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NCLEX > GI Disorders > Flashcards

GI Disorders Flashcards

1
Q

Liver biopsy steps (5)

A
  • Get informed consent
  • Assess coagulation studies
  • NPO 8-10 hours before procedure
  • Position on affected side to promote hemostasis
  • Monitor for bleeding complications
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2
Q

Paracentesis steps (9)

A
  • Have patient void
  • Get baseline vitals
  • Position upright
  • Give mild sedation
  • Give prescribed IV fluids/albumin to restore fluid balance (4-6 L can be drained)
  • Monitor vitals
  • Record weight before/after procedure
  • Measure abdominal girth before/after procedure
  • Assess lab profile before/after procedure (albumin, amylase, protein, BUN, creatinine)
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3
Q

Nasogastric tubes (2)

A
  • Levin
  • Salem sump
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4
Q

Levin NG tube

A

Single lumen

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5
Q

Salem sump

A

Double lumen

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6
Q

Levin tube purpose

A

Decompress stomach

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7
Q

Levin/salem sump nursing interventions (4)

A
  • Elevate head of bed
  • Verify placement
  • Provide frequent mouth care
  • Maintain NPO
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7
Q

Salem sump tube purpose

A

Obtain specimens for analysis

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8
Q

Miller-Abbott tube

A

Double lumen

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9
Q

Miller-Abbott tube purpose

A

Small bowel suction

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10
Q

Miller-Abbott nursing interventions (4)

A
  • Reposition every hour
  • Don’t tape tube to nose
  • Monitor advancement of tube
  • Assess color of gastric contents
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11
Q

Sengstaken-Blakemore tube

A

Triple lumen

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12
Q

Sengstaken-Blakemoore purposes

A
  • Treatment of esophageal varices
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13
Q

Sengstaken-Blakemoore nursing interventions (3)

A
  • Monitor for respiratory distress
  • Keep scissors at bedside
  • Monitor for signs of shock
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14
Q

Gastric pH

A

1.5-4

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15
Q

Intestinal aspirate pH

A

6

16
Q

Respiratory aspirate pH

A

7 or higher

17
Q

Small bore NG tube steps (6)

A
  • Use x-ray to verify placement
  • Assess gastric pH before each feeding, every 4 hours for continuous feedings
  • Maintain semi fowler’s while feeding is infusing
  • Assess residual in stomach and reffed residual unless it exceeds the maximum
  • Provide nose/mouth care
  • Replace tube every 4 weeks
18
Q

Small bore NG tube inserted through skin nursing interventions (5)

A
  • Obtain x-ray to determine placement
  • Assess length of exposed tubing (tube migration)
  • Assess placement prior to feeding using intestinal pH
  • Maintain semi fowler’s position
  • Assess residual (greater volume = upward migration)
19
Q

Percutaneous Endoscopic Gastrostomy (PEG) tube nursing interventions (5)

A
  • Assess skin integrity
  • Assess residual volume
  • Feeding infuse slowly
  • Flush with 30 ml warm water before/after feeding
  • Maintain semi fowler’s 1-2 hours after feeding
20
Q

TPN nursing interventions (10)

A
  • Confirm placement using x-ray
  • Monitor central line insertion site for signs of local infection
  • Strict surgical asepsis for dressing changes (every 72 hours)
  • Change tubing and remaining TPN every 24 hours
  • Monitor for signs of systemic infection
  • Monitor glucose, electrolytes, fluid balance
  • Prevent air embolism
  • Use infusion pump
  • Keep 10% dextrose/water available
  • For patients receiving fat emulsions monitor for fat overload syndrome
21
Q

S/S of fat overload syndrome (4)

A
  • Fever
  • Increased triglycerides
  • Clotting problems
  • Multi-system organ failure
22
Q

Hepatitis A mode of transmission (3)

A
  • Fecal oral
  • Person to person
  • Food/water contamination
23
Q

Hepatitis B mode of transmission (4)

A
  • Unprotected sex
  • Sharing needles
  • Needle sticks
  • Blood products, organ transplants before 1992
24
Q

Hepatitis C mode of transmission (4)

A
  • Blood to blood
  • Illicit IV drug sharing
  • Unprotected sex
  • Blood products, organ transplant before 1992
25
Q

Hepatitis A manifestations (3)

A
  • Mild
  • Flu-like s/s
  • Older age, chronic disease increase severity
26
Q

Hepatitis B manifestations (9)

A
  • Asymptomatic
  • RUQ pain
  • Anorexia
  • N/V
  • Fatigue
  • Febrile
  • Dark urine
  • Light colored stool
  • Jaundice
27
Q

Hepatitis C manifestations (3)

A
  • Asymptomatic
  • Diagnosed with blood test
  • Chronic inflammation progresses to cirrhosis
28
Q

Hepatitis A prevention (2)

A
  • Hand washing
  • Vaccine for 2 years old and older 2 doses 6-18 months apartH
29
Q

Hepatitis B prevention (1)

A
  • Vaccine for infants and high risk populations with 3 doses over 6 month period
30
Q

Hepatitis C prevention (1)

A
  • Avoid high risk behaviors
31
Q

Hepatitis A treatment (2)

A
  • Symptom specific
  • May change medications to give liver a break
32
Q

Hepatitis B/C treatment (3)

A
  • Anti-viral meds
  • Give peginterferon alfa-2B (Pegintron)
  • Monitor kidney function

NCLEX (40 decks)

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