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gero > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

acute pain

A

abrupt onset and lasting a short time

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2
Q

neuropathic pain

A

occurs from an abnormal processing of sensory stimuli by the central or peripheral nervous system

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3
Q

nociceptive pain

A

arises from mechanical, thermal, or chemical noxious stimuli; can be somatic or visceral

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4
Q

persistent pain

A

chronic pain that has been present for 3 months or longer

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5
Q

comfort

A

relative term; sense of physical, emotional, social, and spiritual peace and well-being

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6
Q

pain

A

unpleasant sensory and emotional experience

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7
Q

prevalence of pain in older adults

A

more than half report daily pain; difficult to determine accuracy of reported prevalence of pain in older adults; underreported due to fear of complaining; overreported due to trying to get attention

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8
Q

what are the different types of pain?

A

nociceptive and neuropathic

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9
Q

nociceptive pain

A

mechanical, thermal, and chemical

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10
Q

what are the different types of nociceptive pain?

A

somatic and visceral

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11
Q

somatic pain

A

bone or soft tissue masses; localized; throbbing, aching

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12
Q

visceral

A

disorders that cause generalized or referred pain; deep, aching

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13
Q

neuropathic pain

A

abnormal processing of sensory stimuli by central or peripheral nervous systems

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14
Q

what are the symptoms of neuropathic pain?

A

sharp, stabbing, tingling, burning, onset of high intensity

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15
Q

acute pain

A

abrupt; onset; can be severe; short duration; responses to analgesics; can develop into persistent

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16
Q

persistent/chronic pain

A

present for 3 months or longer; can be mild to severe intensity

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17
Q

what are the effects of unrelieved pain?

A

limited mobility; develop pressure ulcers; pneumonia; constipation; poor appetite resulting in malnutrition and/or dehydration

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18
Q

pain management

A

qualitative and quantitative assessment

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19
Q

what is included in the pain assessment?

A

management; open-ended questions; detailed pain history; physical; need for ongoing assessment; must ask specific questions to figure out if patient is in pain; cognitive status; cultural factors; potential barriers; pain assessment instruments

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20
Q

what are some pain indicators from those who are cognitively impaired?

A

grimacing; crying, moaning; increased vital signs; perspiration; increasing pacing, wandering, aggressive behaviors; hitting, banging on objects; splinting or guarding body parts; agitation; poorer function; change in sleeping pattern; change in appetite or intake; decreased socialization

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21
Q

what are some cultural factors to consider during the pain assessment?

A

tolerate pain without expression? dramatic expression of pain? may not acknowledge severity of discomfort

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22
Q

what are potential barriers when assessing pain?

A

knowledge deficits; inadequate pain assessment; biases or assumptions; staffing issues

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23
Q

what are some pain assessment instruments that can be used?

A

numeric rating scale; visual analog scale; mcgill pain questionaire

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24
Q

what are some integrative approaches to pain management?

A

individualize comprehensive pain management plan; identify underlying cause for pain; goals- realistic, specific, and achievable; common componnets

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25
Q

what are some common components that could help form an integrative approach to pain management?

A

complementary therapies, dietary changes, medications, comfort nursing care

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26
Q

what are some examples of complimentary therapies?

A

medications; need for nursing knowledge; patient education and counseling; acupressure; acupuncture; aromatherapy; biofeedback; chiropractic; electrical stimulation; exercises; guided imagery; heat and cold; herbal; homeopathic; hypnosis; massage; mediation; naturopathy; osteopathy; prayer; progressive relaxation; supplements; touch

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27
Q

what are some foods to avoid for pain? (dietary changes)

A

animal products; high-fat dairy products; egg yolk; beef fat; safflower; corn; sunflower; soybean; peanut oils; white flour; sugars; junk food

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28
Q

what are some foods to encourage for pain? (dietary changes)

A

green leafy vegetables; cold-water fish and fish oils; flaxseed and flaxseed oil; canola oils; walnuts; pumpkin seeds; omega-3 enhanced egg; red, purple, and blue fruits; black and green tea; red wine; chocolate and cocoa; fresh pineapple; garlic; ginger; turmeric

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29
Q

medication for pain in older adults

A

complicated; high risk of adverse effects; analgesics used appropriately and monitored closely; be slow; trial nonopioids>opioids; adjuvant medications may benefit; use narcotics carefully

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30
Q

what medications should you not give older adults?

A

meperidine; indomethacin; pentazocine; muscle relaxants

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31
Q

what medications should you give older adults?

A

acetaminophen; NSAIDs; opioids

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32
Q

what type of opioids can you give an older adult?

A

first: codeine, oxycodone, hydrocodone
severe: morphine, fentanyl patches

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33
Q

what are the negative opioid effects on older adults?

A

nausea; constipation; urinary retention; pruritus; myoclonus; irregular breathing; cognitive dysfunction; addiction

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34
Q

what are some considerations for pain medication on older adults?

A

closely observe response; aim to prevent pain, not treat after; require regular reevaluation; may need to change prescription

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35
Q

how should you comfort an older adult patient?

A

listening attentively; explaining; touching; perceiving

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36
Q

injury

A

an act that results in harm

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37
Q

macroenvironment

A

elements in the larger world that affects groups of people or entire populations

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38
Q

microenvironment

A

the immediate surroundings with which a person closely interacts

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39
Q

restraint

A

anything that restricts movement, can be physical or chemical

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40
Q

accidents in older adults

A

7th leading cause of death; unintentional falls leading to ER visit; falls is the leading cause of premature institutionalization and long-term disability for older adults

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41
Q

infections in older adults

A

altered antigen-antibody response= high prevalence of chronic disease; pneumonia and flu- 8th leading cause of death; atypical symptomatology can lead to delayed diagnosis

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42
Q

adverse effects and accidents related to medications in older adults

A

altered pharmacokinetics, self-administration problems, high volume of drugs consumed; drowsiness; dizziness; 15% of geriatric admissions to hospitals are associated with drug-related problems

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43
Q

what is the importance of the environment to health and wellness

A

promote continued development, stimulation, and satisfaction enhancing psychological well-being; assessment of environment (realistic to fulfill needs)

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44
Q

what is the impact of aging on environmental safety and function?

A

older adults need safe, functional, comfortable, personal, and normalizing environment to compensate for limitations

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45
Q

what are some considerations for an older adult’s environment?

A

lighting, temperature, colors, scents, floor coverings, furniture, sensory stimulation, noise control, bathroom hazards, and psychosocial factors

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46
Q

how does lighting affect the older adult?

A

visibility, function, orientation, mood, and behavior

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47
Q

what are some beneficial types of lighting?

A

diffuse>bright; nightlight= soft red; exposure to natural light during normal day

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48
Q

how does temperature affect older adults?

A

lower than normal; decreased natural insulation; correlates with performance; sensitive to lower temperatures

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49
Q

what is the recommended room temperature for the older adult?

A

75 degrees

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50
Q

what are older adults diagnosed with diabetes or cerebral atherosclerosis at risk for?

A

hyperthermia

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51
Q

what does red, yellow, or white induce?

A

can be stimulating and increase pulse, BP, and appetite

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52
Q

what does blue, brown, or earth ones induce?

A

can be relaxing

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53
Q

what does orange induce?

A

stimulate appetite

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54
Q

what does violet induce?

A

decrease appetite

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55
Q

what does green induce?

A

sense of well-being; master healer color

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56
Q

what does black and gray induce?

A

can be depressing

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57
Q

how do colors affect older adults?

A

identifies specific areas; caution use of patterns if the patient has cognition impairments

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58
Q

aromatherapy/phytomedicine

A

use of essential oils; pathophysiology of aromatherapy

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59
Q

essential oils

A

used in baths, compresses, rubbing, and massaging

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60
Q

like topical medications

A

produce physiological effects

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61
Q

carpeting

A

sound absorber but can cause problems

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62
Q

what kind of problems does carpeting have?

A

static electricity and cling; difficult wheelchair mobility; cleaning; odors; pests; scattered or area rugs can cause falls

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63
Q

what are some carpet considerations?

A

nonglare surface is essential; nonslip surfaces in bathrooms, kitchen, and areas leading from outdoors to indoors; avoid bold designs

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64
Q

what should furnishings be?

A

appealing, functional, and comfortable

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65
Q

what is a consideration for chairs?

A

correct height with arm rests; rocking chairs, love seats, recliners

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66
Q

furniture considerations

A

upholstery should be easy to clean; tables and bookcases should be sturdy; no obstructing pathways from bedroom to bathroom

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67
Q

what kind of environment should a cognitively impaired person have?

A

simple

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68
Q

how can you create an environment pleasing to senses?

A

textured walls and surfaces; soft blankets and spreads; pictures, wall hangings, murals, and sculptures; plants, flowers, coffee brewing, food cooking, perfumes, oils, birds and pets; soft music

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69
Q

what is an intervention for those who are bed bound?

A

sensory stimulation box

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70
Q

what are the effects of sound?

A

physiologic and emotional; can create diffulties for older adults

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71
Q

unwanted disharmonic or chronic noise

A

stressor, causes physical or emotional symptoms

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72
Q

what influences noise control?

A

design of building, landscape, and other devices

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73
Q

how can you avoid the use of intercoms and paging systems?

A

use individual pocket pagers or similar technological device

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74
Q

what are some bathroom safety measures?

A

lighting, floor surface, faucets, tubs and shower stalls, toilets, electrical appliances

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75
Q

what are some fire hazards toward older adults?

A

risk for burn injury; kitchen fires; careless use or disposal of matches/cigarettes; space heaters; fireplaces

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76
Q

what are some psychosocial considerations for older adults?

A

feelings and behavior influenced by their environment; need for own space; need for privacy and personal space; adjustment to new living environments; memory triggering cues are gone; reactions to loss; routine changes; enhance institutional environment

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77
Q

how can we provide privacy and personal space?

A

define specific areas and possessions of individual; provide privacy area for periods of solitude; request permission to enter personal space; allow maximum control over one’s space

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78
Q

what are some reactions to loss?

A

depression, regression, humiliation, and anger

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79
Q

what are some ways to enhance institutional environments?

A

attractive décor; inclusion of personal possessions; respect and privacy and personal territory; recognition of individuality; allowance of maximum control over activities and decision-making; environmental modifications to compensate for deficits; respect, individuality, sensitivity

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80
Q

what are the problem of falls?

A

25% 65 or older experience a fall each year; 1 in 5 results in serious injury; leading cause of fatal and nonfatal injuries in the older population; can lead to development of post-fall syndrome

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81
Q

post fall-syndrome

A

results in unnecessary dependency, loss of function, decreased socialization, poor quality of life

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82
Q

risk factors of falls

A

age-related changes; improper use of mobility aids; medications; unsafe clothing; disease-related symptoms; environmental hazards; distractions; caregiver-related factors

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83
Q

how to prevent falls

A

active program to prevent falls beneficial in facility and community; regular, careful inspection of environment and prompt corrections of hazards; proper assessment of each individual; proper orientation to new environment and reinforce safe practices

84
Q

what is test to assess an older adult for fall risks?

A

hendrich II fall risk model

85
Q

nursing assessment of falls

A

keep immobile until full examination; fractures may not be easily identified initially; may affect location other than area of direct impact; must include psychological assessment; monitor individual for late-appearing signs and/or symptoms; offer suggestions for preventing future falls while encouraging maximum activity

86
Q

risks associated with restraints

A

anything the restricts freedom of movement- chemical or physical; can increase fear and worsen behavior symptoms; nonuse of restraints is standard for gerontological nursing; conduct thorough assessment

87
Q

what are some serious complications with restraints?

A

aspiration, circulatory obstruction, cardiac stress, skin tears and ulcers, anorexia, dehydration, constipation, incontinence, fractures, dislocations

88
Q

what are some alternatives to restraints?

A

placing patient in rooms near nursing station; 1:1 observation; electronic devices to alert staff to movement; comfort measures; frequent reality orientation and reassurance; diversional activities; close observation and documentation of responses are essential

89
Q

interventions to reduce intrinsic risks to safety

A

prevention of injury is essential; reducing hydration and nutritional risks; addressing risks associated with sensory deficits; addressing risks associated with mobility limitations; monitoring body temp; preventing infection; suggestive sensible clothing; using medications cautiously; avoiding crime; promoting safe driving; promoting early detection; addressing risks associated with functional impairment

90
Q

beers criteria

A

originally developed by a group headed by Dr. Mark H. Beers, listing of drugs that carry high risks for older adults and criteria for potentially inappropriate medication use in older adults

91
Q

biological half-life

A

the time necessary for half of a drug to be excreted from the body

92
Q

pharmacokinetics

A

refers to the absorption, distribution, metabolism, and excretion of drugs

93
Q

pharmacodynamics

A

refers to the biologic and therapeutic effects of drugs at the site of action or on the target organ

94
Q

polypharmacy

A

use of multiple medications

95
Q

what are the effects of aging on medication use?

A

special challenges due to number of drugs commonly used; age-related affect; increased risk for adverse reactions

96
Q

what are the most common medications for older adults?

A

cardiovascular agents, antihypertensive, analgesics, antarthritic agents, sedatives, tranquilizers, laxatives, and antacids

97
Q

why is polypharmacy relevant to older adults?

A

high prevalence of health conditions = large use of medications

98
Q

what are some factors altering absorption?

A

route of administration; concentration and solubility of drug; diseases and symptoms

99
Q

what measures do you maximize for absorptions?

A

exercise; heat; massage; preventing dehydration, hypothermia, hypotension; interactions with other medications, use most effective route

100
Q

what are some factors altering absorption?

A

route of administration; concentration and solubility of drug; diseases and symptoms

101
Q

what are some considerations with distribution for the older adult?

A

changes in circulation; membrane permeability; body temp; tissue structure

102
Q

what can decrease drug distribution and lead to toxicity?

A

dehydration and hypoalbuminemia

103
Q

what are some conditions that decrease the metabolism of drugs?

A

dehydration, hyperthermia, immobility, and liver disease

104
Q

extended biological half-life

A

close evaluation of drug clearance

105
Q

what are some general factors regarding adverse reaction in older adults?

A

signs and symptoms differ in older adults; adverse reaction may take longer to become apparent; may be demonstrated even after medication discontinued; may develop suddenly, even after long-term use

106
Q

what is an early adverse reaction?

A

mental dysfunction

107
Q

what are some drugs that cause mental dysfunction?

A

codeine, digitalis, methyldopa, phenobarbital, L-dopa, diazepam, various diuretics

108
Q

mental dysfunction can arise from medication that promotes…

A

hypoglycemia, acidosis, fluid and electrolyte imbalances, temperature elevations, increased intracranial pressure, reduced cerebral circulation

109
Q

how to avoid potentially inappropriate drugs

A

identification of drugs that carry high risks for older adults; major drugs of concern; widely accepted in geriatric care; centers for medicare and medicaid services adopted for use in nursing home surveys; joint commission adopted criteria as potential sentinel event in hospitals

110
Q

what are some major drugs of concern for older adults?

A

anticholinergics, tricyclic antidepressants, antipsychotics, barbiturates, benzodiazepines

111
Q

how to check the scope of drug use and significant adverse reactions for older adults

A

ensure drugs are selectively and cautiously used

112
Q

what is the most common route to administer drugs?

A

oral; problems can interfere with the process

113
Q

suppository form

A

due to lower body temperature may take longer to melt

114
Q

what can reduce the rate of absorption for IM and SC injecgtions?

A

immobile limb

115
Q

patient teaching for self-medication

A

assess for risk of medication errors; plan interventions to minimize risks

116
Q

what factors interfere with safe administration?

A

function limitations; cognitive limitation; educational limitations; sensory limitations; financial limitations; choice

117
Q

anorexia

A

lack of appetite

118
Q

cholelithiasis

A

the formation or presence of gallstones in the gallbladder

119
Q

diverticulitis

A

inflammation or infection of the pouches of intestinal mucosa

120
Q

dysphagia

A

difficulty swallowing

121
Q

esophageal dysphagia

A

difficulty with the transfer of food down the esophagus

122
Q

fecal incontinence

A

involuntary passage of stool

123
Q

flatus

A

gas in intestinal tract

124
Q

gingivitis

A

inflammation of the gums surrounding the teeth

125
Q

hiatal hernia

A

portion of the stomach protrudes through an opening in the diaphragm

126
Q

oropharyngeal dysphagia

A

difficulty transferring food bolus or liquid from mouth into pharynx and esophagus

127
Q

periodontal disease

A

inflammation of the gums extending to the underlying tissues, roots of teeth, and bone

128
Q

presbyesophagus

A

age-related changes to esophagus causing reduced strength of esophageal contraction, slower transport of food down the esophagus

129
Q

what are the effects of aging on GI health?

A

atrophy of the tongue affects taste buds and decreases taste sensation; changes in taste sensation may be due to xerostomia, medication, diseases, smoking; saliva production decreases, swallowing may be difficult; reduction in chewing efficiency due to thinning of oral mucosa and weakening of the muscles; presbyesophagus results in weaker esophageal contractions and weakness of the esophageal sphincter; esophageal and stomach motility decreases; decreased elasticity of the stomach; stomach has higher pH due to declines in HCl acid and pepsin; decline in pepsin; decline in HCl acid; fewer cells on absorbing surface of intestinal wall impact the absorption; slower peristalsis, inactivity, reduced food/fluid intake, drugs, and low-fiber diet; sensory perception decreases; bile salt synthesis decreases; pancreatic changes of fibrosis, atrophy, fatty acids deposits; liver size decreased

130
Q

what happens if the esophageal and stomach motility decreases?

A

risk for aspiration and indigestion

131
Q

what happens if there is a decreased elasticity of the stomach

A

reduces the amount of food accommodation at one time

132
Q

what does the decline in pepsin interfere with?

A

absorption of protein

133
Q

what happens if there is a decline in HCl acid?

A

increase in incidence of gastric irritation; interferes with absorption of calcium, iron, folic acid, and vitamin B12

134
Q

what happens if there is slower peristalsis, inactivity, reduced food/fluid intake, drugs, and low-fiber diet?

A

increase risk of constipation

135
Q

what happens if sensory perception decreases?

A

may lead to constipation or incomplete emptying of the bowel

136
Q

what happens if the bile salt synthesis decreases?

A

increase in the risk of gallstone development

137
Q

what happens if pancreatic changes of fibrosis, atrophy, fatty acid deposits?

A

affects digestion of fats; fatty food intolerance

138
Q

what can an older adult do to promote GI health?

A

good hygiene, proper nutrition, knowledge of the impact of medication, utilization of natural means

139
Q

what are some nursing problems related to GI problems?

A

weakness- reduced participation in activities; constipation; diarrhea; acute pain; dehydration; potential for infection; insufficient nutritional intake; weight gain; oral pain, poor dental status, insufficient food intake

140
Q

what could cause weakness?

A

anemia, constipation, obesity, vitamin and mineral deficiencies, dehydration

141
Q

what could cause constipation?

A

decreased colonic peristalsis, duller neural impulses, anorexia, obesity, hemorrhoids, lack of roughage, dehydration, ahbitual laxative use

142
Q

what could cause diarrhea?

A

medications, peptic ulcer, gastritis, ulcerative colitis, diverticulitis, diabetes, fecal impaction, tube feedings, stress

143
Q

what could cause acute pain?

A

indigestion, constipation, hemorrhoids, flatus

144
Q

what could cause dehydration?

A

uncontrolled diabetes, infection, peritonitis, diarrhea, vomiting, blood loss, insufficient fluid intake, high-solute tube feedings

145
Q

what could cause potential for infection?

A

diabetes, malnutrition, hemorrhoids

146
Q

what could cause insufficient nutritional intake?

A

intestinal obstruction, anorexia, nausea, vomiting, poor dental status, altered taste sensation, constipation

147
Q

what could cause weight gain?

A

altered taste sensations, ethnic preferences, inactivity, lack of motivation to eat well

148
Q

what could cause oral pain, poor dental status, insufficient food intake?

A

diabetes, cancer, gingivitis, periodontal disease, jagged teeth, poorly fitting dentures, dehydration, malnutrition, dry mouth

149
Q

what does dry mouth (xerostomia) result from?

A

decreased saliva, some medications, Sjorgen’s syndrome, mouth breathing, and altered cognition

150
Q

what are some interventions of xerostomia?

A

saliva substitutes, sipping water, sugarless candy, and gum

151
Q

what are underlying dental problems?

A

altered taste sensation, poor diet, deficiencies of vitamin B complex and calcium, hormonal imbalances, hyperparathyroidism, diabetes, osteomalacia, cushing’s disease, syphilis

152
Q

what is the phenytoin of dental problems?

A

gingivitis, antihistamines, antipsychotics, severe dry mouth

153
Q

aging process of dental

A

tooth decay, root absorption, loss of tooth enamel

154
Q

what are the causes of dysphagia?

A

GERD, stroke, and structural disorders

155
Q

what are the different types of dysphagia?

A

oropharyngeal and esophageal

156
Q

what are the symptoms of dysphagia?

A

mild to complete inability to swallow

157
Q

what is the nursing assessment of dysphagia?

A

onset, accompanying symptoms, triggered by solids or liquids, intermittent or present at each meal

158
Q

what are the major goals of dysphagia?

A

prevention of aspiration; promotion of adequate nutritional status

159
Q

what is the nursing care plan of dysphagia?

A

dietary modification; eat in an upright position; ingest small bites in unhurried manner; verbal cues; easily accessible suction machine; monitor food intake and weight

160
Q

what are the causes of hiatal hernia?

A

believed to be a low-fiber diet

161
Q

what are the different types of hiatal hernias?

A

sliding, rolling

162
Q

signs and symptoms of hiatal hernia

A

heartburn, dysphagia, belching, vomiting, regurgitation, pain, bleeding; sometimes mistaken for a heart attack

163
Q

how is a hiatal hernia diagnosed?

A

barium swallow, esophagoscopy

164
Q

what is the treatment/management of a hiatal hernia?

A

weight reduction, bland diet, frequent small meals, discourage bedtime eating, sleep in partly recumbent position, H2 blockers and proton pump inhibitors

165
Q

what are the different types of esophageal cancer?

A

squamous cell carcinoma, adenocarcinoma

166
Q

what are the causes of esophageal cancer?

A

poor oral hygiene, chronic irritation from tobacco, alcohol, and other agents, barrett’s esophagus

167
Q

signs and symptoms of esophageal cancer

A

dysphagia, weight loss, excessive salivation, thirst, hiccups, anemia, chronic bleeding

168
Q

how to diagnose esophageal cancer?

A

barium swallow, esophagoscopy, biopsy

169
Q

what is the treatment/management of esophageal cancer?

A

surgical resection, radiation, chemotherapy, laser therapy, photodynamic therapy

170
Q

what are the causes of peptic ulcer disease?

A

stress, diet, genetic predisposition, COPD, certain medications that can increase gastric secretions and reduce resistance of mucosa

171
Q

what are the risk factors from a peptic ulcer disease?

A

smoking, heavy alcohol use, caffeine, stress, H. pylori infection

172
Q

signs and symptoms of peptic ulcer disease

A

pain, bleeding, obstruction, perforation

173
Q

what are some complications associated with peptic ulcer disease?

A

constipation, diarrhea, dehydration, peritonitis, hemorrhage, shock

174
Q

signs and symptoms of cancer in the stomach

A

anorexia, epigastric pain, weight loss, anemia; may be insidious

175
Q

treatment/management of cancer in the stomach

A

surgery

176
Q

how to prevent cancer in the stomach

A

diet in low in red meats and high in antioxidants

177
Q

causes of diverticulitis

A

chronic constipation, obesity, hiatal hernia, atrophy of intestinal wall muscles, low-fiber, low-residue diets; overeating, straining during a bowel movement, alcohol, and irritating foods with diverticulosis may lead to diverticulitis

178
Q

signs and symptoms of diverticulitis

A

slight bleeding, change in bowel habits, tenderness on palpation of lower left quadrant, nausea, vomiting, constipation, diarrhea, low-grade fever, blood or mucus in the stool

179
Q

treatment/management of diverticulitis

A

increase in dietary fiber intake, weight reduction, avoidance of constipation; reduce infection, provide nutrition, relieve discomfort, promote rest; if surgery, resection or temporary colostomy

180
Q

signs and symptoms of colorectal cancer

A

rectal bleeding, bloody stools; change in bowel pattern; feeling of incomplete emptying of bowel; anorexia; nausea; abdominal discomfort; weakness, fatigue; unexplained weight loss; anemia

181
Q

treatment/management of colorectal cancer

A

surgical resection with anastomosis or colostomy

182
Q

contributing or causative factors of chronic constipation

A

inactive lifestyle; low fiber and low fluid intake; depression; laxative abuse; medications; dulled sensations to need for bowel elimination; failure to allow sufficient time for complete emptying of bowels

183
Q

interventions to promote bowel elimination

A

high-fiber diet, fluids, regular activity; specific foods individual responds to; regular schedule; rocking trunk of body

184
Q

patient education for chronic constipation

A

safe use of laxatives; use of elimination chart

185
Q

causes of flatulence

A

constipation, irregular bowel movements, certain foods, poor neuromuscular control of anal sphincter

186
Q

treatment/management of flatulence

A

achieving regular bowel pattern; avoiding flatus-producing foods, medications, sitting upright after meals

187
Q

interventions for flatulence

A

increased activity, knee-chest position, flatus bag

188
Q

what are the different types of intestinal obstruction

A

partial or complete

189
Q

causes of intestinal obstruction

A

diverticulitis, ulcerative colitis, hypokalemia, vascular problems, paralytic ileus

190
Q

signs and symptoms of a small bowel obstruction

A

upper and mid-abdominal pain in rhythmic recurring waves, vomiting

191
Q

signs and symptoms of obstructions occurring past ileum

A

abdominal distention so severe can inhibit respirations, vomiting

192
Q

signs and symptoms of obstruction of colon

A

lower abdominal pain, altered bowel habits, distension, sensation of need to defecate, vomitting

193
Q

nursing assessment of intestinal obstruction

A

review symptoms thoroughly; careful attention to bowel sounds

194
Q

treatment/management of intestinal obstruction

A

timely intervention is extremely important; medical management- x-rays, blood evaluation, intestinal intubation; surgical management

195
Q

signs and symptoms of fecal impaction

A

distended rectum, abdominal and rectal discomfort, oozing of fecal material around impaction often mistaking as diarrhea; palpable, hard fecal mass; fever

196
Q

nursing interventions of fecal impaction

A

important to follow agency policy; may include enema (oil retention); manual breaking and removal of feces; hydrogen peroxide; avoid traumatizing or overexerting patient

197
Q

causes of fecal incontinence

A

decreased contractile strength, impaired automaticity of puborectal and external anal sphincter, loss of cortical control, reduced reservoir capacity

198
Q

treatment/management of fecal incontinence

A

bowel retraining, drugs, surgery, biofeedback

199
Q

atypical presentation of acute appendicitis

A

minimal or referred pain, minimal fever, absent leukocytosis

200
Q

treatment/management of acute appendicitis

A

prompt surgery

201
Q

signs and symptoms of cancer of the pancreas

A

dyspepsia; belching; nausea; vomiting; diarrhea; constipation; obstructive jaundice; possible fever; epigastric pain radiating to back, relieved by leaning forward, worsens in recumbent position

202
Q

treatment/management of cancer of the pancreas

A

surgery

203
Q

signs and symptoms of choleithiasis

A

pain, often following meals

204
Q

treatment of chloeithiasis

A

rotary lithotrite treatment, extracorporeal shock wave lithotripsy, standard surgical procedures

205
Q

management of chloeithiasis

A

monitor for obstruction, inflammation, infection

206
Q

signs and symptoms for cancer of the gallbladder

A

pain in the upper right quadrant, anorexia, nausea, vomiting, weight loss, jaundice, weakness, constipation

207
Q

treatment for cancer of the gallbladder

A

surgery

gero (2 decks)

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