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NCA spring > GI # 1 high yield > Flashcards

GI # 1 high yield Flashcards

1
Q

enteral vs parenteral nutrition

A

Enteral Nutrition – nutritionally balanced liquid or foods delivered directly to the GI tract

Parenteral Nutrition – administration of nutrients directly into the bloodstream

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2
Q

Nasally and Orally Placed Feeding Tubes vs Gastrostomy and Jejunostomy Tubes

A

NG tube 4 weeks or less

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3
Q

Jejunostomy tubes are used for

A

chronic reflux to decrease risk for aspiration.

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4
Q

5 ways to prevent enteral tube aspiration

A

evaluate all enterally-fed patients for risk,

verify tube position before use,

position patient with HOB > 30-45 degrees,

minimize time in supine position,

and follow agency protocol/orders for checking gastric residual volume

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5
Q

what to monitor to pt with parenteral nurition

A

blood glucose - give insulin if indicated
weight
i and o

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6
Q

how often is parenteral solution and tubing changed

A

q 24 hours

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7
Q

complication of parenteral nutrition

A

refeeding syndrome - fluid retention and electrolyte imbalances, especially hypophosphatemia, hypokalemia, and hypomagnesemia

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8
Q

2 highest risk complications of anorexia

A

renal failure and dysrhythmias

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9
Q

4 supplements needed after Roux-en-Y Gastric Bypass (RYGB):

A

Multivitamin, iron, calcium, and B12 (cobalamin)

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10
Q

nutriton after bariatric surgery

A

NPO then clear low sugar liquid
15-30ml every 15 min gradually increasing
low fat full liquid after 48 hrs
NO STRAWS
no meds bigger than m/m

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11
Q

if pt has excessive pain or pain not relived by meds after baraitric surgery

A

check incision site for leaking

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12
Q

HOB after bariatric surg

A

45

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13
Q

nurse interventions after bariatric surg 3

A

I and O
early mobility/VTE prophylaxis
teach deep breathing/IS

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14
Q

tx for metabolic syndrome

A

weight reduction and PA

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15
Q

generalized weakness, sweating,
palpitations, and dizziness, abdominal cramps.

A

dumping syndrome - small feedings to prevent - usually last 1 hour after eating - pt should have a rest period after eating

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16
Q

5 interventions for vomitting

A

NPO
IV fluids
for persistent vomitting, bowel obstruction or ileus- NG tube
BRAT
meds as ordered

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17
Q

3 interventions for Upper gastro-intestinal endoscopy (EGD)

A

Evaluate for presence of a gag reflex prior to allowing PO intake (including meds) after test

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18
Q

what to give patients after barium swallow

A

fiber and fluids

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19
Q

education for GERD patient 5

A

sleeping/resting with HOB elevated,

not supine for 2-3 hours after eating,

avoiding constrictive clothing,

cigarette cessation

avoid alcohol, chocolate, mints, caffeine, and fatty foods

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20
Q

main cause of PUD

A

hpylori

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21
Q

treating h pylori infection

A

Antibiotics (clarithromycin, amoxicillin, and metronidazole are common) along with a PPI for 7-14 days

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22
Q

gastric vs duodenal ulcer

A

Gastric ulcers – burning or gaseous pressure in the epigastrium, pain 1-2 hours after eating, if penetrating, increased discomfort with food

Duodenal ulcers – burning, cramping, pressure-like pain across mid-epigastrium and upper abdomen or back, 2-5 hours after eating, midmorning, midafternoon, and during the night. Pain relieved with food and antiacids – pain at night

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23
Q

normal vs abnormal gastric contents

A

normal green yellow, abnormal is coffee grounds or red

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24
Q

biggest complication and monitoring for PUD

A

bleeding - monitor BP, HR, Hgb, HCt, gastric contents

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25
Q

3 signs of hemorrage from PUD

A

hypovolemia, dec Hgb/Hct, bright red gastric contents

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26
Q

sudden, severe pain, signs of peritonitis/sepsis

A

preforation from PUD

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27
Q

if NG tube isnt draining

A

ask provider for an xray

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28
Q

Postprandial Hypoglycemia

A

uncontrolled gastric emptying of fluid high in carbohydrate into the small intestine resulting in excess insulin and reflex hypoglycemia

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29
Q

Anastomosis Leak

A

break in the suture line allowing gastric or intestinal contents to enter the peritoneum

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30
Q

Pernicious Anemia

A

loss of intrinsic factor preventing cobalamin (B12) absorption

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31
Q

priority for vomitting red blood

A

IV site for fluids to prevent hypovolemic shock and for blood products

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32
Q

med for upper GI bleeding

A

PPI

33
Q

preventing gastroenteritis

A

hand hygiene

34
Q

intervention for prolonged diarrhea

A

stool culture

35
Q

3 assessments for diarrhea

A

temp, dehydration, VS

36
Q

biggest risk factor for cdiff diarrhea

A

abx use

37
Q

IBS education 2

A

Address underlying psychological factors – stress

eat low FODMAP foods

*Foods to avoid – dairy containing lactose, wheat-based products, beans and lentils, artichokes, asparagus, onions, garlic, cabbage, broccoli, mushrooms, sweet corn, stone fruits

38
Q

education about what s/s of crohns and ulcerative colitis look like

A

exacerbation and remission

39
Q

ulcerative colitis complication and education

A

colorectal cancer - get screened

40
Q

common complication of crohns

A

nutritional deficiencies

41
Q

8 acute care for crohns and UC

A

monitor vital signs,
assess and treat pain,
I & O,
monitor lab results (CBC, electrolytes),
administer IV fluids as ordered,
daily weight,
assess abdomen,
provide hygiene

42
Q

diverticulosis teaching

A

high-fiber diet, fiber supplements/stool softeners, weight reduction (if overweight), physical activity, and avoiding things that increase intrabdominal pressure

43
Q

diverticulitis home tx

A

clear liquids, rest, antibiotics, and analgesics

44
Q

key to tx of acute adbominal pain

A

determining cause because it can be life threatening

45
Q

pain with appendicitis

A

Pain may be dull initially, persists and settles in the right lower quadrant

46
Q

2 dx test for appendicitis

A

CBC and CT abdominal scan

47
Q

7 managements of after apendectomy

A

monitoring vital signs,

advancing diet as tolerated post-operatively,

early ambulation,

abdominal assessment,

tx of pain,

surgical site assessment and care,

monitoring for complications

48
Q

pain with peritonitis

A

more pain with movement - pt may want fetal position

49
Q

complication of periotonitis

A

hypovolemic shock so provide I Vfluids

50
Q

small bowel obstruction symptom

A

vomitting

51
Q

how to know how to tx bowel obstruction

A

location to determine manifestation

52
Q

how to prevent CRC

A

Colonoscopy every 10 years starting at age 45 - if famililal hx, need more frequent screening

53
Q

Illeostomy contents

A

liquid

54
Q

focus of ostomy care

A

assessment, patient and caregiver teaching about ostomy care, and emotional support

55
Q

teaching regarding drainage after ostomy

A

normal until peristalsis is normal

56
Q

The nurse is providing teaching to a client about newly prescribed phentermine. The nurse knows that the client has correct understanding about the medication when the client makes which of the following statements?

A

i will monitor my BP regularly

57
Q

A client tells the nurse that since starting orlistat they have experienced increased gas and diarrhea, especially after eating high-fat foods. What is the nurse’s best response to the client?

A

that is a SE when eating high fat foods

58
Q

The nurse is administering ondansetron to a client. Which of the following side effects should the nurse monitor for after administration?

A

HA and fatigue

59
Q

The nurse should include what information when providing teaching about omeprazole to a client with gastroesophageal reflux disease?

A

lowest dose for shortest duration

60
Q

The nurse is administering sucralfate to a client diagnosed with peptic ulcer disease. The client asks the nurse how the medication works. What is the best response by the nurse?

A

protective barrier

61
Q

The nurse is aware that famotidine works by which of the following methods?

A

blocks histamine

62
Q

The nurse is caring for a client diagnosed with Clostridium difficile diarrhea. The nurse should question a medical prescription for which of the following medications?

A

loperamide

63
Q

The nurse is administering polyethylene glycol to a client prior to a diagnostic procedure. The client asks how quickly the medication will work. What is the nurse’s best response?

A

1 hour

64
Q

The nurse is caring for a client following gastric resection for gastric cancer. The client begins to complain about increasing discomfort and nausea and the nurse observes that the client’s NG tube has not drained any secretions for over 6 hours. What action should the nurse take first?

A

verify placement

65
Q
  1. The nurse is providing education to a client following gastric resection. What measures should the nurse teach the client to prevent dumping syndrome? SELECT ALL THAT APPLY.

A. Avoid foods high in sugar and concentrated carbohydrates.
B. Eat 3 larger meals a day.
C. Eat foods that are high in fiber.
D. Eat smaller, more frequent meals.
E. Avoid foods that are high in protein.

A

A and D

66
Q
  1. The nurse is caring for a client following abdominal surgery. The client is complaining of abdominal pain. Which assessment findings would be consistent with a paralytic ileus?
A

absence of bowel sounds

67
Q

complains of increased pain and feeling light-headed. On assessment, the nurse finds that his abdomen is firm and tense and he is diaphoretic and pale.

  1. Which of the following actions in response to these findings is a priority:
A

check vitals, BP, HR, RR

68
Q
  1. What information does the nurse need to teach SP about adalimumab?
A

more susceptible to infection

69
Q

priority for obstruction

A

NPO

70
Q

An abdominal CT is ordered and shows a small bowel obstruction and stricture in the ileum. SP is taken to the OR for an emergency laparotomy. SP returns to the surgical unit post-operatively with a 5 cm abdominal incision and an ileostomy.

  1. What are the initial assessment priorities for the nurse to make? (List 5)
A

Vital signs and O2 saturation every 15 minutes X 1 hour, then every 30 minutes X 1 hour, then hourly X 4.

Assess surgical site (dressing for bleeding/drainage) and appearance of the ostomy. Recognize that once peristalsis returns, ostomy output will be liquid, constant, and of increased amount after eating.

Assess and maintain NG tube (placement, output, function) and NPO status.

Assess hydration status and I & O, frequent urine output assessment, administer IV fluid as ordered.

Assess pain and administer analgesia as ordered.

71
Q

priority asessment for ostomy

A

assessing pts thoughts about it

72
Q

A patient is receiving peripheral parenteral nutrition. The
solution is completed before the new solution arrives on
the unit. The nurse gives

A

5% dextrose

73
Q
  1. A patient with anorexia nervosa shows signs of
    malnutrition. During initial refeeding, the nurse carefully
    assesses the patient for (select all that apply)
    a. hypokalemia.
    b. hypoglycemia.
    c. hypercalcemia.
    d. hypomagnesemia.
    e. hypophosphatemia.
A

ADE

74
Q
  1. A patient with extreme obesity has undergone Roux-en-Y
    gastric bypass surgery. In planning postoperative care, the
    nurse anticipates that the patient
    a. may have severe diarrhea early in the postoperative
    period.
    b. will not be allowed to ambulate for 1 to 2 days
    postoperatively.
    c. will require nasogastric suction until the drainage is pale
    yellow.
    d. may have limited amounts of oral liquids during the
    early postoperative period.
A

d

75
Q
  1. Which instructions would the nurse include in a teaching
    plan for a patient with mild gastroesophageal reflux
    disease (GERD)?
    a. “The best time to take an as-needed antacid is 1 to 3
    hours after meals.”
    b. “A glass of warm milk at bedtime will decrease your
    discomfort at night.”
    c. “Do not chew gum; the excess saliva will cause you to
    secrete more acid.”
    d. “Limit your intake of foods
A

a

76
Q
  1. The teaching plan for the patient being discharged after an
    acute episode of upper GI bleeding includes information
    about the importance of (select all that apply)
    a. limiting alcohol intake to 1 serving per day.
    b. only taking aspirin with milk or bread products.
    c. avoiding taking aspirin and drugs containing aspirin.
    d. only taking drugs prescribed by the health care
    provider.
    e. taking all drugs 1 hour before mealtime to prevent
    further bleeding.
A

cd

77
Q

The most appropriate therapy for a patient with acute
diarrhea caused by a viral infection is to

A

inc fluids

78
Q

In planning care for the patient with Crohn’s disease, the
nurse recognizes that a major difference between
ulcerative colitis and Crohn’s disease is that Crohn’s
disease
a. often results in toxic megacolon.
b. causes fewer nutritional deficiencies than ulcerative
colitis.
c. often recurs after surgery, while ulcerative colitis is
curable with a colectomy.
d. is manifested by rectal bleeding and anemia more often
than is ulcerative colitis.

A

c

79
Q

A patient with stage I colorectal cancer is scheduled for
surgery. Patient teaching for this patient would include an
explanation that

A

follow up colonoscopies

NCA spring (9 decks)

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