Adult Health GI Jeopardy Flashcards Preview

Nursing 2016 > Adult Health GI Jeopardy > Flashcards

Flashcards in Adult Health GI Jeopardy Deck (25):
1

What is a test done to directly visualize mucous membranes of stomach, esophagus, and duodenum?

EGD: Esophagogastroduodenoscopy or Upper GI Endoscopy

2

What is a diagnostic test that may require a laxative afterwards?

A barium enema or swallow

3

What are the signs/sx might you find if you suspect a bowel obstruction? Early/late?

Early: high-pitched tinkling bowel sounds

Later: bowel becomes silent
May have distension, colicky gas pains/cramping, possible vomiting (perhaps fecal material)

High-pitched borborygmi shound present as the intestine attempts to propel contents past the obstruction. In later stages the bowel becomes silent. With a paralytic ileus, bowel sounds are greatly diminished or absent throughout the process. Abd. Distension minimal with proximal obstructions, but may be pronounced with distal obstruction and paralytic ileus. Abd. May be tender to palpation a well.

4

CEA, CA19-9, AFP…are examples of what?

Tumor markers related to cancers of the GI tract

carcinoembryonic antigen and CA 19-9, alpha-fetoprotein indicate sensitivity and specificity for colorectal and hepatocellular carcinomas. CEA not normally detected in blood and indicative of ca is present when detected. CA 19-9 is also a protein that exists on the surface of certain cells and is shed by tumor cells making it useful as a tumor marker. It is elevated in most pts with advanced pancreatic cancer, but also can be elevated in pts with colorectal, lung, and gallbladder cancers, gallstones, pancreatitis, CF, and liver disease.

5

Your patient reports his stool looks ‘black and shiny’. What would you want to further assess about this pt and what do you suspect?

melena, Physical assessment, assess labs CBC, pt/ptt, medications, history. Suspect upper GI bleed

6

The nurse teaching a client with GERD includes which of the following instructions?

A) This is a benign disease requiring no treatment
B) Elevate the head of the bed on 6-8 inch blocks or pillows
C) Stop taking the prescribed proton-pump inhibitor once symptoms are relieved
D) Peppermint and chocolate candies can help relieve symptoms
E) Avoid lying down for several hours after eating

B) Elevate the head of the bed on 6-8 inch blocks or pillows

and

E) Avoid lying down for several hours after eating

7

The nurse evaluates his teaching of a client with acute stress gastritis as effective when the client states she will: (see next slide)

A) Avoid using aspirin or NSAIDS for routine pain relief
B) Consume only bland foods
C) Return for yearly upper endoscopy exams
D) Fully cook all meat, poultry, and egg products

A) Avoid using aspirin or NSAIDS for routine pain relief

8

The nurse caring for a pt. with esophageal cancer affecting the middle portion of the esophagus would immediately report which of the following?

A) Crackles in the base of the right lung
B) Bright red bleeding from the mouth
C) Weight loss
D) Difficulty swallowing solid foods

B) Bright red bleeding from the mouth

9

Name SIX common GI "offenders".

Caffeine, dairy products, chocolate, pepper, alcohol, spicy foods, tobacco, drugs (remember OTC)

10

Name three risk factors for the development of esophageal cancer

GERD, smoking, excessive alcohol intake

11

The evening following a gastric resection, the nurse notes that there has been no drainage from the NGT for the past three hours. The nurse should:

A) Chart the finding
B) Reposition the nasogastric tube
C) Gently irrigate the tube with normal saline
D) Notify the surgeon

C) Gently irrigate the tube with normal saline

12

The MD has ordered omeprazole 20mg BID, clarithromycin 500mg bid, and amoxicillin 1g daily for a pt with PUD. It is most important for the nurse to instruct the pt to:

A) . Stop the drugs immediately and notify the MD if a rash, hives, or itching develop
B) Consume 8oz yogurt daily while taking these drugs
C) Take the drugs on an empty stomach, 1 hour before breakfast and 2 hours after dinner
D) Take the drugs with a full glass of water

A) . Stop the drugs immediately and notify the MD if a rash, hives, or itching develop

the other answers are appropriate for a pt taking antibiotics

13

The nurse identifies which of the following nursing diagnoses as highest priority for the client admitted with peptic ulcer disease and possible perforation?
A) Acute pain
B) Ineffective health maintenance
C) Nausea
D) Impaired tissue integrity: gastrointestional

D) Impaired tissue integrity: gastrointestional

14

A client with a history of PUD suddenly begins to complain of severe abdominal pain. The nurse should (select all that apply)

A) Administer the prescribed proton-pump inhibitor
B) Obtain an order for a narcotic analgesic
C) Withhold all oral food and fluids
D) Place the pt. in fowler’s position
E) Notify the physician

C) Withhold all oral food and fluids
D) Place the pt. in fowler’s position
E) Notify the physician

15

Following a partial gastrectomy for gastric cancer, a pt. complains of nausea, abdominal pain and cramping, and diarrhea after eating. Recognizing manifestations of dumping syndrome, the nurse recommends:

A) Fasting for a period of 6-12 hours before meals
B) Decreasing the protein content of meals
C) Frequent small meals that contain solid foods or liquids but not both
D) A diet rich in carbohydrates to maintain blood glucose levels

C) Frequent small meals that contain solid foods or liquids but not both

16

Which diagnostic tests would be most appropriate to detect intestinal parasites?

A) Colonoscopy
B) CT of the abdomen
C) Barium enema
D) Stool specimen

D) Stool specimen

17

The appendix is attached to the surface of what segment of the large intestine?

A) Cecum
B) Ascending colon
C) Transverse colon
D) Rectum

A) Cecum

18

You are caring for a client the first day following bowel surgery. You do not hear bowel sounds during your initial assessment. What should you do?

A) Immediately call the MD and report this abnormal finding
B) Repeat the assessment in 30 minutes to ensure accuracy of findings
C) Document the assessment as normal following and surgery
D) Ask another nurse to check your assessment before reporting it

C) Document the assessment as normal following and surgery

19

True or false: the main difference between ulcerative colitis and crohns disease is that crohns affects only one part of the colon, where as UC affects any part of the GI tract?

False, the opposite is true

20

A patient is admitted to the ER with complaints of generalized umbilical pain, rebound tenderness, nausea and vomiting. What might your actions be as a nurse?

A) Give the patient an enema, he is probably constipated.
B) Obtain an order for pain medication
C) Keep the patient NPO
D) Administer a proton-pump inhibitor as ordered

B) Obtain an order for pain medication
C) Keep the patient NPO

21

Name three recommended tests for clients age fifty and over to detect colon cancer.

Do one of these tests: yearly fecal occult blood test, flexible sigmoidoscopy q 5 years, barium contrast enema q 5 years or colonoscopy q10 years

22

Name five risk factors associated with the development of colorectal cancer

Family hx, personal hx of polyps, IBD, aging, low fiber diet, high fat diet, obestiy, smoking, alcohol, diabetes

23

Which of the following questions or statements would be appropriate for the client with an ostomy?

A) “have you had any bleeding from your hemorrhoids?”
B) “has your appetite changed lately?”
C) “tell me about your family”
D) “describe the consistency of your stools”

D) “describe the consistency of your stools”

24

Why is removal of polyps from the colon important?

A) To identify genetic disorders
B) To prevent the development of cancer
C) To facilitate further examination of the bowel
D) To decrease future problems with constipation

B) To prevent the development of cancer

25

A client has developed a paralytic ileus following a recent abdominal surgery. What is the most important nursing consideration when caring for this client?

A) Ensure that the client is able to eat a clear liquid diet
B) Maintain the client on strict bedrest.
C) Monitor bowel sounds every hour
D) Ensure the nasogastric tube is functioning

D) Ensure the nasogastric tube is functioning