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24 Cards in this Set

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a patient arrives in the ed with an ice pick protruding from his left lower abdominal quadrant. an appropriate RN action would be to
leave the object in place until the patient is taken to the operating room
which type of penetrating injury would the rn document in the assessment finding for a patient with a gunshot wound at the sixth intercostal space?
thoracoabdominal
a patient with a gunshot wound to the left lower abdominal quadrant arrives at the ed with the following vital signs : BP 110/70 mm Hg; pulse rate, 96 beats/min and respirations, 24 breaths/min what would be the highest priority at this time
emergency exploratory laparotomy
a patient arrives at the ed with a penetrating gunshot wound to the abdomen and hematuria which diagnostic test would the nurse expect the physician to order before surgery
intravenous pyelography (IVP)
when assessing a patient for potential complications from a gunshot wound to the right upper abdominal quadrant, the rn should observe the patient closely for injury to the
Liver
Transverse colon
Stomach
which rn action would the rn expect to perform preoperatively for a patient with a penetrating abdominal would
establishment of 2 large bore IV lines
insertion of a nasogastric (NG) tube
insertion of an indwelling urinary catheter
the RN would expect to note early signs of shock in a young male patient who has sustained a penetrating abdominal would after the patient has suffered a blood volume loss of
15 %
all of the following injuries are considered penetrating except
a severe abdominal laceration caused by a fall
all of the following assessment findings would lead the RN to suspect a perforated gastric ulcer
absent bowel sounds
hypotension and tachycardia
anxiety and respiratory difficulty
which of the following can cause chemical peritonitis in a patient with a perforated gastric ulcer
gastric and intestinal content spillage
perforated ulcers occur most commonly in the
duodenum which accounts for 80%
the nurse knows that such abdominal emergencies as obstruction, perforation, and acute intractable hemorrhage are tyupically treated by:
Surgery
the most common cause of upper GI bleeding include
peptic ulcers, acute mucosal lesions, and esophageal varices
esophageal varices are
nearly always caused by portal hypertension
nusing care of the patient with a three-lumen , double ballon esophageal tude incudes all of the following
Maintaining constant observation during ballon inflation
ensuring that the ballon pressures are kept at the levels required to contorl bleeding
remaining alert for any complaints of chest pain
a 38-yr man is admitted to the ED with complaints of severe epigastric pain. His vital signs upon admission are within normal limits. His diagnosis is acute pancreatitis.

of the following history findings, the most likely cause of pancreatitis is:
excessive alcohol intake
38-yr man is admitted to the ED with complaints of severe epigastric pain. His vital signs upon admission are within normal limits. His diagnosis is acute pancreatitis.

the RN knows that pancreatitis also may occure as a complicaiton of a perforated duodenal ulcer when?
the perforation erodes into the pancreas
38-yr man is admitted to the ED with complaints of severe epigastric pain. His vital signs upon admission are within normal limits. His diagnosis is acute pancreatitis.

which rn diagnosis is most appropriate for a patient at risk for complications from pancreatitis?
impaired gas exhange related to pulmonary edema
38-yr man is admitted to the ED with complaints of severe epigastric pain. His vital signs upon admission are within normal limits. His diagnosis is acute pancreatitis.

The RN normally assesses a patient with acute pancreatitis for elevated levels of serum:
Amylase
38-yr man is admitted to the ED with complaints of severe epigastric pain. His vital signs upon admission are within normal limits. His diagnosis is acute pancreatitis.

The RN knows that meperidine hydrochloride (demerol) is typically used to treat acute pancreatitis because it
does not cause spasm of the sphincter of Oddi
38-yr man is admitted to the ED with complaints of severe epigastric pain. His vital signs upon admission are within normal limits. His diagnosis is acute pancreatitis.

The RN should assess the pattient for all of the following symptoms of hemorrhagic pancreatitis
Jaundice
Extreme epigastric or umbilical pain extending to the back or flank
Shock
38-yr man is admitted to the ED with complaints of severe epigastric pain. His vital signs upon admission are within normal limits. His diagnosis is acute pancreatitis.

RN interventions for a PT w/ acute hemorrhagic pancreatitis include all of the following
administration of large volumes of colloid and electrolyte solutions
administration of calcium gluconate
monitorng of central venous pressure and urine output
38-yr man is admitted to the ED with complaints of severe epigastric pain. His vital signs upon admission are within normal limits. His diagnosis is acute pancreatitis.

over the course of several months of caring for various PTs w/ pancreatitis, the RN would expect the MD to order broadspectrum antibiotics
Rarely
38-yr man is admitted to the ED with complaints of severe epigastric pain. His vital signs upon admission are within normal limits. His diagnosis is acute pancreatitis.

The PT is being admitted to the medical-surgical unit for further treatmetn and observation. which dietary regimen would the RN expect the physician to order for this PT
Low-fat
no-alcohol
no-caffeine