Management of Gastrointestinal Disorders (Gastroenterology) Questions With 100% Correct Answers 2023 Update

What patient history is gathered regarding GI functioning - ANS--patient and family history Question about -Change in appetite, weight, bowel pattern, skin color, turgor, bloating -Alcohol, caffeine ingestion -Pruritis -Ecchymosis/bleeding (sign of liver disease) -Pain (what is it associated with?) -recent travel outside of US -meal patterns/cultural practices -prescribed and OTC drugs -presence of food/drug allergies -laxative use/abuse -previous GI disease and surgery What organ manufactures clotting factors - ANS-liver GI diagnostic lab assessments - ANS--CBC -Prothrombin Time (PT) & Partial Thromboplastin Time (PTT) -Electrolytes -Bilirubin (breakdown of RBC and indicates obstruction, jaundice) -Liver enzymes -Aspartate aminotransferase (AST ) -Alanine aminotransferase (ALT) -Albumin (decrease = malnourishment) -Amylase, lipase (increase = pancreatitis) -Ammonia (increase = liver disease, confusion) -Oncofetal antigens (marker for GI cancer) What are the 3 types of abdominal diagnostic tests - ANS--flat plate of abdomine (KUB) -CT or CAT scan -MRI *more definitive and contraindicated with pacemaker* What is the upper GI series (UGI) -what should the nurse expect - ANS--visualizes esophagus, stomach, duodenum, and jejunum via oral contrast -nurse should expect laxative post procedure to expel contrast (contrast can cause constipation) What is a Barium enema (lower GI series) -what should the nurse expect - ANS--outlines large intestine thru contrast dye -nurse should expect laxative pre and post procedure to expel contrast What is the pre-procedure for endoscopic procedures - ANS--consent -IV access -sedation (midazalam) -stop metformin and anticoags 7 days prior -NPO after midnight -Bowel prep What is the post-procedure for endoscopic procedures - ANS--frequent vitals (q15) -safety (check swallowing reflex) -Diet (no heavy meal) -Education: teach patient about abdominal pain (possible tear), fever(peritonitis), new unresolved n/v What is an esophagogastroduodenoscopy - ANS--visualizes esophagus, stomach, and duodenum -direct visualization and specimens: biopsy and testing What is an endoscopic retrograde cholangiopancreatography (ERCP) - ANS--visualizes liver, gallbladder, bile ducts, and pancreas -used more to relieve obstructions than for diagnosis *explores bile ducts* What is a capsule endoscopy - ANS-- Patient swallows a small capsule with a camera. - Sends images to a monitor on the patient's waist/shoulder. - Images reviewed. -Bowel prep -only diagnostic What is a colonoscopy - ANS-visualizes anus, rectum, and colon -bowel prep -NPO after midnight What is involved in the care of a patient Post Colonoscopy - ANS-Assess for: -over sedation -bleeding -aspiration -perforation Diet Safety How is a bowel obstruction diagnosed - ANS--physical assessment -radiologic exams -endoscopic exam -laboratory tests What are some non mechanical bowel obstruction interventions - ANS--NPO -NG tube suction -IV fluids -analgesics -activity -assessment: bowel sounds What are the interventions for mechanical bowel obstructions - ANS--Surgery What are the 4 complications of bowel obstructions - ANS-*secondary to emesis* -dehydration -electrolyte imbalance *secondary to malabsorption* -metabolic alkalosis -metabolic acidosis What is gallbladder disease? - ANS-inflammation, infection, stones or blockage of the gallbladder What is cholecystitis - ANS-inflammation of the gallbladder What is choledocholithiasis? - ANS-stones in the common bile duct What are risk factors for gallbladder disease - ANS-1. Women, age 60+ 2. High fat diet 3. Family history 4. Obesity 5. Rapid weight loss 6. Prolonged fasting, TPN -assessment: bowel sounds What are the interventions for mechanical bowel obstructions - ANS--Surgery What are the 4 complications of bowel obstructions - ANS-*secondary to emesis* -dehydration -electrolyte imbalance *secondary to malabsorption* -metabolic alkalosis -metabolic acidosis What is gallbladder disease? - ANS-inflammation, infection, stones or blockage of the gallbladder What is cholecystitis - ANS-inflammation of the gallbladder What is choledocholithiasis? - ANS-stones in the common bile duct What are risk factors for gallbladder disease - ANS-1. Women, age 60+ 2. High fat diet 3. Family history 4. Obesity 5. Rapid weight loss 6. Prolonged fasting, TPN 7. Diabetes, glucose intolerance 8. Pregnancy 9. Birth control pills 10. Hormone replacement 11. Crohn's disease 12. Gastric bypass surgery 13. Sickle cell anemia 14. American Indian 15. Mexican American What are the signs and symptoms of gallbladder disease - ANS-1. Anorexia 2. Nausea, vomiting 3. Dyspepsia 4. Flatulence 5. Feeling of fullness 6. Intense pain after consuming high calorie fatty diet 7. Sudden onset of sharp pain @ RUQ1. Anorexia 2. Nausea, vomiting 3. Dyspepsia 4. Flatulence 5. Feeling of fullness 6. Intense pain after consuming high calorie fatty diet 7. Sudden onset of sharp pain @ RUQ...