Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3512 > week 5 GI > Flashcards

week 5 GI Flashcards

1
Q

which three nursing concepts are affected by issues r/t elimination?

A

fluid and electrolyte balance, tissue integrity, and altered nutrition status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

describe an acute exacerbation of a chronic GI disorder

A

inflammation can flare up and abscesses can form in the mucosal lining of the GI tract causing infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is a common psychological complication of elimination issues?

A

sleep deprivation and subsequent inability to cope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which two specific GI assessments are part of recognizing cues of impaired elimination?

A

bowel sounds and monitoring of stools for frequency, amount, blood, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what will i monitor the bloodwork for in impaired elimination?

A

dehydration and fluid/electrolyte balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

why should i care about checking peripheral pulses and cap refill on a patient admitted with a GI disorder?

A

becuase they are at risk for dehydration and subsequent hemodynamic collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

aside from GI assessment and signs of dehydration/electrolyte issues, what two things willl i monitor for in a patient with inflammatory bowel disease?

A

perineal skin and coping skills/emotional status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are three interventions r/t tissue integrity in IBD?

A

keep skin clean and dry
apply barrier cream
monitor for infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe symptoms of diverticulosis

A

likely asymptomatic, but may have crampy pain, constipation OR diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the difference between diverticulosis and diverticulitis?

A

diverticulitis involves the diverticula becoming inflamed d/t retention of stool in pouches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what might be the signs of diverticulitis?

A

edema, abscesses, perforations, peritonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are symptoms of diverticulitis

A

abdominal pain, tender lower left quadrant, fever/chills/nausea/anorexia (signs of infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how do we diagnose diverticulitis?

A

ultrasound or CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

6 complications of diverticulitis

A
  1. perforation with peritonitis
  2. abscess
  3. fistula formation
  4. bowel obstruction
  5. urethral obstruction
  6. bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are 5 things we can do as treatment/monitoring with diverticulitis?

A

rest the bowel with NPO and iv fluids

consult dietition about low-fibre diets for mild flare-ups

monitor for infection

might need order for antibiotics for severe

pt may need surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

four types of hernia

A
  1. inguinal
  2. femoral
  3. umbilical
  4. incisional
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

are hernias painful?

A

commonly, yes. pain can be reduced if hernia can be placed back into abdominal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what complication of hernias is an emergency?

A

strangulation- pt would have s&s of a bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what three actions can be taken to treat hernia?

A

wearing a truss, surgical replair (herniorrhaphy) or surgical reinforcement of weakened fascia (hernioplasty)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is post-op care for hernia? (5)

A

-watch for bladder distension (I&Os)
-provide scrotal support
-deep breathing and turns
-splint incision
-position to reduce pressure in suture line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is different about post-hernia surgery compared to other surgery recoveries?

A

no coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

discharge teaching for hermorrhoidectomy (5 points)

A
  1. narcotics for sphincter spasm
  2. sitz baths 1-2 days post op
  3. teach pt to change dressing
  4. use stool softeners
  5. take analgesics before a bm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

which three things precipitate peptic ulcers?

A

drugs, stress and H pylori bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the main differences between gastric and duodenal ulcers? (6)

A

-peak age: 50-70 for peptic, 20-50 for duo
-pain factors: food aggravates gastric, sooths duodenal
- nutritional status: only peptic tends to present as poorly nurished
-gastric secretions: decreased in gastric, increased in duo
-pain onset- this makes sense
- gastric heals with tx, duo often has remissions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

which labs will be ordered for suspected peptic ulcer?

A

H pylori in bllod, breath or stool, HGB and HCT (d/t bleeding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

which 2 Dx tools are used for peptic ulcer? which is the gold standard?

A

Esophagogastroduodenoscopy (gold standard), nuclear medicine scan which tests for bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

three complications of PUD

A

hemorrhage/upper GI bleed,
Perforation and spillage into peritoneal space
gastric outlet obstuction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

4 signs of upper gi bleed (one late sign)

A

hematemesis or coffee ground
tarry black stool
abdominal pain
eventual shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

how to intervene in GI bleed

A

treat like hypovolemic shock - frequent VS, O2, IV fluids, monitor I&Os, stools, emesis and labs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

how do they stop a GI bleed?

A

epinephrine sclerosing needles (or glue),
endoclips
electrocoagulation probes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

which 5 drugs are used along with other tx to control GI bleeds? (besides epinephrine given endoscopically)

A

Octreotide
vasopressin
antacids
aluminum hydroxide
PPIs
H2 receptor blockers

32
Q

pt with PUD has sudden, severe abdominal pain, rigid board-like abdomen with increasing distention. What complication is this?

A

perforation and spillage of gastric contents

33
Q

what interventions do I do for PUD perforation?

A

monitor for and treat hypovolemic or septic shock (vitals! lactic acid, cbc, fluids), make sure they have an NG tube for decompression, give antibiotics and prepare them for surgery

34
Q

if gastric mucosa is perforated, what shouuld I NOT do?

A

allow anything into their stomach either via PO intake or NG tube

35
Q

pt with PUD has pain that progesses, swelling of upper abdomen, and starts projectile vomiting. what complication is this

A

gastric outlet obstruction

36
Q

how do we treat gastric outlet obstruction?

A

decompress with NG tube (to prevent vomiting), IV fluid and electrolyte replacement (after they’ve vomited, and b.c they can’t absorb fluids with intestines), and prep for surgery!

37
Q

5 drugs for PUD (some repeat)

A

-H2 receptor blockers like famotidine,
- PPI, antibiotics for h pylori (tetracycline, metronidazole),
-cytoprotective (like pepto-bismol),
- antacids

38
Q

Fill in the blank: Discharge teaching for PUD
- Dietary modifications: four triggers
- stop _______
- two points about meds:
- report this sign:

A
  1. avoid spicy foods, acidic foods, caffeine, alcohol
  2. smoking
  3. avoid OTC meds, take prescribed meds as ordered
  4. tarry stools, bloody emesis, increased pain
39
Q

4 surgeries for PUD

A

gastroduodenostomy, gastrojejunostomy, vagotomy (severing of vagus nerve), pyloroplasty

40
Q

what will a patient not have immediately after PUD surgery?

A

peristalsis

41
Q

what will i want to auscultate regularely after GI surgery?

A

bowel sounds to check for return of peristalsis

42
Q

what is a long-term complication of PUD surgery?

A

anemia d/t loss of blood and not eating

43
Q

what kind of IV fluids are best for post PUD surgery?

A

ones with K+

44
Q

what am I ensuring patency of after PUD surgery? what other care am i doing with this?

A

NG tube. decompressing, monitoring contents, removing after peristalsis returns

45
Q

this complication happens after removal of large portion of stomach and pyloric sphincter and results in uncontrolled gastric emptying of a high carb bolus into small intestine

A

dumping syndrome

46
Q

15 minutes after eating, PUD post-op pt feels dizzy and bloated. what is going on? how do i prevent this?

A

dumping syndrome. don’t let them drink with meals, take small dry feedings, and low-carb diet

47
Q

what is post-prandial hypoglycemia?

A

a varient/ complication of dumping syndrome where hyperglycemia causes ++ insulin release resulting in secondary hypoglycemia

48
Q

what might happen after plyoric surgery?

A

bile reflux gastritis

49
Q

pt has Anemia, Vague epigastric fullness,
feelings of early satiety after meals,
weight loss, dysphagia, dyspepsia
what could this be?

A

adenocarcinoma of stomach wall

50
Q

how would early stomach ca be treated? what about later stage?

A

laparoscopic surgery if tumor small enough, large may require total gastrectomy

51
Q

waht is a patient at risk for following a total gastrectomy with esophagojejunostomy?

A

poor nutrition status, wt loss, vitamin deficiency, anemia, dumping syndrome, postprandial hypoglycemia

52
Q

which labs are used to diagnose IBD? (5)

A

barium, fecal OBT, CBC, ESR and C-reactive protein (for inflammation), electrolytes

53
Q

which IBD causes bloody diarhea?

A

ulcerative colitis

54
Q

which IBD is cured with surgery?

A

Ulcerative collitis

55
Q

Which IBD has FISTULAS?

A

Crohns

56
Q

which IBD causes hemorrhage?

A

UC

57
Q

which IBD causes obstruction?

A

Crohns

58
Q

which IBD causes perforation?

A

both

59
Q

what are 3 extra-intestinal complications of IBD?

A

arthopathy, arthritis, skin issues (could also name thromboembolic events, occular manifestations, osteoporosis)

60
Q

IBD patients require meticulous ___________ care

A

perianal

61
Q

someone with a Hx of IBD brings their medications with them to the ER. what’s in the bag?

A

Sulphasalazine (5-asa), prednisone, cyclosporine and/or infliximab, vitamins-iron suppliment, and diphenaxylate (antidiarrheal)

62
Q

what would i advice an IBD patient about their diet?

A

Keep a food diary!
identify triggers and avoid them (dairy is common)

eat high calorie high protein low fat diet

take suppliments

low-fibre (residue)

63
Q

what exercise do I need to teach my pt to do after surgery with an ileoanal reservoir?

A

kegels!

64
Q

five ways bowel obstructions can happen

A

-adhesions
-CA
-hernia
-paralytic ileus
- anything that blocks (stool?)

65
Q

this type of bowel obstruction has a rapid onset, colic, projectile vomiting frequent and early on.

A

small bowel

66
Q

this type of obstruction presents with gramping, constipation, signnificant abd distension and has a gradual onset

A

large bowel

67
Q

nursing care with bowel obstruction (NOT about digital decomp or laxatives) - name 6

A

abd assessment,
-pain control
- n/g care and decompression
- nutrition/lytes, fluid replacement
- prep for surgery
- monitor for perforation

68
Q

clinical manifestations of colerectal ca

A

change in elimination habits, gas pains, bloody stool

69
Q

what does CEA measure?

A

presence of a fetal growth hormone which would indicate CA

70
Q

what three things are colonoscopies used for?

A

diagnose CA, biopsy, remove polyps

71
Q

what is a abdominal peritoneal resection

A

anus, rectum and sigmoid colon removed, proximal sigmoid brought through abdominal wall and permanent colostomy

72
Q

describe incisions/wounds after AP resection

A

abd incision, perineal incision with drain, and stoma

73
Q

what positioning consideration do i need to know for post AP resection

A

NO PRESSURE ON PERINEUM

74
Q

assess stoma q __

A

8hrs

75
Q

teach pt with a new stoma to report: (4)

A

fever, diarrhea, constipation, stoma problems

76
Q

three big principles for ALL GI surgery

A

pain control, nausea, constipation

3512 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions