GI Level Three MGCCC Level Three

GI Level Three MGCCC Level Three

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Question Answer
Which quadrant is the liver located in? RUQ
Which two viral hepatitises are vaccine preventable? A and B
mode of transmission for hepatitis A? Fecal Oral
mode of transmission for hepatitis B? sexual fluids and blood/blood
mode of transmission for hepatitis C? blood to blood
mode of transmission for hepatitis D? travels with B
mode of transmission for hepatitis E? travels with A
liver specific symptoms of hepatitis? jaundice and pale stools
preventative care for hep a vaccine, immune globulin, hand-washing, personal hygiene
preventative care for hep b hep B vaccine and immune globulin
preventative care for hep c safe sex, no drugs
preventative care for hep d hep B vaccine
preventative care for hep e experimental vaccine, travel precautions such as bottled water, good hygiene
care for hep a bed rest and push food/fluids
care for hep b interferon treatment and supportive care
care for hep c interferon treatment and antivirals
care for hep d interferon treatment under investigation
care for hep e support, exersize, rest, push food and fluids
what should be avoided with hepatitis? caffeine, artificial sweeteners and fruit juices
where does UC affect? Large instestine both mucosa and submucosa
where does Crohns affect? anywhere on GI tract, but most commonly the distal 1/3 of the small intestine
rectal bleeding is common in which IBD? UC
abdominal pain is common in which IBD? Crohns
fistula and stricture common in which IBD? Crohns
appearance of tract w/ Crohns discontinuous pattern w/ cobblestone appearance with thickened wall
appearance of tract w/ UC continuous hemorrhagic and ulcerated mucosa with psuedopolyps and lack of pouches on colon
toxic megacolon appears with UC
10-20 bloody. loose stools per day UC
may have obstruction or 5-6 loose stools Crohns
what can cause a beefy red tongue B12 anemia
what will labs show with IBD low H&H, low serum albumin, high ESR, and abnormal liver function
what happens with toxic megacolon no peristalsis so gas sits in colon and dilates it causing abd pain and distention which allows bacteria to leak to blood stream
S&S of sepsis r/t UC sharp decrease then increase in temp
the removal of colon does what for UC and what for Crohns? UC- curativeCrohns- removes segment only
what type of diet is needed w/ IBD? high protein, high kcal, low residue
give example of foods to avoid with IBD high residue foods like whole wheat, nuts, raw fruits, and vegetables should be avoided
inflamed and edematous appendix resulting form kink or occlusion by pus or stool appendicitis
S&S of appendicitis RLQ pain, temp, N/V, McBurney's point (RLQ pain), and increased WBC
what happens if appendicitis isnt treated w/in 36 hrs gangrene and can lead to peritonitis
what is the cardinal sign of peritonitits rigid, board-like abdomen
those who had recent trauma are at risk for what? peritonitis
paralytic ileus can occur with what peritonitits
distinguishing sx of chronic pancreatitis frequent oily stools with weight loss and elevated CBG
common causes of pancreatitis ETOH and gallstones
diet for pancreatitits low fat with enzyme supplements
where is pain r/t pancreatitis located? LUQ/midepigastric radiating to back
S&s of acute pancreatitis pain aggravated by eating and not relieved by vomiting, flushing, cyanotic, dyspnic, absent bowel sounds, low BP, high HR, possible lung crackles, psudeocysts, and abscess, jaundice, temp, and Cullen's signs (bruising around umbilicus)
main concerns for acute pancreatitis actelectasis, pnuemonia, low BP, tetany r/t hypocalcemia
what should be done to prevent shock r/t acute pancreatitis hang plasma volume expanders like dextran, albumin
what orders should be expected with acute pancreatisis NPO, NG tube, peritoneal dialysis/lavage
diet for acute pancreatitis once stable small frequent meals, with high carb, low fat, and high protien, bland, with no stimulants, and fat soluble vitamins
what should be given to combat low BP r/t acute pancreatitis dopamine
what should be given to combat F&E imbalance r/t acute pancreatitis LRs
which vitamins are fat soluble? ADEK
how should a pt be positioned with acute pancreatitis side lying w/ HOB elevated and knees to abd
what F&E imbalances are r/t acute pancreatitis hypocalcemia and hypomagnesia
s&S of hypocalcemia tetany(muscle cramping and contraction), numbness of lips and fingers, and postive chovestek's (contraction of hyperexcitbale facial muscle) and trousseaus (carpal spasm induced by BP cuff)
s&s of hypomagnesia muscle weakness, confusion, irritability w/ insomnia
bile salts can be used to help absorb fat solube vitamins w/ chronic pancreatitis
peripheral nueropathy, ascites, palmar errythema, edema, spider anginomas, changes in LOC, anemia, esophageal varices, hepatogmegaly, splenomegaly, and jaundice S&S of cirrhosis
nursing interventions for cirrhosis elevate HOB, weigh daily, restrict Na and fluids, diruetics
diet for cirrhosis high protien
thin-walled irritated veins that rupture esophageal varices
whats a Blakemore tube gastric intubation that allows a balloon to put pressure against bleeding varices
why is lactulose ordered w/ cirrhosis to decrease immonia and facilitate its excretion in bowel
labs w/ cirrhosis low H&H and elevated WBC
what vitamin is commonly adminstered w/ cirrhosis Vitamin K
what usually causes liver cancer chronic cirrhosis, hep B/C
what protein is elevated w/ liver cancer? AFP (alphafetoprotein)
focus on care for liver cancer poor prognosis so usually palliative
considerations for TPN administer through central line w/ inline filter, change tubing w/ bag, asepctic, monitor CBG, titrate slowly

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