Week 5 - Assessment & Study Questions

Question 1

what should be asked regarding general abdominal health history questions

Answer 1

questions regarding:

• appetite
• nutritional status
• meds
• ETOH/smoking
• activity lvls
• anxiety/stressors
• toxin exposure
• traveling
• past or present illness
• past surgeries
• FHx
• scars & adhesions

Question 2

what should you ask regarding appeitite

Answer 2

• any recent changes
• loss or gain
• anorexia

Question 3

what could unintentional lost weight indicate?

Answer 3

• cancer

Question 4

what could rapid weight gain indicate

Answer 4

• renal or heart failure

Question 5

what should you assess regarding nutritional status

Answer 5

• healthy weight?
• undernourished?
• overweight?
• allergies?
• food intolerances?
• 24 hr recall and ask abt normal food intake

Question 6

list 3 meds that impact GI and how

Answer 6

• NSAIDs (inhibit mucus production)
• opioids (constipation)
• anticholinergic (constipation)

Question 7

why is it important to ask abt smoking

Answer 7

correlates with:

• ulcers
• cancers
• gastritis

Question 8

what should we assess regarding the head

Answer 8

• lips
• teeth
• gums
• inside mouth
• neck

Question 9

what is dysphagia

Answer 9

• difficulty swallowing

Question 10

what can cause dysphagia

Answer 10

• neuromuscular dysfunction
• structural abnormality
• stomach cancer

Question 11

what is a risk associated with dysphagia

Answer 11

• lack of gag reflex = risk of aspiration

Question 12

what is pyrosis

Answer 12

• heart burn

Question 13

what is dyspepsi

Answer 13

• burning or indigestion

Question 14

what does dyspepsi occur with

Answer 14

• ulcers

- gastritis

Question 15

what is odynophagia

Answer 15

• painful swallowing

Question 16

what is odynophagia associated with

Answer 16

• strept throat

Question 17

what is eructation

Answer 17

• belching

Question 18

what does the nurse need to be aware of when a pt is taking omeprazole

Answer 18

• it is generally well tolerated with few side effects

- provides good relief of GERD

Question 19

what should we assess regarding nausea

Answer 19

• origin
• OPQRSTU
• alone or w vomitting/diarrhea/anorexia
• related to med/intake/activity?
• effective tx

Question 20

what does short term vomiting cause? long term

Answer 20

short = metabolic alkalosis
long = metabolic acidosis

Question 21

what could projectile vomiting w/o warning indicate

Answer 21

• brain injury

- obstruction

Question 22

list symptoms of aspiration pneumonia

Answer 22

• decreased air entry
• hypoxia
• sob
• febrile
• systemic sighs
• productiv cough
• adventitia

Question 23

what should we assess regarding vomiting

Answer 23

• alone or w nausea
• does it contain bile, food, meds
• dry heave or retch
• projectile, any warning
• r/t to meds/intake/activity?
• effective tx

Question 24

what is hematemesis

Answer 24

• vomting blood

Question 25

what is hemoptysis

Answer 25

- coughing blood

Question 26

what is "frank red" hematemesis

Answer 26

- fresh, red, and undigested blood | - due to cause above the stomach

Question 27

what is "coffe ground" emesis

Answer 27

- partially digested blood | - comes from stomach

Question 28

what should you assess regarding hematemesis

Answer 28

- frank red vs coffee ground - associated symptoms - volume loss (slow vs fast) - meds - history of esophageal varices, gastritis, peptic ulcers - BP/HR, PT, PTT, aPTT, INR

Question 29

what are esophageal varices

Answer 29

- enlarged veins in the esophagus

Question 30

`what should you assess regarding BM

Answer 30

- last BM - characteristics of the bowel - meds that might effect BM - control (continent or not) - flutulence

Question 31

what is a test for occult blood

Answer 31

- fecal occult blood test

Question 32

what should you assess regarding abdominal symptoms

Answer 32

- OPQRSTU - guarding - rigidity - descriptors

Question 33

what does rigidity commonly occur with

Answer 33

- peritonitis

Question 34

what are two types of alternate nutrition

Answer 34

- enteral | - parental

Question 35

list 4 types/reasons for stool samples

Answer 35

- fecal analysis - fecal occult blood - stool for C&S - stool for ova & parasites

Question 36

what is a stool culture particulary done for

Answer 36

- clostridium difficile

Question 37

what does a fecal analysis tell us

Answer 37

- any mucus, blood, pus, parasites, & fat content

Question 38

what are two ways to test for h.pylori

Answer 38

- blood work | - breath testing

Question 39

list 3 things assessed in blood work r/t to the GI tract

Answer 39

- amylase - lipase - gastrin

Question 40

why do we assess amylas

Answer 40

- measures secretion of amylase by pancreas | - imp in diagnosing acute pancreatitis

Question 41

why do we assess lipase

Answer 41

- measures secretion of lipase by pancreas | - levels stay elevated longer than amylase

Question 42

what is assessed in liver fnxn test

Answer 42

- serum bilirubin - albumin - ammonia

Question 43

what does serum bilirubin tell us

Answer 43

- ability of the liver to form & excrete bilirubin (bile)

Question 44

why do we assess albumin in liver fnxn tests

Answer 44

- measures the ability of the liver to produce serum proteins

Question 45

why do we assess ammonia in liver fnxn test

Answer 45

- conversion of ammonia to urea commonly occurs in the liver

Question 46

why do we assess a pt's lipid profile? what's included?

Answer 46

- tells us abt the liver's function | - includes cholestrol, LDL, HDL, triglycerides

Question 47

what is an EGD

Answer 47

- esophagogastroduodenoscopy

Question 48

describe how to prep a pt for an EGD

Answer 48

- must be NPO for 8 hr before

Question 49

what is important to consider post-EGD

Answer 49

- must be NPO until gag reflex comes back (risk of aspiration) - monitor temp

Question 50

what is sucralfate used for in the context of peptic or duodenal ulcers

Answer 50

- binds to the base of gastric ulcers to form a protective layer that facilitates tissue healing

Question 51

what is the purpose of bismuth subsalicyclate

Answer 51

- neutralizes bacteria by binding to them & causing them to be expelled in the stool

Question 52

what is diphenoxylate and atropine

Answer 52

- a combo of an opiate drug and an anticholinergic drug which can slow the GI tract by two different mechanisms

Question 53

what is the MOA of psyllium mucilloid

Answer 53

- it is a non-absorbable, non-digestible substance that absorbs water & increases bulk in the feces

Question 54

what is a major nursing consideration when administering a hyperosmotic laxative

Answer 54

- must ensure they have adequate fluid intake as these meds pull water into the intestines and can cause dehydration

Question 55

how does bisacodyl work to treat constipation

Answer 55

- it is a direct stimulant of intestinal nerves which causes an increase in peristalsis