chapter 32,33

Question 1

Where in the body does digestion start?

Answer 1

The mouth

Question 2

What significant patient problem can occur in patient with loose teeth?

Answer 2

Risk of aspiration (of a loose tooth)

Question 3

What organ in the GI tract is where the digestion process ends, where all the necessary nutrients for life have been absorbed?

Answer 3

Small Intestine

Question 4

When caring for a patient with Gastrointestinal symptoms the nurse will palpate the abdomen. Describe the process of abdominal palpitations:

Answer 4

Light palpitation is done by lightly depressing the abdomen no more than to inch. During the palpitation using the finger pads.
Note: if there is any muscle tension, rigidity, masses, or expression of pain

Question 5

When a nurse uses percussion to evaluate the patient’s abdomen, what does Tympanic sound indicate?

Answer 5

High pitch sounds indicate the presence of air

Question 6

When a nurse uses percussion to evaluate the patient’s abdomen, what does Dull sound indicate?

Answer 6

Dull thuds indicate the presence of fluid or solid organs

Question 7

What is Peristalsis?

Answer 7

Peristalsis of the muscle layer in the wall of the esophagus propels food through the GI system

Question 8

Describe the process of listening to bowel sounds

Answer 8

The stethoscope is pressed slightly on the abdomen. Bowels are categorized as normal, hyperactive, hypoactive, or absent

Question 9

About how long could it take to fully listen for bowl sounds in all 4 quadrants?

Answer 9

to fully listen to all 4 quadrants, it can take several minutes: up to 5 minutes or so

Question 10

What problems might hypoactive bowel sounds indicate?

Answer 10

Decrease peristalsis
Constipation
Bowel obstruction

Question 11

What problems might hyperactive bowel sounds indicate?

Answer 11

Increased peristalsis
Diarrhea

Question 12

What is jaundice and what types of diseases will it be seen?

Answer 12

Jaundice is the yellowing of the skin or whites of the eyes, arising from excess of the pigment bilirubin and typically caused by obstruction of the bile duct, by liver disease, or by excessive breakdown of red blood cells
Jaundice has many causes, including hepatitis, gallstones, and tumors

Question 13

Discuss the following drugs that are prescribed for GERD & PUD, specifically: drug names, indications for use, patient teaching:

Answer 13

Proton Pump Inhibitors (PPI’s)
Histamine Blockers (H2) Receptor Antagonists
Antacids
Mucosal Barrier Fortifiers

Question 14

What is Prevpac?

Answer 14

Iansoprazole, amoxicillin, and clarithromycin(PREVAC)

Question 15

What is prevpac used to treat?

Answer 15

treatment for PUD caused by H.Pylori is the PREVPAC. Consists of the following combination of drugs that are to be taken for 10-14 days

Question 16

Care for a patient with a GI bleed

Answer 16

NPO
IV Fluids
Urinary catheter (for more accurate I &O)
NG tube
Oxygen
Vital signs , 02 saturation

Question 17

How is stool for Occult blood (stool for guaiac) performed?

Answer 17

The fecal occult blood test (FOBT) is a lab test used to check stool samples for hidden(occult)blood

Question 18

List causes of GI bleeding

Answer 18

Peptic Ulcer perforation
Tumors
Gastric surgery

Question 19

Signs and symptoms of GI bleeding

Answer 19

Mild: weakness diaphoresis
Severe: hypovolemic shock (hypotension, tachycardia, tachypnea, weak pulse, chills, palpitations)

Question 20

Diagnostic test for GI bleeding

Answer 20

Upper GI scope
Blood work, CBC hemoglobin,Hematocrit

Question 21

Treatment for GI bleed

Answer 21

Surgical repair of bleeding area
Blood transfusions
Oxygen support

Question 22

Nursing interventions for GI bleed pt.

Answer 22

Turn the patient on their side to protect the patients airway

Question 23

What should the nurse do next

Answer 23

take the patients vital signs and notify the physician STAT

Question 24

Complications of GI Bleed

Answer 24

Anemia
Shock
Death

Question 25

What is pernicious Anemia

Answer 25

lack of production in the stomach of Intrinsic factor

Question 26

what vitamin is the patient deficient in?

Answer 26

B12

Question 27

how is b12 deficiency treated?

Answer 27

monthly injections of B12

Question 28

with the respect to colorectal cancer, discuss the CEA blood test

Answer 28

Carcinoembryonic antigen

Question 29

What position should the patient be placed in when having an NG tube for feeding or a permanent feeding tube

Answer 29

Position patient sitting up at 45 degrees (unless contradicted by the patients condition), with a pillow under the head and shoulders. This allows the NG tube to pass more easily through the nasopharynx and into the stomach

Question 30

Why does the nurse check for “residual” before starting a tube feeding or administration of medication via feeding tube?

Answer 30

Excess residual food products from the stomach(>100mL) are an indication that the patient is not digesting the food at the normal pace and is high risk for vomiting and aspiration.

Question 31

What position should the nurse be placed in during 30-45 minutes post Tube feeding/Med administration??

Answer 31

Minimum of semi-fowlers 30-45 degrees

Question 32

What is Total Parental Nutrition(TPN)

Answer 32

Total Parental Nutrition is a method of feeding that bypasses the gastrointestinal tract. A special formula given through a vein provides most of the nutrients the body needs. The method is used when someone cant or shouldn’t receive feedings or fluids by mouth or NG/PEG tube

Question 33

In addition to monitoring the infusion of TPN, what is a important invention(lab value) that the nurse must evaluate: why and how often?

Answer 33

Blood sugar every 6 hours.Report elevation of BS to MD

Question 34

What is a common medication prescribed for Nausea and vomiting?

Answer 34

Ondansetron(Zofran)

Question 35

What is a hiatal hernia

Answer 35

lower esophagus/stomach slides through hiatus of diaphragm into throrax

Question 36

Signs and symptoms of hiatal hernia

Answer 36

Pain
heartburn
Felling of fullness
Reflux