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ATI-MedSurge-GI

ATI-MedSurge-GASTROINTESTINAL

QuestionAnswer
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
Created by: fluency