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Ch 38 MD IV

Ch 38 digestive: GI decompression, TPN,Surgery

QuestionAnswer
GI Decompression: used for? relief or prevention of distention
GI Decompression: What conditions slow motility? structure, patients under Gen. anesthesia after surgery,peritonitis.
After surgery, when does bowel activity return? 3-5 days
name two gastric decompression tubes Levin and gastric sump tubes
gastric decompression tubes are often called what? G.I. suction
name three intestinal decompression tubes Miller-Abbott, Cantor, and Harris tubes
GI Decompression: what type of lumens are used for intermittent and continuous suction? intermittent = single-lumen tubes; continuous = double-lumen tubes
GI Decompression: Monitor for ___ of the tubes patency
GI Decompression: what should you do if the tube not seem to be draining change the patient's position, gently rotate the tubes, pull out very slightly???? call physician
After gastric surgery what should you not do? do not reposition tubes
GI Decompression:irrigations should be done routinely-true or false false: only when ordered
GI Decompression: why should irrigations not be done routinely? frequent irrigations cause acid-base distrubances
GI Decompression: how many mL of what solution for irrigation? 20-30 mL of NS
GI Decompression-output: If drainage is dark brown or green fluid, what does this suggest. obstruction below where the bile enters the digestive tract
GI Decompression: what are the signs indicating that peristalsis has returned? Flatus-gas, bowel sounds positive
GI Decompression: comfort measures are? water-soluble lubricant used to clean nostrils and reduce dryness and irritation, mouth care, moist lips, offer oral spray or lozenges as ordered for sore throat
GI Decompression: what do you do once the tube is in place? tape it to keep it from being pulled out
GI Decompression: where should the tube be secured to? upper lip AND cheek, OR nose
GI Decompression: which part of the body is not good to secure the tube to? why? forehead; puts pressure on nasal tissue
GI Decompression: during activity what must you do?Why? move the tube carefully to avoid trauma to nasopharynx
GI Decompression: what can you do to prevent accidental traction on the tube? wrap tube w/ a piece of tape pinned to gown
TPN: when the digestive tract not be used for feeding what other method can be used? TPN
TPN: how are nutrients delivered to the body? TPN bypasses the digestive track by delivering nutrients directly into the bloodstream
TPN:a catheter is inserted into a large artery or vein? vein such as the subclavian
TPN:the feeding passes directly into the___and the right atrium. Superior Vana cava
TPN: feeding passing directly into the superior vena cava allows for rapid___. Dilution of concentrated feeding
TPN: why are feedings given through a large vein? if given through a small vein, causes thrombophlebitis
TPN: when the catheter is inserted is sutured to where? the insertion site is covered with what? skin; sterile dressing
TPN: what is not mixed with the TPN solution? Lipids
TPN: regarding the insertion site, what is the nurses most important intervention? monitor and prevent infection
TPN: with each dressing change what assessments are immediately reported to the physician? Signs of infection
TPN: if the feeding falls behind schedule, do you catch up by speeding the rate? No
TPN: concentrated glucose solutions cause what complication? hyperglycemia = pancreas releases more insulin = hypoglycemia
TPN: should the catheter be used to administer drugs? Why? no; oral drugs through catheter can cause death
ill patients requiring TPN can develop what psychological condition? Depression
gastrointestinal surgery: surgery in the mouth and esophagus may be needed to correct what two things? Defects or to treat cancer
gastrointestinal surgery: conditions of the stomach that may be treated surgically are? Bleeding ulcers, cancer, hiatal hernia, or extreme obesity
gastrointestinal surgery preop: during bowel cleansing,what assessments should be reported to the physician? Changes in vital signs, abnormal heart rate or rhythm, hypotension, or mental status
gastrointestinal surgery preop:before the surgery diet is usually limited to what for how many hours? Liquids for 24 hours
gastrointestinal surgery preop: if gastrointestinal suctioning is being used, what else may be ordered? IV fluids
gastrointestinal surgery preop: what is given to reduce the bacterial flora in the bowel? why? antibiotics; decrease risk of contamination
gastrointestinal surgery preop: general anesthesia and abdominal surgery cause a temporary loss of what? peristalsis
gastrointestinal surgery preop: since peristalsis is temporarily lost, what may be attached to the suction? NG tube
gastrointestinal surgery post op: immediately after surgery, be especially concerned with what things? Hemorrhage, infection, preventing gastric distention, replacing lost fluids, urine elimination
gastrointestinal surgery post op: an NG tube is usually put in place for what reason? Decompression
gastrointestinal surgery post op:after gastric surgery, what shouldn't you do? irrigate the repositioned tube
gastrointestinal surgery post op: if the abdomen becomes distended or the tube is not draining properly what must be done? Contact a physician
gastrointestinal surgery post op: IV fluids are given until when? G.I. suctioning is discontinued in oral intakes is adequate
gastrointestinal surgery post op: what strict record must a nurse keep? I&O
gastrointestinal surgery post op: jeering the surgery other catheter is inserted and why? Indwelling catheter; patients often have difficulty avoiding
Created by: Jgar2007
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