GI Assessment Class Questions

Question 1

What are key health history questions for abdominal pain and vomiting?

Answer 1

Point to location of your pain

Question 2

When did the pain start?

Answer 2

3 days ago

Question 3

Tell me how has the pain been over these 3 days

Answer 3

It would come and go, but today it won’t stop

Question 4

What does the pain feel like?

Answer 4

It was crampy, but now it is very squeezy and uncomfortable

Question 5

What were you doing when pain started?

Answer 5

Nothing

Question 6

On a scale of 1-10, where 10 is the worse pain ever how would you rate your pain?

Answer 6

9

Question 7

What makes it worse? What makes it better?

Answer 7

I don’t know. I tried some Tylenol I threw it up.

Question 8

When was your last bowel movement?

Answer 8

Last thursday

Question 9

What have you eaten since Friday?

Answer 9

Threw up everything eaten

Question 10

When was your last period?

Answer 10

Menopause started early for me, have not had in 4 years

Question 11

Describe your vomit

Answer 11

Threw up meal from thursday night went from normal to green to yellow to clear, nothing coming out now just clear. no blood

Question 12

How often do you vomit?

Answer 12

Every hour

Question 13

Does the pain get worse or better after vomiting?

Answer 13

No

Question 14

Do you have any fever?

Answer 14

No

Question 15

Are you thirsty?

Answer 15

Yes

Question 16

How often are you urinating?

Answer 16

Every hour

Question 17

What is her circulation like?

Answer 17

Pale, diaphoretic

Question 18

What are her vitals? What kind of drop are we looking for in systolic to call this orthostatic hypotension? HR?

Answer 18

Orthostatic vital sings (have her lie down) then sit her up legs dangling and do her blood pressure. 20mmHg. Change of 10 bpm

Question 19

When would you treat pain? Why?

Answer 19

Once a diagnosis is made. Pattern of pain can provide a lot of information

Question 20

What is the shape of her abdomen? Where would you stand? What do you want to know about how her stomach looks now?

Answer 20

Foot of bed and look u. Protuberant and large. Symmetrical. Might ask about her normal

Question 21

Is umbilicus midline?

Answer 21

Yes

Question 22

Which part of stethescope do you listen with?

Answer 22

Diaphragm

Question 23

What does it sound like in all quadrants?

Answer 23

No sounds

Question 24

How ling do you listen for to determine sound as silent?

Answer 24

5 minutes

Question 25

Why is a nasogastric tube needed for decompression?

Answer 25

Allows bowel to relax or rest and unkink

Question 26

What would you put suction setting at?

Answer 26

80mmHg, low suction, remove anything sitting in stomach

Question 27

Anytime an intervention is going to happen what should we always be asking?

Answer 27

Have you had this before?

Question 28

How do you determine what nostril to insert NG tube in?

Answer 28

Less congestion, trauma

Question 29

Who would you not put an NG tube in?

Answer 29

Facial, head injury, basilar skull fracture, cerebral spinal fluid leakage suspected (tells you there is skull fracture)

Question 30

How do you know tube is where it should be?

Answer 30

Once at carina stop and check if there is airflow at end of tube and then you can continue if there is not. If there is you are in the trachea. Then you aspirate once in stomach and check pH for less than 5. Then xray.

Question 31

If you aspirate and nothing comes out what should you do?

Answer 31

Remove it and try again.

Question 32

What should you be checking hourly for a patient with an NG tube? How?

Answer 32

Placement (use the mark point to make sure it hasn't migrated, how much of NG tube comes out of nares), every x hours you should aspirate (depends on policy). Hourly you can mark how much bile is coming out and add to fluid balance sheet. Auscultate bowel sounds and lung sounds hourly.

Question 33

What kinds of health teaching post operatively would you give for PCA use?

Answer 33

PCA is used to help her control her pain. Reinforce it is a narcotic/ Side effect of narcotics is it slows down your breathing, but I will be here to monitor.

Question 34

How do you answer questions about addiction?

Answer 34

will give you enough to control your pain, but over a few days it will be reduced slowly and eventually you will be switched to lower does to ween nyou as your pain decreases. Therapeutic dose based on her weight

Question 35

What is the difference between a demand and a basal rate mean?

Answer 35

basal rate is continuously administered, on demand means they get it when they push the pump

Question 36

What assessments do you want to do on a patient on PCA?

Answer 36

Pain, respiratory, ABCD, IV site, BP, HR, how much of narcotic in previous hour, pushes of button she did

Question 37

What is the benefit of TPN?

Answer 37

To rest bowel. We have ingestion and digestion food and fluids. Need capability to do both

Question 38

Client comes back from surgery with central line, what do you want to assess?

Answer 38

Is dressing dry and intact, any bleeding?

Question 39

What kind of lines can you have?

Answer 39

Single, double, triple lumens. How many lines do we have and what are we going to do with them?

Question 40

With diagnosis of cancer obstructing bowel and entry into palliative care. What does palliative care mean and what is involved in it?

Answer 40

Symptom, pain, nausea, vomiting management. Prevent complications like pressure ulcers. Support religious, spiritual needs, hypodermoclysis for hydration. MAID discussion. Emotional support (fear, depression, anxiety)

Question 41

What are the benefits of Subcutaneous pain injection?

Answer 41

May take longer to be absorbed if there is even less circulation to the area and medication may stay there longer too

Question 42

What would you do if family wants to give her soup?

Answer 42

She cannot swallow and could possibly end up in lungs further complicating things

Question 43

Family in room, call you with call bell and say patient is not breathing anymore. What do you do?

Answer 43

Take your stethescope, place it on apex and listen for a full minute for a heartbeat. Check for spontaneous breathing, check the time and note it at that point. Don't need physician to pronounce death just certify it. If family is there, could leave them, give them sometime before cleaning and prepping patient.

Question 44

Family in room, call you with call bell and say patient is not breathing anymore. What do you do?

Answer 44

Take your stethescope, place it on apex and listen for a full minute for a heartbeat. Check for spontaneous breathing, check the time and note it at that point. Don't need physician to pronounce death just certify it. If family is there, could leave them, give them sometime before cleaning and prepping patient. Can also allow family to be involved in cleaning as well.

Question 45

Would you clean if it was trauma or violent act?

Answer 45

No