new flashcard deck made with SG topic info from powerpoints and textbook - day before exam highlights

Question 1

what is important when someone has acute abdomen

Answer 1

determining cause

Question 2

what is dumping syndrome - s/s

Answer 2

uncontrolled gastric emptying of chyme into the small intestine (WEAKNESS, SWEATING, PALPITATIONS, DIZZINESS) symptoms occur 15-30 minutes after eating

Question 3

what is postprandial hypoglycemia - s/s

Answer 3

uncontrolled gastric emptying of fluid high in carbohydrate into the small intestine resulting in excess insulin and reflex hypoglycemia (SWEATING, WEAKNESS, CONFUSION, PALPITATIONS) symptoms occur 2 hours after eating

Question 4

A patient has a vagotomy with antrectomy to treat a duodenal ulcer. Postoperatively, the patient develops dumping syndrome. Which of the following statements, if made by the patient, should indicate to the nurse that further dietary teaching is needed?

Answer 4

I should eat bread with each meal - dumping syndrome is excacerbated by carbs and sugar

Question 5

27. At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II), a patient reports that dizziness, weakness, and palpitations occur about 20 minutes after each meal. The nurse will teach the patient to

Answer 5

this is dumping syndrome - the pt should lie down after eating and also eat small meals

Question 6

priorirty intervention for vomiting

Answer 6

NPO and IV access for fluids

Question 7

for an ED, pt is at risk for what

Answer 7

malnutrition causes hyperkalemia so dysrhtymias and electrolyte imbalances

Question 8

how to give meds with enteral feedings

Answer 8

no meds WITH formula, should dissolve tabs in water

Question 9

Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube?

Answer 9

change tubing every 24 hours

Question 10

drainage for NG tube

Answer 10

small amount of blood drainage is normal

Question 11

A 61-year-old patient with suspected bowel obstruction had a nasogastric tube inserted at 4:00 AM. The nurse shares in the morning report that the day shift staff should check the tube for patency at what times?

Answer 11

every 4 hours

Question 12

A patient returns to the surgical unit with a nasogastric (NG) tube to low intermittent suction,
IV fluids, and a Jackson-Pratt drain at the surgical site following an exploratory laparotomy and repair of a bowel
perforation. Four hours after admission, the patient experiences nausea and vomiting. What is a priority nursing
intervention for the patient?

Answer 12

Check the amount and character of gastric drainage and the patency of the NG tube.

Question 13

An important nursing intervention for a patient with a small intestinal obstruction who has an NG tube is to
a. offer ice chips to suck PRN.
b. provide mouth care every 1 to 2 hours.
c. irrigate the tube with normal saline every 8 hours.
d. keep the patient supine with the head of the bed elevated 30 degrees.

Answer 13

mouth care

Question 14

Following bowel resection, a patient has a nasogastric (NG) tube to suction, but complains of nausea and abdominal distention. The nurse irrigates the tube as necessary as ordered, but the irrigating fluid does not return. What should be the priority action by the nurse?

Answer 14

reposition check placement notify HCP if continues

Question 15

what to monitor for pt with parenteral nutrition

Answer 15

BG - goal is <140-180

Question 16

complication of parenteral nutrition and what are s/s

Answer 16

muscle weakness and pain = hypophosphatemia called refeeding syndrome

Question 17

5 education for GERD

Answer 17

• Lifestyle Modifications – sleeping/resting with HOB elevated, not supine for 2-3 hours after eating, avoiding constrictive clothing, cigarette cessation
• Dietary Modifications – avoiding foods that increase lower esophageal sphincter (LES) pressure like alcohol, chocolate, mints, caffeine, and fatty foods – LOW FAT FOODS

Question 18

A 46-year-old female with gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which patient statement indicates that additional teaching about GERD is needed?

Answer 18

I can eat a bedtime snack

Question 19

A 68-year-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a history of gastroesophageal reflux disease (GERD), the nurse will plan to do frequent assessments of the patient’s

Answer 19

BREATH sounds - think respiratory

Question 20

dx test for GERD

Answer 20

barium swallow

Question 21

The nurse is planning to teach a client with GERD about substances that will increase the LES pressure.Which item shoud the nurse include on this list.

Answer 21

inc pressure means lessGERD - nonfat milk good

Question 22

When obtaining a nursing history from the patient with colorectal cancer, the nurse should specifically ask the patient about

Answer 22

diet

Question 23

When evaluating the patient’s understanding about the care of the ileostomy, what statement by the patient indicates the patient needs more teaching?

Answer 23

I can regulate my stool

Question 24

71-yr-old patient had an abdominal-perineal resection for colon cancer. Which nursing action is most important to include in the plan of care for the day after surgery?

Answer 24

drainage and infection - choose this over output from stoma etc

Question 25

A patient is transferred from the recovery room to a surgical unit after a transverse colostomy. The nurse observes the stoma to be deep pink with edema and a small amount of sanguineous drainage. The nurse should

Answer 25

document as NORMAL

Question 26

Which nursing action will be included in the plan of care for a 25-yr-old male patient with a
new diagnosis of irritable bowel syndrome (IBS)?

Answer 26

build rapport, talk about problems

Question 27

when someone is malnourished what is priority

Answer 27

monitor for dyrhtymias like hyperkalemia and they are at higher risk for infection

Question 28

Which action should the nurse in the emergency department anticipate for a 23-year-old patient who has had several episodes of bloody diarrhea?

Answer 28

stool culture

Question 29

A 57-year-old man with Escherichia coli O157:H7 food poisoning is admitted to the hospital with bloody diarrhea and dehydration. Which order will the nurse question?

Answer 29

loperamide

Question 30

A 25-yr-old male patient calls the clinic complaining of diarrhea for 24 hours. Which action
should the nurse take first?

Answer 30

ask patient to describe stool

Question 31

After several days of antibiotic therapy, an older hospitalized patient develops watery
diarrhea. Which action should the nurse take first?

Answer 31

contact precautions

Question 32

A client is to take one daily dose of ranitidine (Zantac) at home to treat her peptic ulcer. The client understands proper drug administration of ranitidine when she says that she will take the drug at which of the following times?

Answer 32

bedtime

Question 33

29. The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient’s peptic ulcer. The nurse will teach the patient to take

Answer 33

antacids after meals and sucralfate 30 minutes before meals.

Question 34

A client is taking an antacid for treatment of a peptic ulcer. Which of the following statements best indicates that the client understands how to correctly take the antacid?

Answer 34

“It is best for me to take my antacid 1 to 3 hours after meals.”

Question 35

10. The nurse will anticipate teaching a patient experiencing frequent heartburn about

Answer 35

PPI’s - prazoles

Question 36

• Upper gastro-intestinal endoscopy (EGD)

Answer 36

NPO AND test gag reflex after test before giving anything

Question 37

barium swallow

Answer 37

give patient fluids and fiber after test to prevent constipation

Question 38

s/s of peritonitis

Answer 38

rebound tenderness and MORE pain with movement

Question 39

priority intervention for peritonitis

Answer 39

IV access for fluids

Question 40

A patient in the emergency department has just been diagnosed with peritonitis caused by a ruptured diverticulum. Which prescribed intervention will the nurse implement first?

Answer 40

IV access, fluids and antibiotics

Question 41

A patient is awaiting surgery for acute peritonitis. Which action will the nurse include in the
plan of care for patient position?

Answer 41

knees flexed

Question 42

someone with UC should be provided what education

Answer 42

frequent colon cancer screening

Question 43

for acute UC attack, priority is

Answer 43

NPO

Question 44

A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy
abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to

Answer 44

NPO

Question 45

The client is diagnosed with an acute exacerbation of ulcerative colitis. Which intervention should the nurse implement?

Answer 45

monitor fluids

Question 46

patient taking adalimumab, teaching is

Answer 46

increased risk for infection

Question 47

teaching for diverticulosis

Answer 47

increase fiber intake

Question 48

The nurse admitting a patient with acute diverticulitis explains that the INITIAL plan of care is to

Answer 48

fluids

Question 49

What should the nurse teach the patient with diverticulosis to do?

Answer 49

high fiber diet

Question 50

high risk factors for PUD

Answer 50

hpylori and NSAID use

Question 51

gastric vs duodenal ulcer

Answer 51

• Gastric ulcers – burning or gaseous pressure in the epigastrium, pain 1-2 hours after eating, if penetrating, increased discomfort with food
• Duodenal ulcers – burning, cramping, pressure-like pain across mid-epigastrium and upper abdomen or back, 2-5 hours after eating, midmorning, midafternoon, and during the night. Pain relieved with food and antiacids – pain at night

Question 52

most common complication of PUD

Answer 52

hemoorhage - hypovolemia

Question 53

A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric region along with a rigid, boardlike abdomen. These clinical manifestations most likely indicate which of the following? and what should nurse do?

Answer 53

ulcer perforated - check vital signs

Question 54

Which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease (PUD)?

Answer 54

eat ANY foods you can tolerate

Question 55

big lifestyle changes for diet for peptic ulcer

Answer 55

ELIMINATE alcohol and smoking

Question 56

When assessing the client with the diagnosis of peptic ulcer disease, which physical examination should the nurse implement first?

Answer 56

auscultate bowel sounds

Question 57

The nurse is teaching the patient a client with a peptic ulcer discharge instructions. The client asks the nurse which type of analgesic he may take. Which of the following responses by the
nurse would be most accurate?

Answer 57

acetaminophen

Question 58

what to give pt before apendectomy

Answer 58

antibiotics

Question 59

A young adult patient is admitted to the hospital for evaluation of right lower quadrant
abdominal pain with nausea and vomiting. Which action should the nurse take?

Answer 59

have pt lie on side flexing right leg

Question 60

10 interventions for after bariatric surgery

Answer 60

• NPO
• No straws
• Clear liquids after 48 hours
• Frequent post-operative vital signs and pulse oximetry, with comparison to baseline
• Assessment of incision for drainage/bleeding initially and for infection after 3 days
• Assess pain and administer pain medication as ordered (excessive pain or pain that does not respond to medication may indicate leaking of suture line)
• Teach patient importance of deep breathing, coughing, splinting incision, and incentive spirometry use
• Keep HOB 45 degrees or higher
• Institute VTE prevention measures –EARLY MOBILITY!
• Maintain IV infusions as ordered, monitor I & O

Question 61

if someone is vomiting bright red blood

Answer 61

priority is NPO and IV access to prevent hypovolemic shock

Question 62

Which assessment should the nurse perform first for a patient who just vomited bright red blood?

Answer 62

take BP and pulse and NPO

Question 63

The nurse will anticipate preparing a 71-year-old female patient who is vomiting “coffee-ground” emesis for

Answer 63

endoscopy

Question 64

40. Which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood?

Answer 64

give LR’s