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Ch 38 MD IV
Ch 38 digestive: GI decompression, TPN,Surgery
| Question | Answer |
|---|---|
| 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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