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89 Cards in this Set

  • Front
  • Back
What is Paralytic ileus?
The effect of surgery or direct manipulation of the bowl. Temporarily stops peristalsis for 24-48 hours. Failure to eat, or return to activity might prolong the effect
What is impaction?
The result of unrelieved consitpation.
A collection of hardened feces wedged in the rectum that cannot be expelled.
What are the Seven Fecal Characteristics?
Color Consistancy Amount
Odor Frequency Shape
Describe Pre and Post for UGI/Barium Swallow.
NPO after midnight before test.
Remove all jewlery and metal objects
Increase fluids to promote passage of barium
Pre and Post of Upper Endoscopy.
NPO after midnight prior
Precautions after light sedation.
Pre and Post care of Barium Enema.
NPO after prior midnight
Bowel Prep - Mag Cit and possible enema
None presented
Describe test, and Pre and Post care for Ultrasound.
High frequency sound waves to echo off body organs making a picture.

Might be NPO or not depending on organ to be visualized.
Describe test, and Pre and Post care for Colonoscopy
Endoscopic examinaion of the entire colon with colonoscopy inserted into rectum.
Clear liquied day before, NPO after prior night, bowel cleansing GoLytely and possible enema
Sandard aftercare of light sedation.
Describe test, and Pre and Post care for Flexible Sigmoidoscopy.
Examination of the interior of the sigmoid colon through rigid lighted tube.

Same as Colonoscopy
Stardard care after light sedatition
Describe test, and Pre and Post care for Computerized Tomography Scan
X-Ray examinationfrom many angles by a scanner and analyzed by a computer.

Possible NPO or not.

The client needs to lie very still and possibly hold breath. If claustrophobic, light sedation might be required, in which case standard aftercare is requrid.
Describe the Test, Pre and Post procedural care of Enteroclysis.
Introduction of contrast to the Jejunum for small intestine study.

Clear Liquid 24 hours, colon cleanse, GoLytely or enemas until clear.
What is the Enteric Nervous System.
Regulates motility and secretion along the entire length of the GI Tract.
Define Malnutrition
When trient availability is consistently inqdequate or excessive. Might include starvation or obesity.
Define Primary and Secondary starvation
Primary is when adequate nutrition is not delivered to the upper GI tract.

Secondary is when theupper GI tract fails to absorb, metabolize, or use the nutrients as in isic bowel or Crohns disease.
Describe Hiatal Hernia
Condition in which the cardiac sphincter becomes enlarged, allowing part of the stomach to pass into the thoracic cavity.
Type I - Sliding Hernia
Type II - Rolling or Paraesophageal hernia
Describe Etiology and Risk Factors of Hiatal Hernia.
Related to muscle weakness in the esophageal hiatus. Can be caused by aging, tgrauma, muscle weakness, surgery, lifting, coughing, pregnancy or obicity.
Describe Pathophysiology of Hiatal hernia.
Protursion of part of the stomach through a weakness in the diaphragm.

Barium swallow with fluoroscopy can reveal a hiatal hernia by showing the position of the stomach in relation to the diaphragm.
What is a reducible Hernia?
One that can be replaced into the abdominal cavity by manipulation.
What is an Irreducible or incarcerated Hernia?
One in which the contents of the can cannot be reduced or replaced by manipulation.
What is meant by a strangulated bowel, and what are the implications?
When the hernial ring cuts off the blood supply to the herniated sugment of bowel.

Usually an emergency because unless it is released, the bowel will become gangrenous due to lack of blood supply.
Describe an Indirect Inguinal Hernia.
Occurs through the inguinal ring and follows the spermatic cord through the inguinal canal.

More commin in males.
Describe a Direct Inguinal Hernia
Bowel passes through the abdominal wall in an area of muscular weakness, not through a canal.
Describe a Femoral hernia.
Peritoneum and almost always the urinary bladder that passes through the femoral ring and is more common in females than in males.
Describe Umbilical Hernia
Most common in women due to increased abdominal pressue. Usually in obese and multiparous women.
Describe etiology and causes of Incisional or Ventral Hernias.
Occurs at the site of a previous surgical incision that has healed inadequately because of post operative problem such as infection, inadequate nutrition, extreme distention, or obisity.
Biliary Tract Terminiology

Pertaining to bile
Biliary Tract Terminiology

Pertaining to bile ducts
Biliary Tract Terminiology

X-ray study of the bile ducts
Biliary Tract Terminiology

Pertaining to the Gall Bladder
Biliary Tract Terminiology

Removal of the Gall Bladder
Biliary Tract Terminiology

Inflammation of the gallbladder
Biliary Tract Terminiology

X-Ray study of the gall baldder
Biliary Tract Terminiology

Incision and drainage of the gallbaldder.
Biliary Tract Terminiology

Pertaining to the Common bile duct
Biliary Tract Terminiology

Stones in the common bile duct
Define Gastgroenteritis
Inflammation of the stomach and intestinal tract that primarily affects the small bowel.

Major manifestations are hiarrhea, nausea, vomiting, fever, anorexia, disteintion, tenesmus, and borborygmi.

Comes from contaminated food by a virus.
Define tenesmus
Straining on defecation
Define borborygmi
Hyperactive bowel sounds
Define Appendicitis
Infalmmation of the vermiform appendix that develops most commonly in adolescents and young adults.

It is not common in oldera adults
Define Diverticula
An esophageal diverticulum is a sac-like outpouching in one or more layers of the esophagus.

As food is ingested, it becomes trapped in a diverticulum and can later be regurgetated.
Can be Traction or Pulsion
Classify a traction diverticulum
The esophageal mucosa has pulled outward from the esophagus. Most common in the middle esophogus.
Classify a pulsion diverticulum.
The esophageal mucosa has pushed outward through a defect in the esophageal mulculature. Most common in upper esophagus.

No means of prevention.
Define Diverticulosis...
Presence of non-inflamed diverticula
Define Diverticulitis...
Inflammation of a diverticulum.
Define IBS
Irratable Bowel Syndrom is a functional disorder of motility in the intestines. There is not organic disease or anatomic abnormaility.
Is IBS Life Threatening?
Does IBS Lead to CA?
Define the Etiology and Risk Factors of IBS.
Diets high in fat, gas producing foods, lactose, carbonated beverages, caffeine, and ETOH.

Also Smokers, lactose intolerant, high stress, alterations in sleep and rest.
Does IBS affect men or women more?
3:1 Women:Men
What are the tests for IBS.
No confirmatory diagnostic tests exsit and diagnosis generally is made by excluding other diseases.
Define Hemorrhoids.
Perianal Varicose Veins. Can be internal or external.

Can affect men or women and incidence is higher in people between 20 and 50 years of age
Who is at risk for Impaction?
Laxitive Abusers
List two signs and symptoms of impaction.
Inability to pass stool for several days.

Continous oozing of liquid stool.
List some common causes of Constipation.
Irregular habits & Ignoring urges

Chronic Illness

Low fiber/High fat/Highly processed

Bedrest or Lack of exercise

Low fluid intake, which slows peristalis

Age decreases peristalis along with decrased muscle elasticity
Who are most at risk for diarrhea?
The Old and the Young
Define Incontinence
Inability to control passage of feces & gas from anus. This has body image issues, soiled clothing is embarrassing.
Define Flatuelence
Gas accumulation in the lumen of intestines. Stretches and distends bowel wall. Can cause severe pain and ABD distention.
What is the best body position to help relieve flatulence?
Left side..this promotes movement.
Define Hemorrhoids
Dilated, encorged veins in the lining of the rectum. External might become purple (thrombus) and need excision

Can be caused by valsalva, strain, pregnancy, heart failure, chronic liver disease.
What are Key during assessment of Bowel Ellimination?
Diet and Medical History
S?S associated with altered elimination
Impact of underlying illness
Fecal characteristics
What iws normal
What is key in the physical assesement for Bowel Elimination?
Mouth, teeth, tongue, gums, dentation, mouth sores.

ABD X4 Quadrants, tones, color, distension

Rectum - Lesions, discoloration, hemorroids.
When doing a fecal specimen, what are some key points?
Never mix with urine.

NN about 1 Inch stool, or 15-30CC of diahrreah.
What are the characterestics of feces?
What do lay people need to understand about coffee and tea?
They are diaretics.
Name 5 Nursing Diagnosis related to GI Disorders.
Percieved constipation
risk for constipation
What are some health promotion steps for normal defecation?
Promote adequate fluid 1.5L daily, preferrable Water.

Avoid coffee, tea, alcohol

Eat 25-30g of fiber daily, except with immobile or dehydrated client

Limit laxative use

Promote physical activity, walking, or lower trunk movement.
Are Cathartics and Laxatives the same thing?
No, Cathartics have a stronger effect.
What effects, and duration do cathartics and Laxatives have?
Short term action (within 30 minutes)of emptying the bowel, with consitpation, or prep for surgery or examinations.
What are the risks of cathartics (dulcolax) and laxatives?
Over use leads to loss of intestinal tone.
Name 3 wetting agents.
Colage, Durfak, Docusate.

Used often, but have little effect ohn chronic constipation.
Describe bulk forming cathartics and key issues of them?

Safest of all cathartics

Need to use plenty of liquids with them.
Name four antidearrheals.

How do they work.
Lomotil (Rx)
Imodium (OTC)
Kaopectate (OTC)
Pepto-Bismal (OTC)

Decrease intestinal muscle tone to slow the passage of feces>
How is Lomotil different from the other anti-diahreals.
It is an opiate, and as such needs a Rx.
Define Enema
The instillation of a solution into the rectum and sigmoid coln. Given primarily to promote defecation by stimulating peristalsis. Most commonly used to relive constipation.
Other than constipation relief, what are four other uses of enemas?
Pre-Surgery Cleanse
Vehicle for Medication
Bowel Training
What is the difference between a a Low and High Enema?
Low (12 Inches) is for rectum and sigmoid.

High (18 Inches) is for the entire colon.
What are the characteristics of a Fleets/Soapsuds enema?


Complete Evacuation
How does an Oil retention enema work?
Good for impaction.

Lubricates the rectum and colon to make route smoother. May even penetrate the feces.

Best if held for several hours.
Because the GI Tract is highly vascular, what else can an emema be used for?
Administering medication
Describe Digital Removal of Stool
-Break up Fecal Matter with Finger.
-Remove in Sections
-Can cause venus nerve trouble, slowing heart rate
-Disturbing rectal mucosa can cause bleeding.
Why is baby powder now used during peri care?
It cakes
What is bowel training?
A program to help clients achieve normal defecation, especially those who still have some neuromuscular training program.

Set up a daily routine, defecate at same time daily
A client with a Salem sump tube begins to drain stomach contents from the blue “pigtail.” Which nursing actions would be appropriate for the nurse to implement at this time?
Irrigate the large lumen with saline.

Position the blue “pigtail” at the level of the client’s ear.
The nurse begins to suspect a fecal impaction in a client who has not had a stool in 10 days when the client:
Oozes liquid stool
Feels nauseated
Has continuous bowel sounds
The nurse instructs the client to avoid which of the following foods that could give a false reading of the fecal occult blood test?

Raw vegetables
Wanting to prevent the Valsalva maneuver, the nurse requests a stool softener for which of the following clients?
Risk for increased intracranial pressure (Glaucoma or Cardiovascular disease)

a. Valsalva can increase intracranial pressure, which is undesirable.

c. Valsalva can increase intraocular pressure and increase risk for optic nerve damage.

c. Hypotension is not aggravated by Valsalva.

d. Valsalva can increase blood pressure, which could place strain on the heart
A client with a recent bout of diarrhea is requesting something to drink. There is an order to force clear liquids to prevent fluid and electrolyte imbalance. The nurse decides to give the client:
Correct Answer: Room-temperature bouillon

Feedback: b. Hot and cold liquids (a, c, and d) stimulate peristalsis, causing abdominal cramping and further diarrhea.

Thus room-temperature liquids are better tolerated. Bouillon also contains some electrolytes that may prevent electrolyte imbalance. In addition, ice cream is not a clear liquid.
Soon after the client’s abdominal surgery the nurse includes in the plan of care the following intervention, which is essential for promoting peristalsis:
Correct Answer: Early ambulation
d. Early ambulation is essential for maintaining peristalsis through improved abdominal muscle tone and stimulation.

a. Large doses of opioids may suppress peristalsis. Dose of opioid should be that which adequately controls pain with the fewest side effects.

b. High-fiber diet is inappropriate immediately following surgery. The bowel is inflamed from surgery.

c. Restricted fluids could contribute to constipation. Fluids should be started as soon after surgery as possible, when bowel sounds have returned.
The nurse is instructing the client about opioids for pain. Included in the teaching is the fact that opioids may cause:
Correct Answer:



c. Constipation is a known side effect of opioids that the client often does not become tolerant to.