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Saunders Comprehensive Review For The NCLEX-PN Examination, 8 Ed./
Chapter 45. Gastrointestinal ProblemsAce Your Saunders Comprehensive Review For The NCLEX-PN Examination, 8 Ed. Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Practical Nurse (LPN) Students
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Saunders Comprehensive Review For The NCLEX-PN Examination, 8 Ed. | Practical Nurse (LPN) School Study Aid
Oral Cavity
- Characteristics
- Mouth
- Mechanical Digestion
- Salivary Amylase Begins Carbohydrate Breakdown
- Lingual Lipase Begins Lipid Breakdown
- Esophagus
- Bolus
- Peristalsis
1 min
GI Absorption
- Stomach
- Alcohol
- Duodenum
- Iron
- Jejunum
- Folate
- Terminal Ileum
- Vitamin B12
- Bile Resorption
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
3 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
2 mins
Large Intestine
- Characteristics
- Colon
- Electrolyte Reabsorption
- Water Reabsorption
- Microflora Produce Vitamins
- Rectum Stores Feces
1 min
Colorectal Cancer Assessment
- 3rd Most Common Cancer
- Assessment
- Change in Bowel Habits
- Bowel Obstruction
- Rectal Bleeding
- Anemia
- Weight Loss
- Ascites
- Considerations
- Colonoscopy
- FOBT and FIT
2 mins
Intestinal Obstruction
- Partial/Early Obstruction
- Severe Abdominal Pain
- Vomiting
- High Pitched Bowel Sounds
- Abdominal Distention
- Increased Peristalsis
- Total/Neurogenic Obstruction
- Absent Bowel Sounds
- Paralytic Ileus
1 min
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
2 mins
Helicobacter Pylori
- Characteristics
- Gram-Negative
- Bacilli
- Curved
- Polar Flagellum
- Catalase-Positive
- Oxidase-Positive
- Disease
- Gastric and Duodenal Ulcers
- Ammonia
- Neutral Environment
- Gastric Adenocarcinoma
- MALT lymphoma
- Diagnosis
- Serology IgG antibody
- Stool Antigen
- Urease Positive Breath Test
- Biopsy
- Treatment
- 2 ABX and PPI
2 mins
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
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
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
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
2 mins
Peptic Ulcer Disease Interventions
- Combination Drug Therapy
- Two Antibiotics
- Proton Pump Inhibitor (PPI)
- Decrease Acid Secretion
- Avoid NSAIDs
- Diet and Lifestyle Changes
1 min
Types of Hernias
- Hiatal
- Gastroesophageal Reflux Disease (GERD)
- Inguinal
- Men
- Femoral
- Women
- Incisional
- Umbilical
- Consideration
- Strangulation
1 min
Hernia Interventions
- Reduce Intra Abdominal Pressure
- Avoid Straining and Lifting
- Open Mouth Sneezing
- Excision
- Herniorrhaphy
- Hernioplasty
- Consideration
- Scrotal Support
1 min
Cholecystitis Assessment
- RUQ Pain
- Referred Shoulder Pain
- Clay Colored Stools
- Jaundice
- Nausea and Vomiting
- Dyspepsia (Indigestion)
- Fever
- Considerations
- Increased WBCs
- Fatty or Spicy Foods
- Ultrasound
2 mins
Cholecystitis Causes
- Gallbladder Inflammation
- 6 Fs
- Female
- Fair (Caucasian)
- Fat (Obese)
- Fertile (Pregnant)
- Forty (Advanced Age Over 40)
- Flatulence
2 mins
Cholecystitis Interventions
- Supportive Therapy
- Antibiotics
- Low Fat Diet
- NG Tube
- Analgesics
- Lithotripsy
- Cholecystectomy
- T Tube
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
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
2 mins
Complications of Cirrhosis
- Portal Hypertension
- Ascites
- Esophageal Varices
- Coagulation Defects
- Portal-Systemic Encephalopathy
- Hepatorenal Syndrome
1 min
Hepatitis A
- Characteristics
- Picornavirus
- 4 Week Incubation Period
- Fecal-oral
- Day Care Centers
- Travel to Developing Countries
- Signs and Symptoms
- Usually Asymptomatic
- Acute Disease
- Jaundice
- Fever
- Vomiting
2 mins
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
2 mins
Hepatitis B Virus Disease
- Can turn chronic
- < 10% of adults become chronic carriers
- 90% of newborns become chronic carriers
- Cirrhosis
- Hepatocellular carcinoma
- Membranous Glomerulonephritis
- Polyarteritis nodosa
- Serum sickness like syndrome
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
2 mins
Hepatitis B Virus Characteristics
- Hepadnavirus
- Enveloped
- Circular
- Partially Double-stranded DNA
- Has Reverse Transcriptase
- IV Drug Use
- Sex
- Maternal Fetal Routes
- 3 Month Incubation Period
2 mins
Hepatitis C
- Characteristics
- Enveloped
- RNA Virus
- Flavivirus
- Icosahedral
- SS positive Linear
- Clinical Features
- Most Cases are Due to IV Drug Use
- Turns to Chronic Hepatitis in Over 70% of Cases
- Cirrhosis
- Hepatocellular Carcinoma
- Most Common Indication for Liver Transplantation
- Associated With Type I MPGN
- Porphyria Cutanea Tarda
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
2 mins
Acute Pancreatitis Causes
- "GET SMASHHED" Mnemonic
- Gallstones
- (Ethanol) Alcohol
- Trauma
- Steroids
- Mumps
- Autoimmune
- Scorpion Sting
- Hypercalcemia
- Hypertriglyceridemia > 1000
- ERCP
- Drugs
1 min
Acute Pancreatitis Assessment
- Mechanism
- Heavy Alcohol Use and Gallstones
- Signs and Symptoms
- Abdominal Pain
- Nausea/Vomiting/Anorexia
- Abdominal Rigidity/Guarding
- Decreased or Absent Bowel Sounds
- Hypotension and Tachycardia
- Jaundice
- Increased White Blood Cells
2 mins
Acute Pancreatitis Interventions
- NPO with NG Tube to Suction
- Pain Management
- Albumin
- Lactated Ringers Solution
- Proton Pump Inhibitor (PPI)
- Antibiotics
- Surgery
- Nutrition
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
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)
2 mins
Ulcerative Colitis Assessment
- Assessment
- Cramping Abdominal Pain
- Tenesmus
- Bloody Diarrhea
- Up to 10-20 / Day
- Fever
- Complications
- Hemorrhage
1 min
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
2 mins
Crohn's Disease Assessment
- Diarrhea
- 5-6 per day
- Cramping Abdominal Pain
- Fever
- Weight Loss
- Malabsorption
- Anemia
- Complications
- Obstruction
- Fistulas
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
2 mins
Appendicitis Interventions
- Treatment
- Appendectomy
- Preoperative Care
- Antibiotics
- IV Fluids
- No Enema or Laxative
- Postoperative Care
- Semi-Fowler's Position
- Nasogastric Tube
- Diet as Tolerated
- Pain Management
- Early Ambulation
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
2 mins
Diverticulosis and Diverticulitis Interventions
- Interventions
- High Fiber Diet
- Reduce Intra-abdominal Pressure
- Stool Softeners
- Exercise
- Anticholinergics
- Considerations
- Antibiotics
- Bowel Resection
2 mins
