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VN 22 Med Surg 1 > VN 22 Test 9 > Flashcards

VN 22 Test 9 Flashcards

1
Q
  1. Antacids K,H,K
A

Aluminum is for constipation
Magnesium is for diarrhea

 Fluid retention
 Electrolyte imbalance
 1 -2 hr before or after other medication
 Avoid patients with heart problems
 Monitor kidney function
- 1-2 hr after meals

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2
Q
  1. Gastrectomy nursing considerations/client Education
A

 Dumping syndrome: due to rapid emptying after surgery*
(Diarrhea, sweating, palpating, abdominal cramps)

 Can cause B12 deficiency; you may need B12 shots for life*
Gastric acid provides components necessary for b12 absorption*

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3
Q
  1. Barium swallow nursing considerations and client education
A

Monitor the passage of the stool and color. It will come out white, streaky or color clay at first then going to normal*

 Fast must fast after midnight the night before the test
 2 to 3 days client place on a low-residue diet before the test
 NPO for 8 to 12 hours
 Do not smoke for 12 to 24 hours before the procedure
 All medications are withheld on the day of procedure
 After the procedure encourages client to drink fluids for constipation

•Is fluroscopic observation of the client actually swallowing a flavored barium solution and its progress down the esophagus. The patient will first receive a thick mixture, then a thin one; the patient must drink 12 to 14 oz (360 to 420mL) during the examination, typically oblique position

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4
Q
  1. G-tube/NG tube: Assessment and Implementation
A

Assessment:
 Good mouth care to counter tastes/odor*
 Frequent assessment of Bowel Sounds*

Implementation:
 Flush tube every 4hr*
 Elevate HOB to 45 degrees/ semi-fowlers/ repositioning frequent*
 Change bag and tubing daily*
 Include drainage in I&Os*
 Monitor labs (electrolytes and hematocrit)*

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5
Q
  1. EGD nursing considerations
A

 Left side-lying with head of bed elevates
 NPO for 6-8hr prior to the exam
 Remove dentures prior to procedure
 Monitor vital signs and respiratory status. Maintain an open airway until the client is awake
 Notify the provider of bleeding, abdominal or chest pain, and any evidence of infection
 Withhold fluids until return of gag reflex
 Discontinue IV fluids therapy when the client tolerates oral fluids without nausea and vomiting
 Instruct the client not to drive or use equipment for 12 to 18 hours after the procedure
 Reinforce teaching with the client to use throat lozenges if a sore throat or hoarse voice persists following the procedure
- during the procedures monitor pain and discomfort
- after the procedure monitor gag reflex

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6
Q
  1. Dysphagia nursing considerations
A

 Montior for aspiration
 Place food on unaffected side
 Tuck in chin to chest while swallowing
 Have suction equipment available
 Avoid distractions to prevent chocking
 Check gag reflux

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7
Q
  1. Esomeprazole and omeprazole K,H,K
A

-Prazole: to reduce gastric acid
-GERD, gastric/duodenal ulcers, erosive esophagitis
-Limited 4-8 week of treatment

 Avoid NSAIDS*
 Monitor for electrolyte imbalance and hypoglycemia in clients who have diabetes mellitus (Monitor blood sugar)
 Digoxin level increase (monitor digoxin levels 0.8-2)
 Avoid Alcohol
 Complete the prescribed regimen, even when manifestations subside
 Rabeprazole (take with or without food) and Pantoprazole are enertic coated tablets (Not crush)
 Long term use can have a development of pneumonia and C-diff. (Monitor stool and asses for lung sounds)*
 Long term use of more than 14 days have risk for bone fractures especially in older adults (increase vitamin D & calcium)*
 Can be be given prophylactic*

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8
Q
  1. PUD manifestations
A

Manifestations
 Severe pain (upper abdomen and back)*
 Bleeding Hematmesis (bloody emesis) Melena (bloody stools)*
 Relieve after eating*
 Weight loss

If severe could mean perforation?*

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9
Q
  1. PUD complications
A

 Perforation/Hemorrhage (when peptic ulcer perforate or bleed, it is an emergency situation)
 Pernicious anemia (occurs due to a deficiency of the intrinsic factor normally secreted by the gastric mucous)
 Dumping syndrome (This can occur following gastrectomy surgery)

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10
Q
  1. Hemorrhoids manifestations
A

External hemorrhoids:
 Soreness*
 Lumps*
 Itching*

Internal hemorrhoids:
 Bleeding*
 Anemic *
- Protrrusion*

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11
Q
  1. Colonoscopy recommended screenings/criteria
A

 The American Cancer Society recommended that beginning at age 50, average-risk adults get a colonoscopy every 10 years*

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12
Q
  1. Anorexia nervosa manifestations and Priority
A

Manifestations:
 Absence of hunger*
 Nausea*
 Constipation*
 Amenorrhea*

Priority:
Hypokalemia electrolyte imbalance*
Signs:
 Muscle weakness*
 Fatigue*
Set up on patient on EKG*

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13
Q
  1. Sulfasalazine K,H,K
A

Use: reduces inflammation of the intestinal mucosa and inhibits prostaglandins
 Take with full glass of water after meals
 Avoid exposure to sunlight
 Urine may be orange yellow. Contacts can turn yellow tint as well
 Caution with chronic kidney and hepatic function
 Contraindication with patient allergic to sulfa or salicylate
 Increase fluids intake to 2L/day
 AE: nausea fever, and rash

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14
Q
  1. Colon cancer manifestations and risks
A

Manifestations:
 Bowel habit change*
 Occult blood in stool*
 Distended abdomen*

Risks:
 Genetics*
 Life*
 Environment/ age uncommon under 40*
 Polyps*

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15
Q
  1. Ulcerative colitis manifestations
A

 Diarrhea*
 Blood*
 Pain*
 Dehydration*
 Anorexia*
 Weight loss*

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16
Q
  1. Endoscopy nursing considerations
A

-verify consent form has been signed
-obtain vitals & verify client’s allergies
-Report unexpected findings of laboratory tests, chest x-ray, ECG, and ABG’S
- review client’s medical history for increased risk of complications.
-notify physician if dietary restrictions weren’t followed
-Ensure client is NPO prior to procedure
-Ensure client followe proper bowel preparation

17
Q
  1. Adalimumab K,H,K
A

 Use for suppresses the immune response and Inhibits tumo necrosis factor, an antibody found in Chron’s disease
 Self administered by SQ injection
 AE: chills, fever, hypotension/hypertension, dysrhythmias, and blood dyscrasias
 Monitor Liver enzymes, coagulation and CBC
 Avoid crowds and other exposures to infectious disease
 Monitor and report bleeding, or infection and transfusion or allergic reaction

18
Q
  1. Corticosteroids K,H,K
A

 Use for reduce inflammation and pain
 Not for long-term use due to AE
 Prolonged use can lead to adrenal suppression, osteoporosis, risk for infection, and Cushing syndrome)
 Monitor BP, electrolytes and glucose
 Take oral dose with food
 Avoid discontinuing dose suddenly
 Report unexpected increase in weight or other indications of fluid retention
 Avoid crowds and other exposures to infectious disease
 Report evidence of infection (Chrons disease can mask infection)

19
Q
  1. FOBT client education (Fecal Occult Blood Test)
A

 No Aspirin or NSAIDS/ASA prior*

 Avoid raw fruits, vegetables, red meat, yeast, vitamin C rich foods, poultry, fish, beets for 3 day prior to obtain sample*

20
Q
  1. Ulcerative colitis and Crohn’s disease nursing considerations
A

 Monitor and schedule colonoscopies*
 Find triggering foods*
 Monitor for electrolyte imbalance*
 Assess for dehydration with good I&Os*
 Monitor for anemia*
 Monitor for mega colon*
 Avoid high fiber intake*
 Educate cleint may have exacerbations and remissions*

Mega colon: from inactivity of the colon risk for perforation

21
Q
  1. Peritonitis manifestations
A

 Lack go bowel motility*
 Rapid respiration*
 Tachycardia*
 Rigid abdomen*

22
Q
  1. Nursing interventions for hiatal hernia
A

 Sit upright for 2 hours*
 Raise head of bed*
 Avoid Valsalva*
 Avoid spicy foods*
 Avoid alcohol/smoking*

23
Q
  1. Sucralfate K,H,K
A

Use for Ulcer
 Allow 30 minutes before or after to give antacids
 Take on empty stomach, 1 hr before meal. Needs to coat lining*
 Do not smoke or drink alcohol
 Continue to take medication even if manifestations subside
 Can cause constipation
 Cautions with patient with chronic kidney and diabetes

24
Q
  1. Appendectomy nursing considerations
A

 Assess pain level*
 Prep for surgery NPO status*
 Delivered IV fluids*
 Obtain surgical consent*

If you come to ER with pain with a appendicitis and out of nowhere you have no pain, it be a sign for a ruptured so you need to call the provider*

25
Q
  1. Gastric bypass nursing considerations
A

 Gradually progress to 5-6 smal; meals a day-less than open cup*
 Chew food slowly take an hour to eat*
 Withhold fluids 15 minutes before and during meals*
 Less than 2g fiber per serving*
 Stop eating when full*

26
Q
  1. Diverticulitis client education
A

 Avoid food containing seeds (nuts, popcorn,seeds) ‘don’t get fooled with healthy choices’*
- High fiber *

 Consume a clear liquid diet until manifestations subside
 Avoid foods or drink that can irritate the bowel (Avoid alchol. Limit fat to 30%of daily calories intake

27
Q
  1. Diarrhea complications
A

Electrolyte imbalance hypokalemia*
 Increase high in potassium*

28
Q
  1. Constipations complications
A

 Decrease narcotics*
 Encourage exercises*
 Increase fluids*
 Increase fiber*

29
Q
  1. Upper GI series (with small bowel series) Nursing priorities
A

 During the procedure: Monitor pain/ discomfort*
 After the procedure: Monitor gag reflex*

30
Q
  1. GERD Nusring Management
A

 Radiating pain to neck, jaw, neck*
 Burning in esophagus*
 Pain worsens with positions*
 Throat irritation*
 Relieved by sitting upright after eating for at least 2 hours*
 Avoid large meals; Carbonated beverages*

GERD can cause esophagus Cancer*

31
Q
  1. Esophageal Cancer Implementation
A

 Improve nutrition and weight loss*
 Soft or semi-liquid foods with high protein*
 Avoid gassy foods*
 Avoid straws*
 Small frequent meals*
 Straws causes gas*

32
Q
  1. Irritable Bowel Syndrome Implementation/Client education
A

 Increased risk of colon cancer*
 Exacerbation and remission common*
 Avoid high fiber quickly*
 Monitor daily weight, I&O, and Bowel sounds*

(Medical Management)Anti-cholinergic: reduces spasms or contractions in the intestines. By block the action of a neurotransmitter called acetylcholine*

33
Q
  1. Crohn’s Disease Assesment Findings
A

 RLQ distention (near ileum) and pain*
 Chronic diarrhea*
 Fever*
 Growth failure*
 Malnourishment*
 Weight loss*

VN 22 Med Surg 1 (14 decks)

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