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When do duodenal ulcer pain usually occur?
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Dumping Syndrome
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ATI-MedSurge-GI
ATI-MedSurge-GASTROINTESTINAL
| Question | Answer |
|---|---|
| When do duodenal ulcer pain usually occur? | 1-1/2 to 3 hrs after meals, during the night |
| Dumping Syndrome | rapid emptying of gastric contents into the small intestine |
| Pancreatitis - first nursing priority | pain interventions |
| Pancreatitis - second nursing priority | auto digestion of the pancreas |
| What is? Cirrhosis | replacement of liver tissue with fibrotic, scar tissue |
| Spider angiomas | |
| Fetor hepaticus | |
| Cirrhosis - highest priority assessment | Blood stools |
| What is? Cholecystitis | inflammation of the wall of the gall bladder |
| Cholecystitis - foods to avoid | dairy, fried, chocolate, nuts, gravy, gas forming (beans, broccoli, cabbage...) |
| Ileostomy weight (gain / loss) is an expected finding? | gain |
| Ileostomy stoma is reddish-purple color, what should nurse do? | report to HCP, this is sign of bowel ischemia |
| Pancreatitis - _______ levels are increased | amylase |
| For a positive amylase result, levels must be? | 2 to 3 times normal value |
| For a positive lipase result, levels must be? | 3 to 5 times normal value |
| What does a Colonoscopy do? | allows visualization of anus, rectum, colon |
| Colonoscopy - dietary prep | - drink liquids 24-hr prior - NPO 6-8 hrs prior |
| Appendicitis - most often seen in what age range / group? | 10 - 30 yrs / peak: males 20 - 30 |
| What is the location of McBurney's Point? | lower right quadrant, halfway bet. umbilicus and anterior iliac spine |
| Appendicitis symptoms | abdominal pain (first), N/V low-grade fever tense posturing / guarding mild elevation, left shift in WBC 10K - 18K |
| What is? Ulcerative Colitis | edema and inflammation of the rectum (may expand length of colon) |
| What is? Crohn's Disease | inflammation and ulceration of the GI tract (at distal ileum) |
| What is? Diverticulitis | inflammation of the intestinal wall (in the colon) due to trapped fecal matter |
| Ulcerative Colitis - nursing care | - teach relaxation techniques - allow for daily rest periods - restrict intake of caffeine - monitor I/O, potassium - eat high protein (calorie), low fibers |
| Lactulose (Cephulac) | given to aid in secretion of ammonia via stool in Cirrhosis of the Liver |
| Lactulose (Cephulac) - pt. teaching | - expect 2 - 5 soft stools /day - dietary: low protein/low sodium - expect bloating |
| What are? Peptic Ulcers | erosion of the mucosal lining of the stomach or duodenum |
| Drugs that give false negative for H. pylori | bismuth, misoprostol, sulcralfate, histamine2 receptor antagonists |
| Sulcralfate - should be administered? | on an empty stomach 1-hr before meals |
| Peptic Ulcer - meals | eating frequent, small meals and bedtime snacks stimulate gastric secretion and should be avoided |
| Symptom of peritonitis secondary to ulcer perforation? | Board-like abdomen |
| Colorectal cancer - expected lab findings | - increased CEA levels - decreased Hct & Hbg - positive fecal occult blood test |
| Metoclopramide Hydrochloride (Reglan), used to? | increases the motility of the esophagus and stomach |
| Metoclopramide Hydrochloride (Reglan), monitor for? | extrapyramidial side effects |
| Hepatitic C patients - pt. teaching | - avoid alcohol - avoid acetaminophen - no special diets required - may need to decrease med dosages |
| What is? Ascites | an abnormal accumulation of fluid in the abdomen |
| Paracentesis | a procedure during which fluid from the abdomen is removed through a needle to analyze it or relieve pressure |
| Paracentesis - symptom of effective treatment | decreased shortness of breath |
| Bismuth subsalicylate (Pepto-Bismol), used for? | destroys the cell wall of H. pylori, does not affect gastric acid secretion |
| Rantidine (Zantac), used for? | an H2 receptor antagonist, used to decrease gastric-acid production |
| Aluminum hydroxide (Amphojel), used for? | antacid that neutralizes gastric acid |
| Sucralfate (Carafate), used for? | to form a protective coating over a gastric ulcer |
| Foods that can help prevent flatus? | Yogurt |
| Foods that can cause odor | fish, eggs, dairy, carbonated beverages, garlic, beans, dark veges |
| Acute Hepatitis B, expected assessments? | - arthralgia / myalgia - headache - fatigue - pruritus |
| Portal-systemic shunt, used to? | decrease amount of ascites, measuring abdominal girth daily will determine this |
| Portal-systemic encephalopathy, complication? | clients with poor liver function, unable to convert ammonia & other waste products to less toxic form |
| Portal-systemic encephalopathy, monitor? | - serum ammonia and potassium levels - L.O.C. - asterixis - fetor hepaticus |
| What is? asterixis | flapping of the hands |
| What is? fetor hepaticus | liver breath |
| Carcinoembryonic antigen (CEA) level... | will decrease if chemotherapy is being effective in controlling growth of cancer cells |
| Post-OP gastroectomy - nursing priority | nasogastric tube patency, to reduce risk of retention of gastric secretions, that can lead to gastric dilation |
| Cirrhosis pt. with elevated ____ should be reported to the HCP? | Ammonia, elevated may indicate portal-systemic encephalopathy |
| GERD - best sleeping position | left side, with head elevated 6 inches |
| Oxybutynin (Ditropan), used for? | alleviate pain with neurogenic or overactive bladder - avoid with GERD |
| Diphenoxylate (Lomotil), used for? | decrease gastrointestinal motility |
| 0.45% sodium chloride IV, used for? | fluid replacement, dehydration |
| Ciprofloxacin (Cipro), used for? | bacterial gastroenteritis |
| 5% dextrose water, used for? | acute gastroenteritis; fluid replacement, dehydration |
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