GI ATI Flashcards

liver function tests

urine bilinogen

fecal occult blood test(FOBT) and stool samples

endoscopy

GI series

5-40 units

elevation occurs with hep or cirrhosis

8-20 units/L 3-35 IU/L

elevation occurs with hep or cirrhosis

30-120 units/L 30-85 IU/L

elevation indicates liver damage

56-90 IU/L

elevation occurs with pancreatitis

0-110 units/L

elevation occurs with pancreatitis

0.1 to 1.0 mg/dL

elevations indicate altered liver function, bile duct obstruction, or other hepatobiliary disorder

0.1-0.3 mg/dL

elevations indicate altered liver function, bile duct obstruction, or other hepatobiliary disorder

0.2-0.8 mg/dL

elevations indicate altered liver function, bile duct obstruction, or other hepatobiliary disorder

3.5-5.0 g/dL

decrease may indicate hepatic disease

less than 40 mcg/L

elevated in liver cancer

15-110 mcg/dL

elevated in liver disease

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.

ulcer, colitis, cancer

colorectal cancer

colonoscopy

EGD

ERCP

sigmoidoscopy

GI bleeding

ulcerations

inflammation

polyps

malignant tumors

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

age

current health status

cognitive status

support system

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

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

insertion through mouth into esophagus, stomach, and duodenum

moderate sedation-topical anesthetic

left side lying

NPO 6-8 hours, remove dentures

monitor VS and Resp

notify provider of bleeding, abd/chest pain, and any evidence of infection

withhold fluids until gag reflex returns

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

VS and Resp

notify if bleeding, abd/chest pain, infection

withhold fluids until return of gag reflex

anus, rectum, and sigmoid colon

left side

bowel prep dulcolax, and golytely

clear liq diet

NPO after midnight

VS and resp

rectal bleeding

resume normal diet

encourage increased fluids

may be increased flatulence

difficult to arouse, poor resp effort, evidence of hypoxemia, tachycardia, elevated/low BP

antidotes

maintain open airway

administer oxygen

notify provider immediately

bleeding

cool and clammy skin

hypotension

tachycardia, dizziness, and tachypnea

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

dyspnea

tachypnea

adventitious breath sounds

tachycardia

fever

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

chest/abd pain

fever

n/v

abd distention

monitor diagnostic tests for evidence of infection, elevated WBC, notify provider of findings

client ed-report fever, pain, and bleeding to the provider

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

possible bowel perforation or obstruction, inflammatory disease

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

monitor elimination of contrast material and administer a laxative if prescribed

increase fluid intake

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.

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

malnutrition

aspiration pneumonia

overfeeding results from infusion of greater quantity of feeding than can be readily digested, resulting in abdominal distention, n/v.

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

occurs secondary to concentration of feeding or its constituents

slow rate of feeding and notify provider

confer with the dietitian

provide skin care and protection

age