Week 5 - Assessment & Study Questions Flashcards
(55 cards)
1
Q
what should be asked regarding general abdominal health history questions
A
questions regarding:
- appetite
- nutritional status
- meds
- ETOH/smoking
- activity lvls
- anxiety/stressors
- toxin exposure
- traveling
- past or present illness
- past surgeries
- FHx
- scars & adhesions
2
Q
what should you ask regarding appeitite
A
- any recent changes
- loss or gain
- anorexia
3
Q
what could unintentional lost weight indicate?
A
- cancer
4
Q
what could rapid weight gain indicate
A
- renal or heart failure
5
Q
what should you assess regarding nutritional status
A
- healthy weight?
- undernourished?
- overweight?
- allergies?
- food intolerances?
- 24 hr recall and ask abt normal food intake
6
Q
list 3 meds that impact GI and how
A
- NSAIDs (inhibit mucus production)
- opioids (constipation)
- anticholinergic (constipation)
7
Q
why is it important to ask abt smoking
A
correlates with:
- ulcers
- cancers
- gastritis
8
Q
what should we assess regarding the head
A
- lips
- teeth
- gums
- inside mouth
- neck
9
Q
what is dysphagia
A
- difficulty swallowing
10
Q
what can cause dysphagia
A
- neuromuscular dysfunction
- structural abnormality
- stomach cancer
11
Q
what is a risk associated with dysphagia
A
- lack of gag reflex = risk of aspiration
12
Q
what is pyrosis
A
- heart burn
13
Q
what is dyspepsi
A
- burning or indigestion
14
Q
what does dyspepsi occur with
A
- ulcers
- gastritis
15
Q
what is odynophagia
A
- painful swallowing
16
Q
what is odynophagia associated with
A
- strept throat
17
Q
what is eructation
A
- belching
18
Q
what does the nurse need to be aware of when a pt is taking omeprazole
A
- it is generally well tolerated with few side effects
- provides good relief of GERD
19
Q
what should we assess regarding nausea
A
- origin
- OPQRSTU
- alone or w vomitting/diarrhea/anorexia
- related to med/intake/activity?
- effective tx
20
Q
what does short term vomiting cause? long term
A
short = metabolic alkalosis long = metabolic acidosis
21
Q
what could projectile vomiting w/o warning indicate
A
- brain injury
- obstruction
22
Q
list symptoms of aspiration pneumonia
A
- decreased air entry
- hypoxia
- sob
- febrile
- systemic sighs
- productiv cough
- adventitia
23
Q
what should we assess regarding vomiting
A
- 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
24
Q
what is hematemesis
A
- vomting blood
25
what is hemoptysis
- coughing blood
26
what is "frank red" hematemesis
- fresh, red, and undigested blood
| - due to cause above the stomach
27
what is "coffe ground" emesis
- partially digested blood
| - comes from stomach
28
what should you assess regarding hematemesis
- 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
29
what are esophageal varices
- enlarged veins in the esophagus
30
`what should you assess regarding BM
- last BM
- characteristics of the bowel
- meds that might effect BM
- control (continent or not)
- flutulence
31
what is a test for occult blood
- fecal occult blood test
32
what should you assess regarding abdominal symptoms
- OPQRSTU
- guarding
- rigidity
- descriptors
33
what does rigidity commonly occur with
- peritonitis
34
what are two types of alternate nutrition
- enteral
| - parental
35
list 4 types/reasons for stool samples
- fecal analysis
- fecal occult blood
- stool for C&S
- stool for ova & parasites
36
what is a stool culture particulary done for
- clostridium difficile
37
what does a fecal analysis tell us
- any mucus, blood, pus, parasites, & fat content
38
what are two ways to test for h.pylori
- blood work
| - breath testing
39
list 3 things assessed in blood work r/t to the GI tract
- amylase
- lipase
- gastrin
40
why do we assess amylas
- measures secretion of amylase by pancreas
| - imp in diagnosing acute pancreatitis
41
why do we assess lipase
- measures secretion of lipase by pancreas
| - levels stay elevated longer than amylase
42
what is assessed in liver fnxn test
- serum bilirubin
- albumin
- ammonia
43
what does serum bilirubin tell us
- ability of the liver to form & excrete bilirubin (bile)
44
why do we assess albumin in liver fnxn tests
- measures the ability of the liver to produce serum proteins
45
why do we assess ammonia in liver fnxn test
- conversion of ammonia to urea commonly occurs in the liver
46
why do we assess a pt's lipid profile? what's included?
- tells us abt the liver's function
| - includes cholestrol, LDL, HDL, triglycerides
47
what is an EGD
- esophagogastroduodenoscopy
48
describe how to prep a pt for an EGD
- must be NPO for 8 hr before
49
what is important to consider post-EGD
- must be NPO until gag reflex comes back (risk of aspiration)
- monitor temp
50
what is sucralfate used for in the context of peptic or duodenal ulcers
- binds to the base of gastric ulcers to form a protective layer that facilitates tissue healing
51
what is the purpose of bismuth subsalicyclate
- neutralizes bacteria by binding to them & causing them to be expelled in the stool
52
what is diphenoxylate and atropine
- a combo of an opiate drug and an anticholinergic drug which can slow the GI tract by two different mechanisms
53
what is the MOA of psyllium mucilloid
- it is a non-absorbable, non-digestible substance that absorbs water & increases bulk in the feces
54
what is a major nursing consideration when administering a hyperosmotic laxative
- must ensure they have adequate fluid intake as these meds pull water into the intestines and can cause dehydration
55
how does bisacodyl work to treat constipation
- it is a direct stimulant of intestinal nerves which causes an increase in peristalsis
