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Flashcards in Targeted M-S GI Deck (28)
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Pword= 63F5466T57


Ax-ing p with Crohn's disease. WOTF is expected?
a. fatty, diarrheal stools
b. hyperkalemia
c. wt gain
d. sharp epigastric pain

a. fatty, diarrheal stools or steatorrhea is a sign of Crohn's disease along with wt loss, possible hypokalemia, and RLQ pain.


P. w/ colorectal CA is receiving chemotherapy. P asks why blood is being drawn for a carcinoembryonic antigen (CEA) level?
a. CEA determines the current stage of colon CA
b. CEA determines the efficacy of your chemo
c. CEA determines if neutrophil count is below the expected reference range.
d. CEA determines if you are experiencing occult bleeding from the GI tract.

b. CEA determines the efficacy of chemotherapy


P postop gastrectomy. WOTF indicate acute gastric dilation?
a. hiccups
b. elevated bp
c. bradycardia
d. LLQ pain

a. hiccups, hypotension, tachycardia and epigastric pain are all indicative of acute gastric dilation


P w/ peritonitis. WOTF is an expected sign?
a. bloody diarrhea
b. board-like abdomen
c. periumbilical cyanosis
d. increased bowel sounds

b. a board like abdomen is a classic sign of peritonitis. This condition is a life-threatening infla of the visceral/parietal peritoneum and endothelial lining of the abd. cavity that leads to blocked peristalsis and major fluid accumulation. There is a high risk for septicemia. Other S&S= abd pain/distention, N/V, anorexia, decreased bowel sounds, rebound tenderness, inability to pass flatus or BMs, hiccups, tachy-c.


periumbilical cyanosis is a sign of?

intraperitoneal hemorrhage


Expected axmt finding for a p w/ acute hep B?
a. joint pain
b. obstipation
c. abdominal distention
d. periumbilical discoloration

a. joint pain


(MM) Expected axmt findings for a p w/ appendicitis?
a. oral T 101.1 degrees
b. WBC 6000/mm3
c. bloody diarrhea
d. N/V
e. RLQ pain

a, d, and e: fever, n/v and RLQ pain are S&S of appendicitis (along with an increased WBC count)


WOTF is the priority for the RN to report for a p w/ cirrhosis?
a. spider angiomas
b. peripheral edema
c. bloody stools
d. jaundice

c. bloody stools. The greatest risk to p's with cirrhosis is hemorrhaging r/t esophageal varices. Cirrhosis causes increased pressure in the portal vein which leads to back up of bld and swollen/dilated vessels that can rupture


POC for p w/ cirrhosis and ascites. Include WOTF?
a. measure abd girth daily
b. give warfarin at the same time each day
c. provide a daily intake of 4g of sodium
d. assess breath sounds q12h

a. mx abd girth daily


WOTF should RN expect to find in a p w/ a duodenal ulcer?
a. p c/o of painful spasms in the RLQ
b. p describes the pain as pressure felt in the epigastrium
c. p states the pain occurs as soon as food enters the stomach
d. p states the pain occurs 1.5-3 hr pc and during the night.

d. duodenal ulcers cause pain hours pc and during the night, midline b/w xiphoid process and the umbilicus


d/c teaching to a p w/ an ileostomy. WOTF should RN tell p to report?
a. intolerance to high fiber foods
b. liquid ileostomy output
c. dark purple stoma
d. sensation of burning during bowel elimination

c. a dark purple stoma indicates inadequate circulation


Expected lab values for a p w/ colorectal CA?
a. negative fecal occult blood test
b. decreased serum CEA level
c. Hct 43%
d. hgb 9.1 g/dL

d. hgb 9.1. Hgb and hct are low in p's with colorectal CA due to bleeding, while fecal occult bld tests are positive. Also, the CEA is increased


d/c teaching for p w/ GERD. WOTF ind teaching effective?
a. I will decrease the amt of carbonated bvgs I drink
b. I will avoid liquids for 30 minutes after taking a chewable antacid tab
c. I will eat a snack before going to bed
d. I will lie down for at least 30 minutes after eating each meal

a. avoid carb bvgs to reduce GI acid. Also, p should take antacids with water, eat 4-6 small meals/day, sit up for 1-2 hours pc, and avoid eating before bedtime


P. w/ cirrhosis and new rx for lactulose. Include in teaching?
a. notify the provider if bloating occurs
b. expect to have 2-3 soft stools/day
c. restrict carbohydrates in the diet
d. limit oral fluid intake to 1000 mL/day of clear liquids

b. lactulose is given to promote defecation (which excretes ammonium ions)


Admitting p w/ acute pancreatitis. First action RN should take?
a. insert a NG tube
b. give ceftazidime
c. ID the p's current level of pain
d. instruct the p to remain NPO

c. determines the p's pain level, then have p remain NPO, later: give antibiotics and insert NG tube if necessary for gastric decompression


Assessing a p after a paracentesis to tx ascites. WOTF ind. the procedure was effective?
a. presence of a fluid wave
b. increased HR
c. equal pre- and post-procedure weights
d. decreased SOB

d. decreased SOB


Food recommendation for a p w/ a new colostomy that is worried about flatus/odor?
a. eggs
b. fish
c. yogurt
d. broccoli

c. yogurt


D/c teaching for a p w/chronic Hep. C. WOTF indicates understanding?
a. I will avoid alcohol until im no longer contagious
b. I will avoid meds containing acetaminophen
c. I will decrease my intake of calories
d. I will need txmt for 3 months

b. I will avoid meds containing acetaminophen


WOTF lab results of a p w/ hepatic cirrhosis should be reported to the HCP?
a. Albumin 4.0
b. INR 1.5
c. bilirubin 0.2mg/dL
d. ammonia 180 mcg/dL

d. normal ammonia levels are 10-80 mcg/dL


Instructions to include in the POC to minimize further exacerbations of UC for a p who has experienced several? (MM)
a. use progressive relaxation techniques
b. increase dietary fiber intake
c. drink two 240 mL glasses of milk/day
d. arrange activities to allow for daily rest periods
e. restrict intake of carbonated bvgs

a d and e. Ps should be told to use relaxation techniques and allow for daily rest periods to reduce stress. Also, they should restrict carbonated bvgs, fiber, and dairy products in their diet.


P w/ GERD has new rx for metoclopramide, RN plans to mon for WOTF AEs?
a. thrombocytopenia
b. hearing loss
c. hypotension
d. ataxia

d. ataxia, metoclopramide can cause EPS like symptoms bc it is a dopamine2 receptor antagonist


Acute pancreatitis expected lab value?
a. BS 110
b. increased serum amylase
c. WBC 9000/mm3
d. decreased bilirubin

b. increased serum amylase


D/C teaching for a p who has gastritis and a new rx for famotidine (Pepcid). WOTF statements ind effectiveness?
a. I should make sure the water I drink is filtered
b. I should expect immediate pain relief
c. I will drink iced tea with my meals and snacks
d. I will mon my BS level regularly while taking this med

a. make sure the water is filtered.


Chronic cholecystitis food recommendations?
a. unsalted nuts
b. bologna
c. cheddar cheese
d. bananas

d. bananas- the p needs to consume low fat foods to prevent exacerbations


Teaching r/t preparing for a colonoscopy should include?
a. begin drinking oral liquid prep for bowel cleansing the morning of the proc
b. drink full liquids for breakfast the day of the proc
c. drink clear liquids for 24 hr prior to the proc, then NPO for 6 before the procedure.
d. drink the oral liquid prep for bowel cleansing slowly



RN is assessing a p w/ an upper GI bleed. WOTF is expected?
a. hypoactive bowel sounds
b. epigastric pain
c. hypotension
d. pernicious anemia

c. hypotension


P w/ hepatic encephalopathy. P asks for larger portion of beef for dinner, WOTF is the correct response?
a. beef is too high in fat, but I can request chicken
b. you need to increase your fluid intake, Would you like beef and noodle soup?
c. you should limit your animal protein intake, can I get you a veggie burger instead?
d. you need to limit calories. Would you like some sugar-free gelatin?