VN 36 test 5 GI

Question 1

1. Cholecystitis client education and assessment (PP slide 17)

Answer 1

 Digestion problems from reduced or absent bile
 If biliary obstruction present will show dark or amber urine & will show fatty stools
 Monitor for jaundice: dark skin look at palms of hands/feet, sclera & hard palate of mouth
 Encourage low fat foods
 RUQ pain

Question 2

2. Hepatitis risk factors (pg.632)

Answer 2

 Hx of illicit IV drug use
 Impaired immune response
 Hemodialysis
 Occupational exposure through sharps injuries (needlesticks)
 Exposure to contaminated equipment that penetrates the skin (includes tattoos and body piercings)
 Blood transfusion
 Organ transplant
 Sexual contact with a person who is infected

Question 3

Hepatitis Prevention: (pg.634)

Answer 3

 Hep A & B vaccination (health care, food prep, foreign travel, blood dyscrasias, IV drug abusur, homosexual, school teacher)
 Obtain Immune globulin (HBIG) if exposed (in household or sexual contacts with infected individuals) to hepatitis without previous immunization.
 Standard precautions (Wear gloves if hands come into contact with body fluids; wear gown and face shield if body fluids may be splashed.) Hand washing after removing gloves
 Don’t recap needles
 Wear gloves during diaper changes & proper hand washing
 Screen food handlers
 Avoid eating from public salad bars and buffets that do not have sneeze guards or other hygienic devices and practices to prevent food contamination
 Use liquid soap dispensers and hand dryers in public restrooms rather than bar soap and cloth towels.
 Avoid placing fingers and handheld objects in mouth.
 Do not share cigarettes, eating utensils, or beverage containers.
 Avoid eating raw seafood or seafood harvested from possibly polluted water.
 Use a pocket mask when giving pulmonary resuscitation.
 Drink bottled water in developing countries. Avoid ice unless it was made from bottled water.
 Dispose of needles and other sharp objects in a puncture-resistant container.
 Use a condom when engaging in sexual intercourse.
 Do not share razors, fingernail tools, toothbrushes, or any personal care item that may come into contact with blood or body fluids.
 If contemplating surgery, investigate the possibility of donating and storing your own blood for later use.
 Wear a mouth shield when giving mouth-to-mouth resuscitation.

Question 4

3. Ascites nursing considerations and medical management (PP slide 9)

Answer 4

 Hepatorenal syndrome, serum protein into peritoneal cavity
 Abdominal paracentesis: diet sodium restriction
 Drug therapy- Aldactone (hold if sodium too low)

Question 5

Cirrhosis Manifestations (pp slide 6):

Answer 5

 Enlarged liver
 Gynecomastia in men
 Weight loss
 Ascites
 Chronic fatigue
 Constipation
 Clay colored stools
 Hemorrhoids
 Anorexia
 Nausea
 Dyspepsia
 SOB
 Tea colored urine
 Abdominal discomfort
 Nose bleeds
 Diarrhea
 Spider angioma

Question 6

Cirrhosis Nursing Interventions: (pp slide 7)

Answer 6

 Monitor VS: daily weight intake, output & abdominal girth Q8hrs, small meals
 Elevate HOB for relief of ascites
 Client response to drug therapy: change in mental status , signs of GI bleed
 Implement fall precautions
 Encourage low sodium diet
 Bleeding precautions

Question 7

5. Bile duct obstruction manifestations (PP slide 17)

Answer 7

 Dark or amber urine
 Fatty stools

Question 8

Acute pancreatitis Nursing interventions (PP slide 20)

Answer 8

 Monitor VS Q 1-2hrs
 Monitor urine output hourly
 Encourage deep breathing/coughing Q HR
 Perform the prescribed Tx measures: NG tube, IV fluids, NPO
 Bed rest to minimize metabolic activity

Question 9

Acute pancreatitis risk factors (pp slide 18)

Answer 9

 Gallstones
 Excess alcohol/tobacco use
 Trauma
 Obesity
 Diabetes

Question 10

7. Chronic pancreatitis client education/Nursing management (PP slide 22)

Answer 10

 Increase calorie intake
 Increase protein
 Low-fat diet
 No alcohol
 Monitor labs closely (amylase, lipase, protease)

Question 11

8. GI bleed manifestations

Answer 11

 Black, tarry, ground emesis like stools
 Hypotension & tachycardia
 Pale, clammy, sweating
 Abdominal pain
 Feeling weak

Question 12

9. Viral hepatitis nursing actions (PP slide 10)

Answer 12

 Symptomatic TX: bed rest, IV fluid, vitamins & antiemetics
 Liver transplantation, immunosuppressives
 Support nutritional intake & preventing complications
 Teach about self-care measures, promoting health, avoiding transmission to others & avoiding alcohol.

Question 13

10. Esophageal Varices NTK (PP slide 8)

Answer 13

 Result of HTN
 Esophageal bleeding : Tx BUN & Bilirubin will be elevated if client ingested blood
 Sclerotherapy, variceal band ligation, Sengstaken- Blakemore tube
 IV fluids, blood products

Question 14

11. Types of Hepatitis (pp slide 10)

Answer 14

 Hepatitis A: oral- fecal route/uncooked foods
 Hepatitis B: blood or bodily fluids
 Hepatitis C: Usually blood to blood/tattoos