Lower GI

Question 1

causes of mechanical obstruction

Answer 1

tumor, Crohn’s, fecal impaction, hernias, volvulus

Question 2

causes of non-mechanical obstruction

Answer 2

spinal fractures, peritonitis, lack of blood flow

Question 3

s/s of SBO

Answer 3

cramping, abd distention, hypoactive/absent bowel sounds, excessive fecal vomiting

Question 4

SBO labs

Answer 4

low Na, K, Cl; increased BUN & Cr – all from dehydration

Question 5

LBO s/s

Answer 5

constipation, abd distention, cramping, hypoactive/absent bowel sounds, bloody stools

Question 6

post op nursing care for obstructions

Answer 6

NG tube - monitor output amount & color
maintain NPO/bowel rest
IV hydration & electrolyte replacement, monitor stool & flatulence & return of bowel sounds - ask q4h, incision care

Question 7

dx criteria for IBS

Answer 7

recurrent abd pain for 3 days/month for past 3 months
pain improved with bowel movements
change in stool frequency & appearance

Question 8

s/s of IBS

Answer 8

alteration in bowel patterns - diarrhea, constipation, or both
abd pain while eating, sensation of incomplete defecation

Question 9

pt education for IBS

Answer 9

stress reduction, limit dairy, spicy/high fat foods, carbonated bevvys
increase fiber, keep food diary

Question 10

s/s of hernia

Answer 10

swollen lump - red or purple if strangulated, pain that increases with abd pressure

Question 11

education on hernias

Answer 11

avoid strenuous activity for a week post op, splint incision w coughing, monitor size, color, and pain level - report severe/sudden changes

Question 12

s/s of appendicitis

Answer 12

low grade fever, severe abd pain, rebound tenderness at McBurney’s point (RLQ)

Question 13

nursing management post appendectomy

Answer 13

high fowlers, morphine, IV hydration/oral as tolerated

Question 14

causes of peritonitis

Answer 14

puncture of peritoneum, rupture/leakage of abd organs

Question 15

s/s of peritonitis

Answer 15

rigid abd, constant pain, n/v, abd distention, low grade fever

Question 16

tx of peritonitis

Answer 16

surgically repair cause

Question 17

peritonitis interventions

Answer 17

IV fluids, abx, antiemetics, analgesics
vitals - monitor for sepsis (BP & temp), monitor WBC, strict NPO
NG drainage

Question 18

ulcerative colitis s/s

Answer 18

LLQ pain, fever, diarrhea, rectal bleeding, 15-20 loose stools/day w blood, mucus, pus
high pitched bowel sounds

Question 19

toxic megacolon tx

Answer 19

colectomy - may need ostomy

Question 20

Crohn’s s/s

Answer 20

RLQ pain, fever, diarrhea - 5/day w mucus/pus, high pitched bowel sounds

Question 21

ulcerative colitis interventions

Answer 21

monitor f&e - dehydration
bowel rest; IV hydration
high protein, high calorie, low fiber diet

Question 22

crohn’s interventions

Answer 22

monitor f&e - dehydration
bowel rest, IV hydration
high protein, high calorie, low fiber diet

Question 23

diverticulosis s/s

Answer 23

no pain
diarrhea, n/v, abd distention

Question 24

what dx testing is contraindicated for diverticulitis & why

Answer 24

barium enema, colonoscopy
risk of perforating a diverticula

Question 25

diverticulosis interventions

Answer 25

high fiber diet, increase fluids
psyllium, avoid alc
no nuts, seeds, popcorn

Question 26

diverticulitis s/s

Answer 26

mild to severe LLQ pain, n/v, fever, possible lower GI bleeding

Question 27

what indicates diverticular perforation

Answer 27

rebound tenderness in LLQ

Question 28

diverticulitis interventions

Answer 28

NPO, NG tube, IV fluids, abx

Question 29

what to avoid w Celiac’s

Answer 29

gluten dumbass

Question 30

bariatric surgeries - pre-op

Answer 30

psych, dietician, counselor, & surgeon eval - need counseling
educate on diet & exercise

Question 31

bariatric surgeries - post op

Answer 31

semi-fowlers, ambulate day of, abd binder, monitor bowel sounds & measure abd girth qday, fluid restriction, incision care

Question 32

diet progression after bariatric surg

Answer 32

clear/full liquids - week 1
then pureed foods
solid foods 6-8 weeks post op

Question 33

pt education after bariatric surg

Answer 33

frequent, small meals; avoid carbonation, low-fowlers after meals

Question 34

dumping syndrome

Answer 34

fatty ate too much too fast

Question 35

dumping s/s

Answer 35

cramping, diarrhea, dizziness, palpitations

Question 36

anastomotic leak s/s

Answer 36

intense abd & back pain, restlessness, tachycardia, oliguria

Question 37

malabsorption interventions

Answer 37

refer to dietary, increase protein, no empty cals, vitamin/mineral supps for life