Adult Health GI Jeopardy Flashcards
What is a test done to directly visualize mucous membranes of stomach, esophagus, and duodenum?
EGD: Esophagogastroduodenoscopy or Upper GI Endoscopy
What is a diagnostic test that may require a laxative afterwards?
A barium enema or swallow
What are the signs/sx might you find if you suspect a bowel obstruction? Early/late?
Early: high-pitched tinkling bowel sounds
Later: bowel becomes silent
May have distension, colicky gas pains/cramping, possible vomiting (perhaps fecal material)
High-pitched borborygmi shound present as the intestine attempts to propel contents past the obstruction. In later stages the bowel becomes silent. With a paralytic ileus, bowel sounds are greatly diminished or absent throughout the process. Abd. Distension minimal with proximal obstructions, but may be pronounced with distal obstruction and paralytic ileus. Abd. May be tender to palpation a well.
CEA, CA19-9, AFP…are examples of what?
Tumor markers related to cancers of the GI tract
carcinoembryonic antigen and CA 19-9, alpha-fetoprotein indicate sensitivity and specificity for colorectal and hepatocellular carcinomas. CEA not normally detected in blood and indicative of ca is present when detected. CA 19-9 is also a protein that exists on the surface of certain cells and is shed by tumor cells making it useful as a tumor marker. It is elevated in most pts with advanced pancreatic cancer, but also can be elevated in pts with colorectal, lung, and gallbladder cancers, gallstones, pancreatitis, CF, and liver disease.
Your patient reports his stool looks ‘black and shiny’. What would you want to further assess about this pt and what do you suspect?
melena, Physical assessment, assess labs CBC, pt/ptt, medications, history. Suspect upper GI bleed
The nurse teaching a client with GERD includes which of the following instructions?
A) This is a benign disease requiring no treatment
B) Elevate the head of the bed on 6-8 inch blocks or pillows
C) Stop taking the prescribed proton-pump inhibitor once symptoms are relieved
D) Peppermint and chocolate candies can help relieve symptoms
E) Avoid lying down for several hours after eating
B) Elevate the head of the bed on 6-8 inch blocks or pillows
and
E) Avoid lying down for several hours after eating
The nurse evaluates his teaching of a client with acute stress gastritis as effective when the client states she will: (see next slide)
A) Avoid using aspirin or NSAIDS for routine pain relief
B) Consume only bland foods
C) Return for yearly upper endoscopy exams
D) Fully cook all meat, poultry, and egg products
A) Avoid using aspirin or NSAIDS for routine pain relief
The nurse caring for a pt. with esophageal cancer affecting the middle portion of the esophagus would immediately report which of the following?
A) Crackles in the base of the right lung
B) Bright red bleeding from the mouth
C) Weight loss
D) Difficulty swallowing solid foods
B) Bright red bleeding from the mouth
Name SIX common GI “offenders”.
Caffeine, dairy products, chocolate, pepper, alcohol, spicy foods, tobacco, drugs (remember OTC)
Name three risk factors for the development of esophageal cancer
GERD, smoking, excessive alcohol intake
The evening following a gastric resection, the nurse notes that there has been no drainage from the NGT for the past three hours. The nurse should:
A) Chart the finding
B) Reposition the nasogastric tube
C) Gently irrigate the tube with normal saline
D) Notify the surgeon
C) Gently irrigate the tube with normal saline
The MD has ordered omeprazole 20mg BID, clarithromycin 500mg bid, and amoxicillin 1g daily for a pt with PUD. It is most important for the nurse to instruct the pt to:
A) . Stop the drugs immediately and notify the MD if a rash, hives, or itching develop
B) Consume 8oz yogurt daily while taking these drugs
C) Take the drugs on an empty stomach, 1 hour before breakfast and 2 hours after dinner
D) Take the drugs with a full glass of water
A) . Stop the drugs immediately and notify the MD if a rash, hives, or itching develop
the other answers are appropriate for a pt taking antibiotics
The nurse identifies which of the following nursing diagnoses as highest priority for the client admitted with peptic ulcer disease and possible perforation?
A) Acute pain
B) Ineffective health maintenance
C) Nausea
D) Impaired tissue integrity: gastrointestional
D) Impaired tissue integrity: gastrointestional
A client with a history of PUD suddenly begins to complain of severe abdominal pain. The nurse should (select all that apply)
A) Administer the prescribed proton-pump inhibitor
B) Obtain an order for a narcotic analgesic
C) Withhold all oral food and fluids
D) Place the pt. in fowler’s position
E) Notify the physician
C) Withhold all oral food and fluids
D) Place the pt. in fowler’s position
E) Notify the physician
Following a partial gastrectomy for gastric cancer, a pt. complains of nausea, abdominal pain and cramping, and diarrhea after eating. Recognizing manifestations of dumping syndrome, the nurse recommends:
A) Fasting for a period of 6-12 hours before meals
B) Decreasing the protein content of meals
C) Frequent small meals that contain solid foods or liquids but not both
D) A diet rich in carbohydrates to maintain blood glucose levels
C) Frequent small meals that contain solid foods or liquids but not both
