GI/GU

Question 1

What are the diagnostic tools for Appendicitis?

Answer 1

• CBC
• Ultrasound
• Urinalysis

Question 2

What is the uncomplicated medical management of Appendicitis?

Answer 2

• 7 to 10 days of antibiotics
• careful follow up

Question 3

What is the complicated medical management of Appendicitis?

Answer 3

• surgical removal
• rupture = EMERGENCY

Question 4

What are the pre-op nursing interventions for Appendicitis?

Answer 4

• I/O
• Vital Signs
• NPO
• Pain management
• IV fluids

Question 5

What are the post-op interventions for Appendicitis?

Answer 5

• Ambulation (prevention of blood clots, atelectesis)
• Incentive spirometer, cough, deep breathing (prevent atelectesis)
• Clear liquid diet
• Assess for bowel sounds (GI assessment)
• Flatulence (gas passage)
• Pain management
• Prevent infection (wound care)
• IV and oral hydration

Question 6

Upper UTI consists of:

Answer 6

ureters and kidneys

Question 7

Lower UTI consists of:

Answer 7

Bladder and urethra

Question 8

Who is at risk for UTI development?

Answer 8

• individual with penis (prostate issues, less common)
• patient with dehydration
• immunosuppressed patient
• underweight individual (malnutrition)
• older adult
• foley catheter (common)
• renal calculi

Question 9

What are the S/S of UTI? Common vs lower UTI

Answer 9

• frequency (common)
• pain (common)
• burning (lower)
• discharge (lower)
• pelvic pressure (lower)
• lower ab discomfort (lower)
• pain with urination (lower)
• blood in urine (lower)

Question 10

What are the diagnostic testing and treatment for lower UTI?

Answer 10

• Broad-spectrum antibiotic (ex. ciprofloxacin) for 3-5 days
• pain relief
• increase urine intake
• Urine culture
• Urinalysis

Question 11

What is the treatment for Acute Pyelonnephritis?

Answer 11

• antibiotics (empiric –> culture)
• fluids
• manage fever and pain
• monitor for new symptoms

Question 12

What do you want to teach the patient to treat UTIs?

Answer 12

• encourage fluid intake
• evaluate diet
• COMPLETE all antibiotics (drug therapy)
• control pain
• when to notify provider

Question 13

What do you avoid in regards to UTI?

Answer 13

• restrictive clothing
• holding urine
• scented products

Question 14

What do you promote regarding UTIs?

Answer 14

• proper wiping
• shower vs bath
• cranberry juice
• void after intercourse

Question 15

Populations at risk for Kidney Stones, name some of them

Answer 15

• situations where there is high solute load (ex dehydration)
• high acidity (diabetes)
• alkalinity: high pH, calcium & phosphate
• gastric bypass surgery (enhances oxalates)
• most common: calcium oxalate

Question 16

What are the symptoms of Kidney Stones?

Answer 16

• sudden lower back, groin, and flank pain
• unable to sit still
• accompanied by UTI - fever/pain/chills

Question 17

What diagnostic tests are used for Renal Calculi?

Answer 17

• XRAY
• Urinalysis

Question 18

How how Renal Calculi managed?

Answer 18

• could let them pass
• lithotripsy (breaks down the stones)

Question 19

What is the patient teaching for Kidney Stones?

Answer 19

• pain medication
• evaluate diet

Question 20

JR is a 28 year old male with abdominal pain, nausea, and a low-grade fever. Initially had pain near the umbilicus 12hrs ago but is now localized to the RLQ. Loss of appetite and feeling more tired than usual. VS: BP 128/78, Temp 100.4 F, HR 90 bpm, RR 19 bpm - Tenderness at RLQ, + Rovsings, + Blumberg sign - What is wrong with the patient?

Answer 20

Acute Appendicitis - ruptured, infection, complicated

Question 21

What is the plan of care for a patient with acute appendicitis?

Answer 21

• surgical team consult
• pre-op care
• pain management
• monitor for sings of complications
• pt/family education