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med surg nursing > Nursing Assessment: GI System (Test 2) > Flashcards

Nursing Assessment: GI System (Test 2) Flashcards

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1
Q

What is part of ingestion and propulsion of food?

A

Mouth, pharynx, esophagus

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2
Q

What is responsible for only digestion?

A

Mouth

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3
Q

What does the mouth consist of?

A

Teeth, saliva/enzymes, mucosal layers, esophagus, lower esophageal sphincter

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4
Q

What is responsible for both digestion and absorption?

A

Stomach

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5
Q

What does the stomach consist of?

A

Mucosal layers, hydrochloric acid, enzymes, pyloric sphincter

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6
Q

What is one of the side effects of chemo r/t GI system?

A

Sore mouth

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7
Q

What can you use to help mouth soreness?

A

Give them magic mouthwash, it has Lidocaine, Malox, etc. in it

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8
Q

Why are mucous membranes so important?

A

The entire GI system is lined with it and in order for the whole system to function we have to keep it healthy

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9
Q

What helps with peristalsis?

A

Stomach and small intestines

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10
Q

What is responsible for the absorption of nutrients?

A

Small intestine

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11
Q

What does the small intestine consist of?

A

Mucosal layers, duodenum, Jejunum, ileum, and villi

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12
Q

What is responsible for elimination?

A

Large intestine

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13
Q

What does the large intestine consist of?

A

Ascending colon, transverse colon, descending colon, rectum, anus

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14
Q

What else is part of the GI system besides mouth, stomach, small intestine, large intestine?

A

Liver, biliary tract, pancreas

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15
Q

What are general effects of aging on the GI system?

A

Muscles weaken, decreased function- effect on valves, sphincters, and wall of colon; decreased production and secretion of enzymes- effect on digestive process

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16
Q

What does the large intestine do besides elimination?

A

It absorbs water and is part of the immune system

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17
Q

What do you need to ask when you find out a patient has a colostomy?

A

Where it is, know that it affects self concept and image and body integrity, and ask how it affects them

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18
Q

How old should a child be before having nuts?

A

2, because of potential allergies

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19
Q

How old should a child be before they have dairy?

A

1

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20
Q

When assessing indigestion what should you ask?

A

What they have for lunch, how much they eat, do you ever have lunch without indigestion?, etc.

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21
Q

What can sclerosis be caused by?

A

Chemicals or overuse of alcohol

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22
Q

What parts of the GI system are affected by aging?

A

Mouth, esophagus, abdominal wall (all muscle basically), stomach (*ulcers), small intestines, liver, large intestine, anus, rectum

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23
Q

What is subjective data needed for assessment of GI system?

A

Important health info: past health history, meds, surgery or other treatments

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24
Q

Study the…

A

GFHP’s on younger and older adults about the GI system!!! :)

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25
Q

What is the objective data needed for assessment of GI system?

A

Physical exam: mouth, abdomen, rectum and anus

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26
Q

How long is the newborn “period?”

A

4 weeks old

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27
Q

To help keep infants to keep food down what should you assess?

A

How they feed their baby, like burping, etc.

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28
Q

How do you assess the abdomen?

A

First look, then listen, then start at RLQ because that’s where the colon starts

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29
Q

What are types of GI radiologic studies?

A

Upper GI Series (barium swallow), lower GI Series (barium enema), abdominal ultrasound, virtual colonoscopy

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30
Q

Are barium swallows and enemas common?

A

No

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31
Q

What is your job in preparing the patient for a barium swallow?

A

You need to teach them what’s going to happen

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32
Q

What is the most important follow up care for the barium swallow?

A

Increase fluids to get rid of barium and they may need a laxative because it becomes concrete eventually

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33
Q

What part of the barium swallow and enema is radioactive?

A

The barium

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34
Q

What is the purpose of the barium enema?

A

An effort to see the colon through the X-ray, the follow up is the same as swallow, esp. with laxative

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35
Q

What is the most popular diagnostic study of the GI system?

A

Endoscopy

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36
Q

What can the endoscope be used for?

A

EsophaGastroDuodenoscopy (EGD), sigmoidoscopy, colonoscopy

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37
Q

What does ERCP stand for?

A

Endoscopic retrograde cholangio-pancreatography

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38
Q

What does the ERCP look at?

A

Gallbladder and pancreas

39
Q

What is the other type of endoscopy besides the endoscope and ERCP?

A

Capsule endoscopy

40
Q

What is the capsule for the capsule endoscopy? What’s the nurse’s job?

A

A tiny camera is in it and the nurse’s job is to recover the camera

41
Q

What is the prep for the EGD?

A

Maybe a few hours of NPO and help explain, they may put anesthesia on throat

42
Q

How do you prevent elders from losing potassium?

A

Go lightly

43
Q 
The nurse observes that Mrs. Creighton's abdomen is firm and distended. WHat assessment is most important for the nurse to perform?
A. Auscultate bowel sounds
B. Measure abdominal girth
C. Observe incisional staples
D. Measure BP
A

A is correct. Her girth has nothing to do with anything at this point, staples aren’t main source of pain, and you’re probably already getting vitals

44
Q 
The nurse auscultates for Joan's bowel sounds and hears faint gurgling sounds after three minutes. How will the nurse record this finding?
A. Hypoactive bowel sounds
B. Normal bowel sounds
C. Paralytic ileus
D. Reduced peristalsis
A

A is correct.

45
Q

In assessing bowel sounds, it is most important for the nurse to perform which action?
A. Ask the client what she had her last BM
B. Listen for up to 5 minutes when auscultating for bowel sounds
C. Perform a rectal exam
D. Place client in knee-chest position to expel excess gas prior to auscultation

A

B is correct.

46
Q

While the nurse is completing the assessment, Joan begins to cry and laments, “I just knew something would go wrong.” What is the best response by the nurse?
A. This is a minor problem. We’ll have you better very soon.
B. You have to expect that problems will occur after surgery.
C. Tell me what is making you feel so upset.
D. Why are you letting this upset you?

A

C is correct.

47
Q

Joan tells the nurse that she hates hospitals because she says “Nobody ever tells you what’s happening, and you end up with all these things going wrong.” Which response by the nurse will encourage continued verbalization by the patient?
A. All the nurses are very busy here, and they are doing the best job they can.
B. You should write down your questions so you can get some answers.
C. I will be happy to tell you everything that’s happening, so nothing else will go wrong.
D. It sounds as if you have had another experience that did not go well.

A

D is correct.

48
Q

Joan responds, “I did everything my HCP told me to do. The surgery must have failed. It was supposed to make my intestines work better! How should the nurse respond?
A. Refer the client to the surgeon to answer any questions about the surgical outcome.
B. Advise the client that an incarcerated hernia is repaired to improve peristalsis so an error must have occurred during the surgery.
C. Offer the client emotional support as she copes with this adverse outcome of surgery.
D. Explain the the client the multiple factors that can decrease peristalsis postop, even when the desired surgical outcome is achieved.

A

D is correct. It is not C because it is a normal effect of surgery.

49
Q

Read the rest…

A

Of the quizzes on PP!!! :)

50
Q

What postop med is most likely to contribute to constipation?

A

Morphine sulfate, an opioid analgesic

51
Q

While performing the digital rectal exam, the nurse recognizes that the client may experience vagal nerve stimulation. This can result in which change in vital signs?

A

Decreased pulse rate

52
Q

Does a stool softener stimulate movement?

A

No

53
Q

Should a stool softener cause abdominal cramping?

A

No because it is inserted rectally

54
Q

What are hemorrhoids?

A

Blood vessels all stretch out because of pressure r/t pregnancy, varicose veins, strain

55
Q

What are hemorrhoids like?

A

Just like varicose veins in the rectum

56
Q

Do you need sterile gloves for a rectal examination?

A

No, just gloves to protect you

57
Q

What do we use D5O IVs for?

A

To bring diabetic’s sugar up and it pulls potassium out of the circulating system

58
Q

When does the gut form in the neonate?

A

???

59
Q

When can we detect GI activity of the embryo?

A

???

60
Q

Is everything in the same spot of a child as an adult?

A

???

61
Q

When would you try to assess the pediatric abdomen?

A

???

62
Q

When is swallowing voluntary?

A

6 weeks

63
Q

How much saliva do infants have?

A

Minimal

64
Q

How does the stomach lie in infant’s abdomen?

A

Stomach lies transversely and is horizontal

65
Q

Infants and children…

A

Have less stomach capacity

66
Q

What are gastric secretions like in an infant compared to older children and adults?

A

Less acidic

67
Q

How is hydrochloric acid concentration until school age?

A

Low concentration

68
Q

Human milk has properties that…?

A

Partially compensate for decreased digestive function and optimize nutrition

69
Q

What can milk or formula do to gastric secretions?

A

Increase alkalinity of them

70
Q

What part of the stomach in a baby is different? How does that affect them?

A

Cardiac sphincter is relaxed at birth, allowing mild, occasional regurgitation of stomach contents

71
Q

What does a baby’s diarrhea look like?

A

A little solid with a water ring around it

72
Q

What are infants at risk for?

A

High risk for dehydration

73
Q

Common illnesses for babies?

A

Ears or upper respiratory infections

74
Q

Why is giving a baby a bottle when their ears are hurting and laying them to sleep a bad idea?

A

The milk may migrate to the Eustachian tubes and make the infection worse

75
Q

What is hydrocephalus?

A

Spinal fluid gets caught in the head

76
Q

How long is head circumference measured for? Why?

A

Until 18 months to 2 years for hydrocephalus

77
Q

What “arrest” type is more common in babies?

A

Respiratory more than cardiac

78
Q

What to know about peristaltic waves in infants?

A

They may reverse and cause regurgitation and vomiting

79
Q

Is peristalsis faster or slower for infants compared to adults?

A

Tends to be faster, with food remaining in the stomach for a shorter period

80
Q

What conditions can increase the rate of propulsion and peristalsis?

A

Fever and diarrhea

81
Q

What enzymes do infants have a deficiency of?

A

Amylase, lipase, and trypsin

82
Q

When are sufficient quantities of enzymes present to aid digestion?

A

Not until 4 to 6 months

83
Q

What kind of function is immature in the first year?

A

Liver function

84
Q

What are things to assess for a pediatric’s GI tract?

A

History, vomiting episodes?, diarrhea?, daily weights, vital signs, intake and output, skin integrity, urine specific gravity, episodes of apnea or respiratory distress?, pain?, bowel sounds, abdominal circumference, calorie count, electrolyte status, hydration status

85
Q

If an infant has vomiting episodes, what should you know about them?

A

Amount, color, and consistency of emesis

86
Q

If an infant is having diarrhea, what should you know about it?

A

Frequency, amount, color, and consistency of stools

87
Q

What should you do with an infant’s daily weights?

A

Plot progress on growth chart

88
Q

When taking an infant’s vital signs, what should you add on top of normal vitals?

A

Quality of respirations

89
Q

When assessing skin integrity of infants, what areas are really important?

A

Perianal and rectal areas

90
Q

What diagnostic tests may be used for infants?

A

CBC, erythrocyte sedimentation rate, electrolytes, liver enzymes, absorption tests, stool reducing substances, pH, fat, trypsin, occult blood, stool culture, ova and parasites, upper GI tract, colonoscopy, small bowel follow through, barium enema, gastric emptying, pH probe

91
Q

Are those diagnostic tests for infants listed common?

A

Not unless there are indicators they are sick

92
Q

What is a standard tests for infants?

A

PKU for Phenylketonuria

93
Q

What is PKU?

A

Excretions of ketones, etc., that say baby can’t digest protein

94
Q

What is testing/treatment for PKU?

A

They test for it by taking blood out of feet, and they can just manage it

med surg nursing (7 decks)

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