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NR 142 Exam 1
Exam 1
| Question | Answer |
|---|---|
| Education for the client with a hiatal hernia | No restrictive clothing, #1 complaint heart burn, weight control, exercise, no eating 2-3 hours before bed, small meals pass easily, no recline 1 hour after eating,HOB on 4 to 8in blocks, no alcohol, smoking, chocolate, peppermint, no lifting or straining |
| Surgery for Hiatal hernia | Nissen Fundoplication- watch for bleeding infection, nutrition, TPN fist couple days, then NG |
| Interventions for oral candidasis | Antifungal medications such as nystatin (mycostatin, amphotericin B, clotrimazole, ketoconazole taken in pill or suspension. when used as suspensions have patient swish vigorously for at least 1 minute then swallow |
| Education for the client with a hiatal hernia | No restrictive clothing, #1 complaint heart burn, weight control, exercise, no eating 2-3 hours before bed, small meals pass easily, no recline 1 hour after eating,HOB on 4 to 8in blocks, no alcohol, smoking, chocolate, peppermint, no lifting or straining |
| Surgery for Hiatal hernia | Nissen Fundoplication- watch for bleeding infection, nutrition, TPN fist couple days, then NG |
| Interventions for oral candidasis | Antifungal medications such as nystatin (mycostatin, amphotericin B, clotrimazole, ketoconazole taken in pill or suspension. when used as suspensions have patient swish vigorously for at least 1 minute then swallow |
| Assessments for oral cancer | Lesions won't heal for 2 weeks, bad breath, dysphagia, coughing, sore throat, lump or thickening of the cheek, red/white patch on or anywhere in mouth, difficulty chewing swallowing, numbness, hoarsness. Discoloration red erythroplakia;white leukoplakia |
| Locations for oral cancer | Face, lower lip, ears, nose, forehead. Erythroplakia- 50% progress to scc. More invasive and metastasizes by blood or lymphatic system; appears as rough thickened scaly tumor is asymptomatic or bleeding. Border is wider, more infiltrated and inflammatory |
| Intervetions following radical neck dissection | Watch airway, swelling, bleeding, infection, head support, do not strain neck, do not mess with ng tube if displaced call physician, speech, and swallowing study of gag reflux, pre-op education, fowlers position facilitate breathing and comfort |
| Radical neck dissection cont. | Coughing and deep breathing, pain management, observer for hemorrhage and constriction, assess graft, cleansing aseptic technique, adequate nutrition, communication methods, no tobacco or alcohol, call light in reach, support pation express fears concerns |
| Education Gerds | avoid eating or drinking 2 hours before bed, maintain normal body weight, no tight fitting clothes, HOB 6-8in blocks upper body pillows, sleep left side, no smoking or alcohol, refrain from lifting heavy ojects, straining, working in bent over posture |
| Gerd diet | Avoid caffeine, coffee, tea, tobacco, beer, milk, foods containing peppermint or spearmint, and carbonated beverages, chocolate, tomatoes. Can have fruit/gelatin |
| Education following surgery for hiatal hernia | low fowlers then fowlers position, monitor for bleeding and edema, coughing discouraged, splint incision for coughin and sneezing, no heavy lifting 6-8 weeks |
| Interventions followng surgery of the esphagus | semi/high fowlers position, support airway, breathing bleeding/infection risk, gag reflex before fluid, eat slow, fluids with food, giave Ca channer blockers and nitrates to decrease pressure, watch for hypovolemic or hemorrhagic shock |
| Assessments for the client with gastritis (weakens protective stomach coating) | use of NSAID, asprin, chem, abd discomfort,HA, lassitude, anorexia, hiccuping, Complaints of anorexia, heartburn, belching, sour taste, bloating, hematemesis, melena, check HCL, B12, and intrinsic factor |
| Indications for famotidine (pepcid) | Peptic ulcer disease and gastritis, decreases acid produced by stomach, best choice for critically ill patients d/t low drug-drug reactions, doesn't alter liver metabolism, short term relief for GERD |
| Assessments following Roux-en-Y gastric bypass surgery |
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