations
Diarrhea |
|
|
Term
| Pt. teaching to decrease dumping syndrome |
|
Definition
Eat small, frequent meals
Separate foods and liquids
Avoid foods that increase dumping syndrome
Increase protein & fats to slow emptying
Lie down for 1 hr after meals |
|
|
Term
| What is a complication of stomach cancer/ gastric surgery? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What happens with the gall bladder when fatty foods enter the duodenum? |
|
Definition
| Releases bile at sphincter of Oddi |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Who is likely to have cholelithiasis or cholecystitis? |
|
Definition
|
|
Term
| What happens in cholecystitis? |
|
Definition
Inflammation of gallbladder ->
Obstruction inc. pressure within gallbladder ->
Ischemia can lead to necrosis or perforation |
|
|
Term
| Cholecystitis complications |
|
Definition
Gangrene & perforation -> peritonitis
Chronic cholecystitis
Empyema
Fistula formation
GI paralytic ileus |
|
|
Term
| How are gallbladder stones formed? |
|
Definition
Abnormal bile composition ->
Biliary stasis ->
Gallbladder inflammation |
|
|
Term
|
Definition
No fat in diet
VS (esp temp) Q4hrs
Semi-fowler's position to take pressure off inflamed GB
Morphine or Demerol for severe pain |
|
|
Term
| Which gallbladder disease has longer acting pain? |
|
Definition
|
|
Term
| Which gallbladder disorder presents with pain increased by movement and breathing, pain generalized RUQ, n/v, anorexia, and chills and fever? |
|
Definition
|
|
Term
| Which gallbladder disorder presents with pain localized to epigastrum and RUQ, RUQ tender with guarding, n/v? |
|
Definition
|
|
Term
| When is surgery on the bile duct indicated? |
|
Definition
| When stones are lodged in ducts |
|
|
Term
| How is bile passed after gallbladder surgery? |
|
Definition
| T-tube (patency & bile passage) |
|
|
Term
| What do you worry about with T-tube care? |
|
Definition
| Obstruction, drainage amount and color, infection, pulling/traction, pt. protecting tube, Fowler's position with drain below surgical wound |
|
|
Term
| How much drainage should there be with a t-tube? |
|
Definition
| 500 cc first day then <200 cc/day |
|
|
Term
|
Definition
Secretes bile
Metabolizes protein, carbs, fats, drugs, RBCs
Stores vitamins, iron & blood
Synthesizes albumin, globulins and clotting factors
Regulates glucose
Converts ammonia to urea |
|
|
Term
|
Definition
|
|
Term
| Inflammation of the liver |
|
Definition
|
|
Term
|
Definition
1. Viral
2. Potentially ETOH, drugs & toxins, Tyelenol |
|
|
Term
|
Definition
Preicteric
Icteric
Posticteric |
|
|
Term
|
Definition
Flu-like, fever, fatigue
N/V
Muscle aches |
|
|
Term
|
Definition
Jaundice
Pruritis
Clay colored stools
Brown urine
Appetite Inc.
Fever Dec. |
|
|
Term
|
Definition
Energy Inc.
Pain subsides
Bilirubin normal
Damage already done |
|
|
Term
| Type of hepatitis with fecal-oral transmission, 2 dose vaccination, healthcare, daycare and restaurant workers at risk |
|
Definition
|
|
Term
Type of hepatitis with:
Blood & body fluid transmission
3 dose vaccine
Healthcare workers, gay men & prisoners at risk |
|
Definition
|
|
Term
Type of Hepatitis:
Blood and body fluid transmission
No vaccine
IV drug abusers at risk |
|
Definition
|
|
Term
| Which type of Hepatitis can you get an IM Immunoglobin within two weeks of exposure? |
|
Definition
|
|
Term
| Which type of Hepatitis can you get a short acting immunity (HGIB IM) and concurrently start vaccinations for after exposure? |
|
Definition
|
|
Term
| Which type of Hepatitis has no vaccine and no post-exposure prevention treatment? |
|
Definition
|
|
Term
| This type of hepatitis is self-limiting (2 months) but has no Tx after Dxd. |
|
Definition
|
|
Term
| Type of hepatitis Txd with Interferon alpha and ribavirin? |
|
Definition
|
|
Term
| Type of Hepatitis treated with interferon alpha and lamivudine |
|
Definition
|
|
Term
| Most clinical recovery of Hepatitis happens within _______. |
|
Definition
|
|
Term
|
Definition
Avoid ETOH & Tylenol
Bedrest
Adequate nutrition as tolerated
Avoid strenuous activity |
|
|
Term
| End stage chronic liver disease that is progressive and irreversible and leads to liver failure. |
|
Definition
|
|
Term
|
Definition
| Functional liver tissue gradually destroyed and replaced w/fibrous scar tissue interrupting blood flow and increasing blood pressure |
|
|
Term
| Manifestation of liver disease |
|
Definition
Jaundice
Pruritis
Brown urine
Pale stools
Liver enlargment
RUQ dull ache
Weakness
Inc. bilirubin level |
|
|
Term
| Later manifestations liver disease |
|
Definition
Impaired metabolism
Altered LOC (Ammonia)
Anemia
Thrombocytopenia
Ascites
Peripheral edema
Bleeding |
|
|
Term
| This symptom of liver disease manifests when bile salts come to the skin |
|
Definition
|
|
Term
|
Definition
Liver biopsy
Can also look at:
Inc. Ammonia levels
Inc. Bilirubin levels
Inc. PT s
Dec. albumin
Dec. glucose and cholesterol
Abd. US
Upper endoscopy |
|
|
Term
| Complications liver disease |
|
Definition
Portal HTN
Ascites
Peripheral edema
Esophageal varices
Hemorrhoids
Splenomegaly
Hepatic Encephalopathy
Hepatorenal syndrome |
|
|
Term
| What does portal HTN cause? |
|
Definition
| Rerouting of blood to lower pressure vessels - causes bulging and too much pressure on these vessels |
|
|
Term
| What happens with splenomegaly as a result of inc. portal HTN? |
|
Definition
Blood is shunted to spleen
Rates of RBC, WBC & platelet removal from circulation is affected.
Blood cell destruction increased.
Anemia
Leukopenia
Thrombocytopenia |
|
|
Term
| Inc. hydrostatic pressure from portal HTN and Dec. Albumin r/t liver malfunction leads to what? |
|
Definition
|
|
Term
| Condition resulting from liver disease that manifests as renal failure w/azotemia, Na+ retention, Oliguria and HoTN |
|
Definition
|
|
Term
| When ammonia cannot be converted to urea in the liver due to malfunction of the liver what happens? |
|
Definition
Hepatic encephalopathy
Normal -> Tremors ->Agitation -> Confusion -> Coma |
|
|
Term
| Is BUN higher or lower in hepatic encephalopathy? |
|
Definition
| Lower (blood UREA Nitrogen) |
|
|
Term
| Manifestation of hepatic encephalopathy in which involuntary jerking movements of extremities, feet and tongue |
|
Definition
|
|
Term
| Rx Cirrhosis to decrease fluid retention |
|
Definition
| Diuretics (spironolactone & furosemide (Lasix)) |
|
|
Term
| Rx Cirrhosis to bring down ammonia levels |
|
Definition
Lactulose (diarrhea)
Neomycin (Abx) |
|
|
Term
|
Definition
| Beta-blockers (eg atenolol) |
|
|
Term
| Rx Cirrhosis to Increase clotting |
|
Definition
|
|
Term
|
Definition
Na+ and fluid restriction
Protein restriction if NH4 High (60 g/day)
Vit supplements B complex, folate, vit ADE
Mg+ replacement if Etiology ETOH |
|
|
Term
|
Definition
Paracentesis (drain ascites)
TIPS (temporary help - bypasses the liver)
Transplantation |
|
|
Term
| Examples of bleeding precautions (Cirrhosis) |
|
Definition
Soft toothbrush
Don't blow nose too hard
Keep stool soft
No enemas, rectal temps or injections
Watch for bruising
Apply pressure to bleeding sites fo 5 min |
|
|
Term
| Liver cancer potential etiologies |
|
Definition
Chronic Hep B or C
Cirrhosis
Contaminated water
Carcinogens in food |
|
|
Term
| Where do exocrine pancreas enzymes empty to? |
|
Definition
| Through duct to the small intestine |
|
|
Term
| Inflammation and self destruction of the pancreas by its own enzymes. Autodigestion |
|
Definition
|
|
Term
|
Definition
| ETOH, gallstones, surgery, infection, hyperlipidemia, NSAIDs, steroids, estrogen |
|
|
Term
| Acute pancreatitis manifestations |
|
Definition
Abrupt onset
Pain LUQ
n/v
fever
Dec. BP
Cold, clammy skin
Retroperitoneal bleeding |
|
|
Term
| Chronic pancreatitis manifestations |
|
Definition
Recurrent epigastric & LUQ pain
n/v, wt loss
Flatulence
Constipation
Steatorrhea |
|
|
Term
| Where does pancreatitis pain radiate to? How is it sometimes relieved? |
|
Definition
Radiates to back.
Relieved by sitting up and leaning forward |
|
|
Term
| What is pancreatitis pain initiated by? |
|
Definition
| Fatty meal or excessive ETOH |
|
|
Term
|
Definition
| Inflammation -> Enzymes released -> Destruction of cells -> hemorrhage & necrosis |
|
|
Term
|
Definition
|
|
Term
| Superficial edema and bruising of SQ tissue around umbilicus |
|
Definition
|
|
Term
| Cullen's and Turner's signs + |
|
Definition
|
|
Term
| Pancreatitis complications |
|
Definition
Pancreatic necrosis
Abscess
Pseudocysts
Ascites |
|
|
Term
|
Definition
Narcotics
Pancreatic enzyme supplements for life
H2 receptor blocker
PPI |
|
|
Term
|
Definition
|
|
Term
|
Definition
Pain
Nutritional deficit
Fluid volume deficit |
|
|
