Med-Surg: GI, Hepatic, Pancreatic/3

Question 1

diverticular disease

Answer 1

includes three conditions that involve numerous small sacs or pockets in the wall of the colon

Question 2

diverticulosis

Answer 2

the presence of pouchlike herniations (diverticula) along the wall of the intestines; most common in sigmoid colon

Question 3

where is diverticulosis most common

Answer 3

sigmoid colon

Question 4

diverticular bleeding

Answer 4

results from injury of small vessels near the diverticula

Question 5

diverticulitis

Answer 5

inflammation of one or more diverticula

Question 6

DD contributing factors

4

Answer 6

1. aging
2. constipation
3. diet - low fiber, high fat, red meat
4. CT disorder causing weakness in the colon wall

Question 7

diverticulitis manifestations

5

Answer 7

1. alternating diarrhea with constipation
2. painful cramps or tenderness in LLQ
3. chills or fever
4. tachycardia
5. NV

Question 8

NI diverticulitis diet

2

Answer 8

1. begin with clear liquids

2. advance to a low fiber diet

Question 9

NI diverticulosis diet

1

Answer 9

1. high fiber diet

Question 10

DD - high fiber diet

Answer 10

diverticulosis

Question 11

DD NI diet - teach about avoiding foods with

3

Answer 11

1. nuts
2. seeds
3. kernels (popcorn)

Question 12

DD - increase fluid intake to

Answer 12

3L/day

Question 13

DD - laxatives

Answer 13

avoid

Question 14

DD - monitor for complications such as

3

Answer 14

1. obstruction
2. hemorrhage
3. infection

Question 15

DD and morphine

Answer 15

contraindicated because it can increase pressure in the colon, exacerbating symptoms

Question 16

DD med - analgesic

Answer 16

meperidine

Question 17

DD - emergency colon resection for

3

Answer 17

1. peritonitis
2. bowel obstruction
3. abscess

Question 18

abd hernia - absent bowel sounds

Answer 18

can indicate strangulation, which cuts off blood supply to bowel; medical emergency

Question 19

abd hernia strangulation s/s

6

Answer 19

1. abd distention
2. nausea
3. vomiting
4. pain
5. fever
6. tachycardia

Question 20

abd hernia contributing factors

8

Answer 20

1. aging
2. male gender
3. obesity
4. heavy lifting, straining
5. abd surgery
6. pregnancy
7. muscle weakness
8. ascites, distention

Question 21

abd hernia NI

3

Answer 21

1. wear abd binder
2. encourage fluid intake
3. monitor for complications - strangulation, perforation

Question 22

abd hernia post op care

Answer 22

1. allow to stand to void
2. inguinal repair - evaluate scrotum and apply ice
3. teach to avoid coughing during recovery period
4. teach to avoid lifting or straining for 4-6 weeks

Question 23

peritonitis manifestations

5

Answer 23

1. rigid board-like abd (hallmark sign)
2. NV
3. tachycardic
4. febrile
5. rebound abd tenderness

Question 24

peritonitis NI

5

Answer 24

1. position fowlers to semi fowlers
2. NG tube on low intermittent
3. oxygen
4. monitor fluid and electros
5. antibiotics

Question 25

intestinal obstruction contributing factors

6

Answer 25

1. Crohn’s disease
2. radiation
3. fecal impaction
4. narcotics
5. hypokalemia
6. diverticulitis

Question 26

intestinal obstruction manifestations

4

Answer 26

1. inability to pass flatus or stool for greater than 8 hours
2. abd distention
3. hyperactive bowel sounds above site of obstruction
4. hypoactive or active bowel sounds below site

Question 27

intestinal obstruction: small bowel or large intestine - sporadic, colicky pain

Answer 27

small bowel

Question 28

intestinal obstruction: small bowel or large intestine - visible peristaltic waves

Answer 28

small

Question 29

intestinal obstruction: small bowel or large intestine - profuse, projectile vomit

Answer 29

small

Question 30

intestinal obstruction: small bowel or large intestine - diffuse and constant pain

Answer 30

large

Question 31

intestinal obstruction: small bowel or large intestine - significant abd distention

Answer 31

large

Question 32

intestinal obstruction: small bowel or large intestine - infreq vomiting

Answer 32

large