Term
|
Definition
lower esophageal sphincter
aka cardiac sphincter |
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Term
| what is a common symptom of LES problems? |
|
Definition
| GERD- acid taste in mouth and burning sensation in chest; burping up stomach contents; excess saliva |
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Term
|
Definition
promotes gastric emptying
prokinetic |
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Term
|
Definition
| help reduce secretion of gastric juices |
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Term
|
Definition
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Term
|
Definition
| shuts off acid production |
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Term
| what is the problem with taking OTC omeprazole? |
|
Definition
| if you take it for more than 14 days and problem persists, they need to be evaluated to see if there is another problem going on because it can mask other problems |
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Term
|
Definition
| antihistamine that lessens the amount of acid |
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Term
| what is the most common reason for hyperacidity |
|
Definition
| mechanical issue: tight belt on a big belly |
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|
Term
| esophageal cancer- life expectancy |
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Definition
|
|
Term
| esophageal cancer- most common in |
|
Definition
men 50-80 years old
African American
heavy ingestion of alcohol and smoking |
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|
Term
| esophageal tumors classified as: |
|
Definition
squamous: scales
slow tissue start and then rapid growth |
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Term
|
Definition
| tie off the stomach at the esophagus and connect it somewhere else |
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|
Term
| treatment of esophageal bleeds |
|
Definition
sclerosing agents
band bleed
esophagectomy |
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Term
|
Definition
| harden- uses scope to identify and a needle to inject sclerosing agent that will go in and dry up/harden the bleed |
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Term
|
Definition
| may have 6 or 7 and are still bleeding because they get new bleeds all the time |
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Term
|
Definition
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Term
|
Definition
| study of esophagus, duodenum, and stomach |
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|
Term
| why are patients kept NPO for EGD? |
|
Definition
| because they are anesthetized and it prevents aspiration because they sometimes vomit afterwards |
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Term
| t/f: the older the patient the less apt they are to recover from anesthesia |
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Definition
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Term
|
Definition
| too much pressure will penetrate the wall of the esophagus, stomach, and/or duodenum |
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Term
| what is the first sign of perforation? |
|
Definition
| blood pressure will drop because they are bleeding |
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Term
|
Definition
| magnesium citrate- cleans the bowel for colonoscopy: start drinking around noon through midnight and again in the morning- mixed in a gallon of water- difficult and unpleasant |
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Term
|
Definition
| used for conscious sedation |
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Term
|
Definition
| unconscious sedation: hung with 2 bags- one is normal saline- as soon as the diprivan is done you open the NS and they have instant recovery and are awake |
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|
Term
| why do colonoscopies inject air? |
|
Definition
| to open the rugae to see if there is anything in it |
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|
Term
| t/f: 75% of polyps are benign |
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Definition
|
|
Term
| how do you find out if a polyp is malignant? |
|
Definition
| using a snare- a wire that loops around the polyp and cuts it off and pulls it out- then you send it to the lab to get a biopsy |
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|
Term
| polyps that are tree like with a stalk to the are (MALIGNANT/BENIGN) |
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Definition
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|
Term
| polyps that are flat and layout like a large mushroom are more often (MALIGNANT/BENIGN) |
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Definition
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|
Term
| t/f: colon cancer is easily corrected if you get the polyps out early |
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Definition
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|
Term
| t/f: people should start getting colonoscopies routinely at age 50 |
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Definition
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|
Term
| what must happen for a colonoscopy patient to go home? |
|
Definition
| they must flatulate and urinate |
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|
Term
| what is the Shilling test? |
|
Definition
| evaluates the ability of the body to absorb vitamin b12- if there is no gastric intrinsic factor, the b12 in someone's diet cannot be absorbed |
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Term
|
Definition
| small painful ulceration of the oral mucousa; recurrent; 1-3 weeks to heal |
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|
Term
| what will neutralize a kanker sore? |
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Definition
|
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Term
|
Definition
| cold sore/fever blister; Herpes type 1- very painful vesicles that contain pus/fluid inside |
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|
Term
| how do you treat herpes type 1? |
|
Definition
| acyclovir or zovirax- both meds are antiviral |
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Term
|
Definition
| candidiasis albicans: creamy, white, curd like patch within the mouth that adheres to mucousa; can bleed, ulcerate, and be scraped off |
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|
Term
| what is used to treat thrush? |
|
Definition
| long term antibiotics- niastatin aka swish and spit |
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Term
| what is a sign of a fungal infection |
|
Definition
swollen, hot, peroteneum
fat folds with a cheesy looking substance |
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Term
|
Definition
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|
Term
| what is oral cancer usually related to |
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Definition
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|
Term
| why is mortality rate high in oral cancer |
|
Definition
| because there is immediate access to the blood supply due to a large amount of capillaries in the lining of the mouth |
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|
Term
| t/f metastasis occurs 65% of the time oral cancer occurs |
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Definition
|
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Term
|
Definition
| smooth irregular white patches with little red particles inside of them that form due to chronic irritation; drinking/smoking; it is a premalignant lesion condition |
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|
Term
| treatment for leukoplakia |
|
Definition
| radiation first to pinpoint and shrink the lesions and kill cancer at initial site- then followed by chemo because by the time you find the cancer it has metastasized; very difficult to treat; usually have to remove portions via surgery |
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|
Term
| why is nutrition an issue with chemo patients? |
|
Definition
| everything tastes like tin- they no longer have an interest in eating because it doesn't taste good; real lemon drops seem to stimulate a sense of taste |
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|
Term
| what do you need to have at bed side with a jaw fracture? |
|
Definition
| wire cutters and emergency trach set |
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Term
|
Definition
| pocket that moves into the thorax; easily repaired; develop because of a weakness in the muscle due to aging, trauma, obesity, or pregnancy; usually asymptomatic until they get reflux; surgically repaired; easy surgery |
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Term
|
Definition
| genetics, environmental, and infection |
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|
Term
| t/f:smoking prevents ulcers from healing |
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Definition
|
|
Term
| t/f: liquour changes the lining of the stomach and prevents healing |
|
Definition
|
|
Term
| t/f: caffeine is an acid inhibitor |
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Definition
|
|
Term
| what is the infection that causes ulcers |
|
Definition
|
|
Term
| basic physiology of the peptic ulcer |
|
Definition
| imbalance between acid secretion and protective nature of the mucosa |
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|
Term
| basic physiology of the duodenal ulcer |
|
Definition
|
|
Term
| how does hyperacidity get started? |
|
Definition
| h. pylori interferes with mucous production and the production of the bicarbonate |
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|
Term
| what are the main difference between peptic ulcers and duodenal ulcers? |
|
Definition
duodenal: occurs 2-4 hours after meals and at night and is relieved by food or antacids
peptic: pain starts 1-2 hours after food and is worsened by food/antacids; have a sensation of nausea and are bloated with distention |
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|
Term
| what do they do first to identify ulcer? |
|
Definition
|
|
Term
|
Definition
| return of the original symptoms after treatment stops; most common example is antihistamines and the use of nasal sprays |
|
|
Term
| what could happen if an ulcer causes scarring? |
|
Definition
| can block of the colon in duodeneum- will cause dysphagia and SBO |
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Term
|
Definition
| NG tube to decompress the abdomen and draw off whatever is occurring above the point of obstruction |
|
|
Term
| what happens with a stress ulcer? |
|
Definition
| development of an ulcer due to an INFARCT due to trauma (Burn, sepsis, shock, etc.) that causes the death of muscle due to cut off of blood supply and oxygen; the bowel can become necrotic just like the heart and infarct; the body's intent is to stay alive- it withdrawals all of the blood from extremities and trunk and sends it to heart, brain, lungs, kidney, and liver |
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Term
|
Definition
| common in the Japanese because they have a diet high in nitrates (fish) |
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Term
|
Definition
| very complex, physical phenomenon that is a subjective experience with no definable cause that usually results in vomiting because the vomit center is in the medulla which is timulated by the vagus nerve and triggers sympathetic nervous system; response is a spasm or inflammation of the GI tract that triggers visceral receptors and causes regurgitation |
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Term
|
Definition
| Arterial venous malformation |
|
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Term
|
Definition
turn them on their side so they don't aspirate
suction immmediately |
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|
Term
| treatment for nausea/vomitting |
|
Definition
Dramamine: helps motion sickness
antihistamines: Benadryl
mecalaxine- dizziness, vertigo
phenogren; iv/im need to be very cautious: give very slowly - 90% of the time it takes away the nausea but may cause uncontrollable diaphoresis
zophran- comes in wafer for kids for sublingual- the iv dose may also be taken orally
reglan: increases GI mobility |
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Term
|
Definition
| group of vasomotor gi syndromes that causes things to come in one end and go directly out the other- irritable bowel |
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Term
|
Definition
| development of very hard stools that cannot pass |
|
|
Term
| how to relieve constipation |
|
Definition
| digitally disempact: enema- risky because they may pass out |
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|
Term
|
Definition
| watery stool that comes out with force |
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|
Term
|
Definition
| bananas, rice, apples, toast |
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|
Term
|
Definition
| tummy tuck- stapling and banding for weight loss- staple stomach so theres less room for food to go in |
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|
Term
|
Definition
|
|
Term
| appendicitis most common in |
|
Definition
|
|
Term
| what is the problem with appendicitis? |
|
Definition
| the umen becomes clogged by hardened stool or capped off/covered over and creates an abscess that will burst after continued growth and cause all of the fluid to enter the peritoneum |
|
|
Term
| where is the pain from appendicitis |
|
Definition
| lower right quadrant of the abdomen- the pain meets in the middle between the navel and right hip |
|
|
Term
| common signs of appendicitis |
|
Definition
pain in lower right quadrant
rebound tenderness
nausea, vomiting, fever, wbc's at 10,000 |
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|
Term
| what is an important nursing consideration for a possible appendicitis pain complaint? |
|
Definition
get a cbc to check for wbc's
NPO because if they eat or drink surgery is no longer an option |
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|
Term
| what is a complication of removal of the appendix? |
|
Definition
| if it has already ruptured and spilled into the peritoneum the pt will come bac from OR with a JP (Jackson drain) |
|
|
Term
|
Definition
| you have to squeeze it and put the cap back on so it will slowly draw off the pus from the peritoneal cavity- it must be emptied and measured after every shift |
|
|
Term
| how do you know that patient has an abscess? |
|
Definition
| area around the incision is hard and has a very foul odor when the pus comes out |
|
|
Term
| diverticulosis vs. diverticulitis |
|
Definition
|
|
Term
| classic symptoms of dierticulitis |
|
Definition
| cramping pain in lower left quadrant |
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|
Term
| most common place for diverticulosis |
|
Definition
| sigmoid and descending colon |
|
|
Term
| how do you find diverticulitis |
|
Definition
palpate- identify LLQ- real pain
ct scan with contrast- reveals diverticuli
colonoscopy- done last to rule out cancer/remove polyps and to examine the nature of diverticuli- wide mouth, large bore, etc. |
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|
Term
| important teaching for patients with diverticulitis/osis |
|
Definition
diet high in fiber and fluid
laxatives that form bulk fiber
avoid popcorn and anything with seeds/nuts |
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Term
|
Definition
| local or general inflammation of peritoneum- which is the covering of the inside of the abdominal cavity |
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|
Term
| why is an infection of peritoneum very serious? |
|
Definition
| it can go from infection to abscess and even cancer |
|
|
Term
| common triggers of peritonitis |
|
Definition
| pelvic inflammatory disease, ulcer perforation that permeates the wall and infection spills into peritoneum, ruptured appendix, and bowel obstruction |
|
|
Term
| secondary triggers of peritonitis |
|
Definition
| trauma, surgical injury, chemical irritation |
|
|
Term
| pathophysiology of peritonitis |
|
Definition
| body takes acute inflammation and walls it off with adhesions and formation of abscesses; progress rapidly to massive fluid and electrolyte shifts throughout the body that will cause the patient to be hypovolemic |
|
|
Term
|
Definition
acute, local, or diffused pain with rebound tenderness
intense abdominal rigidity and guarding
paralytic ileus and abdominal distention
hypovolemic shock- increased heart rate, increased respiratory rate, increased urine output, increased restlessness |
|
|
Term
|
Definition
1. difference between obese and distended
2. assess all for quadrants
3. check for guarding and rebound tenderness
4. feel for obvious masses
5. look at it |
|
|
Term
|
Definition
| abdomen is very distended due to sclerosis/cancers of the liver- tight and shiny skin- can see capillaries and veins under the skin- feels tympanic |
|
|
Term
|
Definition
| when abdomen is distended, large, and tympanic, but is NOT shiny and is disproportionate to patient |
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|
Term
| t/f: always use NG tube on low intermittent suctioning when decompressing abdomen |
|
Definition
| true: this is done so that it doesn't get stuck on the wall- and if it does it will stop working- u just shut it off wait a minute and start again |
|
|
Term
|
Definition
| portion of colon loses the motility to move the food/stool along that area |
|
|
Term
| two inflammatory bowel diseases |
|
Definition
| crohn's disease and ulcerative collitis |
|
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Term
|
Definition
| regional enteritis: everything thickens, scar tissues form, lesions commonly perforate right through the bowel wall, form fissures (cracks) in intestinal walls, and interferes with normal bowel absorption, appear in an ascending pattern going up throughout the bowel- nothing moves and nothing is absorbed |
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|
Term
| most common treatment for crohn's |
|
Definition
| resection with anastomosis to remove sections and hook the functioning parts of the colon back together |
|
|
Term
| problem with reinastimosis |
|
Definition
| crohn's will occur again in the good sections of the colon |
|
|
Term
|
Definition
| occurs at sigmoid colon; bleeds and perforates; bowel wall very edematous- swollen and thickens; formation of scar tissue and los of elasticity leads to loss of bowel control; these people do not have nerves that let them hold their bowels to make it to the bathroom |
|
|
Term
| difference between crohn's and ulcerative collitis |
|
Definition
crohn's: ascending colon; segmental areas, not the entire colon; no bleeding; soft stools; cholic pain cramping of LRQ that can be very severe; formation of fistulas; do not get benefit of what they eat; anastomosis with resection
ulcerative colitis: descending colon; continuous problem- affects entire colon; bloody; liquid stools; pain occurs before BM; hemorrhage, cachexia (skin and bones) wasting syndrome; surgery removes entire rectum |
|
|
Term
|
Definition
| difficult and painful- no bowel control; becomes spastic; colitis of the mucous of the colon; abdominal pain and altered bowel habits, diarrhea and no obvious cause of any organic disease process; most common gi condition in US most common in women |
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|
Term
| two major patterns of IBS |
|
Definition
1. abdominal pain relieved by passing gas or stool with periods of constipation/diarrhea
2. urgent, painless diarrhea during or after meals |
|
|
Term
|
Definition
avoid rich, fatty food
limit intake of gas producing foods- cabbage, sauerkraut, carbonated drinks, alcohol, smoking
reduce stress
fiber and fluids help |
|
|
Term
|
Definition
| in their mouth and through the GI system; directly to gi tract; chew up and swallow |
|
|
Term
|
Definition
| TPN- total pearenteral nutrition- people who can't take things orally for a variety of reasons- everything that they need for nutrition runs over IV over 23 hours; exclusively go through a central line; prescription changes every night |
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|
Term
|
Definition
| parenteral gstric tube- clean underneath and flush before, during, and after feeding/med pass |
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|
Term
|
Definition
| any factor or condition that either narrows the intestinal passageway or interferes with peristalsis; |
|
|
Term
|
Definition
mechanical: problem with the lumen itself
non-mechanical: some reason why peristalsis is not occuring |
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Term
|
Definition
| most common cause of obstruction in small bowel; fibrous obstructions looping the small bowel kinking or obstructing it |
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|
Term
|
Definition
|
|
Term
|
Definition
| bowel goes back upon itself like a telescope |
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|
Term
|
Definition
1. obstruction
2. secretion of fluid and air at proximal end of obstruction
3. increase in peristalsis near obstruction
4. increased intraluminal pressure- trying to push the blockage through- begins to give up and peristalsis stops
5. isotonic fluid moves from plasma into bowel
6. normal reabsorption of fluid and gas stops- bowel becomes edematous; blood flow to that part of the colon stops
7. bacteria sets in and spreads to peritoneal cavity- end result is hypovolemia, electrolyte imbalance, and strangulation of the bowel itself: gastroparesis |
|
|
Term
|
Definition
| essentially a stroke of the colon |
|
|
Term
| t/f as obstruction gets worse in gastroparesis, pain increases |
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Definition
|
|
Term
| t/f SBO's automatically cause vomitting |
|
Definition
|
|
Term
|
Definition
| vomit, hypovolemic shock, decreased BP, cold clammy diaphoretic |
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|
Term
|
Definition
|
|
Term
|
Definition
| occurs when an organ or another structure protrudes through either a congenital or acquired defect in the muscle of the abdominal wall; occur at any age, time; most common in men and the elderly |
|
|
Term
|
Definition
| develop from weakness in the abdominal wall |
|
|
Term
|
Definition
| congenital; occur during fetal development; sporatic cord in male and round ligament in female; not seen very often |
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|
Term
|
Definition
| located at the posterior of the inguinal wall- caused by increased intra-abdominal pressure- need to be repaired surgically; easy surgery |
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|
Term
| how do they surgically repair a direct inguinal hernia |
|
Definition
| 3 small incisions into groin; insert instrument that allows them to suture up that protrusion in the wall and put everything back where it belongs and use a mesh to seal it up |
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|
Term
|
Definition
| moves freely in and out of the hernia sac |
|
|
Term
|
Definition
| can be manually returned to its proper position |
|
|
Term
|
Definition
| leather strap worn around the waist down to the groin with a leather sac that would put pressure on it to reduce the hernia |
|
|
Term
|
Definition
| cannot be pushed back in where it belongs- it is actually a portion of the bowel that sticks out through the abdominal wall; if you cant get it back in you have a bowel obstruction (mechanical) |
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|
Term
| surgical treatment for incarcerated hernia |
|
Definition
| reposition and sew opening close to avoid peritonitis |
|
|
Term
|
Definition
| masses of dilated blood vessels beneath the skin |
|
|
Term
| t/f hemorrhoids more common in women who've been pregnant |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| issue, bleed, annoying to patient |
|
|
Term
| t/f hemorrhoids most common in adults over 50 years old |
|
Definition
|
|
Term
|
Definition
| freeze off, tie off, cut off, sclerotherapy |
|
|
Term
|
Definition
| tear in the rectal sphincter |
|
|
Term
| what causes anal fissures |
|
Definition
|
|
Term
| how to treat anal fissures |
|
Definition
| OTC drugs to help heal and take away the irritation |
|
|
Term
|
Definition
| abscess that forms in the gland and ducts in the rectum that gets obstructed by feces and harden and become abscessed |
|
|
Term
|
Definition
| lance and drain- horrendous smell |
|
|
Term
|
Definition
| development of communication between anal canal and outside the skin; seen in vaginal wall sometimes with opening into the rectum - very elderly ladies- stool goes out rectum through fistula and out of the vagina |
|
|
Term
|
Definition
|
|
Term
|
Definition
| potentially life threatening complication of infection that occurs when chemicals released into the blood stream to fight infection trigger inflammation throughout the body and triggers a cascade of changes that damages multiple organ systems and can cause them to fail- multi-system failure |
|
|
Term
| recognition signs of sepsis |
|
Definition
1. actual or possible infection
2. relative hypotension
3. fever greater than 101 or low temperature
4. chills with rigors (shaking to raise temperature)
5. immune compromised
6. decreased urinary output
7. extermes of age
8. known site of infection
9. oxygenation problems
10. change in mentation
11. need to watch for subtle changes |
|
|
Term
| when to call ambulance with sepsis |
|
Definition
| when their blood pressure drops |
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|
