nurs321 exam 1 - GI, malnutrition, obesity

organs in RUQ

ascending + transverse (colon), duodenum, gallbladder, right kidney, liver, pancreas (head), ureter (R)

organs in LUQ

descending + transverse (colon), left kidney, pancreas (body, tail), spleen, stomach, ureter (L)

organs in RLQ

ascending (colon), appendix, bladder, cecum, rectum, ovary/uterus/fallopian tubes, prostate/sperm cord, small intestine, ureter (R)

organs in LLQ

bladder, descending + sigmoid (colon), ovary/uterus/fallopian, prostate/sperm cord, small intes., ureter (L)

peristalsis

parasymp increase (symp decrease)

what to consider w GI in older adults

SLOW (motility, sphincter weak, less GI acid, dry, lose elasticity)

low pre-albumin indicates

malnutrition (BMI <18.5)

low albumin indicates

liver issue (low protein, alco check BUN/creatinine/CO2+elec.)

PRIMARY protein-calorie malnutrition

no eat (anorexic)

SECONDARY protein-calorie malnutrition

brain injury, autoimmune (cancer -> nausea = low appetite)

BMi of obesity

>30 (25-29.9 = overweight), waist (to hip) >0.8

android shape (APPLE)

high risk (CHF, hypothy, cushings, CKD, hypothal.)

gyencoid shape (PEAR)

hourglass

low leptin indicates

high appetite (+fat, vice versa)

what to consider for pt before bariatric surgery

organ function, motivation/support, (cancer??)

bariatric surgery - restrictive

decrease stomach size + food intake (overeat cause emesis)

restrictive bariatric surgery types - adjustable gastric banding (AGB)

ONLY reversible one, can dislodge stomach (band around upper stomach, create small stomach pouch)

restrictive bariatric surgery types - gastric sleeve (vertical sleeve gastrectomy)

irreversible, remove most of stomach into tube (sleeve shape)

post op for RESTRICTIVE bariatric surgery

deep cough/breathe, early ambulate (foyer lift, trapeze, NO ALC)

bariatric surgery - combination

(restrictive + malabsorp - limit intake + decrease absorp) RYGB

RYGB

small stomach pouch connect to jejunum, still have bile (bypass everything + some of jejunum, feel full fast)

post op for RYGB (combo)

no straws (cause gas), start clear (progress, no caffeine/sugar)

bariatric surgery eligibility requirements

BMI <40, or BMI <30-40 w comorb (diabetes, heart issue)

dumping syndrome (mainly RESTRICTIVE, also COMBO)

rapid movement of food (+GI content)

dumping syndrome s/s

diarrhea (abd pain/cramp)

dumping syndrome caused by

high sugar/salt (LASIX, eat HIGH protein, fiber when no diarrhea), eat/drink at same time (WAIT 30 mins in btwn)

bariatric surgery can cause

pernicious anemia (low B12/iron), osteoporosis