Exam 4- Ch. 32 Gi

Front 1

What is a proctosigmoidscopy? What is the prep for it? When would the bowl preparation not be done r/t severe diarrhea?

Back 1

Examination of the distal sigmoid colon, rectum and the anal canal using a flexible endoscope. Routine prep (clear liquid diet, laxative and fleet enema prior to proc. W/ severe diarrhea can result in electrolyte imbalance. Prep my not be ordered with bleeding or severe diarrhea.

Front 2

Which types of foods are not included in a bland diet?

Back 2

Peppers (spicy food)

Front 3

What type of fluid is used to irrigate an NG tube? Why?

Back 3

Saline. To prevent loss of electrolytes.

Front 4

Why are oral inspections needed? What could happen if a patient has a loose tooth?

Back 4

Aspiration into airway.

Front 5

Define TPN. Administering TPN falls in which nurse's scope of practice?

Back 5

Total Parenteral Nutrition. RN scope of practice. LPN would ask for assignment change.

Front 6

What kind of data collection is used when a nurse inspects a stoma placement?

Back 6

Inspection is observation.

Front 7

As the nurse continues to assess her patient, she touches the patients upper abdominal quadrant and notes that it is warm. What data collecting technique is used?

Back 7

Touch

Front 8

If you have a patient who has an NG tube to low intermittent suction and you see that it is not draining, what do you do?

Back 8

Irrigate the NG tube w/ 30mL of Normal Saline. (Keep suction on low to prevent damage to lining of the stomach).

Front 9

*You have a patient who has tube feedings. You check placement and residual. You find that the patient has 120mL of residual formula. The patient is on a pump and is receiving 60mL an hour. What do you do?

Back 9

Protocol varies but generally residual above 100mL- feeding should be stopped to prevent vomiting.

Front 10

*Define hypoactive bowel sounds.

Back 10

Bowel sounds are in frequent over a 5 minute period (might indicate paralytic ileus).

Front 11

Your patient has a feeding tube and is receiving 60mL an hour. You find a residual of 10mL. What do you do?

Back 11

Continue as ordered.

Front 12

You have a cancer patient who has received chemo. They have an elevated CEA. What might this indicate?

Back 12

Carcinoembryonic Antigen. Used to monitor GI cancer treatment is effective. Elevated CEA would not indicate absence of disease.

Front 13

*What kind of teaching is done for a patient who is going to have a UGI series?

Back 13

This uses barium and is an XR of the esophagus, stomach and duodenum.

Front 14

What nursing action would you do for a patient who has an NG tube and is receiving feeds and who is in a coma?

Back 14

Positioned in a sitting or high Fowler's position to decrease risk of aspiration.

Front 15

How would you confirm NG tube placement?

Back 15

XR- aspiration of fluids and check the pH of gastric aspirate.

Front 16

How would you manage cultural dietary needs?

Back 16

What foods does the patient likes and is allowed for and plan them into meals.

Front 17

With GI functioning, mechanical digestion in the stomach is done by what?

Back 17

3 layers of smooth muscle is efficient mechanical digestion.

Front 18

*What suction setting should a non-vented NG tube be on?

Back 18

low intermittent , explain to decrease anxiety.

Front 19

What labs do we monitor closely for a patient on TPN?

Back 19

Glucose. TPN has high dextrose.

Front 20

Why do we start TPN slowly and gradually increase it?

Back 20

To give the pancreas time to adjust to increase insulin production for the high mounts of glucose.

Front 21

If your patient has a permanent gastric feeding, what actions would you take to help prevent aspiration?

Back 21

Elevate the head of the PT's bed more than or equal to 30 degree's at all times of feeding

Front 22

What type of patients might need TPN?

Back 22

1) A patient who has esophageal cancer. 2) A patient with severe burns across face and chest.

Front 23

List functions of the liver.

Back 23

1) Phagocytize worn red blood cells 2) Form bilrubin 3) Synthesize clotting factors.

Front 24

What processes occur in the small intestines?

Back 24

1) Production of enzymes to complete carbohydrate metabolism. 2) Production of peptides to complete digestion of protein and amino acids. 3) Absorption of water.

Front 25

What structures are found in the hepatobiliary system?

Back 25

1) Bile duct 2) Gallbladder 3) Liver

Front 26

List changes in the GI system r/t ageing.

Back 26

1) Increased constipation 2) Decreased sense of taste 3) Increase periodontal disease 4) Decrease peristalsis

Front 27

Know the % of dextrose in TPN and the route it should be given.

Back 27

12%

Front 28

*If you are examining a patient and use palpation, how far do you depress the abdomen?

Back 28

1 inch.

Front 29

*Define hypoactive bowel sounds.

Back 29

Hypoactive- infrequent (Normal 5-30) over a 5 min period. May be seen in patient with paralytic ileus.

Front 30

*Define hyperactive bowel sounds

Back 30

Greater than 30 sounds heard over 5 min period.

Front 31

*Explain what an upper GI series is and what organ system does it look at?

Back 31

XR of esophagus, stomach and duodenum using barium

Front 32

What is the prep for this test (UGI)?

Back 32

NPO 6-8 hours before procedure.

Front 33

What type of illness might an upper GI series show?

Back 33

Hiatal hernia. Polyps pyloric stricture.

Front 34

What is the pH of hydrochloric acid in gastric juice?

Back 34

1-2.

Front 35

*What are the functions of this acid (gastric)?

Back 35

Kills microorganisms that enter the stomach.

Front 36

What is a reason for placing a Levin NG tube? What if this does not drain and your patient has increased nausea, what might you do to re-establish drainage?

Back 36

Decompression. Irrigate with normal saline.

Front 37

What is the prep for an esophagogastroduodenoscopy(EGD)?

Front 38

You will place an G tube. What is important to do?

Back 38

Explain procedure to your patient.

Front 39

Diets: Know the different b/t clear liquid and full liquid.

Back 39

Full includes milk products.

Front 40

*List might be on a clear liquid diet:

Back 40

Tea with sugar. Beef broth. Apple juice. **Orange gelatin***

Front 41

List what might be on a full liquid diet:

Back 41

Cream soups, milk, milkshakes.

Front 42

*What is meant by advancing a diet?

Back 42

Start with clear to full to mechanical soft to soft to Regular.

Front 43

If you are caring for a patient with liver failure, what vitamins would need to be added because of absorption problems?

Back 43

Vitamin D, Vitamin B12, Vitamin K.

Front 44

What type of foods or meds might be responsible for an occult blood test of the stool to be positive?

Back 44

Fish, ASA, NSAIDs, Red meat (3 days before), dental procedure (caused by bleeding gus).