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165 terms

GI Final

GI Final & additional GI info Sorry for any misspelled words.
STUDY
PLAY
Mouth
Mastication: chewing
Saliva
Salivary glands produce about 1.5 liters of saliva daily
Salivary amylase (ptyalin) begins to break down starch (inactivated in the stomach)
Salivary lipase: begins fat digestion, but has minimal effect
Mucus to lubricate the food for easier swallowing
Lysozyme to kill bacteria
Tongue
Taste receptors: sweet, sour, salty, bitter, savory
Enzymes to help break down fatty acids
GI System
What breaks down food & prepares it for absorption
Non-absorbable substances pass through & are eliminated as solid waste
Solid Waste
Non-absorbable substances pass through & are eliminated as?
Liver, Gallbladder, Pancreas
What are other essential accessory components that aid the GI System in the break down of food & prepares it for absorption?
GI Tract
The primary function of the ________ is to
Metabolize toxic agents
Produce clotting factors
Provide nutrients needed for metabolism
Caries
Another term for Tooth Decay. Breakdown of tooth enamel, later invades dental pulp
Bacteria
Caries is caused by____________ which is nourished by foods particles left on teeth-faulty brushing/flossing-plaque on teeth & sugar in the mouth.
q6 month, twice a year
How often should adults have their teeth checked and cleaned?
Periodontal
What disease Affects bones & tissues around teeth?
Gingivitis
Inflammation of the gums
Pyorrhea alveolaris
Inflammation of gums & teeth (purulent discharge)
Systemic Infection
If Pyorrhea alveolaris is left untreated can cause
antibiotics & extraction
Treatment for pyorrhea alveolaris includes- surgical scraping & drainage, _________ & ___________
Stomatitis
inflammation of the oral mucosa; Caused by:
Primary: Virus & Fungi
Secondary: Irritants
Acute Herpes Simplex virus
small clear vesicles in single or multiple eruptions. Lasts 10-14 days. (viral stomatitis).
Candida albicans AKA Thrush
What fungi that causes a form of stomatitis is characterized by raised white patches & ulcers, can spread to other areas of GI tract, skin or resp. tract.
Tx Mycostatin swish & swallow
Irritants; Secondary
__________ aka toxic agents such as tobacco, alcohol, chemotherapy or radiation cause __________ lesions.
Mouth; anus
The GI Tract begins and ends where?
24-36 hours
How long does food take to move completely thru GI tract?
Tenesmus
Painful abdominal cramps or spasms
Dyspepsia & pyrosis
Heartburn aka indigestion
Micelle
Formed by bile salts , which are colloid (glue-like) particles, most often arranged in a parallel chain. Transport digested fats to the intestinal villi for absorption, then absorbed into lacteals->lymph.
anastomosis
The place where the two ends of the digestive system are joined together.
cachexia
General ill health & malnutrition
dumping syndrome
aka rapid gastric emptying is a condition where ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested.
paralytic ileus
Intestinal paralysis
insufflation
Clients feel the air being instilled into the bowel.
mastication
chewing
steatorrhea
fatty stools that float
fistula
abnormal channeling between loops of bowel.
Currant Jelly Stools
Stools that contain primarily blood and mucus., movements of blood and mucus that contains no feces; common about 12 hours from the onset of intussisception
Anthelmintic
capable of expelling or destroying parasitic worms
chelating agent
a substance that forms complex ions with metal ions in solution
colic
acute abdominal pain (especially in infants)
invagination
the condition of being folded inward or sheathed
Kussmaul breathing
gasping, labored breathing, also called air hunger
kwashiorkor
a form of protein deficiency, most often seen in starving children, characterized by retarded growth and abdominal distention caused by liver enlargement
lactose
a sugar comprising one glucose molecule linked to a galactose molecule
marasmus
a condition caused by a diet low in calories AND protein. Children are usually thin, shriveled and tiny.
pruritus
severe itching
urticaria
hives; an eruption of wheals on the skin accompanied by itch
craniotabes
benign congenital thinness of the top back of the skull of a newborn.
pyloric stenosis
narrowing of the pyloric sphincter
dysphagia
difficulty in swallowing.
bolus
lump (of food)
Chyle
a milky fluid consisting of lymph and emulsified fats
emulsify
break fats into smaller droplets
peritoneal cavity
The space within the abdomen that contains the stomach, intestines, liver, gallbladder, pancreas, spleen, reproductive organs, and urinary bladder.
HCI
Hydrochloric acid; a digestive juices produced in the stomach; when protein content of the stomach rises, so does the HCI content; HCI helps buffer the PH of the stomach
H. pylori
Helicobacter Pylori:
a bacteria that may cause inflammation of the stomach lining and peptic ulcers in some people.
ileostomy
creation of a new opening through the abdominal wall into the ileum
colostomy
creation of an opening in the colon through the abdominal wall to create an abdominal anus allowing stool to bypass a diseased portion of the colon; performed to treat ulcerative colitis, cancer, or obstructions
Celiac Disease
Also know as gluten-sensitive enteropathy. A permanent intolerance to gluten, the protein component of wheat, barley, rye and oats.
coffee ground emesis
Coffee-ground emesis is vomiting of dark brown, granular material that resembles coffee grounds. It results from upper GI bleeding that has slowed or stopped.
Endoscopic Retrograde Cholangiopancreatography
ERCP is an ______ _______ __________ _________, direct visualization of the esophagus, stomach, duodenum, ducts of the pancreas & biliary tract structures.
Achalasia
A motility disorder of the lower portion of the esophagus in which food cannot pass into the stomach.
Hernia
An abnormal protrusion of intestine thru the muscle, can also develop around an incision or stoma.
Reducible Hernia
One that may be pushed back into the intestine by lying down & pressing on the abdomen.
diaphoresis
sigh/symptom that indicates shock; excessive perspiration, may result in wet clammy feeling when the skin is touched
Antacids
Used: Indigestion, reflux esophagitis & peptic ulcers & oth gastric irritants.
Ex: Aluminum Hydroxide (Amphojel); Magnesium, & Alum Hydro & magesium combo (Gelusil, Maalox, Mylanta)
Works by: Neutralize gastric acid, inhibit gastric acide secretions, provides mucosal protection.
Other Affects: can decrease absorp of other antacids, iron, quinolones, tetracycline and EC tabs.
Aluminum Hydroxide
Which antacids can cause constipation?
Magnesium Hydroxide
Which antacids can cause diarrhea?
Histamine2-Receptor Antagonists (H2 Blockers)
Used: Heartburn, prevent or treat active duodenal u. & gastric hypersecretion, prophylaxis for stress ulcers.
Ex: Cimetideine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), nizatidine (Axid)
Other affects: Allow 1hr betwn eating or doses of antacid & takiung H2 Blockers. dizziness, confusion,caution in elderly.
Proton Pump inhibitors (PPI)
Used: Esophagitis, GERD, gastric & duodenal ulcers, NSAID-related ulcers, & H.pylori
Ex: esomeprazole(Nexium), lansoprazole (Prevacid), omeprazole (prilosec), pantoprazole (Protonix), rabeprazole (Aciphex)
Other: take whole, may interfere with metabolism &/or absorp of oth drugs. read drug effects.
Cholinergic Blockers
Used: Adjunct therapy for peptic ulcer dis
Ex: glycopyrrolate (Robinul), mepenzolate bromide (Cantil), methscopolamine bromide (Pamine),propantheline (Pro-Banthine)
Other: Ck for GI Bleed, Abd pain, Avoid GI irritants
Miscellaneous Antiulceratives
Used: Short-term Tx & prevention of gastric, duodenal, & stress ulcers, used separately or in conjunction w/oth antacids/antiulceratives to destroy gastric acid by neutralizing all or part of the acid, absobing the acid, or making acid inactive.
Other: May decrease absorp of other drugs. M
Bismuth subsalicylate may darken tongue or stools. Sooths, topical protective coating on the stomach mucosa.
H. pylori Meds
Antibiotic therapy cobos of amoxicillin, clarithromycin (Biaxin), tetracycline, and/or metronidazole (Flagy) with H2 blocker
75%
H. pylori is found in about _____% of duodenal ulcers.Many do not develop an ulcer. Most of the remainder of ulcers are caused by NSAIDs.
GI Meds
Antidiarrheals, Antiemetics, Emetics, Laxatives & Cathartics, Stool Softeners, Antilipidemic.
Bulk Forming
GI Meds: methylcellulose (Ctrucel), polycarbophil (FiberCon), psyllium (Metamucil)
Lubricant
GI Meds: Mineral oil (Fleet Mineral Oil Enema)
Hyperosmotic
GI Meds: lactulose (Cephulac)
Saline Cathartic
GI Meds: magnesium sulfate, polyethylene glyco-electrolyte solution (Golytely)
Cathartic/Purgative
GI Meds: senna (Senokot), bisacodly (Dulcolax), sodium phosphate & sodium biphosphate (Fleet Phospho-Soda)
IBS
teaserod maleate (Zelnorm)
Surfak
Stool Softener
GERD Meds
Meds: H2Blockers, proton pump inhibitors (PPIs), GI stimulants, cholinergics, and antacids such as Mylanta, Rolaids, or Tums.
Prevacid (Lansoprazole) & Nexium (Esomeprazole)
Which GI Meds: Reduce the secretion of gastric acid by inhibition of the hydrogen-potassium adenosine triphosphate (ATPase) enzyme system of the gastric parietal cells.
Liqu 1-2 hrs, Solids 2-3 hrs (~1-4 or 5 hrs)
How long does food take to empty from the stomach?
3-6hrs
How longs foods takes to absorb in the small intestine
(Taken from the internet)
colo-rectal (colon cancer)
Risks for ___________Cancer are: Family Hx of _______, hx of polyps; precursors of ________cancer; Hx of IBD, & a diet high in fat & protein & low in fiber. pg 1365 RD
Hep A & E
What forms of Hepatitis are not chronic?
Hep B, C, D
What forms of Hepatitis have no cure (chronic)?
Interferon & Ribavirin
What is a Trmt for Chronic Hep B & Hep C?, an antiviral protein produced by cells that have been invaded by a virus
Hep C or HCV
Hep___? 6-7 wks Average, Range 2-26wks, s/s Clinical Janundice 30-40% (20-30% )Illness Chronic Hep 70%; Persistant Infection 85-100%; immunity/none; no protection, antibody, resp volentify. ______: Most contagious, Blood & Body Fluids, Mod. Contagious: Saliva, Semen, Vaginal; Mild Contagious: Sweat
Hep B or HBV
Hep _____: Vaccine 1mo-1mo-6mo, Booster, Easier to get
HBV & HCV: Most contagious, Blood & Body Fluids, Mod. Contagious: Saliva, Semen, Vaginal; Mild Contagious: Sweat
No immunization
Hep A or HAV
Hep___: Oral Fecal, Water, and Food:, Community Living; Vaccine for child only. Tx: Immunity Serrum Globilin for those Infected as Propylatic.
Hep D or HDV
Which hepatitis is a coinfection with HBV?
Hep E or HEV
Which hepatitis is rare in the USA?
Peritoneal cavity
Where are these organs located: stomach, intestines, liver, gallbladder, pancreas, spleen, reproductive organs, and urinary bladder.
Digestive
The ________System consist of the Mouth, Salivary glands (Parotid, Sublingual, Submandibular), Pharynx, Trachea, Esophagus, Stomach, Diaphragm, Liver, Gallbladder, Duodenum (of small intestine)Common bile duct, Spleen, Pancreas, Large intestine (transverse colon), Small intestine, Cecum Appendix, Sigmoid colon, Rectum, Anus
Accessory Organs
The, pancreas, gallbladder, liver, salivary gland are known as the ________organs
Pancreas
What organ Produces Glucogon & Insulin; Manufactures digestive Enzymes: amylase(starch/CHO & Trypsin(protein), peptase (fats/tricly); supplies Bicarb to neutralizee HCL/Chyme. pg 272 RD
Gallbaldder
What organ Stores & Releases Bile; small Intestine releases CCK, causes Gallbladder to contract (Peptids, amino), Salts to process fat, holds 2 oz of bile as.
Liver
What organ Largest Gland; Detoxifier; Bile-Emulsifies fats; stores glucose (as glycogen); Heparin-Anticoagulant; Plasma proteins Albumin-Provides osmotic pressure for blood pressure;Fibrinogen-Necessary for blood clotting;Prothrombin-Necessary for Blood Clotting;Globulins-Forms immunoglobulins(antibodies). filters blood;breaks down fat & protein;stores protein, fat, CHO & minerals, incl iron;Prepares waste (urea); absorbs bilirubin; Regulates amino acids Produces body heat; Detoxifies poisons; Forms vit A; stores vit A,D,E,K, & B complex Forms triglycerides & cholesterol. pg 272
Salivary Gland
Parotid, Sublingual, Submandibular are called the _______ Glands; the produce 1.5 liters of Saliva a day.
Liver Gland
What gland acts as the detoxifier; blood clotting Vit. K; Glucose Storage; Produces Bile (Fat Emulsifier); Synthesizes Amino, Protein, Vit. & Fats; Biliary Ducts aka Hepatic Ducts: Cystic Gall Duct, Hepatic Duct & Pancreatic Duct join in on common bile duct.
A, D, E, K
What are the fat soluble vitamins?
B, C
What are the water soluble vitamins?
Macronutrients
What type of nutrients are Carbohydrate, fat, & protein provide energy? page 301 RD
Micronutrients
What type of nutrients are Vit & minerals; regulate body processes?
Small Intestine
92-97% of nutrients absorb in the?
Large intestine
Water absorbs in?
Diarrhea
What is characterized by Loose freq Watery Stools,light in color, foul smelling. May contain mucus, pus, blood or fats. x?(high frequency)
Constipation
What is characterized by Hard, dry stool that is difficult to pass?
Obstipation
What is characterized by constipation that is now impacted?
4-6; bleeding.
After Liver Bx, LVN positions pt on their R side, applys pressure for _____ hrs, using sandbag or blanket to prevent _________.
Vital Signs
after Liver Bx, LVN takes _________ q 15mins for 1hr, q 30min for 4hrs; hourly for 8 hrs.
Shock
After Liver Bx, hemorrhage into abd from puncture site may occur; LVN watches for signs of _______
LVN
It is the responsibility of the _______ (medical staff) to Explain the procedure; assist client maintain proper position during procedure; wear gloves, stay w/client for support & encouragement.
Right
After Liver Bx, the Lvn positions pt on there _____side.
CCK; cholecystokinin
inhibits gastric glands, stimulates pancreas to release enzymes, stimulates GB to release bile
Gallbladder
What stores & releases bile?
Stomach
Mechnical & Chemical digestion occur in ?
Mouth
Starch digestion BEGINS in the ______ and CONTINUES in the stomach pg 273 RD
Duodenum
Fats are digested in the ________ small intesting using CCK.
Proteins
_______ is broken down by pepsin in the stomach and the, protein get further broken down into amino acid and absorbed in the Small Intestine
Villi
Fingerlike projections on the small intestine( capillary network) absorb 85% of nutrients to bloodstreem to cells, by hepatic portal.
Microvilli
microscopic folds of the cell membrane, covers each villi
Lacteals
What are the dead-end lymph capilllaries in each villi that absorb fat soluble nutrients ->lymph system -> thoracic?
parasympathetic nervous system
What system stimulates digestion & peristalsis (per Mrs. Dicson)
Hemorrhoids
Swollen (varicose veins of the anus or rectum) are called?
Cholecystogram
A diagnostic test that outlines the gallbladder & any existing gallstones?
Gastric Ulcer
s/s of _____ _____ are Vomiting blood or passing melena (ext hemorrhage. If bleeding massive, signs of shock-pallor, weak & rapid pulse, low blood pressure, faintness & collapse, coffee-ground emesis; if small & gradual, blood in stool. pg 1354 RD
white & chalky
After a barium enema, stools appear ______ & ______ pg 1338 RD
paracentesis
Medical term for abdominal tap?
Abdominal Tap
aka paracentesis, a procedure that may be necessary for diagnostic purposes or to relieve ascites, for diagnostic study, for culturing when bleeding or infection is suspected. Therapeutic abd tap if pt is distended w/ascetic fluid, help pt breath better. pg 1349 RD
Ultrasound; catheter
_____________may be used to guide the aspiration of fluid from the abd w/a large syringe & needle. A _________ may be inseerted into the abd cavity for cont. drainage. pg 1349 RD
ascites
What is fluid accumulation in the peritoneal cavity called?
pg 1349 RD
Hiatal hernia
What medical term is used to describe when a Part of the stomach protrudes through the diaphragm's esophageal hiatus (gap or cleft through which the esophagus passes). Weakening of the diaphragmatic muscles a gastroesophageal junction, trauma, or congenital. pg 1352
Appendicitis
What does rebound tenderness at the McBurney's point indicate? pg 1362 RD
Gastroenteritis
Medical Term for Stomach & intestinal inflammation-Overeating, ingesting irritating medications, poisonous food, abusing alcohol or microbial infection.
Ulcerative Colitis
Medical Term for Inflammation & ulceration of mucosa & submucosa (colon's lining), can span entire length of colon, freq begins in the rectum & distal colon. pg 1361 RD
gastroscopy
Examination of the upper GI tract with a gastro scope - Tabers p934)
Low-residue & increased
The diet recommendations for A pt w/ Ulcerative colitis or Crohn's disease is _______ & _________ protein diet, decreased lactose intake, vit supp, pg 1361 RD
Zenker's Diverticulum
herniation of the mucous membrane of the esophagus through a defect in the wall of the esophagus. The location is usually in the posterior hypopharyngeal wall. Small diverticuli are asymptomatic.
s/s of Zenker's Diverticulum
Large ones trap food and may cause esophageal obstruction, dysphagia, or the regurgitation of food. Treatment is surgical or endoscopic. also Bad breath.
Hirschsprung's disease
aka Congenital Aaganglionic Megacolon: Persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Absence of parasympathetic ganglion cells within the muscular wall of the distal colon & rectum.
Gavage Feeding
Another name for enteral tube feeding, tube passed into the stomach through the nose or mouth. Infant/Older child. do not chk with inserting air(not reliable anymore) aspirate stomach content instead/ph acidic.
4-12 hr
pre-operative care for a young child, when NPO status would begin?
loses; dehydrated; projectile
A Baby suffering from pyloric stenosis is fussy, hungry, _____weight, becomes dehydrated; vomits milky substance, later______vomiting. Surgical correction necessary.
Pyloric Stenosis
Medical Term for Congenital anomaly. Increase in size of the musculature at the junction of the stomach & small intestine occurs, causing pyloric opening to constrict. Food can't pass thru.
Hepatitis
A person can develop ______ if they contract one of the viruses that can cause liver inflammation, or as a result of exposure to substances that can cause hepatitis - alcohol, fungal toxins and certain medicines.
Gastric Ulcers
What type of ulcer is caused by A break in the mucous barrier mechanisms that normally protect the stomach's lining. Risk Factors: Stress, Ethol, Smoking, Nonsteroidal anti-inflamm drugs, aspirin, inf. w/H.pylori,High-pigastrium pain 1-2 hrs after meals, eating may not relieve, weight loss.pg 1354 RD
Hydrochloric Acid (Free)
a digestive juice produced in the stomach; when protein content of the stomach rises, so does the HCI content; HCI helps buffer the PH of the stomach.
Dark Urine
A pt w/ hepatitis usually has what color urine? pg 1367 RD
Hernia
An abnormal protrusion of intestine thru the muscle, can also develop around an incision or stoma.
Reducible Hernia
What hernia is One that may be pushed back into the intestine by lying down & pressing on the abdomen?.
Irreducible Hernia
What hernia Can not be manipulated back into the body cavity?
Incarcerated Hernia
an _________Hernia : Occurs when the intestine's peristaltic flow is obstructed.
Strangulated Hernia
A hernia that requires immediate surgical intervention, it interrupts blood flow to tissue, tissue necrosis (infarction).
Helicobacter Pylori
: a bacteria that may cause inflammation of the stomach lining and peptic ulcers in some people. not linked to esophageal ulcers.
ileostomy
creation of a new opening through the abdominal wall into the ileum.
Colostomy
creation of an opening in the colon through the abdominal wall to create an abdominal anus allowing stool to bypass a diseased portion of the colon; performed to treat ulcerative colitis, cancer, or obstructions
Celiac Disease
Also know as gluten-sensitive enteropathy. A permanent intolerance to gluten, the protein component of wheat, barley, rye and oats.
Coffee ground emesis
vomiting of dark brown, granular material that resembles coffee grounds. It results from upper GI bleeding that has slowed or stopped.
Peptic Ulcer Disease
: a break in the integrity of the mucosa of the esophagus, stomach, or duodenum; gastric or duodenal
Peptic Ulcer Medication
: Bismuth (H.Pylori; Histamine (H2), proton pump inhibitors & cytoprotective agents (misoprostol (Cytotec) & sucralfate (Carafate).
s/s Perforated Ulcer
Peritonitis & Sudden viciously sharp abdominal pains; pallor, diaphoresis, abdomen hardens. Rapid breathing; knees drawn up; pt flushed & feverish. Can be fatal, immediate surgery
Closure of perforation site to Gastro-enterostomy.
surgical TX for perforated ulcer
Billroth I
partial resection of the stomach with anastomosis to the duodenum. A gastroduodenostomy is a gastrointestinal reconstruction technique. It may be performed in cases of stomach cancer, a malfunctioning pyloric valve, gastric obstruction, and peptic ulcers.
As a gastrointestinal reconstruction technique, it is usually performed after a total or partial gastrectomy (stomach removal) procedure.
Billroth II
partial resection of the stomach with anastomosis to the jejunum. the surgical removal of the pylorus and the first part of the duodenum. The cut end of the stomach is anastomosed to the jejunum, which is pulled through the transverse mesocolon from the lower abdomen. The remaining duodenum carrying biliary and pancreatic secretions drains into the ileum through a new anastamosis in the lower abdomen. Also called gastrojejunostomy.
GERD
aka Esophageal reflux, occurs when the lower esophageal sphincter (LES) leading into the stomach is weak or relaxes inappropriately. allowing acidic stomach contents to move back up into the esophagus. pg 1352 RD
Valves or Sphincters
Epiglotis, Upper Esophageal Sphincter, Lower Esophageal Sphinter aka Cardiac Sphincter, Pyloric Sphincter, ileocecal valve, internal & External Rectum Sphincter