Test 3 Med Surg review

Question 1

1. Q: What causes Cholecystitis?

Answer 1

Fatty diet, high cholesterol, Affects American Indian’s, and Mexicans the most.

Question 2

2. Q: What are some signs and symptoms of Cholecystitis?

Answer 2

Pain on the right abdomen that radiates to the upper right shoulder.

Question 3

Who are the most likely people to have pain in their gallbladder?

Answer 3

Female, forty, fat and fertile (most likely people to have gallbladder issues)

Question 4

What is a cholecystectomy?

Answer 4

Removal of the gallbladder

Question 5

After they remove the gallbladder laparoscopically do they usually still have gallbladder pain afterwards?

Answer 5

No, they will just have post opt pain

Question 6

if they cannot get it done laparoscopically. What is another way they can remove the gallbladder?

Answer 6

Cholecystectomy, but if done laparoscopically the recovery is faster, less pain and can return to work within days.

Question 7

: If they do have pain going up the right shoulder or pain in general, what should the nurse on the floor tell them to do?

Answer 7

You will get them up and ambulate (walk) them to get rid of the gas that was inserted for surgery.

Question 8

: If a patient wakes up after surgery and they have pain and are connected to a PCA (self-dispense pain medicine machine that prevents overdose). What would the nurse tell them to do?

Answer 8

The nurse would tell them to press their pain medicine button since they are the one in control of it.

Question 9

What kind of a diet would patients with Cholecystitis have?

Answer 9

Patients should have a low-fat diet. Most of the time after the removal of the gallbladder they can eat a regular diet, but some people still should be careful of eating lots of fatty foods after surgery.

Question 10

What are some signs and symptoms of Cholecystitis?

Answer 10

Pain on the right abdomen that radiates to the upper right shoulder.

Question 11

Who are the most likely people to have pain in their gallbladder?

Answer 11

Female, forty, fat and fertile (most likely people to have gallbladder issues)

Question 12

what is the difference between chronic and acute Cholecystitis

Answer 12

Chronic Cholecystitis patients have light clay color stools.

Question 13

If someone went for a doctor’s visit and they lost 40 or 60 pounds from their last visit. What would the nurse ask them?

Answer 13

The nurse would ask them if it was intentional to lose that much weight.

Question 14

If someone had malnutrition which type of malnutrition lacks calories?

Answer 14

Marasmus

Question 15

Which type of malnutrition lacks protein?

Answer 15

Korsakov

Question 16

if a nurse is giving a NG bolus tube feeding every 4 hours. What would the nurse do before and after each feeding?

Answer 16

AUSCULATE LUNG SOUNDS, leave them at a Simi fowlers position, flush the tube, check gastric juices, listen to bowel sounds, check placement of the tube.

Question 17

Lab work comes back who would the nurse see first? A patient with sodium of 138, potassium of 2.6, glucose of 138, or someone with foul smelling diarrhea?

Answer 17

the nurse would see the patient with a potassium level of 2.6 due to it being too low (3.5-5). Potassium deals with muscles and the heart is a muscle.

Question 18

if you have a bariatric patient come in (500+ pounds) and the hospital does not have a big enough bed. As the nurse, what will you do and what will you assess to make sure they are safe?

Answer 18

Place the side rails up to make sure they do not fall. BUT MAKE SURE THAT THEY ARE NOT DIGGING INTO THEIR BODY.

Question 19

:If you have a 400+ pound patient come in. The nurse should make sure she had a bed big enough, right equipment (Hoyer), wheel chair, and adequate staff to help move them to prevent injury. If somehow the nurse did hurt her back, what would be the first thing the nurse should do?

Answer 19

Report it to her supervisor immediately and fill out an incident report.

Question 20

if someone goes for bypass surgery and they are in the bariatric clinic after they had surgery and they start saying “I did not know it would be this hard to live like this” What is the best thing for the nurse to say?

Answer 20

The nurse should find out if they have a support system at home. Assess their coping skills, get them in a support group.

Question 21

If someone has gastritis or gastric ulcers and they suddenly say they have abdominal pain and their stomach is tense and ridged. As the nurse, what would you do? What is your priority action?

Answer 21

Notify the doctor immediately because there is something going on (possibly bleeding)

Question 22

what is the treatment for H pylori?

Answer 22

Antibiotics (2 antibiotics and a proton pump inhibitor, you take one antibiotic 2x a day and the other one 4x a day for 6 weeks)

Question 23

If you are treating someone for H pylori. What assessment would you do with that patient to make sure that they are sticking with that treatment and will be cooperative?

Answer 23

Make sure that they will commit and stick with the antibiotic medication until its finished or else it will never be cured.

Question 24

What kind or type of medication is Carafate/surcrafate?

Answer 24

it’s a barrier

Question 25

If you find your patient in the bathroom throwing up blood, what is the first thing the nurse will do?

Answer 25

Don glove.

Question 26

If someone has an NG tube. What kind of comfort measure would you have your unlicensed personal do?

Answer 26

Perform oral care

Question 27

If you are going to feed someone. What directions will you give your CNA about feeding the patient?

Answer 27

Make sure it’s a nice quite relax atmosphere, food that should be hot are hot and cold are cold. Make sure urinals and bed pans are off the table. A nice environment. The patient should have glasses on, dentures, utensils, hearing aids

Question 28

If you are giving someone Maalox. What is the most important teaching the nurse should do with the patient?

Answer 28

Notify your provider if you have diarrhea?

Question 29

If you have a patient who has diverticulitis (an out pouch vili) The nurse would teach that patient not to eat small grain seeds because it could get stuck in the pouch which will give them pain until its surgically removed.

Answer 29

The nurse should tell them not to eat seeds, rice, nuts, corn, so their diet is important.

Question 30

what are some risk factors for acute gastritis that you ingest?

Answer 30

NSIDS, alcohol, caffeine, steroid, cigarettes

Question 31

who is usually at risk for developing cystitis?

Answer 31

Females have shorter urethras but most importantly FEMALES WHO NO LONGER PRODUCE ESTROGEN.

Question 32

What is the difference between a 24 yr old female and a 76 year old female?

Answer 32

lack of estrogen. Estrogen helps protect you from lots of things. You will see more UTIs with someone who is older.

Question 33

if you have a post-menopausal lady who has had several episodes of cystitis in the last several months and is concern as to why she is getting them suddenly, what should the nurse tell her?

Answer 33

your estrogen is low and you are much more susceptible

Question 34

If you have your patient take pyridium what are you going to teach them about taking that medication.

Answer 34

teach the patient that their color of urine will change to an orange red due to taking pyridium. This will prevent them from getting scared.

Question 35

What will you do with an incontinent patient?

Answer 35

The nurse should do a bowel and urine study program. Most of the time it will be more women due to the pelvic floor muscles becoming less muscular overtime due to child bearing. So, have them do a bladder program and do Kegel exercises.

Question 36

what if they are so embarrassed to be incontinent how should the nurse respond to them?

Answer 36

The nurse should strategize with them about their lifestyle, the use of pads, Kegel exercises, a bladder program.

Question 37

If you have a patient come into the hospital with pneumonia, a bit confused and they have a folly catheter what should the nurse do?

Answer 37

The nurse should try to get rid of the folly as soon as possible.

Question 38

If someone comes in from the nursing home and they have had quite a few falls. What should the nurse do?

Answer 38

The nurse should recommend a urinalysis because when the elderly get sick with pneumonia or UTI they become confused, agitated, (no fever) but this might lead to lots of falls.

Question 39

if your patient is a young girl and they started her on antibiotics what will you teach her about contraception and antibiotics?

Answer 39

Antibiotics can interfere with birth control, especially if they are on the pill.

Question 40

If you are going to do bladder training how would you tell them to do it?

Answer 40

If you are going to do it for every two hours you want to tell them to hold their urine for the whole two hours and then toilet them. This will train the bladder. (around meal time, before you lay down)

Question 41

When assessing someone with a UTI. What assessments should they nurse do?

Answer 41

find out what meds they are on, medical history, medical problems, bladder scan (if they have emptied their bladder) , ask about change in frequency, pain, urgency, falls, confused,

Question 42

what if it is a fungal UTI, will you palpate the kidneys and bladder? Would it matter if they went to Africa?

Answer 42

No, you cannot palpate the kidneys and know if they have a uti, and no going out of the country would not matter for UTIs