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study guide 43
lower GI
Question | Answer |
---|---|
IBS and dumping sydrome are d/t what? | motility disturbances |
bowel resection/bypass, radiation mucousal damage, lactase deficiency, & food/drugs containing sorbitol are caused by what? | decreased fluid absorption |
stool posistive for parasites, and antibiotic-induced c-diff is caused by what? | increased fluid secretion |
`the nurse realizes the pt w/acute infectious diahrrea needs more teaching when he says... | I can use OTC Immodium & something else |
in instituting a bowel training program for a pt w/fecal incontinence, the nurse plans to... | assisst the pt to the restroom at the time of normal defacation |
the food w/the most fiber is... | dried beans |
preferred tx for acute constipation is? | tapwater or hypertonic enema |
A pt is admitted to the ER w/pain. A nursing intervention which should be implemented 1st is... | v/s |
for which causes of acute abdomen is surgery indicated? | foreign body perforation, ruptured abdominal aneurysm, ruptured ectopic prego, acute ischemic bowel |
A nursing intervention for a pt in pain d/t not passing flatus is... | ambulate them |
A 22 year old calls & complains of n/v & pain in right lower abdomen. The nurse advises... | to go see a HCP right away |
when caring for a pt w/IBS, it is important for the nurse to do what... | form a trusting relationship |
The pt w/chronic constipation: holding the urge at work does what? | ignoring the urge causes the mucousa and rectal area to become insensitive to the presence of feces & drying of the stool occurs. The urge is decreased & it becomes more difficult to expel |
The pt w/chronic constipation: A hx of diverticulosis does what? | seen w/low fiber intake, small stool mass & hard |
The pt w/chronic constipation: ther belief that one must defecate QD effects it how? | causes daily laxative use & chronic dilation & loss of tone in the colon |
The pt w/chronic constipation: hx of hemmorhoids and HTN | Hemmoroids are the most common complication of constipation caused by straining to pass the hardened stool. THE STRAINING MAY CAUSE PROBLEMS IN PTS W/HTN |
The pt w/chronic constipation: high dietary fiber w/low fluid intake effects it how? | predisposes the person to obstruction |
A good nursing intervention for a pt who returns to the surgical room w/an IV, NG & jackson pratt? | check the amt and character of gastric drainage & patency of NG tube |
A pt w/a gunshot wound to the abdomen complains of pain after seversl hrs of repair surgery. What should the nurse do? | take v/s |
the major complication w/appendicitis is what? | perforation w/peritonitis |
the site of pain localized in appendicitis is known as? | Mcburney's point |
seen in ulcerative colitis | confined to large intestine, can be cured w/surgical colectomy, rectal bleeding, risk of colon CA |
seen in crohn's dz | involves entire thickness of bowel wall, has segmented distribution, fromation of fistulas |
seen in both ulcerative colitis & crohn's dz | diarrhea, periods of remission & exacerbation, extraintestinal complications, bowel perforation, unkown cause, abdominal pain |
w/ulcerative colitis, bloody diarrhea causes what? | decreased hb and hct |
w/ulcerative colitis, cellular mucousal breakdown causes | hypoalbuminemia |
w/ulcerative colitis, diarrhea & vomitting causes | decreased Na, K, Mg, Cl, and bicarbonate |
toxic megacolon w/ulcerative colitis causes | elevbated WBC |
extraintestinal s/s seen in both crohn's dz & ulcerative colitis | erythma nodosum & arthritis |
In IBD, what methods are used to control inflammation? | corticosteroids and 6-mercapttpurine |
in IBD, what methods are used to promote bowel rest? | parenteral nutrition, IV fluids, nasgastric sx, and NPO are for what purpose? |
What methods are used to prevent secondary infx w/IBD? | sulfasalazine |
In IBD, what methods are used to correct malnutrition? | cobalamin injections, iron injections |
In IBD, what is done to alleviate stress? | sedatives |
In IBD, what is done to relieve symptoms? | antidiarrheals |
1st phase total colectomy w/ileoanal anastosmosis and formation of ileal reservoire, the nurse expects to find... | an unopened loop ileostomy |
A pt w/ ulcerative colitis has a total colectomy w/a fromation of a terminal ileum stoma. An important nursing intervention is... | measure ileostomy output to determine pts determine status of pts fluid output |
A pt w/IBD has the nursing dx of imbalanced nutrition < body requirements. Data supporting this includes... | pallor & hair loss |
bands of scar tissue constrict the intestine | adhesions |
closed loop twisting of bowel on itself | volvulus |
emboli of arterial supply to bowel | vascular obstruction |
protrusion of bowel in weak or abnormal opening | hernia |
bowel folding on itself | intussusception |
nervous paralysis of bowel | adynamic obstruction |
following anal surgery, the nurse promotes what? | sitz baths for comfort & cleaning |
sacrococcygeal hairy tract | pilonidal sinus |
collection of perianal pus | anorectal absess |
ulcer in anal wall | anal fissure |
engorged rectal vein around anal sphincter | hemmorhoid |
tunnel leading from anus or rectum | anorectal fistula |
short bowel syndrome is most likely to occur in a pt with... | an ectensive resection of the ileum |
A pt w/celiac dz needs more teaching when he says... | I don't need to restrict gluten intake... |
the most common form of malabsorption is tx with... | avoidance of milk & milk products |
A nursing intervention for a male following inguinal herniorrhaphy is | elevating the scrotum with scrotal support |
obstruced intestinal flow & blood supply is what kind of hernia? | strangulated |
what kind of hernia follows a spermatic cord or round ligament? | inguinal |
weakness at the site of previous incision is what kind of hernia? | ventral |
what kind of hernia cannot be placed back into the abdominal cavity? | Incarcerated |
protrusion into femoral canal is what kind of hernia? | femoral |
what type of hernia can be placed back into the abdominal cavity? | reducible |
the fluid and lyte balances which occur w/small bowel obstruction are a result of... | movement of fluid & lytes from the bowel into the peritoneal cavity |
rapid projectile vomitting occurs with... | upper small bowel obstruction |
abdominal distention is most apparent w/obstruction of the ___________ bowel | large |
fecal vomitting occurs with _________ bowel obstruction | lower |
metabolic ________ is most likely to occur w/low small bowel obstruction | acid |
sudden, severe, constant abdominal pain is indicative of __________________ bowel obstruction | strangulated |
abdominal pain which is crampy, colicky, coming/going in waves is characteristic of ___________ obstruction | mechanical |
NG and nasointestinal tubes are used to decompress __________ b9owel obstructions | small |
important nursing care for a pt w/an NG tube is... | mouth care Q2-3 hours |
whether polyps are cancerous... | should be removed & depends on type (if malignant) |
in pts over 50, rt side CA screening should be done every year by... | fecal testing for occult blood |
for colorectal CA, the nurse specifically asks about... | dietary intake |
8 hours post colostomy formation, the nurse expects the stoma to be... | brick red, puffy, oozes blood |
ileostomy drainage looks like... | liquid to semi-liquid, extremely irritating to skin, less odiferous than colostomy |
descending colostomy drainage looks like... | formed, keast irritating, may be able to regulate w/irrigation |
transverse loop colostomy drainage looks like... | semi-formed, irregular, irritating to skin, foul odor |
when teaching a pt about colostomy irrigation, the nurse explains... | to allow 30-45 minutes for the solution and feces to be expelled |
the nurse teaches the pt w/diveticulosis to... | maintain a high fiber diet & use bulk laxatives to increase fecal volume |
during an acute attack of diverticulitis, the pt is monitored for what... | signs of peritonitis |
the appropriate tx for the pt w/diarrhea d/t rotavirus is... | increased fluid intake |
during assessment of a pt w/acute abdominal pain, the nurse should check... | temperature (infx) |
the nurse should increase the comfort of a pt w/appendicitis by... | flexing their knees |
the difference between crohns and U.C.? | surgery cures U.C., but recurs w/cron's |
obstruction of large bowel manifestation? | largely distended abdomnen- duh |
A pt is to undergo chemo/radiation for colorectal CA- nurse teaching includes that... | they can both be palliative |
nurse explains to the pt undergoing an ostomy surgery that the one w/the most normal fx of the bowel is... | sigmoid colostomy |
differece in s/s of diverticulitis vs diverticulosis? | diverticulosis has no s/s |
nursing intervention to reduce edema and pain following inguinal herniorrhaphy is... | apply scrotal support w/ice bag |
the nurse determines teaching to a pt w/celiac dz a success when she choses... | scrambled eggs & sausage |
pt teaching post hemorrhoidectomy? | pain meds before bowel movement |
describe an abdominal-perineal resection | abdominal insicion is made, the PROXIMAL SIGMOID COLON is brought throught the abdominal wall & formed into a colostomy. The pt is repositioned, a perineal incision is made and the DISTAL sigmoid colon, rectum, & anus are removed through the incision |