gi jeopardy! gi jeopardy!. 25 a & p gi tests upper gi problems lower gi problems 50 75 50 25 75 100...

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GI JEOPARDY!

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  • Slide 1
  • GI JEOPARDY! GI JEOPARDY!
  • Slide 2
  • 25 A & P GI Tests Upper GI Problems Lower GI Problems 50 75 50 25 75 100 75 100 150 200
  • Slide 3
  • A Name 3 physical factors and 1 psychological factor which can affect the function of the GI tract. (Be specific). A & P: 25 pts
  • Slide 4
  • Answer: A&P 25 pts Mobility Diet: Fat / Fiber / Spices ETOH / caffeine Medication: ASA / NSAIDS / APAP Antacids / Antibiotics Smoking Stress / Anxiety
  • Slide 5
  • A & P: 50 pts Part 1: This structure prevents reflux / regurgitation of stomach secretions into the esophagus. Part 2: This structure prevents aspiration of fluids / solids into the trachea. A
  • Slide 6
  • Answer: A&P 50 pts What is the LES (Lower Esophageal Sphincter)? Remains contracted most of the time Relaxes for swallowing / belching / vomiting What is the epiglottis? Opens breathing / talking Closes eating / drinking
  • Slide 7
  • A & P: 75 pts This substance is needed for Vitamin B12 absorption in the small intestine. (Name the substance and where it is made). A
  • Slide 8
  • Answer: A&P 75 pts What is Intrinsic Factor (which is made in the stomach)?
  • Slide 9
  • A & P: 100 pts This is where digestion is completed and most absorption takes place. A
  • Slide 10
  • Answer: A&P 100 pts What is the small intestine? 23 feet for absorption Inflammation / disease or removal of part of the bowel will result in less absorption of essential nutrients / calories.
  • Slide 11
  • A & P: 150 pts This organ: Regulates glucose (by storing / breaking down glycogen); Stores nutrients (vitamins, minerals, proteins); Makes essential nutrients (clotting factors, transferrin, proteins, bile); Breaks down substances / wastes. (cholesterol, RBC, protein, meds) A
  • Slide 12
  • Answer: A&P 150 pts Answer: A&P 150 pts What is the liver? If damaged / diseased can lead to: bilirubin / ammonia levels glucose levels Bleeding problems cholesterol levels Drug toxicity
  • Slide 13
  • A & P: 200 pts This organ supports the GI system by releasing many enzymes needed to promote digestion of carbohydrates, fats, and proteins. (Name the organ and 3 enzymes it produces). A
  • Slide 14
  • Answer: A&P 200 pts What is the pancreas? Enzymes it produces: Amylase carbohydrates Lipase fat Trypsin / Peptidase proteins Bicarbonate neutralizes stomach acids
  • Slide 15
  • GI Tests: 25 pts A This physical assessment technique is done to localize the area of pain in the abdomen.
  • Slide 16
  • Answer: GI Tests 25 pts What is rebound tenderness? Remember: Auscultate 1 st (2-5 mins in each quadrant), then palpate or irrigate NG Palpate most painful area last!!
  • Slide 17
  • GI Tests: 50 pts This test looks for hidden blood in the stool. A
  • Slide 18
  • Answer: GI Tests 50 pts What is a Guaiac / Hemoccult test? **Should be done on a yearly basis, starting at age 50, to screen for colorectal cancer!!
  • Slide 19
  • GI Tests: 75 pts This invasive procedure requires: Informed consent; Clear liquids day prior / NPO after midnoc; Laxatives / enemas before; IV conscious sedation. A flexible tube with a lighted scope is inserted into the large intestine during this procedure. A
  • Slide 20
  • Answer: GI Tests 75 pts What is a colonscopy? Direct visualization of colon (polyps, diverticuli, masses) Gold standard for Colon Cancer screening / dx (done q 10 years & prn based on findings) Expect cramping / flatus after test Monitor for bleeding / perforation / infection after test
  • Slide 21
  • GI Tests: 100 pts GI Tests: 100 pts This test requires: NPO 8-12 hrs before; Ingestion of liquid barium; Laxatives / fluids after. A
  • Slide 22
  • Answer: GI Tests 100 pts What is an UGI Series / Barium Swallow? (SBFT: Small Bowel Follow Through) Looking for: strictures / masses / hernias Stools will be white after the test FYI: LGI Series (Lower GI Series) / Barium Enema Looking for polyps, lesions, diverticuli Requires laxatives / enemas before
  • Slide 23
  • GI Tests: 150 pts This invasive procedure requires: Informed consent; NPO status; IV conscious sedation; Lidocaine spray to numb the throat. A flexible lighted scope is passed through the esophagus, stomach and into the duodenum during this procedure. A
  • Slide 24
  • Answer: GI Tests 150 pts What is an EGD? (Esophagogastroduodenoscopy) Direct visualization of upper GI tract Looking for: GERD / Ulcers / Hiatal Hernia Bx / cautery / removal After test: Protect airway NPO until gag reflex returns and pt is awake HOB elevated / side-lying position Monitor for bleeding / perforation / infection
  • Slide 25
  • GI Tests: 200 pts GI Tests: 200 pts This noninvasive procedure requires: NPO 2-6 hrs before test; No smoking 8-12 hrs before test. It is usually the 1 st test done to visualize the size / shape / integrity of internal organs of the abdomen. A
  • Slide 26
  • Answer: GI Tests 200 pts What is an Abdominal Ultrasound? Notes: Gallstones / Obstructions / Masses Appendicitis / Liver enlargement
  • Slide 27
  • Upper GI Probs: 25 pts A Risk factors include: 5 Fs: Female, Fat, 40, Fertile, Family; Sedentary lifestyle; High fat diet; Trauma / infection to area. (Name disease process & 2 common S/S).
  • Slide 28
  • Answer: UGI Probs 25 pts What is Gall Bladder Disease? (Cholelithiasis: gallstones) (Cholecystitis: inflammation of GB) S/S: Indigestion / N/V / heartburn & flatulence (esp after high fat meal) RUQ pain (biliary colic) radiation to shoulder / back (Demerol: drug of choice to decrease spasms) Tachycardia, diaphoresis, fever, restlessness Obstruction (D/T stones in bile duct): Jaundice / White, clay-colored stools Bleeding problems Pancreatitis / Hepatitis
  • Slide 29
  • Upper GI Probs: 50 pts This syndrome is treated with: Dietary changes No spices, citrus, fatty foods, No caffeine, ETOH Lifestyle changes Small freq meals No bedtime snacks Bed up on blocks Wt loss / No smoking Meds Antacids / H2 blockers / PPI. (Name syndrome, 2 causes and 2 S/S). A
  • Slide 30
  • Answer: UGI Probs 50 pts What is GERD? (Gastroesophageal Reflux Disease) Causes: Weakened LES Delayed gastric emptying Impaired esophageal motility Hiatal Hernia S/S (esp after eating irritating foods): Pyrosis (heartburn) Regurgitation (sour liquid coming up throat) Sore throat / hoarseness / lump in throat Post meal N/V & fullness Resp S/S (wheezing / cough / SOB) due to aspiration
  • Slide 31
  • Upper GI Probs: 75 pts What type of medications can be used to treat GERD? (Name 3 categories of medications and an example of each). A
  • Slide 32
  • Answer: UGI probs 75 pts Antacids: Maalox / Mylanta Histamine (H2) Blockers: Zantac / Pepcid / Axid / Tagamet Proton Pump Inhibitors: Prilosec / Nexium / Protonix / Aciphex / Prevacid Other meds: Antiulcer meds: Carafate / Gaviscon Prokinetic agents: Reglan Cholinergic agents: Urecholine Surgical tx: when diet / meds fail, HH, complications Nissen Fundoplication
  • Slide 33
  • Upper GI Probs:100 pts This disease process is caused by: Irritating foods / caffeine Smoking / ETOH Medications (ASA / NSAIDS / steroids) Bacteria (H. Pylori) which can lead to GI bleeding / ulcers, anemia and gastric cancer if not treated. (Name disease and 2 tx options). A
  • Slide 34
  • Answer: UGI Probs 100 pts What is Gastritis? Tx options: Rest stomach Treat nausea / pain Change diet BLAND Medications: Antacids, H2 blockers, PPI Antibiotics Vit B12 (chronic gastritis)
  • Slide 35
  • Upper GI Probs: 150 pts. This invasive procedure includes the insertion of a lighted scope into the esophagus, stomach and duodenum and back up into the common bile duct to retrieve stones or material causing obstruction and / or place stents. A
  • Slide 36
  • Answer: UGI probs 150 pts What is an ERCP? (Endoscopic Retrograde CholangioPancreatography) Important: ** Monitor for pancreatitis after procedure (due to manipulation of common bile duct)
  • Slide 37
  • Upper GI Probs: 200 pts Describe the medical and surgical treatment options for a client with GB disease. A
  • Slide 38
  • Answer: UGI probs 200 pts Medical Tx for GB disease: Tx S/S: pain, nausea, infection, fluids / lytes Stone removal / duct dilatation Low fat diet Surgical Tx for GB disease: Lap vs Open Cholecystectomy Routine post-op care Drains: T-tubeto keep duct open Right shoulder pain: D/T CO2 movement
  • Slide 39
  • Lower GI Probs: 25 pts Part 1: These are out-pouchings of the large intestine (sigmoid colon) caused by age and / or lack of fiber and fluid in the diet. Part 2: These are excess growths that project into the bowel (sigmoid colon) and are often seen and removed during a routine colonoscopy. A
  • Slide 40
  • Answer: LGI Probs 25 pts What are diverticuli? Usually asymptomatic until inflamed (diverticulitis) which can lead to increased pain, fever, bleeding, obstruction &/or perforation. What are polyps? Usually asymptomatic / benign All polyps are considered abnormal (a risk factor for colon cancer) and removed
  • Slide 41
  • Lower GI Probs: 50 pts This disease process occurs more often in teenage males and is caused by a blockage / build up of stool, lymph tissue or foreign material. (Name disease & 2 common S/S). A
  • Slide 42
  • Answer: LGI Probs 50 pts What is an Appendicitis? S/S: Periumbilical / RLQ pain Rebound tenderness Muscle guarding Anorexia / N/V / fever Tx: Control pain (ice / no heat, limit narcotics until dx made) Confirm dx (Ultrasound / CT scan) Prompt surgical removal
  • Slide 43
  • Lower GI Probs: 75 pts The S/S of this problem include: Rigid / board-like abdomen; Abdominal distention; Abd pain / tenderness; Absence of bowel sounds; Tachycardia / tachypnea; Fever / diaphoresis. A
  • Slide 44
  • Answer: LGI Probs 75 pts What is peritonitis? Can be caused by: Perforation of internal abd organ (appendix / bowel / diverticuli / ulcer) Can lead to Sepsis Shock Organ failure Death! Requires: Prompt recognition / tx!! **Need to support ABCs 1 st, then investigate / tx the cause.
  • Slide 45
  • Lower GI Probs: 100 pts How does tx of diverticulosis differ from tx of diverticulitis? A
  • Slide 46
  • Answer: LGI Probs 100 pts Answer: LGI Probs 100 pts Tx of Diverticulosis: Increase fiber / fluids (no nuts, seeds, popcorn) Bulk laxatives Anticholinergics: short term use Wt loss Decrease intra-abd pressure Tx of Diverticulitis: Acute situation!! Bowel rest: NPO / IV fluids Bed rest IV antibiotics ? Surgery: needed in 30% of cases
  • Slide 47
  • Lower GI Probs: 150 pts Where do intestinal obstructions occur most often and why? (Name location and 2 mechanical causes & 2 non-mechanical causes). A
  • Slide 48
  • Answer: LGI Probs 150 pts Small Intestine (23 feet of narrow bowel) Mechanical causes: Adhesions / scar tissue Hernias Neoplasms / tumors Twisted bowel Non-mechanical causes: Lack of nerve stimuli Lack of blood flow (emboli / ischemia) Paralytic ileus / Immobility Electrolyte imbalance (low K+ levels) Infection
  • Slide 49
  • Lower GI Probs: 200 pts Name three common S/S of a bowel obstruction and how they are treated: medically vs surgically. A
  • Slide 50
  • Answer: LGI Probs 200 pts S/S: N/V (esp with SBO) Abdominal pain / distention Tympanic or absent bowel sounds No flatus or BM Medical tx: Surgical tx: Support ABCs!!Bowel rx / anastomosis Thorough GI assessment: Bowel rx / ostomy BS / N/V / pain / firmness Stoma: beefy red / moist Decompress bowel: edematous NG to LIS / NG management shrinks as it heals Maintain fluid / electrolyte balance IV fluids / NPO / I&O Ambulate