gi/gu

Question 1

pancreatitis is manifested by

what are the interventions and what to monitor?

Answer 1

lots of vomiting, very painful, epigastric pain

give opiods (pain med)
give saline (since pancreatitis causes hypovolemia)

monitor blood sugar since inflammation of the pancreas impair insulin and may cause hyperglycemia

surgery is not required for pancreatitis, unless its chronic (last a long time)
antibiotics are not require but may be given only if an infection is present.

steroids may be given to reduce inflammation.

Question 2

complex carbohydrates is better because

Answer 2

higher fiber, lentils, etc..
think of CC: complex is the right carbohydrate, CC reduces CAD, cholesterol, complications, etc..

Question 3

cerebral aneurysm, what does vomiting mean?

Answer 3

aneurysm has ruptured, immediate surgical intervention is required

Question 4

nephrolithiasis, what is it, side effects, and interventions
what’s the diff b/w nephrolithiasis and pyelonephritis

Answer 4

urolithiasis/renal calculi/ nephrolithiasis / kidney stone. it is not an infection, so temp is normal. in pyelonephritis, you will see high temp/fever

all are names of kidney stones.
symptoms dysuria, inc. urinary frequency
flank pain, N/V

interventions: drinking water, peeing, pain medications

Question 5

cystitis

Answer 5

dysuria, inc. urinary frequency
foul smelling urine, suprapubic discomfort

Question 6

SIADH

Answer 6

high urine specific gravity (conc. urine)

Question 7

acute graft rejection signs

Answer 7

so after a transplant, acute graft rejection can occur.
signs and symptoms: tachycardia, fever.
if this happens w/ liver transplant: inc. AST/ALT, flank pain, diminished bile drainage, change in bile color, or inc. jaundice

Question 8

48hrs after surgery, is a moderate serosanguinous drainage normal?

Answer 8

yes it is normal.
serousanguinous: containing blood
sanguinous: primarily blood (that would be too much blood after 48hrs)
foul smelling is bad. but here that is not indicated.

Question 9

serous, sanguinous, serosanguinous, purulent

Answer 9

serous: thin and clear
sanguinous: primarily blood
serousanguinous: has blood
purulent: yellow, green, white, pus like. may indicate an infection.

Question 10

hydrocolloid

Answer 10

use in dressings when patient has shallow ulcers, partial thickness, eroded areas (but no necrotic areas)

alginate are used if there’s significant drainage, they can absorb a large amt of exudate

Question 11

can you take urine from a catheter port?

Answer 11

yes, you can when its 1/2 full

no need to clamp urinary catheter tubing prior to discontinuation and cause extra fluids to go back into the bladder, may inc. risk for infection

Question 12

collect urine sample when?

Answer 12

midstream

not first stream (inc. risk of contamination due to bacteria)
always discard the first urine, even when counting 24hr urine

Question 13

dumping syndrome
what causes it?
s/s (4)
what’s an adverse effect?

Answer 13

common after gastric/esophageal surgeries
food gets dump in the small intestine before being properly digested. pyloric sphincter removed or damaged.
early dumping: 10-30mn after a meal
bloating, abdominal cramps, N/V, diarrhea, tachy, dizziness
late dumping symptoms: 1-3hrs after eating
pancreas try to reduce sugar which may cause hypoglycemia (weakness, confusion, tremors), GI symptoms, symptoms are high after meals high in simple carbohydrates

interventions:
diet changes: eating smaller meals, avoid sample sugar
eat proteins, fibers, complex carbohydrates (whole grain)
do not drink liquids with meals, *lay down after eating (to slow digestion)
meds slow down gastric emptying or inhibit insulin: acarbose

Question 14

dumping syndrome (late dumping) managements
true or false
wait 30mn after meals to drink liquids
sit up 30mn after eating
eat 5-6 small meals
eat cold or hot foods to Dec. symptoms

Answer 14

true: wait 30mn after meals to drink liquids
false: sit up 30mn after eating (pt should lie down)
true: eat 5-6 small meals
false: eat cold or hot foods to Dec. symptoms (that inc. gastric motility & emptying, eat warm temp foods)

symptoms: diaphoresis, tachycardia, hypotension (fluid shift), hypoglycemia (worst), nausea, weak, abdominal cramps (small intestine are going to swell)

it goes on small intestine prematurely

Question 15

symptoms of dumping syndrome resolves after how long

and what should the patient eat? what’s the dumping syndrome diet

Answer 15

several months to a year after gastrectomy surgery

patient should eat foods low in carbohydrates (or moderate in complex carbs and low in simple carbs), moderate - high protein, more fiber, avoids foods that are hot or cold, restrict fluids while eating. ex: eggs, rice cereal, chicken breast.
avoid pastries, cola

Question 16

which therapist assess w/ mobility and fall risks

Answer 16

physical therapist
bedside commodes may reduce the risk for falls

Question 17

clients w/ acne should avoid using oil based product and heavy cosmetic use b/c they clog pores
true or false

Answer 17

true

Answer 18

mild soap and tepid (warm) water
cut toenails straight across, not at lateral corners

Question 19

how to avoid gluten

Answer 19

avoid barley, wheat, white flour, macaroni, pasta, soup, beer, malted milkshakes, cereals, bran

gluten free: meat, fish, eggs, gluten free four, fruits

Question 20

stoma care

Answer 20

always wear a colostomy pouch over the stoma
thick mucus is normal
stoma should be reddish to pink in color

Question 21

diabetes type of pain
neuropathic, chronic pain

explain the cystic fibrosis diet

Answer 21

cystic fibrosis diet: high in fat, high in protein, high in calorie

Question 22

which is soft vs mechanical diet

chunky peanut butter
applesauce
raw carrot sicks
beef
jery
bananas
nuts
seeds
raw veggies

Answer 22

chunky peanut butter: chunky = mechanical
applesauce = soft
raw carrot sicks = mechanical
beef = mechanical
bananas = soft
nuts = mechanical
seeds = mechanical
raw veggies = mechanical

Question 23

urine specific gravity
which diseases has high or low urine specific gravity

Answer 23

urine specific gravity: 1.005 - 1.30
higher means more conc.
lower urine specific gravity: dilute urine, like diabetes insispidus. Diabetes Dilute.

Question 24

how to assess pain

Answer 24

only client can assess pain, so from 0 - 10. also for hospice patients
if the patient can’t talk then press on nail beds to asssess

urine is very concentrated in SIADH, ex 1.60, this is b/c very little water gets released in the urine

Question 25

safe foods for htn

smoked salmon
fish
scrambled eggs
boiled lentils
grilled chicken

Answer 25

fish in general has high sodium, smoked salmon has high sodium as well, bacon is extremely high in sodium.
scrambled eggs, boiled lentils, grilled chicken are low sodium diets (if prepared well of course), but on the NCLEX they’re safe.

Question 26

where should catheter be placed for a female vs male

Answer 26

for a male, attach the catheter to a male’s lower abdomen (w/ penis pointed upward) or to their upper thigh

for a female, the catheter should be connected to their inner tigh

remove the device w/ alcohol swab, saline water to prevent shearing of skin.

Question 27

steatorrhea is what type of stool

Answer 27

reduced fat absorption by intestine and that fat all goes into the stools
stool is pale, fatty, oily, maladorous

mechanical block in the biliary tract, emulsification of fat is not done

Question 28

hematochezia
melena
which is a sign of upper vs lower GI tract bleeding

Answer 28

melena is upper, you can see melanin, upper gi bleeding

hematochezia: you can’t see blood inside the body, so blood is low. fresh blood from anus, signs of lower GI tract bleeding

Question 29

phenylketonuria, which foods to avoid?

Answer 29

Phenyl: p for protein, p for phenylalanine
avoids foods high in protein & phenylalanine
avoid chicken, pork, eggs, beef, avoid dairy,

Question 30

ischemic vs neuropathic pain

Answer 30

for ischemic, think of sickle cell, mi: squeezing, crushing, heavy
neuropathic: CNS issue, shooting, burning, numbness, tingling, shock like

Question 31

diabetic foot care

Answer 31

keep feet dry (to prevent chafing from moisture), don’t put any lotion or creams between toes.
creams can be added to the top and bottoms of feet to prevent cracking, but not between toes (will create moisture and cause chafing) and inc. risk of fungal infections.

talcum powder and cornstarch may help the skin in between toes to be dry/stay dry

wear loose socks with closed toe shoes that fit well

Question 32

bladder cancer main symptom

Answer 32

gross painless hematuria

Question 33

kock’s pouch, how to urinate?

Answer 33

self Cath every 4-6hrs
no external pouch

Question 34

neobladder

Answer 34

new bladder, patient with a neobladder can urinate normally, they don’t have an external pouch.

Question 35

stoma, how often to change pouch

Answer 35

change pouch every 5 days

Question 36

peritoneal dialysis
what causes insufficient outflow?
which correct position?

is alteplase indicated?

should you check the tubing for kinks or clots?

Answer 36

the tubing is clamped the allow the fluid to remain in the cavity.

insufficient outflow is usually caused by constipation. when distended intestines block the catheter’s hole. if outflow becomes sluggish, the nurses should assess for abdominal distension and perform appropriate interventions (stool softeners)
-side lying position

assess for clots and administer fibrinolytics (alteplase) as prescribed. check for kinks/clots

Question 37

should type 1 diabetes reduce carbohydrates or stop taking insulin when they’re sick

and can clients check their urine for ketones?

Answer 37

don’t reduce carbohydrates
continue taking insulin

yes they can by the paper kits, like the ph kits. and check to see if they notice a color change in their urine (pink to purple), darker means a higher level of ketones.

Question 38

peritoneal dialysis
when to use sterile technique

Answer 38

peritoneal dialysis should be a sterile procedure
infection control is a top priority
when spiking the bag and attaching the diasylate, that should be sterile
infection control is a priority over placing the bag below the level of the bladder

Question 39

with kidney failure or with high creatnine, is IV contrast contraindicated

which BP med to avoid?

Answer 39

so, avoid IV contrast with kidney disease (acute kidney injury or ckd)

avoid ace inhibitors b/c they inc. k+ (which is already present in ckd), they make kidney retain k+. if patient k+ is already high, that puts them at risk for life threatening arrhytmia (Vfib, etc..)

Question 40

as you get older
mucus membranes get drier
immune system diminish
the number of cilia mobility decreases, cilia is less mobile (which makes sense since older adults might have comorbidities that cause them to be less active)
the ability to cough forcefully decreases (strength decreases also with age)

chest wall stiffens (or becomes less flexible)
resp system is more likely to make mucus, poorer cilia motility harder to clear pathogens

Question 41

diabetic neuropathy symptoms

Answer 41

feelings pins and needles
patient should have pulse in leg
if a pulse is not felt after using the Doppler, patient may be at risk.

Question 42

GERD interventions

Answer 42

when I have acid reflux, I have to elevate hob in order to sleep. if not, I will not be able to. i’d feel the food coming back so, therefore elevate HOB when sleeping or when not is necessary in GERD

avoid spicy foods, tobocco, caffeine,
eat small frequent meals