quiz 7

Question 1

how to calculate an ankle brachial index

Answer 1

higher ankle pressure on the side youre testing, divided by the higher arm pressure

Question 2

ABI ranges

Answer 2

normal: 1.00 to 1.29
borderline: 0.91 to 0.99
mid to moderate: 0.41 to 0.90
severe: less than 0.40

Question 3

procedure for ABI

Answer 3

• patient lies supine for five minutes to prepare
• BP cuff on right and left arms and an ankle
• use doppler to measure SBP in right and left arms, and right DP and PT
• then repeat on the other side

Question 4

ideal position for inspection of abdomen

Answer 4

supine with knees slightly flexed

Question 5

when assessing dressings

Answer 5

do not displace
- CDI or OTA

Question 6

visially inspect abdomen for…

Answer 6

skin color, contour, distention, dressings, dehiscence or evisceration

Question 7

borborygmi

Answer 7

loud, prolonged, gurgles sometimes associated with bowel infection

Question 8

high pitched tinkling sounds can indicate …

Answer 8

bowel obstruction

Question 9

paralytic ileus

Answer 9

• no peristalsis
• absent bowel sounds
• happens post surgery or anesthesia

Question 10

listen for ? minutes if reporting no bowel sounds

Answer 10

five minutes

Question 11

percussion over stomach or intestines should be

Answer 11

tympany

Question 12

percussion tells you…

Answer 12

organ position or massess

Question 13

patient had abd surgery : do you still palpate?

Answer 13

yes

Question 14

where is an enlarged liver palpated

Answer 14

below right rib margin

Question 15

abnormal findings

Answer 15

tenderness
masses
hernia
fluid wave
spasms of muscle wall
hematoma

Question 16

what to ask after surgery or with ileus /bowel obstruction

Answer 16

• are you passing flatus
• do you feel like eating or have hunger pains

Question 17

components of GI surgery specific assessment

Answer 17

location and size of incision

flatus? (expected to be none 24-48 hours post-op)

N/V?

abd pain or distension

NG tube to suction for decompression
- low intermittent wall suction (LIWS)
- check for low blood Na+ and K+

IV fluids
- TPN after 2-5 days NPO

Question 18

PEG tube stands for

Answer 18

percutaneous endoscopic gastrostomy tube

Question 19

if PEG tube is in jejunum…

Answer 19

less volume but continuous flow
(as opposed to bolus feedings)

Question 20

salum sump

Answer 20

used for suction

Question 21

deefing tube (dobhoff)

Answer 21

• used for tube feeding
• ND or NJ

Question 22

check residuals…

Answer 22

only if ordered

Question 23

hold TF if…

Answer 23

residual is 250mL

Question 24

colostomy/ ileostomy

Answer 24

• surgery to remove part of the intestine and bring “cuffed” end out through abd wall
• creates stoma
• difference in stool based on location

Question 25

paralytic ileus results from…

Answer 25

surgery ruptured appendicitis

Question 26

S&S of mechanical obstruction

Answer 26

- high pitched tinkling sound over bowels - hyperactive BS/visible peristalsis THEN absent bowel sounds - N/V increasingly more projectile - possible emesis w feces - abd pain, cramping, and distention

Question 27

if emesis w feces...

Answer 27

- pt will need surgery - make pt NPO

Question 28

GERD

Answer 28

gastro esophageal reflux disease - reflux of gastric secretions up into esophagus - d/t weak lower esophageal sphincter (LES)

Question 29

S&S of GERD

Answer 29

- heartburn - acidic sour taste - hoarseness and chronic cough

Question 30

most classic symptom of GERD

Answer 30

dry, unproductive chronic cough tx: PPI and H2 blockers

Question 31

hiatal hernia

Answer 31

part of the stomach passed through the hiatus in the diaph. up into the chest

Question 32

S&S of hiatal hernia

Answer 32

epigastric pain relieved by sitting upright - dysphagia-- difficulty swallowing - may be asymptomatic

Question 33

GI bleeding indicated by ...

Answer 33

bright red blood in stool or emesis

Question 34

hematochezia

Answer 34

recent bleeding in the stool sometimes called currant jelly stools by lay people

Question 35

hematemesis

Answer 35

recent bleeding in vomit

Question 36

coffee ground emesis

Answer 36

old blood

Question 37

melena

Answer 37

black, tarry stool from old blood

Question 38

occult blood

Answer 38

not visible - guaiac test

Question 39

kehr sign

Answer 39

referred shoulder pain if blood in peritoneal cavity irritates diaphragm

Question 40

lab sign for anemia

Answer 40

decreasing H&H

Question 41

severe GI bleeding...

Answer 41

hypovolemia - BP plummets - dizzy and weak - diaphoresis and tachycardia

Question 42

lower GI bleed often d/t

Answer 42

colon cancer

Question 43

signs of appendicitis

Answer 43

pain low grade fever mcburney sign pain moves from periumbilical to RLQ guarding anorexia rupture rebound tenderness (if the rupture causes peritonitis)

Question 44

mcburney sign

Answer 44

intense pain in RLQ 1/3 the distance from right iliac spine toward the belly button

Question 45

rebound tenderness is caused by...

Answer 45

peritonitis caused by a ruptured appendix

Question 46

peritonitis

Answer 46

life threatening infection of membrane lining abdomen caused by rupture of bowel or other organs