Week 6 - Assessment & Study Questions

Question 1

what should you assess regarding the mouth

Answer 1

• anything that interferes with ingestion

- abnormal tissue/growths

Question 2

what should you assess regarding the esophagua

Answer 2

signs of GERD and cancer:

• dysphagia
• dyspepsia
• bleeding (frank)

Question 3

list the symptoms for a small bowel obstruction

Answer 3

• NV
• crampy abdominal pain
• feces (short time)

Question 4

list the symptoms for a large bowel obstruction

Answer 4

• distension
• obstipation
• crampy abdominal pain

Question 5

what should you inspect regarding the stomach

Answer 5

• comfort
• symmetry
• contour
• movement
• tender
• rigid?

Question 6

what two types of stomach contour correlate with distension

Answer 6

• rounded

- protuberant

Question 7

what possible inspection findings could be found during abdominal assessment

Answer 7

• striae
• scars
• petechiae
• angiomas
• moles
• pulsations or peristalsis

Question 8

what are peteachiae

Answer 8

• pinpoint, round red or purple spots on the skin as a sign of bleeding

Question 9

what does petechiae in the face indicate

Answer 9

• excessive vomiting

Question 10

what is cullen’s sign? what does it indicate

Answer 10

• bruising around the umbilicus

- indicates intrabdominal bleeding

Question 11

what is grey turner’s sign? what does it indicate?

Answer 11

• bruising around the flanks

- indicates intra-abdominal or retroperitoneal bleeding

Question 12

what should you assess during auscultation of the stomach?

Answer 12

• BS

- vascular sounds

Question 13

what should you assess regarding BS

Answer 13

• location
• character
• frequency
• changes

Question 14

what should you assess regarding vascular signs

Answer 14

• bruit? (not normal)

Question 15

what should you assess during percussion

Answer 15

• abdominal contents
• location & size of organs (such as the liver)
• screen for abnormalities

Question 16

what should you assess during palpation

Answer 16

• tenderness
• firmness
• rebound tenderness
• guarding
• involuntary rigidity
• grimacing

Question 17

what does involuntary rigidity indicate

Answer 17

• peritonitis

Question 18

what does rebound tenderness indicate

Answer 18

• peritonitis

- appendicitis (if the peritoneum is involbed)

Question 19

list reasons why we may do a rectal exam

Answer 19

• screening (such as for prostate health)

- impaction

Question 20

what is a common position for pt to be in during rectal exam

Answer 20

• left lateral decubitus (laying on L side with top leg bent)

Question 21

what should the prostate feel like during a rectal exam

Answer 21

• smooth

Question 22

what are common GI diagnostics

Answer 22

• radiology
• abdominal US
• abdominal CT scan
• abdominal MRI
• endoscopy

Question 23

what radiology test is used for upper GI tract

Answer 23

• barium swallow

Question 24

describe how barium swallow works

Answer 24

• pt drinks contrast (barium) which coats the upper GI tract allowing better detail
• contrast is then passed in stool

Question 25

what does the stool look like following barium swallow

Answer 25

- white | - constipating

Question 26

what does barium swallow of the upper GI tract allow

Answer 26

can examine: - esophagus - stomach - start of duodenom

Question 27

what must a pt be prior to an upper GI series

Answer 27

- pt must be NPO

Question 28

what radiology test is used for the small intestine

Answer 28

- barium

Question 29

describe the use of barium for the small intestine

Answer 29

- pictures q30 min as it passes into and thru the small bowel

Question 30

what is a nursing priority prior to using barium in the small intstine

Answer 30

- must be NPO prior

Question 31

what radiology test is used for lower GI series

Answer 31

- barium enema + purgatives

Question 32

what type of barium is used for lower GI

Answer 32

- enema | - air contrast barium enema

Question 33

what are purgatives

Answer 33

- type of laxative that helps clear the lower GI tract

Question 34

what is an example of a purgative

Answer 34

GoLytelyy

Question 35

should pts be NPO prior to lower GI series?

Answer 35

- yes

Question 36

who are abdominal MRIs contraindicated in?

Answer 36

- pregnant pts | - pts with metal

Question 37

what is a MRI

Answer 37

- imaging technique that uses radiofrequency waves & magnetic field

Question 38

what is a CT scan

Answer 38

- imaging technique that uses radiological exposure

Question 39

what is one thing to note regarding CT scan

Answer 39

- can be nephrotoxic | - so assess u/o

Question 40

what is a gastroscopy

Answer 40

- EGD | - can see esophagus, stomach, and duodenom

Question 41

what is the prep for gastrscopy

Answer 41

- NPO

Question 42

what is a colonoscopy

Answer 42

- endoscopy that allows you to visualize the colon up to the ileocecal valve with flexible scope

Question 43

what is prep for a colonscopy

Answer 43

- NPO & purgative

Question 44

what is a sigmoidscopy

Answer 44

- endoscopy that allows you to visualize the rectum & sigmoid colon

Question 45

what is prep for a sigmoidoscopy

Answer 45

- NPO & purgative

Question 46

what is a capsule endoscopy

Answer 46

- pt swallows a disposable video camera | - as cam passes thru the intestine images are transmitted via radiofrequency

Question 47

what is a capsule endoscopy useful for

Answer 47

- visualizing sections of the small bowel that is difficult to reach w endoscopy

Question 48

what is a laparoscopy

Answer 48

- surgery that uses a thin, lighted tube put thru a cut in the belly to look at the abdominal organs or female pelvic organs

Question 49

what can a laparoscopy be used for

Answer 49

- taking tissue samples - performing procedures - or inspection

Question 50

what can a laparoscopy detect

Answer 50

- cysts - adhesions - fibroids - infection

Question 51

what is a laparotomy

Answer 51

- open procedure where the stomach is opened up to look at things you cannot see with a laproscopy

Question 52

what is a colectomy

Answer 52

- partial or complete removal of the colon

Question 53

describe what a normal stoma looks like

Answer 53

- pink - rose to brick red (indicates good blood flow) - raised

Question 54

describe what an abnormal stoma looks like

Answer 54

- pale pink - blanching, dark red to purple - edema - bleeding - prolapse or concave

Question 55

what does pale pink stoma indicate

Answer 55

- possible anemia

Question 56

what does a blanching, dark red to purple stoma indicate

Answer 56

- inadequate blood supply

Question 57

what amount of edema is normal vs not

Answer 57

- mild may be normal | - change may be due to trauma or abstruction

Question 58

what amount of bleeding is normal vs not

Answer 58

- small amount normal | - moderate to large may indicate trauma, coagulation problem, lower GI bleeding

Question 59

during your physical assessment of a pt with crohn's disease you notice red, painful nodules on their legs & the skin on their abdomen is inflamed. You recognize these findings as

Answer 59

- a systemic complication associated with active inflammation

Question 60

what percentage of pts with an exacerbation of UC go into remission with conservative therapy (meds) and nursing management

Answer 60

80%

Question 61

what is the significance of cullen's and grey turner's sign

Answer 61

- sign of pancreatitis | - result from seepage of blood-stained exudate from the pancreas

Question 62

what type of bowel sounds would you expect to hear in diarrhea? constipation?

Answer 62

- diarrhea = hyperactive | - constipation = decreased

Question 63

why are immunosuppressant and immunomodulatory drugs used for IBD

Answer 63

- for severe cases - if pt has failed to respond to other drugs - before surgery is considered