front 1 GI diagnostics | back 1 liver function tests urine bilinogen fecal occult blood test(FOBT) and stool samples endoscopy GI series |
front 2 Aspartate aminotransferase (AST) | back 2 5-40 units elevation occurs with hep or cirrhosis |
front 3 Alanine aminotransferase (ALT) | back 3 8-20 units/L 3-35 IU/L elevation occurs with hep or cirrhosis |
front 4 Alkaline phosphatase (ALP) | back 4 30-120 units/L 30-85 IU/L elevation indicates liver damage |
front 5 amylase | back 5 56-90 IU/L elevation occurs with pancreatitis |
front 6 Lipase | back 6 0-110 units/L elevation occurs with pancreatitis |
front 7 total bilirubin | back 7 0.1 to 1.0 mg/dL elevations indicate altered liver function, bile duct obstruction, or other hepatobiliary disorder |
front 8 direct (conjugated) bilirubin | back 8 0.1-0.3 mg/dL elevations indicate altered liver function, bile duct obstruction, or other hepatobiliary disorder |
front 9 indirect (unconjugated) bilirubin | back 9 0.2-0.8 mg/dL elevations indicate altered liver function, bile duct obstruction, or other hepatobiliary disorder |
front 10 albumin | back 10 3.5-5.0 g/dL decrease may indicate hepatic disease |
front 11 alpha-fetoprotein | back 11 less than 40 mcg/L elevated in liver cancer |
front 12 ammonia | back 12 15-110 mcg/dL elevated in liver disease |
front 13 fecal occult blood test | back 13 collected and tested for blood, ova, and parasites (Giardia lamblia), and bacteria (c.diff) stool may also be collected to assess for DNA changes in the vimentin gene. |
front 14 GI bleeding | back 14 ulcer, colitis, cancer |
front 15 what does a change in the vimentin gene indicate | back 15 colorectal cancer |
front 16 GI scope procedures | back 16 colonoscopy EGD ERCP sigmoidoscopy |
front 17 indications for scopes | back 17 GI bleeding ulcerations inflammation polyps malignant tumors |
front 18 general endoscopic preprocedures | back 18 evaluate client's understanding verify consent assess VS and allergies evaluate CBC, electrolyte panel, BUN, Cr, PT, aPTT, and liver function studies evaluate chest XRay, ECG, and ABG |
front 19 increased risks of complications for scopes | back 19 age current health status cognitive status support system |
front 20 colonoscopy | back 20 moderate sedation-midazolam (Versed) usually with an opiate analgesic positioning-left sided with knees to chest bowel prep dulcolax/golytely clear liq diet(avoid red, purple, orange fluids) NPO after midnight |
front 21 colonoscopy post procedure | back 21 notify of severe pain monitor for rectal bleeding monitor VS and resp status resume normal diet encourage increased fluid may be increased flatulence d/t air intillation |
front 22 EGD | back 22 insertion through mouth into esophagus, stomach, and duodenum moderate sedation-topical anesthetic left side lying NPO 6-8 hours, remove dentures |
front 23 EGD postprocedure | back 23 monitor VS and Resp notify provider of bleeding, abd/chest pain, and any evidence of infection withhold fluids until gag reflex returns |
front 24 ERCP | back 24 through the mouth into the biliary tree via the duodenum, allows visualization of the biliary ducts, gall bladder, liver, and pancreas conscious sedation-topical anesthetic initially semi prone with repositioning throughout procedure NPO 6-8 hr, remove dentures |
front 25 ERCP postprocedure | back 25 VS and Resp notify if bleeding, abd/chest pain, infection withhold fluids until return of gag reflex |
front 26 sigmoidoscopy | back 26 anus, rectum, and sigmoid colon left side bowel prep dulcolax, and golytely clear liq diet NPO after midnight |
front 27 sigmoidoscopy postprocedure | back 27 VS and resp rectal bleeding resume normal diet encourage increased fluids may be increased flatulence |
front 28 oversedation manifestations | back 28 difficult to arouse, poor resp effort, evidence of hypoxemia, tachycardia, elevated/low BP |
front 29 nursing actions for oversedation | back 29 antidotes maintain open airway administer oxygen notify provider immediately |
front 30 hemorrhage manifestations | back 30 bleeding cool and clammy skin hypotension tachycardia, dizziness, and tachypnea |
front 31 nursing actions hemorrhage | back 31 assess for hemorrhage from the site, monitor VS, and monitor diagnostic test results(Hgb and Hct) notify provider immediately client ed-report fever, pain and bleeding to provider |
front 32 aspiration manifestations | back 32 dyspnea tachypnea adventitious breath sounds tachycardia fever |
front 33 nursing actions aspiration | back 33 keep client NPO until gag reflex returns ensure client is awake and alert prior to consuming food or fluid deep breathe and cough notify provider if there is delay in gag reflex client ed-report any resp congestion or compromise to provider |
front 34 perforation of GI tract | back 34 chest/abd pain fever n/v abd distention |
front 35 nursing actions perforation | back 35 monitor diagnostic tests for evidence of infection, elevated WBC, notify provider of findings client ed-report fever, pain, and bleeding to the provider |
front 36 preprocedure barium | back 36 clear liq diet and/or low residue NPO after midnight avoid smoking or chewing gum(increases peristalsis) barium enema studies must be scheduled prior to upper GI studies |
front 37 contraindications to bowel preparation | back 37 possible bowel perforation or obstruction, inflammatory disease |
front 38 client education barium | back 38 restrict food and fluids for bowel preparation inform client that if the sm intestine is to be visualized additional radiographs will be done over the next 24 hr |
front 39 post procedure barium | back 39 monitor elimination of contrast material and administer a laxative if prescribed increase fluid intake |
front 40 client ed barium | back 40 instruct client to monitor elimination of contrast and to report retention of contrast(constipation or diarrhea accompanied by weakness discuss the possible need for an over the counter med to prevent constipation resulting from barium instruct the client that stools will be white for 24-72 hours until barium clears. the client should report abdominal fullness, pain or delay in return to brown stool. |
front 41 enteral feedings | back 41 instituted when a client can no longer take adequate nutrition orally clients who are intubated pathologies that cause difficulty swallowing(stroke, advanced parkinsons, and MS) clients who cannot maintain adequate oral nutrition |
front 42 client presentation | back 42 malnutrition aspiration pneumonia |
front 43 complications of enteral feedings | back 43 overfeeding results from infusion of greater quantity of feeding than can be readily digested, resulting in abdominal distention, n/v. |
front 44 nursing actions for overfeeding | back 44 check residual every 4-6 hours follow protocol for withholding excess residual volumes as directed (typically 100-200mL) withhold feeding as prescribed and resume at reduced rate as prescribed |
front 45 diarrhea from enteral feedings | back 45 occurs secondary to concentration of feeding or its constituents |
front 46 nursing actions for diarrhea of enteral feedings | back 46 slow rate of feeding and notify provider confer with the dietitian provide skin care and protection |
front 47 aspiration pneumonia | back 47 age |