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MedSurg Test 4 > GI disorders Flash Cards > Flashcards

GI disorders Flash Cards

1
Q

What should be included in your general assessment of a patient?

A

history, medications, pain level, location, duration, diagnostic tests, fluid and electrolytes, CBC, physical exam, food intake, calories

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2
Q

What body parts should be included in physical exam of the GI?

A

mouth, abdomen, rectum (stool quality and vomitus)

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3
Q

What are risk factors that can cause GI problems?

A

peristalsis and nutrition problems, immobility, medications, dehydration, anorexia, age, infection

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4
Q

What are some common manifestations of GI disorders?

A

anorexia, n & v, vomiting, dysphagia, constipation, diarrhea, constipation, pain, bleeding

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5
Q

_____ is the feeling to vomit

A

nausea

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6
Q

What s/s will accompany nausea?

A

diaphoresis, increased salivation, pallor, tachycardia, dizziness, and faintness

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7
Q

True or false, nausea is defined as reverse peristalsis and relaxation of the esophageal sphincter

A

False, vomiting

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8
Q

What are 2 types of vomiting?

A

projectile and retching (dry heaves)

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9
Q

Your post-op patient Kim is experiencing severe vomiting. What would you included in your assessment?

A

Condition associated with N/V, amount, odor, content [undigested food, mucus, parasites, foreign bodies, and color (green, red, coffee grounds, black, brown)]

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10
Q

After your assessment of Kim (severe vomiting), what nursing interventions would you implement?

A

NPO, IV w/ electrolyte replacement, NG tube insertion, give antiemetic

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11
Q

What preventative measures can you implement to prevent your patient for vomiting?

A

give water first, then slowly give clear liquids, warm cola, continue to increase if no vomiting, advance dry toast, crackers, bland food as tolerated.

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12
Q

What foods should a patient avoid that stimulate peristalsis?

A

high fat foods, orange juice, caffeine, high fiber, extremely hot or cold fluids

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13
Q

True or False, Bowel movements can vary from three a day to three a week

A

TRUE

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14
Q

What are your nursing interventions for constipation?

A

assist physician tx underlying cause, encourage to eat HIGH fiber diet to increase the bulk, increase fluid intake, administer prescribed laxatives/stool softeners, and assist in relieving stress

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15
Q

What are your nursing interventions that diarrhea?

A

record the color, volume, frequency and consistency of stools; identify factors that cause or contribute to diarrhea; eliminate gas-producing and spicy foods; rest the bowel; record weight regularly; monitor skin; antidiarrheal medications

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16
Q

You are educating your patient who has had diarrhea for the past two days on the ideal diet he should eat. What do you encourage him to eat?

A

a low-fiber, high-protein, high-calorie diet

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17
Q

What are some common diagnostic tests for GI disorders?

A

gastric analysis, lab tests (serum & urine), x-rays, endoscopy

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18
Q

What are 5 endoscopy diagnostic procedures?

A

gastroscopy, EGD, ERCP, colonoscopy, sigmoidoscopy

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19
Q

What does ERCP stand for and what is it?

A

endoscopic retrograde cholangiopancreatography. Exam of the hepatobilary system performed via a flexible endoscope inserted into the esophagus.

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20
Q

What does EGD stand for and what is it?

A

Esophagogastroduodenoscopy. Test to examine the lining of the esophagus

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21
Q

True or False, a upper gastrointestinal fiberoscopy is the aspiration of gastric juice to measure pH, appearance, volume and contents

A

False, Gastric analysis

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22
Q

What do you educate your patient on Pre-test and post-test instructions for gastric analysis?

A

Pre-Test: NPO 8 hours, avoidance of stimulants, drug and smoking. Post-test: resume normal activities

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23
Q

True or False, the only nursing responsibility for x-rays is prep

A

TRUE

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24
Q

What are the nursing responsibilities for endoscopy, ERCP, and colonoscopy

A

preps (MD order), consents, conscious sedation, post procedure assessment

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25
Q

What is the difference between upper and lower GI tract barium studies?

A

Upper- client drinks barium and only fluoroscopy exam. Lower- barium enema administered and fluoroscopic & radiographic exam

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26
Q

You need to give your patient a bowel prep. What does that entail?

A

laxative 12-15 hours before the test and give the patient 4 liters/quarts of a special cleansing solution to clean out the colon

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27
Q

Name one medication for bowel cleansing

A

polyethylene glycol 3350 (GoLYTELY)

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28
Q

What are 2 laxatives used to cleanse the bowel?

A

mag citrate (Citroma) or senna (X-Prep)

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29
Q

What are 2 common orders before a GI diagnostic test?

A

Bowel Prep, Diet Orders (NPO or Clear liquids only)

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30
Q

Suzie has just came back from an upper GI fiberoscopy, what will you monitor her for?

A

Vomiting, reflux, difficulty swallowing, chest pain or heart burn, N & V, abdominal pain, diarrhea

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31
Q

What are some nursing dx for patients with some kind of feeding tube?

A

altered elimination, n & v, FVD, pain, discomfort, nutrition, malabsorption, metabolic, self care deficit-feeding, elimination, tissue integrity, skin integrity, risk of infection, risk of injury

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32
Q

Your GI patient is at risk for imbalanced nutrition, what are some interventions you will implement?

A

anticipate pain & nausea, monitor bowel sounds and elimination, I & O, arrange for feeds, encourage supplements, dietary consult and tube feeding

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33
Q

If you are taking care of a patient on TPN, PPN, or Lipids, what are 2 nursing intervention you will implement?

A

site and line care, glucose levels

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34
Q

What are the clinical manifestations of an esophageal tumor?

A

dysphagia, odynophagia, regurgitation, vomiting, foul breath, chronic hiccups, pulmonary complications, chronic cough, and hoarseness

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35
Q

A _______ is an ulceration in the ______ wall of the stomach, pylorus, duodenum or esophagus in portions accessible to _____ secretions.

A

A peptic ulcer is an ulceration in the mucosal wall of the stomach, pylorus, duodenum or esophagus in portions accessible to gastric secretions.

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36
Q

True or False, vascular occlusion causes localized necrosis and HCL backwash in peptic ulcers

A

TRUE

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37
Q

Melanie comes into the ER c/o epigastric pain, n & v, and coughing up blood. What would you expect she is suffering from?

A

Peptic Ulcer

38
Q

What are your interventions during an active bleeding ulcer?

A

monitor vital signs closely, assess for signs of dehydration, hypovolemic shock, sepsis, and respiratory insufficiency, maintain NPO and administer IV fluid replacement, monitor I & O, monitor H & H, administer blood prn

39
Q

What is the action of antacids?

A

elevate the level of the gastric contents

40
Q

True or False, the action of histamine receptor antagonists is to increase acid production

A

False, the action is to decrease acid production

41
Q

What is the action of proton pump inhibitors?

A

Provide effective, long-acting inhibition of gastric acid secretion

42
Q

What is the action of prokinetic drugs?

A

increase gastric emptying and improve lower esophageal sphincter pressure and esophageal peristalsis

43
Q

Cisapride is an example of what kind of drug?

A

prokinetic drug

44
Q

What are the treatments of peptic ulcer?

A

decrease risk factors, drug therapy, surgery, manager complications: GI bleeding

45
Q

What are drugs prescribed for a peptic ulcer?

A

Histamine 2 blockers, pepcid, antacids, prostaglandins, omperazole

46
Q

What are common surgeries used to correct a peptic ulcer?

A

vagotomy, pyloroplasty, bilroth I Bilroth II (total gastric resection)

47
Q

What are the nursing interventions for postop care of a peptic ulcer?

A

monitor VS, monitor NG tube, NPO until peristalsis, monitor for complications (dumping syndrome, reflux gastropathy, bleeding)

48
Q

Constellation of vasomotor symptoms after eating is called what?

A

Dumping syndrome

49
Q

You suspect your patient is hypovolemic, what nursing intervention will implement?

A

Monitor VS(including ortho BP) and observe for fluid loss from bleeding and vomiting, monitor serum electrolytes, insert 2 large-bore peripheral IV caths to replace fluid and blood loss,

50
Q

What type of volume replacement would you expect for a hypovolemic patient?

A

isotonic crystalloid solution

51
Q

True or False, gastric cancer patients may be asymptomatic, but indigestion and abdominal discomfort re the most common symptoms

A

TRUE

52
Q

True or False, drug therapy in chemo of gastric cancer remains uncertain

A

TRUE

53
Q

True or False, the use of radiation in gastric cancer is limited because the disease is often widely disseminated

A

TRUE

54
Q

_______ is defined as the ______ inflammation of the ____ appendix—- the blind _____ attached to the _____ of the colon

A

Appendicitis is defined as the acute inflammation of the vermiform appendix—- the blind pouch attached to the cecum of the colon

55
Q

True or False, flank pain is the initial symptoms of classic appendicitis?

A

False, epigastric or periumbilical abdominal pain

56
Q

What are the 6 non-surgical interventions to tx appendicitis?

A

NPO, IV fluid, semi-fowlers, analgesics, no laxatives or enema, and no heat

57
Q

What are your nursing interventions for our gastric cancer patient?

A

monitor VS, monitor H & H, monitor weight, assess nutritional status (encourage small, bland, easily digestible meals with vitamin and mineral supplementation), administer pain meds prn, get patient ready for chemo or surgery

58
Q

True or False, when the appendix becomes inflamed or infected, rupture may occur within a matter of hours, leading to peritonitis and sepsis

A

TRUE

59
Q

Where will the pain be the most painful in a patient with appendicitis?

A

McBurney’s Point

60
Q

What are the post-op interventions of a patient that had an appendectomy?

A

monitor temp for s/s of infection, assess incision for signs of infection such as redness, swelling and pain, maintain NPO until bowel sounds have returned, change dressing prn, keep patient in semi-fowlers with legs flexed to promote drainage, administer antibiotics or pain meds prn

61
Q

Would you expect a patient to have a Jackson Pratt or a Penrose drain post appendectomy rupture?

A

Penrose

62
Q

What is Crohn’s Disease?

A

An inflammatory disease of the small intestine and/or colon

63
Q

Which layer of the bowel is involved in Crohn’s disease?

A

all layers, mostly terminal ileum

64
Q

What assessment findings would you anticipate in a patient with CD?

A

fever, abdominal distention, diarrhea, colicky abdominal pain, anorexia, n & v, weight loss, anemia

65
Q

Name 4 classes of drugs used to treat CD

A

salicylate compounds, corticosteroids, immunosuppressive drugs, antidiarrheal drugs

66
Q

True or False, the treatments for Crohn’s disease (CD) and ulcerative colitis (UC) are the same?

A

True, except surgery is prolonged in CD for as long as possible due to high change of disease reoccurring in same area

67
Q

What are common nursing interventions for CD and UC?

A

maintain NPO during active phase, monitor for complications (severe bleeding, dehydration, electrolyte imbalance), monitor bowel sounds, stool and blood studies, restrict activities, administer fluids, electrolytes, TPN prn, administer meds

68
Q

Which meds would you likely see ordered for patients with CD and UC?

A

anti-inflammatory, antibiotics, steroids, bulk forming agents, vitamin/iron supplements

69
Q

What education would you give you patient on CD and UC?

A

avoid gas-forming foods, milk products and foods such as whole grains, nuts, RAW fruits and veggies (esp. spinach), pepper, alcohol, and caffeine

70
Q

What’s the difference between diverticulosis and diverticulitis?

A

Diverticulosis is abnormal out-pouching of the intestinal mucosa occurring in any part of the LI most common in the sigmoid. Diverticulitis- inflammation of the diverticula that occurs from penetration of fecal matter through the thin walled diverticula

71
Q

True or False, diverticulitis can result in local abscess formation and perforation

A

TRUE

72
Q

What are the nursing interventions for diverticulosis and diverticulitis?

A

NPO, bed rest, admin antibiotics, analgesia, and antispasmodics, increase fluid intake and monitor for complications (perforation, hemorrhage, and fistula)

73
Q

What is another name for nonmechanical obstruction?

A

paralytic ileus

74
Q

What are the clinical manifestations of a mechanical obstruction?

A

midabdominal pain, vomiting, obstipation, diarrhea, alteration in bowel pattern and stool, abdominal distention, borborygmi, abdominal tenderness

75
Q

What is obstipation?

A

a type of sever form of constipation

76
Q

Constant diffuse discomfort, abdominal distention, decreased to absent bowel sounds, vomiting, and obstipation are all s/s of what GI disorder?

A

nonmechanical obstruction

77
Q

Describe the nonsurgical management of GI obstructions

A

NPO, NG tube insertion, nasointestinal tubes, fluid and electrolyte replacement, pain management, drug therapy (broad spectrum antibiotics and sandostatin)

78
Q

______ refers to the colon and the rectum, which together make up the large intestine

A

Colorectal

79
Q

True or False, tx of colon cancer depends of the stage or extent of the disease

A

TRUE

80
Q

Evelyn has rectal bleeding, change in stool texture, and labs show she is severely anemic. Upon palpation, you feel a mass in abdomen. What is her dx?

A

colorectal cancer

81
Q

If your patient is at risk for metastasis cancer, what interventions do you implement?

A

tx based off Duke’s staging, radiation therapy, drug therapy (chemo after surgery, antiangiogenesis meds, monoclonal antibodies & colorectal tumor vaccine (in clinical trials)

82
Q

What is the post op care of colorectal cancer patients?

A

colostomy and wound mgmt. and ng tube care

83
Q

What are the s/s of bowel perforation and peritonitis?

A

guarding, increased fever and chills, pallor, abdominal distention & pain, restlessness, and tachycardia and tachypnea

84
Q

What are the nursing colostomy care that you would implement?

A

monitor stoma for size and unusual bleeding or necrotic tissue, monitor for color changes, assess consistency of stool, and encourage client to avoid foods that cause gas and odor

85
Q

Describe the different colors the stoma could be?

A

pale pink- low H & H levels, purple and black- compromised circulation (call MD asap), pink to bright red & shiny- normal stoma color

86
Q

What are ostomy priorities?

A

elimination, stoma (cherry red), skin, self care, body image & sexuality

87
Q

What are the s/s of cholestasis and cholelithiasis?

A

varies on size, movement, inflammation, degree of obstruction- biliary colic, n & v, upper abdominal discomfort, fever and chills

88
Q

impacted stone in cystic duct, obstruction, inflammation, cholangitis, sepsis, sudden starvation and immobility are all causes of what?

A

cholecystitis

89
Q

Acute abdominal pain midepigastric & RUQ, n & v, anorexia, fever, headache, leukocytosis, tachycardia, tachypnea, and intolerance of fatty foods are all s/s of what?

A

cholecystitis

90
Q

What are common post-op care nursing interventions for postsurgical cholecystitis patients?

A

free air pain result of CO2 in abdomen, ambulation and educate pt. to return to activities in 1 to 3 weeks

MedSurg Test 4 (3 decks)

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