GI: Noninflammatory Intestinal Disorders

Question 1

What signs & symptoms indicate a strangulated hernia?

Answer 1

Abdominal distention, nausea, vomiting, pain, fever, tachycardia

Question 2

What should you tell a patient who just had a surgical hernia repair to avoid?

Answer 2

Avoid coughing

Question 3

What patient teaching would you provide to a patient who will be completing a fecal occult blood test (FOBT)?

Answer 3

Avoid aspirin, vitamin C, and red meat for 48 hours before giving specimen; Anti-inflammatories (NSAIDs, corticosteroids, salicylates) should be discontinued for a designated period before the test

Question 4

What are the most common signs & symptoms of colorectal cancer?

Answer 4

Rectal bleeding, anemia, change in stool consistency or shape

Question 5

Which signs & symptoms may indicate a strangulated obstruction or peritonitis?

Answer 5

Fever, tachycardia, hypotension, increasing abdominal pain, abdominal rigidity, change in color of skin overlying the abdomen

Question 6

Define obstipation.

Answer 6

No passage of stool

Question 7

Which electrolytes should be closely monitored for patients with intestinal obstructions or NG tubes?

Answer 7

Sodium, potassium, chloride (particularly potassium); these electrolytes can be decreased due to fluid loss from vomiting or NG suction

Question 8

Which position helps alleviate the pressure of abdominal distention on the chest?

Answer 8

Semi-fowlers

Question 9

What patient teaching can you provide to an older patient to prevent fecal impaction?

Answer 9

Increase fiber and fluid intake, exercise regularly, use natural foods to stimulate peristalsis (eg. prune juice, warm beverages)

Question 10

What are your priority assessments for a patient with abdominal trauma?

Answer 10

1. airway, breathing, circulation

2. Mental status, vital signs, skin perfusion

Question 11

Which signs & symptoms would you see in a patient with mild hypovolemic shock?

Answer 11

Skin is pale, cool, moist

Question 12

Which signs & symptoms would you see in a patient with moderate hypovolemic shock?

Answer 12

Diaphoresis with no urine output

Question 13

Which signs & symptoms would you see in a patient with severe hypovolemic shock?

Answer 13

Changes in mental status, manifested by agitation, disorientation and recent memory loss

Question 14

Which signs & symptoms may indicate abdominal bleeding?

Answer 14

Abdominal pain, nausea, bloody or black stools, fever, weakness, dizziness

Question 15

For a patient with a recent polypectomy, which signs & symptoms should be monitored for?

Answer 15

Abdominal distention, pain, rectal bleeding, mucopurulent drainage from the rectum, fever

Question 16

What patient teaching is important postoperatively for a patient wh has had surgical intervention for hemorrhoids?

Answer 16

Be sure that someone is with or near the patient during the first postoperative bowel movement in case of syncope (first post-op bowel movement is very painful)

Question 18

How often should a patient with an NGT be assessed for proper placement, tube patency, and quality/quantity of output?

Answer 18

Q4h

Question 19

What is the most common cause of RLQ pain?

Answer 19

Appendicitis

Question 20

What are the priority interventions for a patient with suspected appendicitis?

Answer 20

Administer IV fluids, advise pt to maintain semi-fowler’s position, administer opioid analgesics and antibiotics as prescribed

Question 21

Which interventions should you always avoid for a patient with suspected appendicitis?

Answer 21

Avoid giving laxatives, enemas, or applying heat; these can lead to perforation of the appendix

Question 22

Following an appendectomy, which day should the patient get out of bed?

Answer 22

The evening of surgery, to prevent respiratory complications

Question 23

What complications can occur in response to peritonitis?

Answer 23

Hypovolemic shock, kidney failure (from hypovolemic shock), septicemia, respiratory distress

Question 24

What classic symptom is often seen with malabsorption?

Answer 24

Chronic diarrhea