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53 Cards in this Set

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Meconium is usually passed
In the first 24 hours
A newborn who has jaundice for 2 weeks, the diagnosis is
Physiologic jaundice
A baby has blackish-greenish stools 24 hours after birth, what should the nurse do?
should the nurse do? Record data in nursing notes, this is completely normal.
Physiology of pyloric stenosis is
Hypertrophy of the pylorus.
How do you feed a baby with pyloric stenosis?
Small, frequent feedings given slowly. Prop the baby upright slightly on the right side.
The clinical manifestation of pyloric stenosis is (3)
A paristolic wave that goes from right to left, weight loss and projectile vomiting.
How long should a patient sit in a sitz bath?
20 minutes.
gastroesophageal reflux disease (GERD)
acidic contents of stomach move upwards into esophagus

causes heartburn & may lead to ulcers esophageal ulcers

caused by loosening of lower esophageal sphincter
H2-receptor antagonist
drug that inhibits effects of histamine at receptors in stomach

usually first choice for treating peptic ulcers
proton pump inhibitors
drugs that reduce acid secretion in stomach by binding irreversibly to enzyme H+,K+-ATPase

widely used in short-term therapy of peptic ulcers
antacids
alkaline substances used to neutralize stomach acid

effective at reducing s/s of reflux dx
What are 2 symptoms of Irritable Bowel Syndrome?
Altered Bowel Functions (Change in frequency or consistency)
Abdominal Pain in the left lower quadrant.
What is the cause of Irritable Bowel Syndrome?
No definite cause.
Other symptoms of IBS besides pain and altered bowel functions.
nausea, belching, bloating, anorexia.
What is the diagnostic tool for IBS?
Barium enema - picks up spasms in colon and rules out other bowel disorders.
What are the risk factors for colorectal cancer?
Genetics, Age, Polyps, Diet, Inflammatory Bowel Disease
Facts about the genetic risk factor for Colorectal Cancer.
With an immediate relative w/colorectal CA, chance is 3-4 times greater than with no relatives with Colorectal CA.
What is the typical age for colorectal cancer?
Over 50 years of age.
What is the biggest risk factor in the diet for colorectal cancer?
High fat foods, fried or broiled meats (release carcinogens), and refined carbs (pastries)
What are the symptoms of colorectal cancer?
Change in bowel habits (consistency or frequency), blood in stool and anemia, symptoms of obstruction.
What are the diagnostic tools of colorectal cancer?
CBC (H&H dec. if bleeding), Chemistries (liver enzymes elevated), fecal occult blood, carcinoembryonic antigen (CEA), Radiographic (barium enema)
What is a nursing intervention before giving a client a fecal occult blood test for colorectal cancer?
Tell the patient to not eat red meat 48 hours prior to the test.
Why would liver enzymes be elevated when testing for colorectal cancer?
If the cancer metastasized to the liver.
What are nursing interventions for fecal occult blood test?
Avoid vitamin C supplements, avoid aspirin products, avoid meat 48 hrs. prior to test.
What is the routine for submitting stool specimens to check for colorectal cancer?
Submit specimens for 3 consecutive days.
What are side effects to radiation treatment of colorectal cancer?
Extreme fatigue and diarrhea.
What are side effects for chemotherapy in the treatment of colorectal cancer?
Bone marrow depression, anemia (assess blood counts), low WBC's, problems with mucous membranes and skin breakdown.
Why is skin breakdown a problem with chemotherapy in colorectal cancer treatment?
Chemotherapy targets rapidly dividing cells such as in the skin, bone marros, and mucous membranes)
What is an anastomosis?
The two healthy ends of the bowel are joined together
Why is an NG tube inserted after colorectal cancer surgery?
For decompression.
What is the post-op care for client with ostomy?
Same as abdominal surgery + stoma assessment and management, diet, psychosocial issues
What are diet considerations for client with ostomy?
Stay away from gas-forming foods (cabbage, onions, turnips, mushrooms, beans, brussel sprouts, spinach, cheese, eggs, beer, carbonated beverages, fish, highly seasoned foods, some fruit drinks, corn, pork, peas, coffee, high-fat foods)
How do the stools look for each type of ostomy?
Small bowel - liquid
Ascending colon - liquid
Transverse colon - semi-solid
Descending, sigmoid colon - solid
Definition of intestinal obstruction.
Partial or complete blockage of small or large bowel that impedes the digestive process.
What are the 3 causes of intestinal obstruction?
Mechanical (tumor, adhesions)
Nonmechanical (nothing physical)
Vascular insuffiency (thrombus or embolus)
What are the assessments for an intestinal obstruction?
Abdominal pain, nausea/vomiting, bowel changes, distention, altered bowel sounds, visible peristaltic waves.
What are the S&S of a complete obstruction?
No flatus or stool.
What is the definitive test for intestinal obstruction?
There is no diagnostic test that definitively diagnoses intestinal obstruction.
What is the management of intestinal obstruction?
NPO, NG or NI tube for decompression, F&E replacement, pain management, antibiotics.
What intervention is done to replace F&E that are lost during an intestinal obstruction?
IV fluids.
Why is pain management difficult with an intestinal obstruction?
Narcotic analgesics are avoided so symptoms are not masked. Also a side effect of narcotic analgesics is the slowing down of peristalsis.
When are antibiotics given to a patient with an intestinal obstruction?
If there is a possibility of strangulation.
How is a nasointestinal tube used?
Inserted by physician, extends into small bowel, weight on end allows peristalsis to move it through the small bowel, may have order to advance tube at intervals.
What are 2 surgical techniques used in intestinal obstruction?
Tumor removal, correction of a twisted intestine.
What causes changes in the mucosal lining?
Inflammatory Bowel Disease
Where is McBirney's point?
Midway between umbilicus and anterior illiac crest on the right side.
What are nursing interventions pre-op for appendectomy?
NPO, IV Fluids, pt. in Semi Fowlers position to facilitate drainage into lower abdomen. NO HEAT - can lead to perforation.
What is peritonitis?
Inflammation of the epitheleal lining of the abdominal cavity (normally sterile)
What are some S&S of Peritonitis?
Abdominal pain, tenderness, rigid distended abdomen (filling w/gas & fluid), N, V, Anorexia, Dec. bowel sounds, dec. urine output, inc. WBC's, + blood cultures, respiratory difficulties.
What are post-op nursing interventions for appendectomy?
Drainage tube if abcess formation, NG tube for decompression if peritonitis, post-op antibiotics.
What are non-surgical measures for peritonitis?
NPO, NG tube, IV fluids & antibiotics, analgesics, O2 PRN, I&O, daily weight.
What is the surgical management of peritonitis?
Repair the cause of peritonitis and remove additional fluid and foreign material.
Post-op nursing interventions for peritonitis?
Semi fowler's position to promote drainage and facilitate breathing.