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87 Cards in this Set

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pt with abdominal discomfort when drinking milk, whats the prob?
-lactose intolerance, lacking enzyme lactose
what part of GI absorbs food?
what part of GI absorbs food?

-small intestine
when you are assessing for gastro intestinal problems, what is the first step in your assessment
assessing gi problems - 1st step - inspection
what structure would you expect to find in the RUQ?
- liver and gallbladder
your pt is coming back from having a Esophagogastroduodenoscopy (EGD) procedure post surgically, what would be your nursing concern?
your pt is coming back from having a Esophagogastroduodenoscopy (EGD) procedure post surgically, what would be your nursing concern?

- put down scope need to numb pt, and before giving any food or drink need to check gag reflex
preparation before GI series?
preparation before GI series?

- pt cannot have anything to eat, need to have NPO

- then pt need to drink large amount of barium for procedure, x-ray

--npo 8 hrs
after GI series we are waiting for gag reflex to return, how long do you wait?
after GI series we are waiting for gag reflex to return, how long do you wait?

- 2-4hrs

***when gag reflex comes back they need to be NPO***
pt schedule for a sigmoidoscopy, how should pt prep?
pt schedule for a sigmoidoscopy, what

- enema night before procedure and maybe morning too

- lightly NPO after midnight, clear liquid diet

- bowel prep

sygmoidoscopy, normal prep,
-ennemas at night, NPO midnight, clear liquid before that
pt came into the emergency room complaining of RLQ?
pt came into the emergency room complaining of RLQ?

- wbc elevated, appendicitis
doctor orders a stool culture for diarrhea, pt gives you culture, what do you do with it?
doctor orders a stool culture for diarrhea, pt gives you culture, what do you do with it?

- keep in at room temp, and bring to lab within 30 min
you have a group of pt’s, which one needs to be your #1 priority?
you have a group of pt’s, which one needs to be your #1 priority?

*** answer: pt with acute abdominal pain***
pt complaining of RLQ pain, what do you think it is?
pt complaining of RLQ pain, what do you think it is?

appendicitis
which task can you tell a CNA to do?
which task can you tell a CNA to do?

*** answer: can ambulate a pt who had surgery 3 days ago***
pt has been treated for pneumonia, and now complaining of mouth pain, suspected of candidiasis, what would see when you inspect the mouth?
pt has been treated for pneumonia, and now complaining of mouth pain, suspected of candidiasis, what would see when you inspect the mouth?

- pearly, bluish-white milk curd lesions
pt has cancer of the tongue, when inspecting the mouth what kind of lesions do you find?
pt has cancer of the tongue, when inspecting the mouth what kind of lesions do you find?

- leukoplakia
What are some risk factors for cancer of the tongue?
risks factors for cancer of the tongue?

- smoking, alcohol use, candidiasis
Priority Question: You have a group of pt’s, which one needs to be your #1 priority?
Priority Question: You have a group of pt’s, which one needs to be your #1 priority?

*** Answer: pt with acute abdominal pain***
early symptom of esophageal disease?
early symptom of esophageal disease

- dysphagia
Your pt has GERD, and having trouble sleeping at night. What are you going to advise pt to do?
Your pt has GERD, and having trouble sleeping at night. What are you going to advise pt to do?

- elevate head 30 degrees
PT with GERD, what is their diet?
PT with GERD, what is their diet?

- meals, small portions

-avoid spicy, caffeine, alcohol, no high fat foods

- needs to have high protein, high caloric diet
What meds can you prescribe for GERD?
what meds can you prescribe for GERD?

- H2 antagonist, antacids, proton pump inhibitors

- if meds are not working need to call doctor
PT is admitted for chronic gastritis, what vitamin is he lacking?
pt is admitted for chronic gastritis, what vitamin is he lacking?

- B12

- needs to be given injections, take them for life
What is an antrectomy, and what is for?
what is an antrectomy, and what is for?

- removal of the antrum, the gastic producing portion of the lower stomach

- usually done on people who have gastric ulcers

FYI: an·trec·to·my ( n-tr k t -m ) The removal (resection) of part of the stomach, often combined with a vagotomy
what is a vagotomy? why is it done?
what is a vagotomy? why is it done?

- removal of the vagas nerves to the fundus

- to decrease HCI acid
PT is post gastrectomy and on a PCA pump, which condition requires your immediate nursing intervention?
pt is post gastrectomy and on a PCA pump, which condition requires your immediate nursing intervention?

*** answer: a slight temperature*** sign of infection
what is a common problem with gastrectomy procedures?
what is a common problem with gastrectomy procedures?

- dumping syndrome
pt is diagnosed with gastric ulcers and complaining of a black tary stool, what is this a sign of?
pt is diagnosed with gastric ulcers and complaining of a black tary stool-

this is a sign of upper GI bleeding
pt is taking an NSAID for pain and experiencing dizziness and is light headed, what should she do? Why?
pt is taking an NSAID for pain and experiencing dizziness and is light headed, what should she do? Why?

- stop taking the medication

- suffering from hypovolemia and could have a proliferated ulcer, need to see the doctor
pt with active GI bleeding
pt with active GI bleeding

- need to be NPO
pt has gastric ulcer, c/o of black tarry stool, u know that is sign of...?
pt has gastric ulcer, c/o of black tarry stool, u know that is sign of?

- upper GI bleeding
billiroth II procedure, s/s of this what is it called?
billiroth II procedure, s/s of this what is it called?

- dumping syndrome
pt came in with diagnosis with chronic duodeunal ulcer, which statement would be related to pt diagnosis?
pt came in with diagnosis with chronic duodeunal ulcer, which statement would be related to pt diagnosis?

***answer: i take aspirin for headaches***
after gastric surgery, NGT is place into pt, why?
after gastric surgery, NGT is place into pt, why?

- to decompress the stomach in order to reduce distention

- remove fluids and promote healing
pt had subtotal gastrictomy for stomach cancer, what kinds of foods would you remove to reduce dumping syndrome?
pt had subtotal gastrictomy for stomach cancer, what kinds of foods would you remove to reduce dumping syndrome

- low carb, high protein, high caloric

- avoid coffee, jelly, pancakes w/syrup, no soup, no alcohol

*** the only one not check is peanut butter w/crackers***
your assessing post op pt and hear hypoactive BS, what is that a sign of?
your assessing post op pt and hear hypoactive BS, what is that a sign of?

- paralytic ileus (hypoactive or absent bowel sounds)
your pt has had a colostomy, before you can start talking to the pt about rehab, what signs would indicate to you he/she is ready to discuss about rehab?
your pt has had a colostomy, before you can start talking to the pt about rehab, what signs would indicate to you he/she is ready to discuss about rehab?

- pt will make eye contact and indicate that he is ready to participate in taking care of his colostomy
What would be an early sign of colorectal cancer?
what would be an early sign of colorectal cancer?

- change in bowel habits

FYI: Colon, or colorectal, cancer is cancer that starts in the large
intestine (colon) or the rectum (end of the colon).
pt has a suspected peptic ulcer, what kind of pain are they experiencing?
pt has a suspected peptic ulcer, what kind of pain are they experiencing

- burning pain, goes away by eating food
What are early signs and symptoms of perforation from a peptic ulcer?
what are early signs and symptoms of perforation from a peptic ulcer

- pt is restless, elderly may be confused

- heart rate (pulse) or heart
rhythm, beating too fast (tachycardia)

- Low blood pressure, or hypotension,

- respiration are elevated (signs of bleeding)
What causes dumping syndrome?
what causes dumping syndrome?

- rapid passing of gastric contents (food)
What foods do you start off & end with after a gastrectomy procedure?
gastrectomy procedures:

start with clear liquid diet, then full liquid diet, with small amount of food, and eventually regular diet, start with small amounts
why do pt develop pernicious anemia?
why do pt develop pernicious anemia

- lack of vitamin B12

- need intrinsic factor
what is gastroenteritis?
what is gastroenteritis?

- inflammation of the stomach and intestines
pt has gastroenteritis with lots of diarrhea, what is the acid base?
pt has gastroenteritis with lots of diarrhea, what is the acid base

- metabolic acid doses
You're assessing a pt for signs of dehydration, what is the data you need to gather?
you're assess a pt for signs of dehydration, what is the data you need to gather

- thirst is early sign

- weight reduces

***orthostatic hypotension is an early sign= pulse goes up, BP goes down, increase respirations***
pt diagnosis with CDIFF, what kind of isolation would you provide for pt?
pt diagnosis with CDIFF, what kind of isolation would you provide for pt?

- contact isolation

- need to wear gloves
irritable bowel syndrome, what type of foods should you eliminate?
irritable bowel syndrome, what type of foods should you eliminate?

caffeine, alcohol, diary products, spices, carbonated beverages
what kind of stool would a pt have with ulcerative colitis?
what kind of stool would a pt have with ulcerative colitis?

- black tary, only if their bleeding

- consistency would be runny (diarrhea)
what is the purpose of doing a daily stool evaluation?
what is the purpose of doing a daily stool evaluation?

- irritable bowel

- occult blood, blood in stool
what is crohn's disease?
what is crohn's disease?

- affects all layers in the bowel, colon
pt has diarrhea, what should you monitor?
pt has diarrhea, what should you monitor

- fluids and electrolytes
what kind of diet should someone be on if they have Crohn's disease?
what kind of diet should someone be on if they have Crohn's disease?

- low fat, high caloric, high protein, low fiber, roughage

*** cream potatoes would be the best option***

(FYI: Following a low fat, low fiber diet can provide relief from Crohn's disease symptoms such as stomach cramping and indigestion)
pt with crohn’s disease, what would you pay attention to in accordance to their stool?
pt with crohn’s disease, what would you pay attention to in accordance to their stool?

- amount, color, and consistency
18 yr old complains of right lower pain, you are assessing the pt, where do you start?
18yrs complains of right lower pain, you are assessing the pt, where do you start?

- upper left, away from pain area

- ascultation

- if all BS are present, chart BS x4

-palpation then percussion or ves versa





***rebound tenderness, appendicitis***
elevated WBC count shows appendicitis is infected, What do you do?
elevated WBC count shows appendicitis is infected, what do u do?

do ultrasound, MRI, cat scan
pt WBC of 14,000 suspected of appendicitis what do you ask them?
pt WBC of 14,000 suspected of appendicitis what do you ask them

- when did you last eat or drink

- sign a consent form
what is the difference between diverticulosis and diverticulitis?
what is the difference between diverticulosis and diverticulitis?

- diverticulosis it the development of diverticuli

- become inflamed or infected then its diverticulitis
pt with diverticulosis needs to remove anything with seeds from his diet, avoid…
pt with diverticulosis needs to remove anything with seeds from his diet, avoid…

- popcorn

- peanuts
pt who’s going to have colon or any surgery on the bowel…
pt who’s going to have colon or any surgery on the bowel…

- need to put on Neomycin and Vancomycin in order to decrease intestinal bacteria

- Enema to eliminate anything in the stomach
pt come back from surgery, after assessing their ABC, what is the next assessment?
pt come back from surgery, after assessing their ABC, what is the next assessment?

- want to look at the dressing to see any drainage

- don’t take dressing off only surgery can, if to much drainage apply another dressing on top until surgery gets there and changes it
pt has lost a lot of blood post op and increase respirations, what is the quality of their pulse?
pt has lost a lot of blood post op and increase respirations, what is the quality of their pulse

- weak, thready, and fast

- hypovolemia
what constitency of stool for someone who has ileostomy?
what constitency of stool for someone who has ileostomy?

- liquidy, at risk for fluid lost
What should a stoma look like?
What should a stoma look like?

Stoma should look pink/reddish
order was given to irrigate colostomy, instill fluid and pt complains of cramping. what do you do?
order was given to irrigate colostomy, instill fluid and pt complains of cramping. what do you do?

- don't pull the tube, stop, clamp and wait until the cramp is gone
what is perintonitis?
what is perintonitis?

- inflammation of peritoneum membrane
pt is complaining of abdominal pain. when palpating the abdomen, what kind of tenderness would you find?
pt is complaining of abdominal pain. when palpating the abdomen, what kind of tenderness would you find?

- rebound tenderness
what is they symptom for hiatal hernial?
what is they symptom for hiatal hernial?

- pain, heartburn after you eat,
doing abdominal assessment on pt and noticed a mass in the groin, what do you suspect?
doing abdominal assessment on pt and noticed a mass in the groin, what do you suspect?

- inguinal hernia
s/s of a paralytic ileus?
s/s of a paralytic ileus?

- absent of decreased bowel sounds, pt complains of n/v, abdominal girth is distended
what term do you use when part of intestine telescopes (turns onto itself) into another part of the intestines?
what term do you use when part of intestine telescopes (turns onto itself) into another part of the intestines?

- Intussusception

(FYI: Intussusception is a problem with the intestine in which one portion of the bowel slides into the next, much like the pieces of a telescope.)
in planning care of a pt with a small bowel obstruction, what would your initial goal be?
in planning care of a pt with a small bowel obstruction, what would your initial goal be?

- maintaining adequate nutritional and fluid balance
same pt has intestinal obstruction and has NG tube for suction, what do you assess for?
same pt has intestinal obstruction and has NG tube for suction, what do you assess for?

- fluids, if losing fluid concerns include: dehydration, metabolic alkalosis (HCL is being sucked out)
your pt has been told that he has rectal cancer, he tells you there is nothing wrong with me and that all i have is hemorrhoids, what are they exhibitng?
your pt has been told that he has rectal cancer, he tells you there is nothing wrong with me and that all i have is hemorrhoids, what are they exhibitng?

- denial
what would be an early warning sign of colorectoral cancer?
what would be an early warning sign of colorectoral cancer?

- change in bowel habits (either constipation or diarrhea)
What are the common symptom of hemorroids?
What are the common symptom of hemorroids?

- bleeding after passing stool (on top of stool)

- itching and burning
hemorrhoidectomy, what would be the doctors order?
hemorrhoidectomy, what would be the doctors order?

- NPO and enema
pt has had hemorrhoidectomy, has gag relfex back, what do you want them to do?
pt has had hemorrhoidectomy, has gag relfex back, what do you want them to do?

- urinate, important for them to do this due to urinary retention
what kinds of things do you teach ur patient to avoid (constipation?)
what kinds of things do you teach ur patient to avoid (constipation?)

ruphage, exercise, and lots of fluids
fecal impaction, what signs tell you that?
fecal impaction, what signs tell you that?

- stool is loosened around the edges, leaking diarrhea fluid, and stool is wedged into rectum
pt exacerbation of chronic gastritus?
pt exaserbation of chronic gastritus
-deficient in vitamin B12, administer B12 injections for life
pt is post-gastrectomy, on pca pump(narcotics), what would require immediate interventions?
pt is post-gastrectomy, on pca pump(narcotics), what would require immediate interventions?

-resperations at 10
gastrectomy, may need vagotomy, what is it?
gastrectomy, may need vagotomy, what is it?

-cutting vegus nerve, decreases amount of stomach secretions
pt exaserbation of chronic gastritus
pt exaserbation of chronic gastritus
-deficient in vitamin B12, administer B12 injections for life
pt with GERD, trouble sleeping, what do you advise?
pt with GERD, trouble sleeping

-advise elevate 30* HOB, sleep on more pillows
after surgery, what should be accessed after ABC's?
after surgery, what should be accessed after ABC's

- dressing
term used when part of intestine telescopes into another part of the intestine?
term used when part of intestine telescopes into another part of the intestine?

- intussusception
Priority Question: Which task can you tell a CNA to do?

*** Answer: can ambulate a pt who had surgery 3 days ago***
Priority Question: Which task can you tell a CNA to do?

*** Answer: can ambulate a pt who had surgery 3 days ago***