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GI JEOPARDY!

GI JEOPARDY!. Upper GI Problems. Lower GI Problems. A & P. GI Tests. 25. 25. 25. 25. 50. 50. 50. 50. 75. 75. 75. 75. 100. 100. 100. 100. 150. 150. 150. 150. 200. 200. 200. 200. A & P: 25 pts.

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GI JEOPARDY!

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  1. GI JEOPARDY!

  2. Upper GI Problems Lower GI Problems A & P GI Tests 25 25 25 25 50 50 50 50 75 75 75 75 100 100 100 100 150 150 150 150 200 200 200 200

  3. A & P: 25 pts Name 3 physical factors and 1 psychological factor which can affect the function of the GI tract. (Be specific). A

  4. Answer: A&P 25 pts • Mobility • Diet: • Fat / Fiber / Spices • ETOH / caffeine • Medication: • ASA / NSAIDS / APAP • Antacids / Antibiotics • Smoking • Stress / Anxiety

  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

  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

  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

  8. Answer: A&P 75 pts • What is Intrinsic Factor (which is made in the stomach)?

  9. A & P: 100 pts This is where digestion is completed and most absorption takes place. A

  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.

  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

  12. 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

  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

  14. Answer: A&P 200 pts What is the pancreas? Enzymes it produces: Amylase  carbohydrates Lipase  fat Trypsin / Peptidase  proteins Bicarbonate neutralizes stomach acids

  15. GI Tests: 25 pts This physical assessment technique is done to localize the area of pain in the abdomen. A

  16. Answer: GI Tests 25 pts What is rebound tenderness? Remember: • Auscultate 1st(2-5 mins in each quadrant), then palpate or irrigate NG • Palpate most painful area last!!

  17. GI Tests: 50 pts This test looks for hidden blood in the stool. A

  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!!

  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

  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

  21. GI Tests: 100 pts This test requires: NPO 8-12 hrs before; Ingestion of liquid barium; Laxatives / fluids after. A

  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

  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

  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

  25. 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 1st test done to visualize the size / shape / integrity of internal organs of the abdomen. A

  26. Answer: GI Tests 200 pts What is an Abdominal Ultrasound? Notes: Gallstones / Obstructions / Masses Appendicitis / Liver enlargement

  27. Upper GI Probs: 25 pts Risk factors include: 5 F’s: Female, Fat, 40, Fertile, Family; Sedentary lifestyle; High fat diet; Trauma / infection to area. (Name disease process & 2 common S/S). A

  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

  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

  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

  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

  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

  33. Upper GI Probs:100 pts A 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).

  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)

  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

  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)

  37. Upper GI Probs: 200 pts Describe the medical and surgical treatment options for a client with GB disease. A

  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-tube—to keep duct open Right shoulder pain: D/T CO2 movement

  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

  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

  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

  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

  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

  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 ABC’s 1st, then investigate / tx the cause.

  45. Lower GI Probs: 100 pts How does tx of diverticulosisdiffer from tx of diverticulitis? A

  46. 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

  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

  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

  49. Lower GI Probs: 200 pts A Name three common S/S of a bowel obstruction and how they are treated: medically vs surgically.

  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 ABC’s!! 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

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