Gastrointestinal and Hepatorenal Nursing Review

Vocabulary practice flashcards covering liver procedures, hepatitis transmission, gastrointestinal tubes, surgical diets, ulcers, and clinical pharmacology from Chapter 1 through Chapter 8 of the lecture transcript.

Liver biopsy

A procedure in which a piece of liver tissue is excised to study under a microscope in a pathology lab to diagnose conditions like cirrhosis or liver failure; post-procedure care requires monitoring the right upper quadrant site for bleeding or hemorrhaging, maintaining bed rest, and reviewing CBC and coagulation panels.

Ascites

The accumulation of fluid in the abdominal cavity between the abdominal contents and the abdominal wall, often associated with portal hypertension and cirrhosis; also referred to as third spacing and tracked by measuring abdominal circumference every $8\text{ hours}$.

Fowler's position

An upright bed positioning recommended to the degree the patient tolerates to relieve respiratory difficulty caused by abdominal distension from ascites, as well as to prevent aspiration or vomiting in patients with nasogastric decompression tubes.

Hepatitis A

A form of viral hepatitis contracted via the fecal-oral route through contaminated food, water, or unwashed hands, requiring patients to abstain from sexual activity until they are non-infectious.

Hepatitis B and C

Types of viral hepatitis that are transmitted through direct contact with infected blood, such as via contaminated needles, dental supplies, or unsterilized manicure tools.

Colectomy

The surgical removal of all or a portion of the colon, which requires pre-operative dietary restrictions progressing from clear liquids to complete NPO status.

Sigmoid colon

The S-shaped section of the large intestine situated at the very bottom of the colon, identified as the area most commonly affected by diverticulosis.

Post-bariatric surgery diet

A dietary regimen characterized by high protein to promote tissue healing and low carbohydrates with low calories to maintain post-surgical weight loss goals.

Pernicious anemia

An autoimmune disorder affecting the stomach lining that impairs the intrinsic factor necessary for the intestinal absorption of vitamin $B_{12}$, necessitating vitamin $B_{12}$ supplementation.

Digital deimpaction

The manual stimulation and extraction of hardened, impacted fecal matter from the rectum using one or two gloved digits or specialized metal manipulation tools, commonly required for quadriplegic patients.

Referred shoulder pain (Gastric perforation)

A medical emergency occurring when an ulcer erodes through the stomach lining and leaks gastric juices, irritating the adjacent diaphragm whose sensory pathways register in the brain as pain in the shoulder.

Gastric pH

The normal acidic pH level of stomach secretions, identified as ranging between $1$ and $4$.

Naso-duodenal (ND) tube

An enteral feeding tube that passes through the nose and esophagus to bypass the stomach entirely, entering directly into the duodenum so patients with persistent vomiting can absorb nutrients in the small intestine.

Naso-jejunal (NJ) tube

An enteral tube extending through the nose past both the stomach and the duodenum to deliver nutrition directly into the jejunum.

Salem sump tube

A large, clear nasogastric tube (around $12\text{ French}$) with large holes at the tip connected to a wall suction device ($20\text{ to }40\text{ cm}$ of water suction) used exclusively for gastric decompression rather than feeding.

Esophagogastroduodenoscopy (EGD)

An upper endoscopic diagnostic procedure inserted through the mouth to directly visualize the lining of the esophagus, stomach, and duodenum to evaluate gastric pain or ulcerations.

Endoscopic retrograde cholangiopancreatography (ERCP)

An upper endoscopic and laparoscopic procedure guided by ultrasound through the common bile duct and duodenum used to extract gallstones and place biliary or pancreatic stents.

Sucralfate (Carafate)

A mucosal protectant medication prescribed for peptic ulcers that forms an extra protective barrier over the stomach lining to shield it from gastric acid, taken $1\text{ hour}$ before meals.

Amylase and lipase

Two diagnostic serum laboratory enzymes that rise exponentially to indicate acute inflammation of the pancreas (pancreatitis).

Lactulose

A foul-smelling medication administered to lower and reverse elevated serum ammonia levels in patients experiencing liver failure or hepatic complications from cirrhosis.

Celiac disease

An autoimmune disorder characterized by an inability to digest or process the gluten protein found in oats, wheat, and barley.

Liver Biopsy

A procedure in which a piece of liver gland tissue is removed to study under a microscope for conditions such as liver failure or cirrhosis; pre-op typically requires $8\text{ hours}$ NPO, post-op dressing is on the right upper quadrant, and the nurse must closely monitor for hemorrhaging and check coagulation labs (CBC, hemoglobin, hematocrit).

Ascites

The accumulation of fluid in the peritoneal cavity between the abdominal contents and the abdominal wall (also termed third spacing) resulting from liver inflammation, cirrhosis, and portal vein dysfunction.

Cirrhosis Assessment Findings

Clinical signs of liver malfunction characterized primarily by jaundice (yellow coloration), light or clay-colored stool, abdominal distension from ascites, and altered portal circulation.

Hepatitis A

A viral liver infection transmitted via the fecal-oral route through unwashed hands contaminating food or water; infected individuals must abstain from sexual activity until they are non-infectious.

Hepatitis B and C

Forms of viral hepatitis transmitted primarily through exposure to contaminated blood, such as unsterile needles or shared equipment.

Colectomy

Surgical excision of all or a portion of the colon; preoperatively, patients are maintained on NPO status according to physician orders.

Post-Bariatric Surgery Diet

A dietary regimen characterized by high protein to promote tissue healing and low carbohydrates/low calories to support weight maintenance.

Digital Deimpaction

The manual stimulation and removal of hardened stool directly from the rectum using one or two gloved digits, frequently indicated as an initial intervention for patients lacking sensation, such as quadriplegics.

Referred Shoulder Pain (Gastric Perforation)

A critical emergency occurring when acidic gastric contents erode through a peptic ulcer to form a perforation in the stomach wall, irritating the adjacent diaphragm, whose sensory signals are misinterpreted by the brain as pain in the shoulder.

Gastric pH

The normal baseline acidity level of the stomach juices, measuring between $1\text{ and }4$.

Pernicious Anemia

An autoimmune stomach condition where a loss of intrinsic factor impairs the absorption of vitamin $B_{12}$, necessitating supplemental vitamin $B_{12}$ therapy.

Nasoduodenal (ND) Tube

A feeding tube passed through the nose directly into the duodenum, used to bypass the stomach and deliver enteral nutrition straight to the small intestine in patients who have malfunctioning sphincters or persistent vomiting.

Nasogastric (NG) Tube Insertion Position

The patient posture wherein the neck is flexed with the chin directed down toward the chest once the tube hits the back of the throat, which opens the passage and propels the tube downward.

Salem Sump Tube

A large, clear nasogastric tube (around $12\text{ French}$) with side openings attached to continuous or intermittent wall suction ($20\text{ to }40\text{ cm H}_2\text{O}$) specifically used for stomach decompression rather than feeding.

Abdominal Circumference Measurement

A routine assessment required every $8\text{ hours}$ in cirrhotic patients with ascites to monitor disease progression, fluid buildup, and detect possible perforation.

Esophagogastroduodenoscopy (EGD)

An endoscopic diagnostic examination visualized through the mouth, advancing through the esophagus and stomach into the duodenum to assess mucosal lesions, pain, or inflammation.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

An endoscopic and laparoscopic procedure guided by ultrasound through the mouth, esophagus, and duodenum into the common bile duct, used to remove gallstones and place biliary stents.

Sucralfate (Carafate)

A mucosal protectant medication that forms a protective barrier over ulcer sites against gastric acid, prescribed to be taken $1\text{ hour}$ before meals.

Amylase and Lipase

The two primary diagnostic serum pancreatic enzymes that rise exponentially during acute inflammation of the pancreas (pancreatitis).

Hyperammonemia

An accumulation of toxic levels of ammonia in the bloodstream due to liver failure or advanced cirrhosis, clinically manifesting as acute confusion.

Lactulose

A foul-smelling medication administered to patients with hepatic dysfunction to lower elevated serum ammonia concentrations.

Celiac Disease

A disorder characterized by an inability to digest the proteins found in oats, wheat, and barley, necessitating strict adherence to a gluten-free diet commonly substituted with rice.