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.
A & P
Name 3 physical factors and 1 psychological factor which can affect the function of the GI tract. (Be specific).
This structure prevents reflux / regurgitation of stomach secretions into the esophagus.
This structure prevents aspiration of fluids / solids into the trachea.
This substance is needed for Vitamin B12 absorption in the small intestine.
(Name the substance and where it is made).
(which is made in
This is where digestion is completed and most absorption takes place.
of part of the bowel will result in
less absorption of essential
nutrients / calories.
(by storing / breaking down glycogen);
(vitamins, minerals, proteins);
Makes essential nutrients
(clotting factors, transferrin, proteins, bile);
Breaks down substances / wastes.
(cholesterol, RBC, protein, meds)
What is the liver?
If damaged / diseased can
bilirubin / ammonia levels
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).
What is the pancreas?
Enzymes it produces:
Trypsin / Peptidase proteins
Bicarbonate neutralizes stomach acids
This physical assessment technique is done to localize the area of pain in the abdomen.
What is rebound tenderness?
then palpate or irrigate NG
This test looks for hidden blood in the stool.
What is a Guaiac / Hemoccult test?
**Should be done on a yearly basis, starting at
age 50, to screen for colorectal cancer!!
This invasive procedure requires:
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.
What is a colonscopy?
(polyps, diverticuli, masses)
(done q 10 years & prn based on findings)
This test requires:
NPO 8-12 hrs before;
Ingestion of liquid barium;
Laxatives / fluids after.
What is an UGI Series / Barium Swallow?
(SBFT: Small Bowel Follow Through)
LGI Series (Lower GI Series) / Barium Enema
This invasive procedure requires:
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.
What is an EGD?
GERD / Ulcers / Hiatal Hernia
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.
What is an Abdominal Ultrasound?
Notes: Gallstones / Obstructions / Masses
Appendicitis / Liver enlargement
Risk factors include:
5 F’s: Female, Fat, 40, Fertile, Family;
High fat diet;
Trauma / infection to area.
(Name disease process & 2 common S/S).
What is Gall Bladder
(Cholecystitis: inflammation of GB)
(esp after high fat meal)
(Demerol: drug of choice to decrease spasms)
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).
What is GERD?(Gastroesophageal Reflux Disease)
Delayed gastric emptying
Impaired esophageal motility
S/S (esp after eating irritating foods):
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
What type of medications can be used to treat GERD?
(Name 3 categories of medications and an example of each).
Maalox / Mylanta
Histamine (H2) Blockers:
Zantac / Pepcid / Axid / Tagamet
Proton Pump Inhibitors:
Prilosec / Nexium / Protonix / Aciphex / Prevacid
Antiulcer meds: Carafate / Gaviscon
Prokinetic agents: Reglan
Cholinergic agents: Urecholine
Surgical tx: when diet / meds fail, HH, complications
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).
What is Gastritis?
Treat nausea / pain
Change diet BLAND
Medications: Antacids, H2 blockers, PPI
Vit B12 (chronic gastritis)
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.
What is an ERCP?
(Endoscopic Retrograde CholangioPancreatography)
**Monitor for pancreatitis after procedure
(due to manipulation of common bile duct)
Describe the medical and surgical treatment options for a client with GB disease.
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
These are out-pouchings of the large
intestine (sigmoid colon) caused by age and / or lack of fiber and fluid in the diet.
These are excess growths that project into the bowel (sigmoid colon) and are often seen and removed during a routine colonoscopy.
What are diverticuli?
(diverticulitis) which can lead to
increased pain, fever, bleeding,
obstruction &/or perforation.
What are polyps?
(a risk factor for colon cancer) and removed
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).
What is an Appendicitis?
S/S:Periumbilical / RLQ pain
Anorexia / N/V / fever
Tx: Control pain (ice / no heat,
limit narcotics until dx made)
Confirm dx (Ultrasound / CT scan)
Prompt surgical removal
The S/S of this problem include:
Rigid / board-like abdomen;
Abd pain / tenderness;
Absence of bowel sounds;
Tachycardia / tachypnea;
Fever / diaphoresis.
What is peritonitis?
Can be caused by:
Perforation of internal abd organ
(appendix / bowel / diverticuli / ulcer)
Can lead toSepsis Shock
Organ failure Death!
Requires: Prompt recognition / tx!!
**Need to support ABC’s 1st,
then investigate / tx the cause.
How does tx of diverticulosisdiffer from tx of diverticulitis?
Tx of Diverticulosis:
Increase fiber / fluids (no nuts, seeds, popcorn)
Anticholinergics: short term use
Decrease intra-abd pressure
Tx of Diverticulitis: Acute situation!!
Bowel rest: NPO / IV fluids
? Surgery: needed in 30% of cases
Where do intestinal obstructions occur most often and why?
(Name location and
2 mechanical causes &
2 non-mechanical causes).
(23 feet of narrow bowel)
Adhesions / scar tissue
Neoplasms / tumors
Lack of nerve stimuli
Lack of blood flow (emboli / ischemia)
Paralytic ileus / Immobility
Electrolyte imbalance (low K+ levels)
Name three common S/S of a bowel obstruction
and how they are treated:
medically vs surgically.
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