GI Flashcards
what are the steps we take when administering a feeding or medications into an NG tube?
- assist into fowlers position - keep head elevated 30 min after
- confirm tube is in the correct place
- monitor residual
- obtain correct formula or medications in separate containers crushed and mixed with water
describe the following forms of endoscopy and nursing considerations for upper GI
detects abnormalities of esophagus and stomach
describe the following forms of endoscopy and nursing considerations for lower GI
detects abnormalities of small intestines and large intestines
describe the following forms of endoscopy and nursing considerations for capsule camera
swallow it and it transmits info to a belt
What are symptoms of dumping syndrome?
sweating abdominal distension with diarrhea
why might dumping syndrome occur when a patient is receiving tube feeds?
occurs because of rapid feeding
list the risk factors for developing oral cancer:
alcohol, smoking and smokeless tobacco
what are some tips we can provide for our patients to help prevent aspiration when eating and drinking? (regarding size of meals, body position, timing of meals)
small meals, fowlers, tilt head forward, eat earlier and frequent small meals.
What are some things we can teach our patient do to prevent reflux/regurgitation?
keep head of the bed up after meals
small meals
avoid smoking
drink in between meals not during meals
When giving Phenergan to your patient, what are some side effects you can expect?
drowsiness, confusion, dizziness
what interventions would you want to take to promote safety regarding the side effects of phenergan?
safety, side rails up, fall precautions - mat on floor, bed alarm
Why would we use a central line for TPN?
rapid dilution
what is the risk associated with peripheral IV use?
phlebitis
when referring to hernia, what is reducible vs. irreducible?
reducible - push it back in
irreducible - can’t push it back in
why is an irreducible hernia something we would want to report to the physician right away?
increased risk of strangulation or incarceration
if a patient has had severe diarrhea for several days, what might you expect their vital signs to display?
hypotension, tachycardia. fatigue
what lab values may be abnormal for a patient who has had severe diarrhea for several days?
metabolic acidosis
what are stool softeners?
they pull fluid or moisture into the stool, allowing for easier passage
why is it important to remain adequately hydrated when taking these?
your body can use that fluid to take into the stool
what are assessment findings that indicate a patient is adequately hydrated and has a good fluid balance?
vital signs within normal limits, moist mucous membranes and I &O s equal
why do we help a post surgical patient splint their incision with a pillow when coughing/deep breathing?
reduce pain and allow better lung expansion
what is the surgical treatment for ulcerative colitis? is it permanent or reversible?
removal of the colon - permanent ileostomy
what are some non surgical treatments for inflammatory bowel disease?
stress management
low roughage
no milk products
no alcohol
what are some risk factors for developing diverticulitis?
eating low fiber diet, stress
what foods would a patient with diverticulitis want to avoid?
food with seeds or hard particles spicy, corn, peanuts, seeds
When giving TPN, what are some important points to remember?
always give at prescribed rate or you can cause hyperglycemia
what signs and symptoms may our patient on TPN display if they become hyperglycemic?
polydipsia, polyuria, sweaty
What are some assessments and interventions we perform following a liver biopsy? what are these things directed toward detecting/preventing?
focus on bleeding
In reference to skin changes due to hepatitis, what is the reason for jaundice?
high bilirubin
in reference to skin changes due to hepatitis, what is the reason for pruritus?
accumulation of bile salts
in reference to skin changes due to hepatitis are the conditions permanent?
no they usually last 2-4 weeks
what is the reference between bilirubin and liver function in a patient with hepatitis?
when bilirubin goes down liver function is goes up
if bilirubin goes up, liver function is down
if the bilirubin is dropping in a patient with hepatitis what does that tell us?
the liver function is improving
What are some measures a patient with cirrhosis can take to promote the liver to regenerate healthy tissue and return to normal functioning?
rest, manage symptoms avoid further toxins, monitor for liver varicies - bleeding, monitor for liver cancer.
Why would we see a low-protein diet ordered for a patient with cirrhosis?
keep ammonia levels low.
how would we assess ascites? What would we document in the chart so that the physician may evaluate the progress?
daily weights, I/O, abdominal girth, measurements
What is the advantage of a LeVeen peritoneal-venous shunt vs. a paracentesis?
protein rich serum is retained and returned to the vascular circulation and it prevents loss of this protein.
what is the reason for hepatic encephalopathy?
caused by build up of ammonia
What are some assessments and precautions we would take when our patient develops this hepatic encephalopathy?
neuro - seizure precautions
How is hepatitis A transmitted? and can patients become permanent carriers or not?
through food, water, saliva that is infected with fecal matter. patients do not become carriers
how is hepatitis B transmitted? and can patients become permanent carriers or not?
body fluids, patients can become carriers
how is hepatitis C transmitted? and can patients become permanent carriers or not?
body fluids, blood - some patients can become carriers
What are some foods some on a low-sodium diet would want to avoid?
canned food - soups, fast foods and cured meats
When a patient has portal hypertension, what are some things we can encourage our patients to do in order to reduce the risk of hemorrhage?
don’t life heavy objects, don’t strain with BM’s and no straining or baring down
what lab values may indicate pancreatitis?
elevated serum amylase, serum lipase,
what is a common modifiable risk factor for pancreatic disease?
drinking alcohol, stop drinking alcohol
why would a patient have clay-colored stools?
bile duct is blocked
why would a patient with liver disease be at a high risk of drug overdose?
can’t metabolize the drugs. they build up to toxic levels
what are some dietary suggestions the nurse can make in teaching an elderly patient to prevent constipation?
high fiber, increase fluids, increase activity and exercise
what are some interventions we can perform during a meal to help stimulate appetite on a patient with anorexia?
assist with oral hygiene, smaller portions, remove bad smells - they cause food aversion, offer foods they like, make sure dentures fit, visitors during meals.
what foods can trigger cholecystitis?
high fat foods
what are some dietary recommendations for a patient with pancreatitis?
small frequent meals, bland foods, easy to digest foods, low fat, no caffeine
what are some teaching points we want to review when administering bowel prep to our patients?
check with provider about meds
what are some interventions we would expect to perform for a patient that is on TPN?
monitor for hyper/hypoglycemia, monitor for infections, monitor temperature, assess hydration with I/O’s
