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00NCLEX > Adult Gasto > Flashcards

Adult Gasto Flashcards

1
Q

Cullen’s sign

A
  • discoloration of the abdomen and periumbilical area
  • indicates pancreatitis
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2
Q

Acute pancreatitis symptoms

A
  • dehydration = n/v
  • hypovolemia
  • hyperglycemia
  • hypocalcemia
  • leukocytosis
  • diagnose w amylase and lipase
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3
Q

Pancreatitis treatment

A
  • 0.9 fluid bolus
  • monitor LOC
  • NPO = TPN
  • acute is very painful
    • patient controlled analgesia
    • fentanyl
    • hydromorphone/morphine
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4
Q

Necrotizing pancreatitis

A
  • ecchymosis around the umbilicus
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5
Q

Irrigating a nasogastric tube

A

draw 30 mL of irrigant into the syringe

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6
Q

Colonoscopy should begin at age

A

45

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7
Q

Dumping syndrome care

A
  • dietary changes
    • multiple, small means
    • increase protein with each meal
    • increase complex carbs
      • whole grain, pasta, potatoes, rice
      • gives body time to absorb before dumping
  • lying down for 30 minutes after meals
  • avoid drinking with meals
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8
Q

Fecal impaction

A
  • watery fecal material around the impacted mass, mimicking diarrhea (paradoxical diarrhea)
  • abdomen appears distended and swollen
  • stomach is hard to the touch
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9
Q

Fecal impaction care

A
  • enemas of tap water
  • manual fragmentation (painful, may need sedation)
  • increase fiber to 30 grams a day
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10
Q

Acute perforated ulcer

A
  • “board-like” rigidity of the abdominal wall
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11
Q

4

complications following bariatric surgery (roux-en-y)

A
  • venous thromboembolism
    • early ambulation
    • compression stocking
    • anticoagulants
  • dumping syndrome
  • pneumonia
  • infection
  • follow strict diet after
    • clear liquid for 1 week post
    • no sugar or cafferine
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12
Q

bariatric surgery care

A
  • early ambulation
  • compression devices
    • prophylactic anticoagulant
  • clear liquids
  • multivitamin
  • oxycodone
    • stool softener
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13
Q

Infectious mononucleosis (IM)

A
  • causes splenomegaly
  • fever
  • cervical lymphadenopathy
  • rash
  • kissing disease
  • standard precautions
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14
Q

liver biopsy positioning

A
  • During
    • supine
    • right arm abducted
    • head turned to the left
  • Post
    • right side
  • conscious
  • avoid coughing/straining
  • hold breathe*
  • conscious with lidocaine for pain
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15
Q

Appendicitis

A
  • right lower quadrant pain
    • can refer to left lower quadrant
    • McBurney’s point / Psoas sign
      • rebound tenderness
  • leukocytosis (HIGH WBC)
    • fever
  • anorexia
    • nausea and vomiting
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16
Q

Appendicitis and suddenly feels better

A
  • likely experienced a rupture of the appendix (perforated)
    • emergency surgery
    • abdominal pain worse with cough or movement
    • relieved when bending right hip or knees
    • progresses to peritonitis then sepsis
17
Q

Pain in pancreatitis

A
  • severe
  • begins mid-epigastrium and radiates to the back
18
Q

Pain in cholecystitis

A
  • pain in the right upper quadrant
  • can refer to the right shoulder and scapula
19
Q

Older adults at increased risk for malnutrition

A

live alone, especially widowed

20
Q

Order of abdominal assessment

A
  • inspection
  • auscultation
  • percussion
  • palpation
21
Q

Paralytic ileus

A
  • abdominal distention
  • nausea vomiting
  • hypokalemia
  • hiccups
  • decreased bowel sounds
  • NG tube helps to decompress
22
Q

NG tube

A
  • decompress the stomach and relieve the pressure from the ileus
  • causes hyponatremia and hypokalemia
  • insert NOT during inspiration
    • insert during swallowing of water
  • wash bridge of nose with soap/water or alcohol to promote adherence of tape
  • HOB 90 degrees
23
Q

Gastric residual volume (GRV)

A
  • enteral nutrition should not be stopped for a GRV of less than 500 mL
  • elevate HOB when feeding
24
Q

Hyperalimenation

A
  • means TPN
  • given through central IV line
    • tubing with in-line filter
    • change tubing every 24 hr
  • check glucose every 4-6 hours
  • do not abruptly stop
    • TPN contains regular insulin
    • can cause hypoglycemia
25
Q

Peptic ulcer disease

A
  • mid-epigastric pain
  • hematemesis
  • gastric ulcer symtpoms
26
Q

Cirrhosis

A
  • caused by A.B.C.D.
    • Alcohol
    • Hep B
    • Hep C
    • Diet
  • risk for FLUID VOLUME EXCESS d/t PORTAL HYPERTENSION
  • increased ammonia levels
    • altered LOC
    • give lactulose
27
Q

Melena

A
  • black tarry stools
  • gastrointestinal bleeding
28
Q

Abdominal surgery

A
  • bowel sounds return within 48 hours
  • use incentive spirometer
    • if child have them blow bubbles
29
Q

Increase risk for gastric cancer

A
  • chronic gastritis
  • gastric ulcer
30
Q

Pernicious anemia

A
  • inability of the body to utilize Vitamin B12.
  • decrease in hemoglobin
  • prescription for Vitamin B12, administered parenterally
  • Cyanocobalamin = B12
    • found in animal products (eggs, dairy, meat, fish)
  • VEGAN DIET CAUSES THIS
  • paresthesia
  • glossitis (inflamed tongue)
  • memory impairment
31
Q

Peritonitis

A
  • caused by leakage or hole
    • BURST APPENDIX
  • slowing of peristalsis
    • hyperactive bowl sounds
  • pain, tenderness
  • rigid abdominal muscles
  • fever, nausea/vomiting
  • HIGH WBC
    • give antibiotics
  • NG tube to decompress
    • NOT TO FEED
  • keep NPO
    • feed through parental nutrition (IV)
32
Q

Crohn’s disease

A
  • inflammation of GI tract
    • extends from stomach to anus
  • abdominal pain/cramps
  • diarrhea
  • loss of appetite = weight loss
  • melena = bloody stools
  • mouth ulcers
  • fever and fatigue
33
Q

Irritable bowl syndrome (IBS)

A
  • alternating between constipation and diarrhea
34
Q

Gastroenteritis

A
  • clincial feature is diarrhea
  • rapid peristalsis
  • abdominal cramping
  • hyperactive bowl sounds
  • not present in gastroenteritis
    • fever
    • tachycardia
    • tachypnea
    • UNLESS DEHYDRATED
35
Q

Bowel obstruction

A
  • abrupt onset stomach pain
  • distended abdomen
  • NO FEVER
  • nausea and vomiting = DEHYDRATION
    • fluid/electrolyte imbalance
      • can lead to metabolic alkalosis
  • TREATMENT
    • NPO
    • establish vascular access
      • rehydrate
      • IV pain control
36
Q

Cirrhosis care

A
  • give albumin to enhance oncotic pressure
    • helps with ascites and edema
  • perform bowl movements
  • increased ammonia levels
    • altered LOC
    • give lactulose

00NCLEX (30 decks)

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