CGRN flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Split-dose bowel preparation

Regimen dividing the colonoscopy preparation into two doses, with the second taken 4-6 hours before the procedure; it improves cleansing and is preferred over day-before single dosing.

Post-ERCP pancreatitis monitoring

After ERCP, keep the patient NPO and watch for epigastric pain, nausea, and amylase or lipase elevation at least three times the upper limit of normal.

Spontaneous bacterial peritonitis threshold

SBP is diagnosed when the ascitic fluid polymorphonuclear cell count reaches 250 cells/mm3 or more, prompting cephalosporin therapy plus intravenous albumin.

Hepatic encephalopathy lactulose goal

Lactulose is titrated to two to three soft bowel movements daily; more causes dehydration and hypernatremia, while fewer leaves encephalopathy inadequately controlled.

PEG tube medication flushing

Flush the feeding tube with about 30 mL of water before and after each medication, administering drugs separately to prevent clogging and drug interactions.

Barrett esophagus biopsy protocol

The Seattle protocol takes four-quadrant jumbo biopsies every 1-2 cm along the Barrett segment to detect dysplasia and early adenocarcinoma.

Celiac disease diagnostic biopsy

Duodenal biopsies showing villous blunting are required for diagnosis; IgA tissue transglutaminase serology supports testing but does not replace endoscopy with biopsy.

Modified Aldrete discharge score

This score rates activity, respiration, circulation, consciousness, and oxygen saturation from 0 to 2 each; a total of 9-10 typically supports discharge from recovery.

Capnography versus pulse oximetry

End-tidal CO2 detects apnea and hypoventilation seconds before oxygen saturation falls, because pulse oximetry lags during supplemental oxygen therapy.

Abdominal assessment sequence

Inspect, auscultate, percuss, then palpate the abdomen; auscultation precedes percussion and palpation so that bowel sounds are not altered by manipulation.

Signs of colon perforation

Sudden severe abdominal pain, board-like rigidity, absent bowel sounds, and free air on imaging after endoscopy indicate perforation and require immediate surgical evaluation.

Boston Bowel Prep Scale

This scale rates each of three colon segments from 0 to 3 for cleansing after washing; a segment score of 2 or higher is adequate.

MELD score components

MELD 3.0 uses bilirubin, INR, creatinine, sodium, and albumin to rank short-term mortality risk for patients with cirrhosis awaiting transplant.

Child-Pugh classification

This system grades cirrhosis severity from bilirubin, albumin, INR, ascites, and encephalopathy, assigning class A, B, or C to predict survival and surgical risk.

Moderate sedation definition

A drug-induced depression of consciousness in which the patient responds purposefully to verbal or tactile stimulation and maintains a patent airway without intervention.

Midazolam onset and peak

Intravenous midazolam produces sedation within 1-3 minutes and peaks at 3-5 minutes; slower titration in older adults reduces oversedation and respiratory depression.

Flumazenil dosing

Give flumazenil 0.2 mg IV over 15 seconds and repeat each minute up to 1 mg per dose; its effect lasts 45-90 minutes, often shorter than the benzodiazepine.

Naloxone for opioid reversal

Titrate naloxone 0.04-0.4 mg IV to restore adequate respiration; its 30-90 minute duration is shorter than many opioids, so monitor for renarcotization.

Propofol characteristics

Propofol produces rapid deep sedation with no reversal agent; it causes hypotension and apnea and is given by providers trained in airway management and rescue.

ASA fasting guidelines

Elective sedation requires 2 hours of fasting for clear liquids, 6 hours for a light meal or nonhuman milk, and 8 hours for fatty or fried meals.

Resedation after reversal

Because reversal agents have shorter half-lives than the sedatives they reverse, patients need extended monitoring for at least two hours after the last reversal dose.

Spaulding classification endoscopes

Flexible GI endoscopes contact mucous membranes and are classified as semicritical devices, requiring at least high-level disinfection between every patient use.

Endoscope leak testing

A leak test is performed before each procedure after bedside cleaning to detect punctures; a leaking scope is removed from service to prevent fluid damage and exposure.

Bedside precleaning endoscope

Wipe the insertion tube and suction detergent through the channels immediately after withdrawal, before transport, so bioburden does not dry and harden.

Ortho-phthalaldehyde use

OPA is a high-level disinfectant requiring about 12 minutes at 20 degrees C, needs no activation, stains protein, and requires adequate ventilation because of mucosal irritation.

Duodenoscope infection risk

Duodenoscopes have a complex elevator that resists cleaning and has transmitted multidrug-resistant organisms; culture-and-quarantine and disposable elevator components reduce that risk.

C diff hand hygiene

Alcohol-based rub does not kill Clostridioides difficile spores; hands are washed with soap and water, with contact precautions and bleach-based surface cleaning used.

Informed consent nursing role

The performing provider obtains informed consent; the nurse may witness the signature, verify the patient understands the procedure and alternatives, and confirm identity.

Pre-procedure time-out

Immediately before starting, the team verbally confirms correct patient, procedure, site, consent, allergies, and equipment, with any member empowered to stop.

Teach-back for bowel prep

The patient restates the preparation schedule in their own words, which confirms comprehension and reveals barriers such as literacy, language, or cost.

SGNA standards of practice

The Society of Gastroenterology Nurses and Associates publishes role definitions and competency standards that guide GI nursing practice, education, and certification.

Nurse practice act scope

State law defines registered nursing scope, including whether administering and monitoring moderate sedation requires additional certification or physician supervision.