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Stack #184018
Stack #184018-GI
| Question | Answer |
|---|---|
| Nursing assessments for fluid imbalances | Pyrosis,hematemesis,hematachezia,melena |
| GI Diagnostic test-upper GI | Barium Swallow - used to find duodenal ulcers |
| No smoking...why? | Nicotene relaxes spinchter |
| Gold standard GI diagnostic test | EGD-esophagogastroduodenoscopy (endoscopy) |
| what test is used to determine PUD | EGD - endoscopy |
| occult blood is... | hidden blood in the stool |
| android obesity | fat distributed over abdomen and upper body =GREATER CARDIOVASCULAR RISK |
| roux en Y | gastric bypass surgery-bypassing duodenum, extremely hypertonic(pulls fluid in) rapid withdraw of fluids into jejuneum |
| Gastric bypass complications | Dumping syndrome - signs of this are tachycardia,flushed,sweating,cramping;shock like symptoms |
| post-op nrsg interventions | teach the client to increase volume by 1 oz. q 5 minutes till satisfied. |
| medical management for GERD | antacids - neutralize stomach acids |
| dietary management for GERD | avoid caffeine, chocolate, acidic foods,milk, carbonated beverages...no smoking,or alcohol |
| Drugs that cause ulcers | ulcerogenic drugs-NSAIDS,ASA,corticosteroids, potassium salts, antineoplastic drugs |
| present in over 95% of DUODENAL ULCERS & over 85% of GASTRIC ULCERS | Helicobacter Pylori...H.Pylori |
| PUD - what lifestyle factors increase Hcl production? | Alcohol,smoking,caffeine |
| Pain characteristics in GASTRIC ulcers? | Occurs w/meals & 1-2 hrs after a meal; eating DOES NOT ease the pain |
| Pain characteristics in DUODENAL ulcers? | Occurs 2-4 hrs after a meal & during the night; pain IS relieved by eating |
| Risk factors for stress ulcers | severe traumas, burns, head injuries, Myocardial infarctions, spinal cord injuries, and patients on ventialtors |
| Pain characteristics in STRESS ulcers | Typically painLESS |
| What is the test used to best determine PUD (peptic ulcers) | Endoscopy with biopsy |
| Complications of PUD | HEMORRHAGE...hematemesis, melena |
| What is perforation in PUD? | ulcer erodes through all layers of GI tract, highly acidic gastric juices spill into the peritoneal cavity injuring adjoining tissues and organs. |
| S & S of a perforation in a patient? | SUDDEN sever pain,rigid - boardlike abdomen, shocklike symptoms. This requires immediate surgery and could be life threatening. |
| What causes metabolic alkalosis? | It is a retention of base or excess acid loss; excessive use of antacids,prolonged vomiting, excessive gastric drainage and/or suctioning, excessive K+ loss, & burns |
| Decreased K+ effects what? | Heart rate |
| Nrsg interventions for metabolic alkalosis: | Use 0.9%NS to lavage (to wash) or irrigate Gastric tubes |
| Signs & symptoms of metabolic alkalosis: | hypoventialtion-slow shallow breathing, nervousness,irritability,confusion,& disorientation, muscle weakness, or cramping of muscles, weak, irregular pulse, numbness & tingling (hypokalemia,hypocalcemia,hyponatremia) |
| medication therapy goal for PUD | Neutralize the gastric acid contents - antacids (TUMS) |
| H.Pylori drug therapy | NEW TRIPLE THERAPY - Amoxicillin,Biaxin,& Prilosec (take meds same time and complete regimen) |
| Post op GI surgical complications | DUMPING SYNDROME-occurs in 50% of pts. due to rapid emptying of HYPERTONIC chyme after meals |
| Name one of the MOST COMMON complications of GI surgery: | Nutritional deficits - vitamin & mineral malabsorption and anemia...must be assessed for in all post-op GI surgical pts. and treated collaboratively |
| What is a SYSTEMIC S&S related to decreased blood volume in Dumping syndrome | diaphoresis(sweating) |
| Name 2 nursing interventions to manage dumping syndrome? | Teach the patient to drink minimal liquids with meals and to lie down on LEFT side after eating for 20-30 minutes |
| Name the types of UPPER GI bleeding: | Hematemesis, melena, and hematachezia |
| Name CLINICAL manifestations of GI bleeding: | Stool-occult,melena, hematachezia |
| Name SYSTEMIC affects of GI bleeding: | N&V,diaphoresis,& abdominal pain |
| Nursing management(assessment) for GI bleeding: | Assess VITAL SIGNS,VITAL SIGNS,VITAL SIGNS |
| Nursing Managment (intervention)of GI bleed: | Vital signs q 15 minutes |
| What is SHOCK??? | Life threatening-inadequate supply of O2 & nutrients to cells from INADEQUATE TISSUE PERFUSION |
| Most common form of shock: | HYPOVOLEMIC-lack of(inadequate)circulating blood volume (HEMORRHAGE) |
| What is the main goal of the body when in hypovolemic shock? | RESTORE TISSUE PERFUSION |
| what is happening in hypovolemic shock during compensatory mechanism? | Cardiac output falls,arterial BP decreases within seconds which stimulates the carotids & pressoreceptors in the aorta to sense the falling BP... "FightorFlight" |
| Compensatory mechanism vs. effect | adrenal medulla is stimulated to release epinephrine & norepinephrine = vasoconstriction(increased B/P & pulse) |
| Compensated stage(2nd)AKA reversible stage | BP-systolic is normal slightly decreased-decreased stroke volume, diastolic is normal and slightly increased(vasoconstriction) and pulse increased 20 beats above pts. normal, respirations are increased in rate & depth-increased CO2 in blood. |
| Progressive stage if comp.mech.has failed | Respirations greater then 20 tachypneic and urine output(oliguria)less than 30ml/hr,increase in specific gravity |
| ER care in Pt with hypovolemic shock | nrsg assmnt-ensure pt has adequate tissue perfusion,s&s of shock q 15 min,maintain IV 0.9%NS,whole blood, position pt. supine w/lower extremities slightly elevated,keep warm N quiet. |
| what pharmacologic care would you use for pt.in hypovolemic shock? | Dopamine, epinephrine or Levophed IV (which are potent vasoconstrictors.) |
| Clinical picture of ANEMIA: | pallor,progressive weakness and fatigue with activity intolerance, bone pain die to increased RBC,growth restriction & delayed sexual maturation in child with chronic anemia. |
| Top two Nrsg dx for anemaia: | Activity Intolerance, Alteration in Nutrition less than body reqrmnts |
| Types of Anemia: | APLASTIC ANEMIA-impaired erythrocyte production of RBCs & SICKLE CELL ANEMIA- increased erythrocyte destruction |
| Option of anemia or shock: | anemia |
| Reduction or destruction of RBCs which decreases the O2 carrying capacity of the blood | Anemia |
| Definitoin of Aplastic anemia | Dx by physical symptoms, normal or decreased RBC,decreased WBC,decreased platelets(pancytopenia),prolonged bleeding time,bone marrow biopsy |
| Clinical picture of IRON DEFICIENCY ANEMIA | DECREASED RBC,Hgb,Hct,MCV,MCH,MCHC |
| what deficiency during conception or pregnancy increases the risk of neural tube defects in the fetus | Folic Acid |
| Clinical pictures in Vitamin B 12 Deficiency | inability to absorb the vitamin due to the LACK OF INTRINSIC FACTOR, lemon yellow pallor skin, beefy red tongue, & associated with NEUROLOGICAL(brain)symptoms if left untreated. |
| Vitamin B12 Deficiency is also known as: | Pernicious anemia |
| A patient with any type of ANEMIA is at risk for: | Activity Intolerance |
| Popular symptom in Diarrhea | Oliguria-decreased urine output to anuria |
| Diarrhea evaluation | Correct fluid volume deficit-Mild diarrhea rarely requireshsptliztn,give oral rehydration therapy(ORT) wtih pedialyte, resol, ricelyle, lytren |
| Name an infectious diarrhea | Viral - ROTAVIRUS |
| What is the most COMMON cause of dehydration in children? | Diarrhea |
| Assessment of CLEFT LIP/PALATE | cleft LIP is obvious upon physical exam,cleft PALATE may not be obvious-must ASSESS infant's mouth with a gloved finger,infants ability to suck & parent-infant atachment or bonding |
| Feeding the infant wtih CL/CP | upright position, use special niples wehn feeding the infant LAMBS NIPPLES,Flangea and Breck nipples |
| Surgical correction of the lip(cheiloplasty) | A Logan's bow(arched metal device secured to the cheeks with tape) is used after surgery to protect the suture line and the infants arms must be restrained @ the elbows to prevent them from pulling the lip/packing |
| Closure of the palate - feeding | CUP only, no spoons, straws, etc until palate is well healed.And restrained arms of infant at the elbows |
| What is a usual prognosis after a Palatoplasty? | Speech therapy |
| What are the 4 stgs of shock? | Initial,compensatory,progressive,irreversible/ refactory |
| What are shocklike sypmtoms? | Hypotension, tachycardia, tachypneic,cold & clammy skin,oliguria, confused |
| Lab values metabolic alkalosis... | increased Ph above 7.45,PcO2-normal and HCO3 above 26 |
| Causes of metabolic alkalosis? | Excessive use of anatacids, prolonged vomitting, excessive gastric drainage &/or suctioning, excessive K+ loss,burns |
| Tests used for H.Pylori detection? | Endoscopy with biopsy, blood test, urea breath test, tissue sample, stool test for antigens |
| Signs & symptoms of metabolic alkalosis? | hypoventilation, nervousness-irritability, weakness or cramping of muscles,irregular pulse,numbness/tingling |
| What is esophageal artesia &/or tracheosophageal fistula? | The esophagus fails to develop into a continuous passage,a fistula or pathway develops from the esophagus to the trachea (95% of these infants have tracheal fistulas-TEF |
| Etiology of TEF | Cause of TEF is unknown but there is a high incidence of prematurity in infants with this |
| Assessment or S&S of TEF or EA | excess of slaiva or blowing bubbles and 3C's - COUGHING,CHOKING,CYANOSIS |
| What are pyloric stenosis manifestations? | PROJECTILE VOMITING,dehydration(no tears,sunken in fontanel)upper abd. distended |
| Evaluation of pyloric stenosis (labs) | CBC will indicate Increased Hct,with severe dehydration, lytes will show decreased (Na,K&HCO3) |
| What is esophageal artesia &/or tracheosophageal fistula? | The esophagus fails to develop into a continuous passage,a fistula or pathway develops from the esophagus to the trachea (95% of these infants have tracheal fistulas-TEF |
| Etiology of TEF | Cause of TEF is unknown but there is a high incidence of prematurity in infants with this |
| Assessment or S&S of TEF or EA | excess of slaiva or blowing bubbles and 3C's - COUGHING,CHOKING,CYANOSIS |
| What are pyloric stenosis manifestations? | PROJECTILE VOMITING,dehydration(no tears,sunken in fontanel)upper abd. distended |
| Evaluation of pyloric stenosis (labs) | CBC will indicate Increased Hct,with severe dehydration, lytes will show decreased (Na,K&HCO3) |
Created by:
nms2018
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