Adult Health Study Guide Exam 4 Flashcards Preview

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Flashcards in Adult Health Study Guide Exam 4 Deck (21)
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1

-Appendicitis: signs/sx, pre and post-surgical nursing care for pt with appendicitis, complications

Signs/sx-
Pre and post- surgical-
complications-

2

-Peritonitis: s/sx, nursing interventions, labs associated

S/Sx:
Nursing interventions:
Labs:

3

difference between crohn’s disease and ulcerative colitis

?

4

What is the nursing care/treatment for each, s/sx of each

Crohn's s/sx
Ulcerative Colitis- s/sx

5

-Celiac disease: s/sx, cause, therapy (dietary tx)

gluten free- abdominal pain, inflammation of the small intestine

6

Diverticulosis vs diverticulitis: s/sx of each, how are the two different, causes? Nursing interventions for each and diet tx

?

7

Obesity/malnutrition

?

8

-What are anthropometric measurements?

height weight- nutritional status

9

-What are common s/sx of malnutrition and associated labs with malnutrition?

?

10

What is the difference between kwashiorkor and marasmus?

Kwashiorkor-
Marasmus-

11

Enteric vs. parenteral nutrition: what are indications for each, routes of delivery, nursing care and complications for each?

?

12

What is obesity and complications of obesity? Nursing implications/care- surgical interventions?

?

13

-Bariatric surgery- indications, pre-post-op care. What is dumping syndrome? Dietary management?

?

14

What is cholecystitis? What are common causes, s/sx, nursing care? Post-op cholycystectomy care?

acute cholecystitis- inflammation of gallbladder- usually get gallstones,
Chronic cholecystitis- repeated episodes of cystic duct obstruction result in chronic inflammation, pancreatitis, jaundice, icterus, obstructive jaundice,

Clinical manifestations- Upper abd pain, possibly radiating to right shoulder or triggered by high-fat meal
Flatulence, dyspepsia, eructation, anorexia, nausea and vomiting
Rebound tenderness
Fever
Steatorrhea (fatty stools) and jaundice (associated with chronic cholycystitis)

Risk Factors-The four F’s (female, forty, fat and fertile)
Rapid wt. loss or prolonged fasting
Long-term TPN use
Family hx
Gastric bypass
Cystic fibrosis
Glucose intolerance


diagnosis-No one specific lab test; look at LFT’s (GGT/LDH), alkaline phosphatase, WBC’s, bilirubin
Abdominal ultrasound: right upper quadrant: see edema and fluid around gallbladder
Cholangiogram to visualize gall bladder and bile ducts
ERCP endoscopic retrograde cholangopancreatography- visualizes bile ducts, pancreas and gall bladder

15

What is pancreatitis? What are common causes, s/sx, nursing care? Complications? Labs associated?

Can be mild to possibly life-threatening inflammatory process of the pancreas: can be acute or chronic

Inflammation/autodigestion

Necrotizing hemorrhagic pancreatitis/necrosis of blood vessels

Pancreatic pseudocyst

Malabsorption of fats

Diabetes mellitus


Clinical manifestations-Severe abdominal pain, nausea and vomiting
Cullen’s sign/Turner’s sign (periumbilical and flank ecchymosis).
Bowel sounds diminished/ileus
Abdominal tenderness, rigidity, guarding
Pancreatic ascites/pleural effusions
Significant changes in vital signs/shock

Lab assessment
-Amylase(stays elevated 48-72 hrs)
-Lipase (stays elevated for several days longer)

-Serum ALT (three fold rise or greater….biliary pancreatitis)
WBC
-Glucose
-Bilirubin
-Hypocalcemia
table 59-4

-Monitor for signs of shock

16

What is cirrhosis: causes, s/sx, most common complications? Labs associated? Treatments for associated problems (ex. Portal htn, hepatic encephalopathy, ascites, bleeding varices, hepatopulmonary syndrome).

?

17

How are the various viral hepatitis contracted: A,B,C,D,E? What are preventative measures?

A- spread fecal-oral route
B-unprotected sex, sharing needles, blood transfusions,
C- similar to B however it is the leading indication for liver transplantation in US!
D- transmitted by parenteral routes
E- resembles Hep A- fecal oral route

18

-General causes of liver disease?

cirrhosis, bilirary diseases, autoimmune liver disease, liver cancer, Hep B and C, alcoholic liver disease, NAFLD, fulminant acute liver failure

19

When is a liver transplant indicated? Post-op care…signs of rejection?

Donors- usually trauma victims-
immunosuppressant therapy- life long

20

-What is NAFLD? What are some causes and treatments?

Fatty inflitration of liver tissue that can lead to cirrhosis- most common cause of liver disease in the world- associated with diabetes type 2, obesity, and metabolic syndrome- may be asymptomatic- will see elevated liver enzymes (ALT and AST)-

Treatment- weight loss- glucose control, and lowering lipids

21

General GI stuff to know: how to insert an NGT or feeding tube? Caring for a pt. undergoing EGD and paracentesis

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