Exam 1 Review pt.5

Question 1

SBFT is a procedure to visualize

Answer 1

oropharynx, esophagus, stomach, and small intestine

Question 2

SBFT

Answer 2

Patient swallows contrast medium and assumes different positions on table

Films are taken every 30 minutes until medium reaches terminal ileum

Question 3

SBFT: Nursing Implications

Answer 3

NPO x 8 hours before

Avoid smoking after midnight

Force fluids after to prevent constipation

Patient will have white stools

Question 4

Indications for modified barium swallow

Answer 4

Dysphagia

Non-cardiac chest pain

Painful swallowing

Gastroesophageal reflux

Question 5

Barium Enema

Answer 5

Enemas till clear and clear liquid the night before

NPO x 8 hours

Cathartics aftwards

White stool

Question 6

Gastric Emptying Study

Answer 6

Done to assess stomach emptying

Patient eats egg containing radioactive metal and images are take at 0-1-2-4 hrs

Question 7

When is a gastric emptying test done?

Answer 7

PUD
Ulcer
Diabetes
Gastric malignancies

Question 8

Gastric Emptying Study: NSG consideration

Answer 8

Explain ingested substance are of no danger

Explain need to lie flat during scann

Question 9

What procedure is done to visualize UGI tract

Answer 9

Esophagogastroduodenoscopy

Question 10

Criteria for bariatric surgery

Answer 10

BMI > 40

BMI of 35 with severe medical complication

Question 11

Restrictive bariatric surgery

Answer 11

Sleeve gastrectomy

Intragastric balloon

Question 12

Combination restrictive malabsorptive

Answer 12

Roux-en- Y procedure

Question 13

Bariatric Surgery: Post op care

Answer 13

NG-LWS

Enhance mobility

Pain management

Risk for infection / dehiscence

Question 14

GERD complications

Answer 14

Esophagitis

Barretts esophagus

Cough

Bronchospasm

Question 15

GERD diagnostic studies

Answer 15

Barium swallow

EGD

Question 16

Before surgery to how is GERD treated

Answer 16

High dose PPI x 2 weeks as first step

Question 17

GERD: Nutritional Therapy

Answer 17

Avoid fatty foods

Small frequent meals w/ no fluids

Avoid late night snacking (2-3hrs before)

Elevate HOB with 4-6 inches

Weight loss

Question 18

Lifestyle modifications for GERD

Answer 18

Avoid triggers

Quit smoking = helps stregnthen LES

Question 19

LINX device

Answer 19

Endoscopic procedure

Augments the LES with a ring made up of a serious of rare earht magnest

Question 20

Fundoplication

Answer 20

Endoscopic or open procedure

Question 21

Causes of PUD

Answer 21

H-pylori

Alcohol

Smoking

Family history

Stress (aggravate)

Question 22

PUD: Diagnostic studies

Answer 22

EGD = most accurate diagnostic procedure

Urea breath or stool test

Biopsy of mucosa testing for urease

CBC

Stool for occult blood

Question 23

PUD complications

Answer 23

HOP

Hemorrhage

Obstruction

Perforation (most lethal)

Question 24

Surgical Option for PUD

Answer 24

Billroth 1 and Billroth 2

Question 25

Dumping syndrome

Answer 25

Bolus of hypertonic food dumps into small intestines; manifestations are result of fluid quickly shifting out of plasma into GI tract

Question 26

Dumping Syndrome Clinical Manifestations

Answer 26

Weakness - sweating - palpitations Abdominal cramping Borborygmi Urge to defecate

Question 27

Postprandial Hypoglycemia

Answer 27

Consequence of Dumping syndrome Bolus of fluid high CHO results in hyperglycemia Body release excessive amount of insulin which results in hypoglycemia

Question 28

Dumping Syndrome: Nutrition

Answer 28

6 small meals / day Fluids should not be taken with meal Avoid sweets High protein and fats encouraged Rest after eating

Question 29

Most common causes of upper GI bleed

Answer 29

Esophageal varices Stomach and Duodenal ulcers -h-pylori -NSAIDS

Question 30

UGI Bleed Nursing Interventions

Answer 30

Monitor VS closely Asses for tense rigid board like abdomen Monitor H&H and BUN Establish large bore IV NG to lavage

Question 31

Crohns vs Ulcerative Colitis

Answer 31

Crohns: -Anywhere from mouth to anus -Terminal ileum -Skip lesion and cobblestone appearance Ulcerative Colitis: -Starts in rectum and spread up -Bleeding

Question 32

TPN-Factoids

Answer 32

Lipid emulsion usually infused as separate solution Needs a dedicated CV line Start slowly and end slowly (pancreatic beta cells need time to adapt)

Question 33

IBD complications

Answer 33

Hemorrhage Strictures Perforation Sometimes surgery

Question 34

Total Proctocolectomy and Ileal Anal Reservoir IPAA

Answer 34

Two stage surgery Large intestine removed J pouch is formed Most common surgery for U.C

Question 35

Ulcerative Colitis Surgery Types

Answer 35

IPPA Permanent ileostomy Continent ileostomy

Question 36

Colon Cancer RF

Answer 36

Diet high in red meat Obesity Physical inactivity Alcohol Long term smoking Low intake fruits and veggies Genetic / familial history of IBD

Question 37

Three major types of ostomies

Answer 37

End Loop Double barrel stoma

Question 38

End stoma

Answer 38

Divides bowel and bringing out the proximal end as single stoma Distal portion: -Surgically removed -Oversewn and left in (hartmann's pouch)