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Saunders Comprehensive Review For The NCLEX-RN Examination, 7 Ed.
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52 - Gastrointestinal System

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Saunders Comprehensive Review For The NCLEX-RN Examination, 7 Ed. | Registered Nurse (RN) School Study Aid

52 - Gastrointestinal System
32 Picmonics to Learn | 57 mins
Oral Cavity
Characteristics
Mouth
Mechanical Digestion
Salivary Amylase Begins Carbohydrate Breakdown
Lingual Lipase Begins Lipid Breakdown
Esophagus
Bolus
Peristalsis
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1 min
Stomach Digestion
Characteristics
Chief Cells Secrete Pepsinogen
Pepsinogen Turned to Pepsin By H+
Protein Breakdown Begins
Mucous Cells Secrete Mucus and Bicarbonate
G Cells Secrete Gastrin
Gastrin Stimulates Parietal Cell HCl Release
Parietal Cells Secrete Intrinsic Factor
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2 mins
Small Intestine Absorption
Characteristics
Carbohydrates Undergo Active Transport
Amino Acids Undergo Active Transport
Small Lipids Undergo Passive Diffusion
Epithelial Cells
Intestinal Capillaries
Hepatic Portal Transports Nutrients
Liver
Large Lipids Transported as Chylomicrons
Lacteals Transport Chylomicrons
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2 mins
Small Intestine Digestion
Brush border enzymes
Pancreatic Enzymes are secreted via a Duct
Pancreas secretes bicarbonate
Brush Border activates Pancreatic Trypsin
Trypsin activates Chymotrypsin
Trypsin and Chymotrypsin digest Proteins
Gallbladder Releases Bile
Pancreatic Lipase breaks down Lipids
Goblet cells secrete mucus
Pancreatic Amylase breaks down Carbohydrates
Pancreatic Nucleases breakdown DNA/RNA
Digestion occurs in the Duodenum
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2 mins
Pancreatin, Pancrelipase (Pancreatic Enzymes)
Mechanism
Pancreatic Enzymes
Indications
Cystic Fibrosis
Pancreatic Insufficiency
Side Effects
GI Distress
Considerations
Inactivated by Gastric Acid
24 Hour Fat Excretion
Take with Every Meal and Snack
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2 mins
Large Intestine
Characteristics
Colon
Electrolyte Reabsorption
Water Reabsorption
Microflora Produce Vitamins
Rectum Stores Feces
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1 min
Pancreas
Characteristics
Acinar Cells Release Digestive Enzymes
Ductal Epithelial Cells Release Bicarbonate
Islets of Langerhans
Beta Cells Release Insulin
Alpha Cells Release Glucagon
Delta Cells Release Somatostatin
Somatostatin Inhibits Alpha and Beta Cells
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3 mins
Liver Biopsy Procedure
Indications
Diagnosis of Liver Disease
Types of Liver Biopsy
Incisional (Open Method)
Needle Biopsy (Closed Method)
Considerations
Coagulation Status
Type and Crossmatch Blood
Right-Side Lying
Post-Biopsy Monitoring
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2 mins
Liver Enzyme Tests: AST and ALT
AST/ALT Ratio
AST: 8-20 U/L
ALT: 8-20 U/L
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1 min
Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
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2 mins
Acute Gastritis
Erosive
Disruption of Mucosal Barrier
Caused by Stress
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
Alcohol
Uremia
Burns
Curling's Ulcer
Brain Injury
Cushing Ulcer
Increase H+ Production
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1 min
Chronic Gastritis
Type A
Type A
Fundus and Body
Autoimmune
Autoantibodies to Parietal Cells
Pernicious Anemia
Achlorhydria
Type B
Type B
Most Common Type
Helicobacter pylori
Antrum
Increased Risk of MALT Lymphoma
Associations
HIV/AIDS
Crohn's Disease
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3 mins
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
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2 mins
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
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1 min
Cobalamin (Vitamin B12)
Mechanism
Vitamin B12
Indications
Vitamin Deficiency
Pernicious Anemia
Side Effects
Hypokalemia
Arthralgia
Dizziness
Considerations
IM Injection for Pernicious Anemia
Never Give IV
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2 mins
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
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1 min
Hernia Interventions
Reduce Intra Abdominal Pressure
Avoid Straining and Lifting
Open Mouth Sneezing
Excision
Herniorrhaphy
Hernioplasty
Consideration
Scrotal Support
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1 min
Cholecystitis Interventions
Supportive Therapy
Antibiotics
Low Fat Diet
NG Tube
Analgesics
Lithotripsy
Cholecystectomy
T Tube
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2 mins
Cirrhosis Assessment
Mechanism
Degeneration and Destruction of Liver Cells
Signs and Symptoms
Jaundice
Fatigue
Palmar Erythema
Spider Angiomas
Hepatosplenomegaly
Edema
Gynecomastia
Change in LOC
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2 mins
Cirrhosis Interventions
Interventions
Maintain Nutrition
Paracentesis
Esophageal and Gastric Varices
Drug Therapy
Endoscopic Band Ligation or Sclerotherapy
Balloon Tamponade
Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Hepatic Encephalopathy
Lactulose
Antibiotics
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2 mins
Complications of Cirrhosis
Portal Hypertension
Ascites
Esophageal Varices
Coagulation Defects
Portal-Systemic Encephalopathy
Hepatorenal Syndrome
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1 min
Hepatitis A (HAV) Assessment
Transmission
Fecal-Oral
Ingestion of Contaminated Food or Water
Incubation
4 Weeks
Assessment
Fever
General Malaise
Hepatomegaly
Considerations
Self-Limiting
Proper Hand Washing
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2 mins
Hepatitis B (HBV) Assessment
Transmission
Bodily Fluids
Blood Transmission
People Who Use IV Drugs
Incubation
Variable 1-6 Months
Assessment
Fever
Nausea and Vomiting
Hepatomegaly
Chronic Disease
Cirrhosis
Hepatocellular Carcinoma
Considerations
Vaccination
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2 mins
Hepatitis C (HCV) Assessment
Transmission
Blood Transmission
High Risk Sex (rare)
IV Drug Users
Incubation
7 Weeks
Chronic Disease
Cirrhosis
Considerations
Barrier Protection
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2 mins
Irritable Bowel Syndrome (IBS) Assessment
Abdominal Pain
Relieved by Defecation
Alternating Diarrhea and Constipation
Fatigue
Excessive Flatulence
Sensation of Incomplete Evacuation
Considerations
Stressors
Food Intolerances
More Common in Women
Rule Out Other Disorders
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2 mins
Irritable Bowel Syndrome (IBS) Interventions
Interventions
Identify Triggers
Increase Fiber Intake
Probiotics
Anticholinergics
Tricyclic Antidepressants (TCAs)
Loperamide
Linaclotide
Medications for Women
Tegaserod (Zelnorm)
Lubiprostone (Amitiza)
Alosetron (Lotronex)
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2 mins
Ulcerative Colitis Assessment
Assessment
Cramping Abdominal Pain
Tenesmus
Bloody Diarrhea
Up to 10-20 / Day
Fever
Complications
Hemorrhage
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1 min
Crohn's Disease Assessment
Diarrhea
5-6 per day
Cramping Abdominal Pain
Fever
Weight Loss
Malabsorption
Anemia
Complications
Obstruction
Fistulas
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2 mins
Colostomy Care
Wash with Warm Water
Cut 1/8 inch Around Stoma
Decreases Skin Irritation
Empty When 1/3 to 1/2 Full
Change 3-7 Days
Considerations
Avoid Odor Causing Foods
Irrigate at Same Time
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2 mins
Appendicitis Assessment
Mechanism
Obstruction of Appendix
Signs and Symptoms
Periumbilical Pain
RLQ Pain
Nausea/Vomiting/Anorexia
Increased White Blood Cells
Rebound Tenderness
Fever
Complications
Peritonitis
Sepsis
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2 mins
Diverticulosis and Diverticulitis Assessment
Diverticulosis
Outpouching
Diverticulitis
Inflamed Diverticula
Assessment
Abdominal Pain
Abdominal Distention
Flatulence
Fever
Rectal Bleeding
Alternating Constipation and Diarrhea
Considerations
Peritonitis
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2 mins
Diverticulosis and Diverticulitis Interventions
Interventions
High Fiber Diet
Reduce Intra-abdominal Pressure
Stool Softeners
Exercise
Anticholinergics
Considerations
Antibiotics
Bowel Resection
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2 mins

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