GI Review

The pancreas has 2 separate functions:
Endocrine - _________________
Exocrine - ________________
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The pancreas has 2 separate functions:
Endocrine - _________________
Exocrine - ________________
Endocrine - Insulin
Exocrine - Digestive enzymes
Auto-digestion of the pancreas
Pancreatitis
A client presents w/ pain that increases w/ eating, ascites, abdominal mass, rigid board-like abdomen w/ guarding, Cullen's sign, Gray-Turner's sign, fever, N/V, Jaundice, & hypotension. The nurse suspects
Pancreatitis
Bruising in the flank area
Gray-Turner's sign
Bruising around the umbilical area
Cullen's sign
Any time there's an occlusion in the pancreas (scar tissue, gallstones) the digestive enzymes cannot get, & the enzymes begin digesting the pancreas. This is known as
Pancreatitis
What is the most specific enzyme for pancreatitis?
Lipase
Normal lipase
0-160
Normal Amylase
30-220
When caring for a client w/ pancreatitis, it's important to keep the stomach
Empty & dry
When caring for a client suspected of having pancreatitis, the nurse would expect to see an increase in what lab values?Lipase & Amylase WBCs BG ALT & AST PT & aPTT Bilirubin HematocritWhy would a client w/ pancreatitis have an elevated hematocrit?DehydrationWhy would a client w/ pancreatitis have decreased Hgb?BLEEDINGIf your liver is sick, what is your #1 concern?Bleeding!When your liver is sick, _____________ the dose of medicationsDecreaseNever give what medication to people w/ liver problems?AcetaminophenWhat organ detoxifies the body, helps blood clot, helps metabolize drugs, & synthesizes albumin?LiverA client presents w/ abdominal pain, chronic dyspepsia, change in bowel habits, ascites, splenomegaly, decreased serum albumin, increased ALT/AST, anemia, & a firm nodular liver. The nurse suspectsCirrhosisWhen caring for a client w/ cirrhosis, the nurse palpates an enlarged spleen (splenomegaly). The nurse knows that this is a sign that the ___________________ system has kicked inImmune systemWhat diagnostic test confirms the diagnosis of a cirrhosis?Liver biopsyWhat information should the nurse gather on a client pre liver biopsy?Vital signs PT, INR, & aPTTHow do you a position a client for a liver biopsy?Supine w/ R arm behind headThe nurse should instruct the client who's about to undergo a liver biopsy to ___________________________ to get the diaphragm out of the wayExhale & hold breathWhat position should the nurse place a client in post liver biopsy?Right sideWhen you eat protein, it breaks down into ____________, & the liver converts it to urea.AmmoniaWhen the liver becomes impaired, what chemical builds up in the blood?AmmoniaWhat affect does ammonia have on LOC?Decreases LOCA client is experiencing minor mental/motor changes, difficulty awakening, asterixis, handwriting changes, decreased reflexes, slow EEG, & fetor. The nurse suspectsHepatic comaLactulose, enemas, decreased protein diet, & monitoring ammonia levels are expected treatments for the client withHepatic comaWhat medication lowers BP in the liver & used in the treatment of bleeding esophageal varices?Octreotide (Sandostatin)Any time someone is anemic _______________ is neededOxygenWhat are the most common procedures used for esophageal varices?EVL or Endoscopic SclerotherapyBanding procedure performed on clients with esophageal varicesEVLProcedure where the HCP injects a sclerosing agent into the varices via an endoscopeEndoscopic SclerotherapyType of balloon tamponade tube used to hold pressure on esophageal varicesSengstaken-Blakemore TubeEmergency procedure used to stabilize clients with severe hemorrhage secondary to esophageal varices ruptureBalloon tamponadeSengstaken-Blakemore tube should not be used for more than ____ hrs12 hoursA client attempts to pull their Sengstaken-Blakemore tube, it is now obstructing their airway. What is the immediate action by the nurse?Deflate the balloon - cut it w/ scissors if have toA client presents with burning mid-epigastric pain & heartburn (dyspepsia) the nurse suspectsPeptic ulcerWhat procedure is performed on clients w/ peptic ulcers?Gastroscopy (EGD)Is a patient NPO & sedated for a Gastroscopy?YesW client who underwent a Gastroscopy must remain NPO until _________ returnsGag reflex returnsClient appears malnourished, pain lasts 30 min-1 hr after meals, food doesn't help, but vomiting does, vomiting blood. Gastric or Duodenal ulcers?Gastric ulcersClient appears well-nourished; night time pain is common & occurs 2-3 hrs after meals, food helps, blood in stools. Gastric or Duodenal ulcers?Duodenal ulcersCongenital abnormalities, trauma, straining, & large abdomen (overweight) are all causes ofHiatal herniaA client presents w/ heartburn, fullness immediately after eating, regurgitation, & dysphagia. The nurse suspectsHiatal hernia