GI 27, 28, 29, 30 (test 7)

Liver 4,000 mg in 24 hrs is max

Gallblader, liver, pancreas

• Native americans have higher cholesterol in bile = increased gallstone risk

• Mexican americans also have incrased gallstone risk

Foods in nitrates and nitrites

• hot dogs

• bacon

• ham

• charred grilled foods

• bolonga

2500 mL/day

True, hydrocloric acid is a stomach acid that breaks down food and is lower in gertiatric patients.

Dehydration, electrolyte imbalance. fluid overload

• Immunize against Hep A + B

• No uprotected sex with known drug users to redue risk of Hep C

• Less alchol

• Avoid rapid weight loss

• low fat, low cholestol

• high fiber and calcium

More pregnancies increases risk for gallbalder disease

• Cardiac disease

• Renal disease

true

• Trendelenburg position

• Ambulation

• Abd massage

Pour over ice or chill in fridge

Shellfish, iodine

5-30 per minute

No BS in all 4 quadrents for 5 minutes

None for 30 seconds or less

Intestinal obstruction

Dull = mass such as organ Higher pitch = resonant = air/fluid

Can cause hyperglycemia due to high glucose content

• CBG testing q4h

• Must be given through central line

To avoid damage to mucosa

30 degrees during and for one hour after

NG,PEG

• Salem sump (into stomach) has pigtails

• NG tube (into stomach)

• Miller Abbott (into small intestine)

• Cantor (into small intestine)

• Harris (into small intestine)

• Levin (into stomach)

Instill a few milli of air into tube to clear

Is it blocked or open

Keep tubing leading into suction machine above the height of entry into drainage container

PH should be around 5 (proton pump inhibits can make higher)

• looks like bile

• Hold feeding if excessie residual is aspirated

Metabolic alkalosis

Lowered nutitonal abosorption

• Banannas

• white toast

• applesause

• rice

NO Coffee and tea

• thicken liquids

• sit upright with head forward and chin tucked

• keep suction equipment nearby always

• smoking

• alchol use

• HPV infection

• Oral lesions

Usually painless

BMI over 40

Limits how much stomach can hold

Decreases calorie and nurtient absoprtion

Both restrictive and malabsorptive

• gastric bypass RYGB

Gallstones due to liver secreting extra cholestol into bile

Obestiy = BMI greater than 30 Morbid Obesity = BMI greater than 40

Less than 6 wks

• x ray to check placement

• test PH

• Auctltating not relaibe

• long term

• not used if needed shorter than 4 wks

-Opened feeding formula = disgaurd after 24 hrs -Feeding bags filled by nurses with commercial foruma digaurd after 4-8 hrs

• Open systems change q24h

• Closed systems changed q24-48 hrs (bags pre filled at factory with formula)

Via gravity over 15 minutes, only for patients with intact gag reflex

Thorugh pump

15 mL

Flush with 30mL of water q4h during continuous feedings

• 30 mL of water after each residual check

• 15 mL before and after each med

Yes, stop feeding and clamp suction for 30 minutes before restarting after meds

Stores bile produced in the liver and delivers it to the small intestine.

Fluid in the abdominal cavity

dark

Stool will float in the bowl, if there is bile stool may be white

True

After bariatric surgery when large amounts of food and liquid pass into jejunum. Occurs 15-30 min after eating s/s:

• weakness

• dizziness

• tachycardia

• abd cramping **** may help to lie down for 30 minutes after eating****

Patient should be in private environment 20-40 min after a meal, digital stimulation is performed.

GERD is primary cause

• precancerous lesions

Lower esophagus/stomach slides up into diaphragm and thorax

• result of a defect in diaphragm wall

• more common in women

• cannot be seen

• No tight fitting clothes

• elevating HOB 6-8 inches

• not eating within 3 hours of bedtime

• avoid fatty foods

• reduce weight

• no lifting heavy weight

• Sit upright 2 hours after eating

True

Nutrient malabsorption of magnesium, calcium and b12

inflammation of stomach and small intestine

• caused by intake of food/water contaminated with a virus (norovirus for example)

Inflammation of MM on stomach lining (atrophic involves all layers)

• usually caused by H-pyloi bacteria

H-pylori causes erosion of the gI mucosa, making it easily damaged by gastric juices.

• massive hemorrhage can occur from ulcer

• H-pylori, smoking, NSAIDS are major causes

• H-pylori causes erosion of the gI mucosa, making it easily damaged by gastric juices.

• Hot spicy foods and caffeine NOT PROVEN as a cause, but make s/s worse

• more likely to hemorrhage

• most likely caused by unrelieved stimulation of the vagus nerve

• r/t being severely ill, burn patients, trauma patients, ect.

Pain relieved with meals and in morning (when secretion is low), and high before meals and at bedtime

• Usually discovered late because patients lack s/s

• H-pylori, nitrites and nitrates in foods = risk factors

• anemia like symptoms due to blood loss in GI tract, may see blood in stool

Altered motility of the small and large intestine

• no known cause

• Change in bowel elimination (constipation, diarrhea or both)

• Abd pain and bloating relieved by defecation

• Absence of detectable disease

• Mucus in stool

Lower left abd

• high fiber diet encouraged

Mechanical = tumors, twisting of bowel, strangulated hernias, adhesions Non-mechanical = absence of peristalsis

Fowler position to lower pressure

• measure abd girth q 2-4 h

Reducible = organ can be pushed back into place by pressing Incarcerated = organ is tightly wedged outside cavity, cannot be re-set

Strangulation leading to necrosis

hernia in the groin area

• may disappear when lying down

• avoid lifting

• brace site when coughing, sneezing

Mesh places, or a truss to re-enforce the weakened cavity wall

Ulcerative colitis (UC) and crohn's disease

• more common in Jewish population

• attacks of diarrhea

UC: inflammation of rectum/colon Crohn's: masses of inflamed tissue in small intestine with "cobblestone" appearance

UC

Low fiber!

• high protein

• low fat

true

Halfway between the umbilicus and the crest of the ilium at McBurney point (LRQ)

• pain when extending leg, walking

COLD. Never hot. Hot can cause rupture of the appendix.

• Also laxatives can cause rupture

• Inflammation of the peritoneum... usually occurs when one of the enclosed organs ruptures and contents spill out (ie appendix bursting)

• peristalsis slows/stops CAN BE FATAL

• board like abd rigidity

• rebound tenderness

• fever, chills, ect. Keep pt semi fowler, turn and move gently

• people most at risk = those with GI disorders such as UC

• polyp like growths that cancer grows from

• colonoscopy can help find polyps early and remove them b4 cancerous. Routinely starting at 45

• change in bowel habits

• weight loss

• bowel obstruction

Ascending, Transverse, Dissenting, Sigmoid (all frogs dislike salt)

Dark red/pink

• purple or black could mean necrosis

• when disease causes the need to bypass the entire colon

true

Chronic scarring of liver from disease such as

• alcholism

• Hep B and C

• Blood vessels also begin to fail and leak into the abd

True

• Rash

• Leg and food edema

• Bleeding and bruising due to vit k defficiency

• Palpable nobby liver under right rib cage

• Abd distention/acities

• Spider angiomas

• Dark and foamy urine

• Clay colored stool

• Jaundice

Complication of liver cirrosis

• caused because normal blood flow to the liver is diverted to veins of stomach/esophagus

• vein walls rupture, massive bleeding occurs

• Tx by vasopressin

Complication of liver cirrosis

• Build up of toxins/ammonia due to liver failure

• S/S: confusion, coma, flapping tremors of hands

-Lactulose given to lower intestinal absorption of ammonia

Occurs as liver failure progresses

• breath with a sweet, fecal odor

Inflammation of the pancreas (acute)

• frequently accompanies gallstones blocking pancreatic duct

• most common cause = alcoholism

• pseydocysts may occur (sac like structure around the pancreas, danger of hemorrhage if rupture occurs)

• Left upper quad pain, eating makes pain worse

• Lowered BS

• gaurding and tenderness of abd

• Most common in men who have been drinking for years

• Abd pain

• weight loss

• mild jaundice

• DM develops

• dark urine