Week 5 - Assessment & Study Questions Flashcards
what should be asked regarding general abdominal health history questions
questions regarding:
- appetite
- nutritional status
- meds
- ETOH/smoking
- activity lvls
- anxiety/stressors
- toxin exposure
- traveling
- past or present illness
- past surgeries
- FHx
- scars & adhesions
what should you ask regarding appeitite
- any recent changes
- loss or gain
- anorexia
what could unintentional lost weight indicate?
- cancer
what could rapid weight gain indicate
- renal or heart failure
what should you assess regarding nutritional status
- healthy weight?
- undernourished?
- overweight?
- allergies?
- food intolerances?
- 24 hr recall and ask abt normal food intake
list 3 meds that impact GI and how
- NSAIDs (inhibit mucus production)
- opioids (constipation)
- anticholinergic (constipation)
why is it important to ask abt smoking
correlates with:
- ulcers
- cancers
- gastritis
what should we assess regarding the head
- lips
- teeth
- gums
- inside mouth
- neck
what is dysphagia
- difficulty swallowing
what can cause dysphagia
- neuromuscular dysfunction
- structural abnormality
- stomach cancer
what is a risk associated with dysphagia
- lack of gag reflex = risk of aspiration
what is pyrosis
- heart burn
what is dyspepsi
- burning or indigestion
what does dyspepsi occur with
- ulcers
- gastritis
what is odynophagia
- painful swallowing
what is odynophagia associated with
- strept throat
what is eructation
- belching
what does the nurse need to be aware of when a pt is taking omeprazole
- it is generally well tolerated with few side effects
- provides good relief of GERD
what should we assess regarding nausea
- origin
- OPQRSTU
- alone or w vomitting/diarrhea/anorexia
- related to med/intake/activity?
- effective tx
what does short term vomiting cause? long term
short = metabolic alkalosis long = metabolic acidosis
what could projectile vomiting w/o warning indicate
- brain injury
- obstruction
list symptoms of aspiration pneumonia
- decreased air entry
- hypoxia
- sob
- febrile
- systemic sighs
- productiv cough
- adventitia
what should we assess regarding vomiting
- alone or w nausea
- does it contain bile, food, meds
- dry heave or retch
- projectile, any warning
- r/t to meds/intake/activity?
- effective tx
what is hematemesis
- vomting blood
what is hemoptysis
- coughing blood
what is “frank red” hematemesis
- fresh, red, and undigested blood
- due to cause above the stomach
what is “coffe ground” emesis
- partially digested blood
- comes from stomach
what should you assess regarding hematemesis
- frank red vs coffee ground
- associated symptoms
- volume loss (slow vs fast)
- meds
- history of esophageal varices, gastritis, peptic ulcers
- BP/HR, PT, PTT, aPTT, INR
what are esophageal varices
- enlarged veins in the esophagus
`what should you assess regarding BM
- last BM
- characteristics of the bowel
- meds that might effect BM
- control (continent or not)
- flutulence
what is a test for occult blood
- fecal occult blood test
what should you assess regarding abdominal symptoms
- OPQRSTU
- guarding
- rigidity
- descriptors
what does rigidity commonly occur with
- peritonitis
what are two types of alternate nutrition
- enteral
- parental
list 4 types/reasons for stool samples
- fecal analysis
- fecal occult blood
- stool for C&S
- stool for ova & parasites
what is a stool culture particulary done for
- clostridium difficile
what does a fecal analysis tell us
- any mucus, blood, pus, parasites, & fat content
what are two ways to test for h.pylori
- blood work
- breath testing
list 3 things assessed in blood work r/t to the GI tract
- amylase
- lipase
- gastrin
why do we assess amylas
- measures secretion of amylase by pancreas
- imp in diagnosing acute pancreatitis
why do we assess lipase
- measures secretion of lipase by pancreas
- levels stay elevated longer than amylase
what is assessed in liver fnxn test
- serum bilirubin
- albumin
- ammonia
what does serum bilirubin tell us
- ability of the liver to form & excrete bilirubin (bile)
why do we assess albumin in liver fnxn tests
- measures the ability of the liver to produce serum proteins
why do we assess ammonia in liver fnxn test
- conversion of ammonia to urea commonly occurs in the liver
why do we assess a pt’s lipid profile? what’s included?
- tells us abt the liver’s function
- includes cholestrol, LDL, HDL, triglycerides
what is an EGD
- esophagogastroduodenoscopy
describe how to prep a pt for an EGD
- must be NPO for 8 hr before
what is important to consider post-EGD
- must be NPO until gag reflex comes back (risk of aspiration)
- monitor temp
what is sucralfate used for in the context of peptic or duodenal ulcers
- binds to the base of gastric ulcers to form a protective layer that facilitates tissue healing
what is the purpose of bismuth subsalicyclate
- neutralizes bacteria by binding to them & causing them to be expelled in the stool
what is diphenoxylate and atropine
- a combo of an opiate drug and an anticholinergic drug which can slow the GI tract by two different mechanisms
what is the MOA of psyllium mucilloid
- it is a non-absorbable, non-digestible substance that absorbs water & increases bulk in the feces
what is a major nursing consideration when administering a hyperosmotic laxative
- must ensure they have adequate fluid intake as these meds pull water into the intestines and can cause dehydration
how does bisacodyl work to treat constipation
- it is a direct stimulant of intestinal nerves which causes an increase in peristalsis
