Scott Gardner Tcc Nursing Q2W05 Unit 2

Front 1

What is Paralytic ileus?

Back 1

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

Front 2

What is impaction?

Back 2

The result of unrelieved consitpation.
A collection of hardened feces wedged in the rectum that cannot be expelled.

Front 3

What are the Seven Fecal Characteristics?

Back 3

Color Consistancy Amount
Odor Frequency Shape
Constituents

Front 4

Describe Pre and Post for UGI/Barium Swallow.

Back 4

PRE
NPO after midnight before test.
Remove all jewlery and metal objects
POST
Increase fluids to promote passage of barium

Front 5

Pre and Post of Upper Endoscopy.

Back 5

PRE
NPO after midnight prior
POST
Precautions after light sedation.

Front 6

Pre and Post care of Barium Enema.

Back 6

PREP
NPO after prior midnight
Bowel Prep - Mag Cit and possible enema
POST
None presented

Front 7

Describe test, and Pre and Post care for Ultrasound.

Back 7

High frequency sound waves to echo off body organs making a picture.

PREP
Might be NPO or not depending on organ to be visualized.

Front 8

Describe test, and Pre and Post care for Colonoscopy

Back 8

Endoscopic examinaion of the entire colon with colonoscopy inserted into rectum.
PREP
Clear liquied day before, NPO after prior night, bowel cleansing GoLytely and possible enema
POST
Sandard aftercare of light sedation.

Front 9

Describe test, and Pre and Post care for Flexible Sigmoidoscopy.

Back 9

Examination of the interior of the sigmoid colon through rigid lighted tube.

PREP
Same as Colonoscopy
POST
Stardard care after light sedatition

Front 10

Describe test, and Pre and Post care for Computerized Tomography Scan

Back 10

X-Ray examinationfrom many angles by a scanner and analyzed by a computer.

PREP
Possible NPO or not.

POST
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.

Front 11

Describe the Test, Pre and Post procedural care of Enteroclysis.

Back 11

Introduction of contrast to the Jejunum for small intestine study.

Clear Liquid 24 hours, colon cleanse, GoLytely or enemas until clear.

Front 12

What is the Enteric Nervous System.

Back 12

Regulates motility and secretion along the entire length of the GI Tract.

Front 13

Define Malnutrition

Back 13

When trient availability is consistently inqdequate or excessive. Might include starvation or obesity.

Front 14

Define Primary and Secondary starvation

Back 14

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.

Front 15

Describe Hiatal Hernia

Back 15

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

Front 16

Describe Etiology and Risk Factors of Hiatal Hernia.

Back 16

Related to muscle weakness in the esophageal hiatus. Can be caused by aging, tgrauma, muscle weakness, surgery, lifting, coughing, pregnancy or obicity.

Front 17

Describe Pathophysiology of Hiatal hernia.

Back 17

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.

Front 18

What is a reducible Hernia?

Back 18

One that can be replaced into the abdominal cavity by manipulation.

Front 19

What is an Irreducible or incarcerated Hernia?

Back 19

One in which the contents of the can cannot be reduced or replaced by manipulation.

Front 20

What is meant by a strangulated bowel, and what are the implications?

Back 20

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.

Front 21

Describe an Indirect Inguinal Hernia.

Back 21

Occurs through the inguinal ring and follows the spermatic cord through the inguinal canal.

More commin in males.

Front 22

Describe a Direct Inguinal Hernia

Back 22

Bowel passes through the abdominal wall in an area of muscular weakness, not through a canal.

Front 23

Describe a Femoral hernia.

Back 23

Peritoneum and almost always the urinary bladder that passes through the femoral ring and is more common in females than in males.

Front 24

Describe Umbilical Hernia

Back 24

Most common in women due to increased abdominal pressue. Usually in obese and multiparous women.

Front 25

Describe etiology and causes of Incisional or Ventral Hernias.

Back 25

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.

Front 26

Biliary Tract Terminiology

Chole-

Back 26

Pertaining to bile

Front 27

Biliary Tract Terminiology

Cholang-

Back 27

Pertaining to bile ducts

Front 28

Biliary Tract Terminiology

Cholangiography

Back 28

X-ray study of the bile ducts

Front 29

Biliary Tract Terminiology

Cholecyst-

Back 29

Pertaining to the Gall Bladder

Front 30

Biliary Tract Terminiology

Cholecystectomy

Back 30

Removal of the Gall Bladder

Front 31

Biliary Tract Terminiology

Cholecystitis

Back 31

Inflammation of the gallbladder

Front 32

Biliary Tract Terminiology

Cholesystography

Back 32

X-Ray study of the gall baldder

Front 33

Biliary Tract Terminiology

Cholecystostomy

Back 33

Incision and drainage of the gallbaldder.

Front 34

Biliary Tract Terminiology

Choledocho-

Back 34

Pertaining to the Common bile duct

Front 35

Biliary Tract Terminiology

Choldocholithiasis

Back 35

Stones in the common bile duct

Front 36

Define Gastgroenteritis

Back 36

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.

Front 37

Define tenesmus

Back 37

Straining on defecation

Front 38

Define borborygmi

Back 38

Hyperactive bowel sounds

Front 39

Define Appendicitis

Back 39

Infalmmation of the vermiform appendix that develops most commonly in adolescents and young adults.

It is not common in oldera adults

Front 40

Define Diverticula

Back 40

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

Front 41

Classify a traction diverticulum

Back 41

The esophageal mucosa has pulled outward from the esophagus. Most common in the middle esophogus.

Front 42

Classify a pulsion diverticulum.

Back 42

The esophageal mucosa has pushed outward through a defect in the esophageal mulculature. Most common in upper esophagus.

No means of prevention.

Front 43

Define Diverticulosis...

Back 43

Presence of non-inflamed diverticula

Front 44

Define Diverticulitis...

Back 44

Inflammation of a diverticulum.

Front 45

Define IBS

Back 45

Irratable Bowel Syndrom is a functional disorder of motility in the intestines. There is not organic disease or anatomic abnormaility.

Front 46

Is IBS Life Threatening?

Back 46

No

Front 47

Does IBS Lead to CA?

Back 47

No

Front 48

Define the Etiology and Risk Factors of IBS.

Back 48

Diets high in fat, gas producing foods, lactose, carbonated beverages, caffeine, and ETOH.

Also Smokers, lactose intolerant, high stress, alterations in sleep and rest.

Front 49

Does IBS affect men or women more?

Back 49

3:1 Women:Men

Front 50

What are the tests for IBS.

Back 50

No confirmatory diagnostic tests exsit and diagnosis generally is made by excluding other diseases.

Front 51

Define Hemorrhoids.

Back 51

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

Front 52

Who is at risk for Impaction?

Back 52

Debilitated
Confused
Unconsious
Dehydratged
Laxitive Abusers

Front 53

List two signs and symptoms of impaction.

Back 53

Inability to pass stool for several days.

Continous oozing of liquid stool.

Front 54

List some common causes of Constipation.

Back 54

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

Front 55

Who are most at risk for diarrhea?

Back 55

The Old and the Young

Front 56

Define Incontinence

Back 56

Inability to control passage of feces & gas from anus. This has body image issues, soiled clothing is embarrassing.

Front 57

Define Flatuelence

Back 57

Gas accumulation in the lumen of intestines. Stretches and distends bowel wall. Can cause severe pain and ABD distention.

Front 58

What is the best body position to help relieve flatulence?

Back 58

Left side..this promotes movement.

Front 59

Define Hemorrhoids

Back 59

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.

Front 60

What are Key during assessment of Bowel Ellimination?

Back 60

Diet and Medical History
S?S associated with altered elimination
Impact of underlying illness
Fecal characteristics
What iws normal

Front 61

What is key in the physical assesement for Bowel Elimination?

Back 61

Mouth, teeth, tongue, gums, dentation, mouth sores.

ABD X4 Quadrants, tones, color, distension

Rectum - Lesions, discoloration, hemorroids.

Front 62

When doing a fecal specimen, what are some key points?

Back 62

Never mix with urine.

NN about 1 Inch stool, or 15-30CC of diahrreah.

Front 63

What are the characterestics of feces?

Back 63

Color
Odor
Consistancy
Amount
Shape
Contents

Front 64

What do lay people need to understand about coffee and tea?

Back 64

They are diaretics.

Front 65

Name 5 Nursing Diagnosis related to GI Disorders.

Back 65

Constipation
Percieved constipation
risk for constipation
Diahrreah
Incontinece

Front 66

What are some health promotion steps for normal defecation?

Back 66

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.

Front 67

Are Cathartics and Laxatives the same thing?

Back 67

No, Cathartics have a stronger effect.

Front 68

What effects, and duration do cathartics and Laxatives have?

Back 68

Short term action (within 30 minutes)of emptying the bowel, with consitpation, or prep for surgery or examinations.

Front 69

What are the risks of cathartics (dulcolax) and laxatives?

Back 69

Over use leads to loss of intestinal tone.

Front 70

Name 3 wetting agents.

Back 70

Colage, Durfak, Docusate.

Used often, but have little effect ohn chronic constipation.

Front 71

Describe bulk forming cathartics and key issues of them?

Back 71

Metamucil.

Safest of all cathartics

Need to use plenty of liquids with them.

Front 72

Name four antidearrheals.

How do they work.

Back 72

Lomotil (Rx)
Imodium (OTC)
Kaopectate (OTC)
Pepto-Bismal (OTC)

Decrease intestinal muscle tone to slow the passage of feces>

Front 73

How is Lomotil different from the other anti-diahreals.

Back 73

It is an opiate, and as such needs a Rx.

Front 74

Define Enema

Back 74

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.

Front 75

Other than constipation relief, what are four other uses of enemas?

Back 75

Impaction
Pre-Surgery Cleanse
Vehicle for Medication
Bowel Training

Front 76

What is the difference between a a Low and High Enema?

Back 76

Low (12 Inches) is for rectum and sigmoid.

High (18 Inches) is for the entire colon.

Front 77

What are the characteristics of a Fleets/Soapsuds enema?

Back 77

Irritation

Agressive

Complete Evacuation

Front 78

How does an Oil retention enema work?

Back 78

Good for impaction.

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

Best if held for several hours.

Front 79

Because the GI Tract is highly vascular, what else can an emema be used for?

Back 79

Administering medication

Front 80

Describe Digital Removal of Stool

Back 80

-Break up Fecal Matter with Finger.
-Remove in Sections
-Can cause venus nerve trouble, slowing heart rate
-Disturbing rectal mucosa can cause bleeding.

Front 81

Why is baby powder now used during peri care?

Back 81

It cakes

Front 82

What is bowel training?

Back 82

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

Front 83

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?

Back 83

Irrigate the large lumen with saline.

Position the blue “pigtail” at the level of the client’s ear.

Front 84

The nurse begins to suspect a fecal impaction in a client who has not had a stool in 10 days when the client:

Back 84

Oozes liquid stool
Feels nauseated
Has continuous bowel sounds

Front 85

The nurse instructs the client to avoid which of the following foods that could give a false reading of the fecal occult blood test?

Back 85

Fish

Raw vegetables

Front 86

Wanting to prevent the Valsalva maneuver, the nurse requests a stool softener for which of the following clients?

Back 86

Risk for increased intracranial pressure (Glaucoma or Cardiovascular disease)

Feedback:
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

Front 87

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:

Back 87

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.

Front 88

Soon after the client’s abdominal surgery the nurse includes in the plan of care the following intervention, which is essential for promoting peristalsis:

Back 88

Correct Answer: Early ambulation
Feedback:
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.

Front 89

The nurse is instructing the client about opioids for pain. Included in the teaching is the fact that opioids may cause:

Back 89

Correct Answer:

Constipation

Feedback:

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