Podcast
Questions and Answers
Which of the following is a modifiable risk factor for coronary artery disease (CAD)?
Which of the following is a modifiable risk factor for coronary artery disease (CAD)?
- Age
- Family history
- Gender
- High blood pressure (correct)
A patient is experiencing predictable chest pain during exertion that is relieved by rest. What condition is MOST likely causing this pain?
A patient is experiencing predictable chest pain during exertion that is relieved by rest. What condition is MOST likely causing this pain?
- Myocardial infarction (MI)
- Pulmonary embolism
- Aortic dissection
- Chronic stable angina (correct)
During angiography, which finding would be MOST indicative of coronary artery disease (CAD)?
During angiography, which finding would be MOST indicative of coronary artery disease (CAD)?
- Decreased heart rate
- Elevated cardiac enzymes
- Arterial blockages visualized with contrast dye (correct)
- Normal blood pressure
Following a cardiac angiography, what is the MOST important nursing intervention to prevent complications?
Following a cardiac angiography, what is the MOST important nursing intervention to prevent complications?
Which of the following lab results would be expected in a patient experiencing a myocardial infarction (MI) but NOT in a patient with chronic stable angina?
Which of the following lab results would be expected in a patient experiencing a myocardial infarction (MI) but NOT in a patient with chronic stable angina?
A patient reports sudden, intense chest pain radiating to the left arm, accompanied by nausea and sweating. Which condition is MOST likely?
A patient reports sudden, intense chest pain radiating to the left arm, accompanied by nausea and sweating. Which condition is MOST likely?
Which non-modifiable risk factor places an individual at higher risk for coronary artery disease (CAD)?
Which non-modifiable risk factor places an individual at higher risk for coronary artery disease (CAD)?
What pathophysiological process underlies most cases of coronary artery disease (CAD)?
What pathophysiological process underlies most cases of coronary artery disease (CAD)?
Why is it important to assess kidney function (BUN, creatinine) prior to a cardiac angiography?
Why is it important to assess kidney function (BUN, creatinine) prior to a cardiac angiography?
Which diagnostic test is considered the 'gold standard' for detecting coronary artery blockages?
Which diagnostic test is considered the 'gold standard' for detecting coronary artery blockages?
Following a cardiac stress test, a patient reports chest pain and shortness of breath. What is the IMMEDIATE next step?
Following a cardiac stress test, a patient reports chest pain and shortness of breath. What is the IMMEDIATE next step?
A patient with a history of chronic stable angina is prescribed nitroglycerin. How should the patient be instructed to take this medication when experiencing chest pain?
A patient with a history of chronic stable angina is prescribed nitroglycerin. How should the patient be instructed to take this medication when experiencing chest pain?
What is the primary reason for keeping the leg straight after a cardiac angiography via the femoral approach?
What is the primary reason for keeping the leg straight after a cardiac angiography via the femoral approach?
Which of the following dietary modifications is MOST important for a patient with high cholesterol to reduce their risk of CAD?
Which of the following dietary modifications is MOST important for a patient with high cholesterol to reduce their risk of CAD?
What is the significance of elevated troponin levels in a patient presenting with chest pain?
What is the significance of elevated troponin levels in a patient presenting with chest pain?
Compared to men, why are postmenopausal women at an increased risk for coronary artery disease (CAD)?
Compared to men, why are postmenopausal women at an increased risk for coronary artery disease (CAD)?
A patient is scheduled for a cardiac stress test. What instructions should the nurse provide regarding medication use prior to the test?
A patient is scheduled for a cardiac stress test. What instructions should the nurse provide regarding medication use prior to the test?
Which symptom differentiates a myocardial infarction (MI) from chronic stable angina?
Which symptom differentiates a myocardial infarction (MI) from chronic stable angina?
A patient with coronary artery disease asks how atherosclerosis leads to decreased blood flow. What is the BEST explanation?
A patient with coronary artery disease asks how atherosclerosis leads to decreased blood flow. What is the BEST explanation?
In managing a patient post-angiography, why is encouraging fluid intake an important nursing intervention?
In managing a patient post-angiography, why is encouraging fluid intake an important nursing intervention?
Which complete blood count (CBC) finding would be MOST concerning in a patient with coronary artery disease (CAD)?
Which complete blood count (CBC) finding would be MOST concerning in a patient with coronary artery disease (CAD)?
What is the MOST appropriate initial action for a nurse to take when a patient reports chest pain?
What is the MOST appropriate initial action for a nurse to take when a patient reports chest pain?
A patient with a history of CAD is starting a new exercise program. Which instruction is MOST important to provide?
A patient with a history of CAD is starting a new exercise program. Which instruction is MOST important to provide?
Which of the following is the MOST significant risk associated with cardiac angiography?
Which of the following is the MOST significant risk associated with cardiac angiography?
A patient's lipid panel shows elevated LDL and low HDL cholesterol levels. What dietary advice is MOST appropriate?
A patient's lipid panel shows elevated LDL and low HDL cholesterol levels. What dietary advice is MOST appropriate?
A patient with diabetes is at higher risk for CAD. What underlying mechanism explains this increased risk?
A patient with diabetes is at higher risk for CAD. What underlying mechanism explains this increased risk?
What is the rationale behind the NPO (nothing by mouth) order for 6-8 hours prior to a cardiac angiography?
What is the rationale behind the NPO (nothing by mouth) order for 6-8 hours prior to a cardiac angiography?
An African American patient is concerned about their increased risk for CAD. What should the nurse emphasize during patient education?
An African American patient is concerned about their increased risk for CAD. What should the nurse emphasize during patient education?
A patient reports that their angina is now occurring more frequently and with less exertion. How should the nurse interpret this change?
A patient reports that their angina is now occurring more frequently and with less exertion. How should the nurse interpret this change?
Which coagulation study is MOST important to monitor in a patient receiving heparin therapy?
Which coagulation study is MOST important to monitor in a patient receiving heparin therapy?
A patient is prescribed a statin medication to manage their high cholesterol. What information about potential side effects is MOST important to provide?
A patient is prescribed a statin medication to manage their high cholesterol. What information about potential side effects is MOST important to provide?
What is the primary goal of a cardiac stress test?
What is the primary goal of a cardiac stress test?
A patient is diagnosed with Metabolic Syndrome. Which combination of factors increases their risk for CAD?
A patient is diagnosed with Metabolic Syndrome. Which combination of factors increases their risk for CAD?
What information should the nurse provide regarding shellfish allergy, prior to a cardiac angiography?
What information should the nurse provide regarding shellfish allergy, prior to a cardiac angiography?
A patient had a cardiac angiography through the femoral artery site. Upon assessment, the nurse notes swelling and tenderness at the site. What intervention is MOST appropriate?
A patient had a cardiac angiography through the femoral artery site. Upon assessment, the nurse notes swelling and tenderness at the site. What intervention is MOST appropriate?
Which of the following findings would indicate a successful cardiac rehabilitation program for a patient with CAD?
Which of the following findings would indicate a successful cardiac rehabilitation program for a patient with CAD?
A patient is being discharged after a myocardial infarction (MI). What is the MOST important educational point to emphasize?
A patient is being discharged after a myocardial infarction (MI). What is the MOST important educational point to emphasize?
What is the BEST strategy to reduce stress in patients with Coronary Artery Disease (CAD)?
What is the BEST strategy to reduce stress in patients with Coronary Artery Disease (CAD)?
A patient with chronic angina is being discharged. Which dietary recommendation is MOST appropriate regarding fat intake?
A patient with chronic angina is being discharged. Which dietary recommendation is MOST appropriate regarding fat intake?
Which of the following strategies is MOST effective for a patient with CAD to reduce their sodium intake?
Which of the following strategies is MOST effective for a patient with CAD to reduce their sodium intake?
For a patient with CAD, what is the primary benefit of including fatty fish like salmon and tuna in their diet twice a week?
For a patient with CAD, what is the primary benefit of including fatty fish like salmon and tuna in their diet twice a week?
A patient with chronic angina asks how much salt they should aim to consume daily. What is the MOST appropriate recommendation?
A patient with chronic angina asks how much salt they should aim to consume daily. What is the MOST appropriate recommendation?
Which type of carbohydrate should a patient with CAD be encouraged to consume more of?
Which type of carbohydrate should a patient with CAD be encouraged to consume more of?
A patient with chronic angina wants to start an exercise program. Which piece of advice is MOST important?
A patient with chronic angina wants to start an exercise program. Which piece of advice is MOST important?
A patient who smokes is diagnosed with CAD. What is the MOST important reason to encourage smoking cessation?
A patient who smokes is diagnosed with CAD. What is the MOST important reason to encourage smoking cessation?
Which of the following is a key component of a heart-healthy diet for patients with CAD?
Which of the following is a key component of a heart-healthy diet for patients with CAD?
What is the primary benefit of regular exercise for a patient with CAD?
What is the primary benefit of regular exercise for a patient with CAD?
A patient with CAD is overwhelmed by the dietary changes they need to make. What is the BEST initial advice the nurse can offer?
A patient with CAD is overwhelmed by the dietary changes they need to make. What is the BEST initial advice the nurse can offer?
Which of the following smoking cessation aids might a physician recommend for a patient with CAD?
Which of the following smoking cessation aids might a physician recommend for a patient with CAD?
What is the MOST accurate statement about the role of red meat in a heart-healthy diet for a patient with CAD?
What is the MOST accurate statement about the role of red meat in a heart-healthy diet for a patient with CAD?
A patient with CAD is advised to increase their intake of complex carbohydrates. Which of the following foods is the BEST choice?
A patient with CAD is advised to increase their intake of complex carbohydrates. Which of the following foods is the BEST choice?
A patient with chronic angina experiences chest pain during exercise. What is the MOST appropriate action?
A patient with chronic angina experiences chest pain during exercise. What is the MOST appropriate action?
What is the overall goal of lifestyle modifications for a patient with CAD and chronic angina?
What is the overall goal of lifestyle modifications for a patient with CAD and chronic angina?
A patient, being discharged after experiencing angina, is struggling to quit smoking. Which of the following is the MOST important message to convey?
A patient, being discharged after experiencing angina, is struggling to quit smoking. Which of the following is the MOST important message to convey?
A patient with CAD is concerned about the cost of fresh fish for adequate Omega-3 intake. What is a reasonable alternative source to suggest?
A patient with CAD is concerned about the cost of fresh fish for adequate Omega-3 intake. What is a reasonable alternative source to suggest?
Which cooking method is MOST appropriate for a patient with CAD who is trying to reduce fat intake?
Which cooking method is MOST appropriate for a patient with CAD who is trying to reduce fat intake?
A patient who recently had a stent placed due to CAD asks if they can return to their usual diet. Which is the MOST appropriate answer?
A patient who recently had a stent placed due to CAD asks if they can return to their usual diet. Which is the MOST appropriate answer?
How does quitting smoking reduce the risk of heart attack for patients with CAD?
How does quitting smoking reduce the risk of heart attack for patients with CAD?
A patient with chronic angina is planning a walk. Which of the following symptoms should prompt them to stop and rest?
A patient with chronic angina is planning a walk. Which of the following symptoms should prompt them to stop and rest?
A patient is discharged with a prescription for nicotine patches. What is an important instruction regarding their usage?
A patient is discharged with a prescription for nicotine patches. What is an important instruction regarding their usage?
A patient with chronic angina is going to a restaurant. What is the BEST strategy for adhering to their low-sodium diet?
A patient with chronic angina is going to a restaurant. What is the BEST strategy for adhering to their low-sodium diet?
What role does fiber play in managing CAD through dietary modifications?
What role does fiber play in managing CAD through dietary modifications?
When educating a patient about lifestyle modifications for CAD, what approach is MOST likely to lead to successful long-term change?
When educating a patient about lifestyle modifications for CAD, what approach is MOST likely to lead to successful long-term change?
A patient with mitral valve stenosis is MOST likely to experience which of the following symptoms due to the backflow of blood?
A patient with mitral valve stenosis is MOST likely to experience which of the following symptoms due to the backflow of blood?
An elderly patient is diagnosed with aortic valve regurgitation. Which symptom is MOST indicative of decreased forward flow of blood in this condition?
An elderly patient is diagnosed with aortic valve regurgitation. Which symptom is MOST indicative of decreased forward flow of blood in this condition?
A patient with a history of rheumatic fever is being evaluated for valvular heart disease. Which diagnostic test would BEST provide detailed information about valve function and severity of any stenosis or regurgitation?
A patient with a history of rheumatic fever is being evaluated for valvular heart disease. Which diagnostic test would BEST provide detailed information about valve function and severity of any stenosis or regurgitation?
What is the PRIMARY reason beta blockers are prescribed for patients with valvular heart disease?
What is the PRIMARY reason beta blockers are prescribed for patients with valvular heart disease?
Which instruction is MOST important for a patient taking furosemide (Lasix) for valvular heart disease?
Which instruction is MOST important for a patient taking furosemide (Lasix) for valvular heart disease?
A patient with a mechanical heart valve replacement is prescribed warfarin. What is the MOST important dietary consideration the nurse should discuss with this patient?
A patient with a mechanical heart valve replacement is prescribed warfarin. What is the MOST important dietary consideration the nurse should discuss with this patient?
A patient with a newly diagnosed valvular heart disease reports experiencing increased fatigue and shortness of breath. What should the nurse advise the patient to do FIRST?
A patient with a newly diagnosed valvular heart disease reports experiencing increased fatigue and shortness of breath. What should the nurse advise the patient to do FIRST?
What is the MOST significant advantage of choosing a biologic (tissue) valve over a mechanical valve for valve replacement?
What is the MOST significant advantage of choosing a biologic (tissue) valve over a mechanical valve for valve replacement?
A patient with a mechanical valve is being discharged on warfarin. What INR range indicates effective anticoagulation for this patient?
A patient with a mechanical valve is being discharged on warfarin. What INR range indicates effective anticoagulation for this patient?
What activity modification is MOST important to teach a patient recovering from valve replacement surgery?
What activity modification is MOST important to teach a patient recovering from valve replacement surgery?
A patient taking beta-blockers for valvular heart disease should be taught to monitor for which of the following potential side effects?
A patient taking beta-blockers for valvular heart disease should be taught to monitor for which of the following potential side effects?
Which finding on a chest X-ray of a patient with mitral valve stenosis would MOST strongly support the diagnosis?
Which finding on a chest X-ray of a patient with mitral valve stenosis would MOST strongly support the diagnosis?
A patient with aortic valve disease reports chest pain, dizziness, and occasional fainting spells. Which medication would the nurse expect to be ordered with caution, if at all?
A patient with aortic valve disease reports chest pain, dizziness, and occasional fainting spells. Which medication would the nurse expect to be ordered with caution, if at all?
A patient is scheduled for an echocardiogram to evaluate possible mitral valve prolapse. What should the nurse explain to the patient about this diagnostic test?
A patient is scheduled for an echocardiogram to evaluate possible mitral valve prolapse. What should the nurse explain to the patient about this diagnostic test?
Which of the following is the MOST appropriate nursing intervention to prevent endocarditis in a patient with valvular heart disease?
Which of the following is the MOST appropriate nursing intervention to prevent endocarditis in a patient with valvular heart disease?
A patient with valvular heart disease is prescribed lisinopril. What is the primary therapeutic effect of this medication in managing this condition?
A patient with valvular heart disease is prescribed lisinopril. What is the primary therapeutic effect of this medication in managing this condition?
A patient with mechanical valve replacement reports noticing increased bruising and bleeding after starting a new supplement. Which supplement is MOST likely interacting with their warfarin?
A patient with mechanical valve replacement reports noticing increased bruising and bleeding after starting a new supplement. Which supplement is MOST likely interacting with their warfarin?
A patient with aortic stenosis is being educated about lifestyle modifications. Which activity should the nurse advise the patient to avoid?
A patient with aortic stenosis is being educated about lifestyle modifications. Which activity should the nurse advise the patient to avoid?
A patient with mitral valve regurgitation asks why they are experiencing shortness of breath. What is the BEST explanation the nurse can provide?
A patient with mitral valve regurgitation asks why they are experiencing shortness of breath. What is the BEST explanation the nurse can provide?
A patient with a history of endocarditis is at increased risk for developing which valvular disorder?
A patient with a history of endocarditis is at increased risk for developing which valvular disorder?
Which symptom would be MOST concerning in a patient with a mechanical heart valve who is non-compliant with warfarin therapy?
Which symptom would be MOST concerning in a patient with a mechanical heart valve who is non-compliant with warfarin therapy?
A patient with a bioprosthetic valve is scheduled for a dental procedure. Why is it important to inquire if prophylactic antibiotics are prescribed before the procedure?
A patient with a bioprosthetic valve is scheduled for a dental procedure. Why is it important to inquire if prophylactic antibiotics are prescribed before the procedure?
How does hypertension contribute to the development of valvular heart disease?
How does hypertension contribute to the development of valvular heart disease?
A patient with suspected valvular heart disease has a murmur detected during auscultation. While the murmur itself is important, what other assessment finding would MOST strongly suggest heart failure?
A patient with suspected valvular heart disease has a murmur detected during auscultation. While the murmur itself is important, what other assessment finding would MOST strongly suggest heart failure?
A nurse is providing discharge teaching for a patient with newly diagnosed mitral valve prolapse who is asymptomatic. What is the MOST important information to include?
A nurse is providing discharge teaching for a patient with newly diagnosed mitral valve prolapse who is asymptomatic. What is the MOST important information to include?
A patient with heart failure is prescribed lisinopril. What is the PRIMARY mechanism by which this medication improves cardiac function?
A patient with heart failure is prescribed lisinopril. What is the PRIMARY mechanism by which this medication improves cardiac function?
Which assessment finding would differentiate right-sided heart failure from left-sided heart failure?
Which assessment finding would differentiate right-sided heart failure from left-sided heart failure?
A patient with heart failure is prescribed furosemide. Which electrolyte imbalance is the MOST important for the nurse to monitor?
A patient with heart failure is prescribed furosemide. Which electrolyte imbalance is the MOST important for the nurse to monitor?
Why is it important to educate a patient with heart failure regarding a low-sodium diet?
Why is it important to educate a patient with heart failure regarding a low-sodium diet?
A patient with heart failure is prescribed metoprolol. What is the MOST important action of this medication in managing heart failure?
A patient with heart failure is prescribed metoprolol. What is the MOST important action of this medication in managing heart failure?
Which risk factor, if managed effectively, would have the MOST significant impact on preventing the progression of heart failure?
Which risk factor, if managed effectively, would have the MOST significant impact on preventing the progression of heart failure?
A patient experiences rapid fluid removal due to aggressive diuretic therapy. Which assessment finding would be MOST concerning?
A patient experiences rapid fluid removal due to aggressive diuretic therapy. Which assessment finding would be MOST concerning?
Which diagnostic test is MOST valuable in determining the ejection fraction (EF) in a patient with heart failure?
Which diagnostic test is MOST valuable in determining the ejection fraction (EF) in a patient with heart failure?
A patient with heart failure is being discharged. Which statement indicates an understanding of prescribed exercise guidelines?
A patient with heart failure is being discharged. Which statement indicates an understanding of prescribed exercise guidelines?
A patient with chronic heart failure is prescribed digoxin. Which assessment finding would warrant holding the medication and contacting the provider?
A patient with chronic heart failure is prescribed digoxin. Which assessment finding would warrant holding the medication and contacting the provider?
Which dietary modification is MOST important for a patient with heart failure and a history of atrial fibrillation?
Which dietary modification is MOST important for a patient with heart failure and a history of atrial fibrillation?
How does coronary artery disease (CAD) contribute to the development of heart failure?
How does coronary artery disease (CAD) contribute to the development of heart failure?
A patient with heart failure suddenly develops pink, frothy sputum. What does this symptom indicate?
A patient with heart failure suddenly develops pink, frothy sputum. What does this symptom indicate?
Which compensatory mechanism eventually exacerbates heart failure if left unmanaged?
Which compensatory mechanism eventually exacerbates heart failure if left unmanaged?
Prior to administering a beta-blocker to a patient with heart failure, which assessment is MOST critical?
Prior to administering a beta-blocker to a patient with heart failure, which assessment is MOST critical?
A patient with heart failure is prescribed a fluid restriction of 1.5 liters per day. Which of the following strategies would be MOST helpful in managing thirst?
A patient with heart failure is prescribed a fluid restriction of 1.5 liters per day. Which of the following strategies would be MOST helpful in managing thirst?
Which statement BEST explains the relationship between diabetes mellitus and the development of heart failure?
Which statement BEST explains the relationship between diabetes mellitus and the development of heart failure?
What is the MOST appropriate initial activity for a patient with heart failure starting a cardiac rehabilitation program?
What is the MOST appropriate initial activity for a patient with heart failure starting a cardiac rehabilitation program?
A patient with heart failure reports a weight gain of 5 pounds in 2 days. What is the MOST likely cause of this weight gain?
A patient with heart failure reports a weight gain of 5 pounds in 2 days. What is the MOST likely cause of this weight gain?
A patient with right-sided heart failure is admitted with severe peripheral edema and ascites. What is the primary underlying cause of these findings?
A patient with right-sided heart failure is admitted with severe peripheral edema and ascites. What is the primary underlying cause of these findings?
A patient with heart failure and chronic kidney disease is prescribed both furosemide and an ACE inhibitor. Which laboratory value requires careful monitoring due to the combined effects of these medications?
A patient with heart failure and chronic kidney disease is prescribed both furosemide and an ACE inhibitor. Which laboratory value requires careful monitoring due to the combined effects of these medications?
What activity should a nurse advise a patient with heart failure to avoid to minimize cardiac workload?
What activity should a nurse advise a patient with heart failure to avoid to minimize cardiac workload?
A patient with heart failure is educated about the importance of daily weight monitoring. Which weight change should prompt the patient to contact their healthcare provider?
A patient with heart failure is educated about the importance of daily weight monitoring. Which weight change should prompt the patient to contact their healthcare provider?
A patient with heart failure is having difficulty adhering to a low-sodium diet. Which of the following suggestions is MOST likely to improve their adherence?
A patient with heart failure is having difficulty adhering to a low-sodium diet. Which of the following suggestions is MOST likely to improve their adherence?
Which of the following is NOT a typical symptom of left-sided heart failure?
Which of the following is NOT a typical symptom of left-sided heart failure?
Which characteristic is MOST indicative of Crohn's disease rather than ulcerative colitis?
Which characteristic is MOST indicative of Crohn's disease rather than ulcerative colitis?
A patient with confirmed Crohn's disease develops a fever, severe abdominal pain, and signs of peritonitis. What is the MOST immediate concern?
A patient with confirmed Crohn's disease develops a fever, severe abdominal pain, and signs of peritonitis. What is the MOST immediate concern?
A patient with ulcerative colitis is scheduled for a colectomy. What should the nurse explain to the patient regarding the expected outcome of this surgery?
A patient with ulcerative colitis is scheduled for a colectomy. What should the nurse explain to the patient regarding the expected outcome of this surgery?
What laboratory finding would MOST strongly suggest active bleeding and inflammation in a patient with ulcerative colitis?
What laboratory finding would MOST strongly suggest active bleeding and inflammation in a patient with ulcerative colitis?
Which diagnostic procedure allows for direct visualization of the colon and is MOST useful in differentiating between Crohn's disease and ulcerative colitis?
Which diagnostic procedure allows for direct visualization of the colon and is MOST useful in differentiating between Crohn's disease and ulcerative colitis?
A patient with IBD is prescribed Mesalamine. What is the primary mechanism of action of this medication?
A patient with IBD is prescribed Mesalamine. What is the primary mechanism of action of this medication?
A patient with Crohn's disease is started on Infliximab. What is the MOST important assessment the nurse should make prior to administering this medication?
A patient with Crohn's disease is started on Infliximab. What is the MOST important assessment the nurse should make prior to administering this medication?
A patient with Crohn's disease experiences frequent diarrhea and malabsorption. What dietary modifications are MOST appropriate for managing these symptoms?
A patient with Crohn's disease experiences frequent diarrhea and malabsorption. What dietary modifications are MOST appropriate for managing these symptoms?
A patient with ulcerative colitis is experiencing frequent bloody stools. Which nutrient deficiency is MOST likely to develop as a result of this symptom?
A patient with ulcerative colitis is experiencing frequent bloody stools. Which nutrient deficiency is MOST likely to develop as a result of this symptom?
A patient with IBD is prescribed Prednisone during a flare-up. What is an important consideration regarding the long-term use of this medication?
A patient with IBD is prescribed Prednisone during a flare-up. What is an important consideration regarding the long-term use of this medication?
A patient with a history of IBD reports experiencing increased abdominal pain, fever, and tachycardia. What should the nurse advise the patient to do FIRST?
A patient with a history of IBD reports experiencing increased abdominal pain, fever, and tachycardia. What should the nurse advise the patient to do FIRST?
Which food choice should a nurse recommend that a patient with IBD avoid during a flare-up to help manage their symptoms?
Which food choice should a nurse recommend that a patient with IBD avoid during a flare-up to help manage their symptoms?
A patient with IBD is concerned about maintaining adequate hydration. What guidance should the nurse provide regarding fluid intake?
A patient with IBD is concerned about maintaining adequate hydration. What guidance should the nurse provide regarding fluid intake?
A patient with Crohn's disease develops a fistula between the small intestine and the bladder. What is a potential complication associated with this condition?
A patient with Crohn's disease develops a fistula between the small intestine and the bladder. What is a potential complication associated with this condition?
A patient with ulcerative colitis is scheduled for a barium enema. What information should the nurse provide to the patient about the purpose of this test?
A patient with ulcerative colitis is scheduled for a barium enema. What information should the nurse provide to the patient about the purpose of this test?
A patient with IBD reports feeling overwhelmed and fatigued due to the chronic nature of their condition. What is an appropriate nursing intervention to help the patient cope?
A patient with IBD reports feeling overwhelmed and fatigued due to the chronic nature of their condition. What is an appropriate nursing intervention to help the patient cope?
What is the rationale behind recommending a low-residue diet for patients with IBD?
What is the rationale behind recommending a low-residue diet for patients with IBD?
Which of the following is the MOST likely reason why vitamin and mineral supplementation is particularly important for patients with Crohn's disease?
Which of the following is the MOST likely reason why vitamin and mineral supplementation is particularly important for patients with Crohn's disease?
A patient with ulcerative colitis is prescribed azathioprine. What is the primary reason for using this medication in the management of IBD?
A patient with ulcerative colitis is prescribed azathioprine. What is the primary reason for using this medication in the management of IBD?
What instruction is MOST important for a nurse to provide to a patient with IBD who is creating a symptom journal?
What instruction is MOST important for a nurse to provide to a patient with IBD who is creating a symptom journal?
A patient with Crohn's disease is advised to avoid high-fat foods. What is the MOST likely rationale behind this dietary recommendation?
A patient with Crohn's disease is advised to avoid high-fat foods. What is the MOST likely rationale behind this dietary recommendation?
When should a nurse advise a patient with IBD to seek immediate medical attention?
When should a nurse advise a patient with IBD to seek immediate medical attention?
A patient with ulcerative colitis is prescribed electrolytes during a flare-up. What is the rationale behind this intervention?
A patient with ulcerative colitis is prescribed electrolytes during a flare-up. What is the rationale behind this intervention?
A patient with IBD tells the nurse, 'I am not eating much because I'm afraid it will cause more diarrhea.' What is the MOST appropriate response?
A patient with IBD tells the nurse, 'I am not eating much because I'm afraid it will cause more diarrhea.' What is the MOST appropriate response?
What is the underlying mechanism by which a low-fiber diet contributes to the development of diverticulitis?
What is the underlying mechanism by which a low-fiber diet contributes to the development of diverticulitis?
Why are NSAIDs generally avoided for pain control in patients hospitalized with diverticulitis?
Why are NSAIDs generally avoided for pain control in patients hospitalized with diverticulitis?
During an acute diverticulitis flare-up, why is a patient typically kept NPO (nothing by mouth)?
During an acute diverticulitis flare-up, why is a patient typically kept NPO (nothing by mouth)?
A patient with known diverticulitis reports sudden, severe abdominal pain that was initially intense but has now subsided. What complication is MOST likely occurring?
A patient with known diverticulitis reports sudden, severe abdominal pain that was initially intense but has now subsided. What complication is MOST likely occurring?
What is the rationale for slowly reintroducing fiber into the diet of a patient recovering from a diverticulitis flare-up?
What is the rationale for slowly reintroducing fiber into the diet of a patient recovering from a diverticulitis flare-up?
Why is maintaining a healthy BMI recommended for patients with diverticulitis?
Why is maintaining a healthy BMI recommended for patients with diverticulitis?
What is the primary goal of a high-fiber diet in the long-term management of diverticulitis?
What is the primary goal of a high-fiber diet in the long-term management of diverticulitis?
Why is a CT scan considered the gold standard diagnostic test for diverticulitis?
Why is a CT scan considered the gold standard diagnostic test for diverticulitis?
What is a potential consequence of untreated peritonitis resulting from a perforated diverticulum?
What is a potential consequence of untreated peritonitis resulting from a perforated diverticulum?
Why might an NG tube be used in a patient hospitalized with severe diverticulitis?
Why might an NG tube be used in a patient hospitalized with severe diverticulitis?
During the acute phase of diverticulitis, which dietary choice would be MOST appropriate?
During the acute phase of diverticulitis, which dietary choice would be MOST appropriate?
A patient with diverticulitis calls the clinic reporting a fever of 102°F (38.9°C). What is the MOST appropriate nursing advice?
A patient with diverticulitis calls the clinic reporting a fever of 102°F (38.9°C). What is the MOST appropriate nursing advice?
Which food should a patient with diverticulitis AVOID during a flare-up?
Which food should a patient with diverticulitis AVOID during a flare-up?
Why is hydration an important aspect of managing diverticulitis?
Why is hydration an important aspect of managing diverticulitis?
A patient with diverticulitis who has been on a low-fiber diet is ready to transition back to a normal diet. What food should the nurse recommend introducing FIRST?
A patient with diverticulitis who has been on a low-fiber diet is ready to transition back to a normal diet. What food should the nurse recommend introducing FIRST?
A patient with diverticulitis is concerned about preventing future flare-ups. What lifestyle modification should the nurse emphasize?
A patient with diverticulitis is concerned about preventing future flare-ups. What lifestyle modification should the nurse emphasize?
What is a potential complication of a fistula developing in a patient with diverticulitis?
What is a potential complication of a fistula developing in a patient with diverticulitis?
Following resolution of an acute diverticulitis episode, what key teaching should the nurse reinforce regarding long-term pain management?
Following resolution of an acute diverticulitis episode, what key teaching should the nurse reinforce regarding long-term pain management?
What is the MOST important rationale for promoting exercise in patients with diverticulitis?
What is the MOST important rationale for promoting exercise in patients with diverticulitis?
If a patient with diverticulitis reports GI bleeding, what is the MOST appropriate initial action?
If a patient with diverticulitis reports GI bleeding, what is the MOST appropriate initial action?
Why are broad-spectrum antibiotics typically prescribed during hospitalization for diverticulitis?
Why are broad-spectrum antibiotics typically prescribed during hospitalization for diverticulitis?
A patient with diverticulitis asks if it's okay to eat nuts occasionally once their symptoms have subsided. What is the nurse's BEST response?
A patient with diverticulitis asks if it's okay to eat nuts occasionally once their symptoms have subsided. What is the nurse's BEST response?
What is the MOST important teaching point about recognizing complications that should be emphasized with patients who are being discharged home after being treated for diverticulitis?
What is the MOST important teaching point about recognizing complications that should be emphasized with patients who are being discharged home after being treated for diverticulitis?
Why is it important for the nurse to assess for abdominal distension and tenderness in a patient admitted with diverticulitis?
Why is it important for the nurse to assess for abdominal distension and tenderness in a patient admitted with diverticulitis?
A patient with diverticulitis is prescribed both metronidazole and ciprofloxacin. What is the purpose of using two different antibiotics?
A patient with diverticulitis is prescribed both metronidazole and ciprofloxacin. What is the purpose of using two different antibiotics?
Which of the following factors contributes to an increased risk of colorectal cancer (CRC) due to its impact on chronic inflammation and insulin resistance?
Which of the following factors contributes to an increased risk of colorectal cancer (CRC) due to its impact on chronic inflammation and insulin resistance?
A patient reports experiencing a persistent feeling of incomplete evacuation, known as tenesmus. Where is the MOST likely location of the tumor causing this symptom based on the provided content?
A patient reports experiencing a persistent feeling of incomplete evacuation, known as tenesmus. Where is the MOST likely location of the tumor causing this symptom based on the provided content?
What is the MOST appropriate initial dietary modification for a patient recovering from a colectomy, based on standard post-operative nutritional guidelines?
What is the MOST appropriate initial dietary modification for a patient recovering from a colectomy, based on standard post-operative nutritional guidelines?
For a patient with a family history of colorectal cancer, which screening approach is generally recommended according to the guidelines?
For a patient with a family history of colorectal cancer, which screening approach is generally recommended according to the guidelines?
A patient with known colorectal cancer is scheduled for radiation therapy prior to surgery. What is the PRIMARY goal of radiation therapy in this scenario?
A patient with known colorectal cancer is scheduled for radiation therapy prior to surgery. What is the PRIMARY goal of radiation therapy in this scenario?
What is the primary purpose of using an NG tube in a patient post-colectomy, if deemed necessary?
What is the primary purpose of using an NG tube in a patient post-colectomy, if deemed necessary?
A patient recovering from a recent colectomy reports new onset of severe abdominal pain and bloating. Which of the following complications should the nurse suspect FIRST?
A patient recovering from a recent colectomy reports new onset of severe abdominal pain and bloating. Which of the following complications should the nurse suspect FIRST?
A patient with a history of Inflammatory Bowel Disease (IBD) for over ten years is at an increased risk for developing colorectal cancer. What underlying mechanism primarily contributes to this increased risk?
A patient with a history of Inflammatory Bowel Disease (IBD) for over ten years is at an increased risk for developing colorectal cancer. What underlying mechanism primarily contributes to this increased risk?
Which symptom, if present in a patient, would MOST strongly suggest lower gastrointestinal bleeding?
Which symptom, if present in a patient, would MOST strongly suggest lower gastrointestinal bleeding?
What is the PRIMARY reason for promoting activity and ambulation for a patient in the post-operative period after colorectal surgery?
What is the PRIMARY reason for promoting activity and ambulation for a patient in the post-operative period after colorectal surgery?
During a routine physical exam on a 50-year-old patient, the nurse learns the patient has never had any colorectal cancer screenings. Which of the following screening tests should the nurse recommend as the MOST comprehensive initial test?
During a routine physical exam on a 50-year-old patient, the nurse learns the patient has never had any colorectal cancer screenings. Which of the following screening tests should the nurse recommend as the MOST comprehensive initial test?
A patient who has undergone a colostomy is preparing to advance their diet. Which food, although generally healthy, should be introduced gradually and monitored due to its potential to cause gas and bloating?
A patient who has undergone a colostomy is preparing to advance their diet. Which food, although generally healthy, should be introduced gradually and monitored due to its potential to cause gas and bloating?
A patient who is status-post polypectomy asks what this surgery entails. What is the MOST accurate description of a polypectomy?
A patient who is status-post polypectomy asks what this surgery entails. What is the MOST accurate description of a polypectomy?
A patient is scheduled for a colectomy. What does this surgical procedure involve?
A patient is scheduled for a colectomy. What does this surgical procedure involve?
A patient is undergoing chemotherapy for colorectal cancer. What is the PRIMARY goal of chemotherapy in this context?
A patient is undergoing chemotherapy for colorectal cancer. What is the PRIMARY goal of chemotherapy in this context?
Which of the following factors is MOST directly associated with damaging the colon lining and increasing the risk of colorectal cancer?
Which of the following factors is MOST directly associated with damaging the colon lining and increasing the risk of colorectal cancer?
A patient with newly diagnosed colorectal cancer reports experiencing persistent fatigue. What is the MOST likely cause of this symptom based on the information provided?
A patient with newly diagnosed colorectal cancer reports experiencing persistent fatigue. What is the MOST likely cause of this symptom based on the information provided?
In the context of colorectal cancer, what does the presence of 'black stool' typically indicate?
In the context of colorectal cancer, what does the presence of 'black stool' typically indicate?
A patient with a family history of Familial Adenomatous Polyposis (FAP) is considered high-risk for colorectal cancer. What is the primary recommendation for screening in these individuals?
A patient with a family history of Familial Adenomatous Polyposis (FAP) is considered high-risk for colorectal cancer. What is the primary recommendation for screening in these individuals?
A patient is scheduled to undergo a fecal occult blood test (FOBT) as part of a routine colorectal cancer screening. How often is this test typically performed for average-risk individuals?
A patient is scheduled to undergo a fecal occult blood test (FOBT) as part of a routine colorectal cancer screening. How often is this test typically performed for average-risk individuals?
A patient who had a colostomy created several weeks ago continues to express significant distress about the changes in their body image. Which of the following nursing interventions is MOST appropriate to support the patient's psychosocial well-being?
A patient who had a colostomy created several weeks ago continues to express significant distress about the changes in their body image. Which of the following nursing interventions is MOST appropriate to support the patient's psychosocial well-being?
A patient has a history of colorectal cancer. If the patient reports signs of infection, such as fever or redness at the incision site, what is the MOST important initial action for the nurse to take?
A patient has a history of colorectal cancer. If the patient reports signs of infection, such as fever or redness at the incision site, what is the MOST important initial action for the nurse to take?
A patient, post-resection, is tolerating a low-fiber diet well. What key benefit does a high-fiber diet provide in the long-term management and prevention of colorectal issues?
A patient, post-resection, is tolerating a low-fiber diet well. What key benefit does a high-fiber diet provide in the long-term management and prevention of colorectal issues?
What is the PRIMARY purpose of obtaining a detailed family history when assessing a patient's risk for colorectal cancer?
What is the PRIMARY purpose of obtaining a detailed family history when assessing a patient's risk for colorectal cancer?
A patient recovering from colorectal cancer surgery is being discharged home. What is the MOST important instruction related to diet progression the nurse should provide?
A patient recovering from colorectal cancer surgery is being discharged home. What is the MOST important instruction related to diet progression the nurse should provide?
Flashcards
Coronary Artery Disease (CAD)
Coronary Artery Disease (CAD)
Narrowing or blockage of coronary arteries due to atherosclerosis, potentially leading to angina or MI.
Non-Modifiable CAD Risk Factors
Non-Modifiable CAD Risk Factors
Age, gender, family history, and ethnicity. These cannot be changed.
Modifiable CAD Risk Factors
Modifiable CAD Risk Factors
High blood pressure, high cholesterol, smoking, diabetes, obesity, sedentary lifestyle, poor diet, and stress.
Atherosclerosis
Atherosclerosis
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Chronic Stable Angina
Chronic Stable Angina
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Myocardial Infarction (Heart Attack)
Myocardial Infarction (Heart Attack)
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Complete Blood Count (CBC)
Complete Blood Count (CBC)
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Cardiac Enzymes (Troponin, CK-MB)
Cardiac Enzymes (Troponin, CK-MB)
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Coagulation Studies (PT, INR, PTT)
Coagulation Studies (PT, INR, PTT)
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Lipid Panel
Lipid Panel
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Cardiac Stress Test
Cardiac Stress Test
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Angiography (Cardiac Cath)
Angiography (Cardiac Cath)
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Pre-Angiography Nursing
Pre-Angiography Nursing
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Post-Angiography Nursing
Post-Angiography Nursing
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Heart-Healthy Fats
Heart-Healthy Fats
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Dietary Cholesterol Control
Dietary Cholesterol Control
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Red Meat Limitation
Red Meat Limitation
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Recommended Daily Sodium Intake
Recommended Daily Sodium Intake
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Omega-3 Fatty Acids
Omega-3 Fatty Acids
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Complex Carbohydrates
Complex Carbohydrates
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Weekly Exercise Goal
Weekly Exercise Goal
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Exercise Safety
Exercise Safety
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Smoking Cessation Benefits
Smoking Cessation Benefits
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Nicotine's Effects
Nicotine's Effects
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Smoking Cessation Aids
Smoking Cessation Aids
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Early Valvular Heart Disease Signs
Early Valvular Heart Disease Signs
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Valvular Heart Disease Risk Factors
Valvular Heart Disease Risk Factors
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Mitral Valve Dysfunction
Mitral Valve Dysfunction
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Aortic Valve Dysfunction
Aortic Valve Dysfunction
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EKG Use in VHD
EKG Use in VHD
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CXR Use in VHD
CXR Use in VHD
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Echocardiogram
Echocardiogram
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Diuretics for VHD
Diuretics for VHD
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Beta Blockers for VHD
Beta Blockers for VHD
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ACE Inhibitors/ARBs for VHD
ACE Inhibitors/ARBs for VHD
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Anticoagulants for VHD
Anticoagulants for VHD
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Mechanical Valve Pros and Cons
Mechanical Valve Pros and Cons
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Biologic Valve Pros and Cons
Biologic Valve Pros and Cons
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PT/INR Monitoring for Warfarin
PT/INR Monitoring for Warfarin
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HF Symptoms Monitoring
HF Symptoms Monitoring
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Diuretics Timing
Diuretics Timing
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Beta Blockers Precautions
Beta Blockers Precautions
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Warfarin Education
Warfarin Education
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Post-Surgery Activity Modifications
Post-Surgery Activity Modifications
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Infection Prevention
Infection Prevention
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When to Seek Help
When to Seek Help
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Mitral Valve = Lungs
Mitral Valve = Lungs
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Aortic Valve = Low Output
Aortic Valve = Low Output
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Warfarin Monitoring
Warfarin Monitoring
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Hypertension in Heart Failure
Hypertension in Heart Failure
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CAD (Coronary Artery Disease) in HF
CAD (Coronary Artery Disease) in HF
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MI (Myocardial Infarction) in HF
MI (Myocardial Infarction) in HF
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Diabetes Mellitus in HF
Diabetes Mellitus in HF
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Left-Sided Heart Failure
Left-Sided Heart Failure
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Right-Sided Heart Failure
Right-Sided Heart Failure
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Orthopnea
Orthopnea
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Pulmonary Congestion
Pulmonary Congestion
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Peripheral Edema
Peripheral Edema
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JVD (Jugular Vein Distension)
JVD (Jugular Vein Distension)
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Ascites
Ascites
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Hepatomegaly
Hepatomegaly
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Ejection Fraction (EF)
Ejection Fraction (EF)
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BNP (Brain Natriuretic Peptide)
BNP (Brain Natriuretic Peptide)
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ACE Inhibitors in HF
ACE Inhibitors in HF
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Beta Blockers in HF
Beta Blockers in HF
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Diuretics in HF
Diuretics in HF
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Digoxin in HF
Digoxin in HF
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Hypokalemia
Hypokalemia
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Symptoms of Hypokalemia
Symptoms of Hypokalemia
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Risks of Rapid Fluid Removal
Risks of Rapid Fluid Removal
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Ototoxicity
Ototoxicity
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Low-Sodium Diet Goal in HF
Low-Sodium Diet Goal in HF
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Exercise Guidelines for HF Patients
Exercise Guidelines for HF Patients
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Fluid Restriction in HF
Fluid Restriction in HF
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Inflammatory Bowel Disease (IBD)
Inflammatory Bowel Disease (IBD)
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Crohn’s Disease Location/Pattern
Crohn’s Disease Location/Pattern
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Ulcerative Colitis (UC) Location/Pattern
Ulcerative Colitis (UC) Location/Pattern
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Typical Crohn’s Stool/Nutritional Impact
Typical Crohn’s Stool/Nutritional Impact
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Typical UC Stool/Nutritional Impact
Typical UC Stool/Nutritional Impact
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Crohn’s: Ulcer Characteristics
Crohn’s: Ulcer Characteristics
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UC: Ulcer Characteristics
UC: Ulcer Characteristics
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Crohn’s: Surgical Options
Crohn’s: Surgical Options
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UC: Surgical Options
UC: Surgical Options
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Colonoscopy for IBD
Colonoscopy for IBD
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Barium Enema for IBD
Barium Enema for IBD
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CBC in IBD Diagnosis
CBC in IBD Diagnosis
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CRP/ESR in IBD Diagnosis
CRP/ESR in IBD Diagnosis
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Electrolyte Monitoring in IBD
Electrolyte Monitoring in IBD
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Aminosalicylates (5-ASA)
Aminosalicylates (5-ASA)
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Corticosteroids (Prednisone) in IBD
Corticosteroids (Prednisone) in IBD
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Immunosuppressants (Azathioprine, Methotrexate)
Immunosuppressants (Azathioprine, Methotrexate)
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Biologics (Infliximab, Adalimumab)
Biologics (Infliximab, Adalimumab)
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Small, Frequent Meals for IBD
Small, Frequent Meals for IBD
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Low-Residue Diet
Low-Residue Diet
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High-Protein, High-Calorie Diet
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Vitamin/Mineral Supplementation
Vitamin/Mineral Supplementation
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IBD: When to Call 911
IBD: When to Call 911
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IBD: Infection Warning Signs
IBD: Infection Warning Signs
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IBD: Dehydration Signs
IBD: Dehydration Signs
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Diverticula
Diverticula
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Diverticulitis
Diverticulitis
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Low-fiber diet
Low-fiber diet
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LLQ pain
LLQ pain
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Perforation
Perforation
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Abscess Formation
Abscess Formation
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CT Scan
CT Scan
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NPO
NPO
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NG tube
NG tube
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Acetaminophen
Acetaminophen
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Low-fiber diet
Low-fiber diet
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Foods to avoid during a flare
Foods to avoid during a flare
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Healthy BMI
Healthy BMI
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Hydration
Hydration
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Call 911
Call 911
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What is Colorectal Cancer?
What is Colorectal Cancer?
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CRC Risk Factors (Lifestyle & Health)
CRC Risk Factors (Lifestyle & Health)
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CRC Risk Factors (Genetic & Family History)
CRC Risk Factors (Genetic & Family History)
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General CRC Symptoms
General CRC Symptoms
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Specific CRC Symptoms
Specific CRC Symptoms
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CRC Screening for Average-Risk Individuals
CRC Screening for Average-Risk Individuals
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Medical Management for CRC
Medical Management for CRC
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Post-Surgical Nursing Considerations for CRC
Post-Surgical Nursing Considerations for CRC
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When to call the provider (CRC)
When to call the provider (CRC)
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Polypectomy
Polypectomy
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Colectomy
Colectomy
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Colostomy/Ileostomy
Colostomy/Ileostomy
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NG Tube Purpose (Post-Op)
NG Tube Purpose (Post-Op)
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Promote Activity (Post-Op)
Promote Activity (Post-Op)
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Fatigue and CRC
Fatigue and CRC
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Unexplained Weight Loss and CRC
Unexplained Weight Loss and CRC
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Abdominal Pain & CRC
Abdominal Pain & CRC
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Bowel Habit Changes & CRC
Bowel Habit Changes & CRC
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Tenesmus & CRC
Tenesmus & CRC
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Chemotherapy for CRC
Chemotherapy for CRC
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Radiation Therapy for CRC
Radiation Therapy for CRC
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Screen before 45!
Screen before 45!
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Intake & Output
Intake & Output
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Post-Op Diet & Fluids
Post-Op Diet & Fluids
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Study Notes
- Coronary Artery Disease (CAD) involves the narrowing or blockage of coronary arteries due to atherosclerosis, which is the buildup of fatty plaque.
- CAD can result in angina (chest pain) or a myocardial infarction (MI), also known as a heart attack.
Risk Factors for CAD
- Non-modifiable risk factors include age, gender, family history, and ethnicity.
- Risk increases with age.
- Men are at higher risk than premenopausal women; postmenopausal women's risk increases.
- African Americans have a higher risk.
- Modifiable risk factors include high blood pressure, high cholesterol, smoking, diabetes, obesity, sedentary lifestyle, poor diet, and stress.
- High cholesterol includes elevated LDL and decreased HDL levels.
- A poor diet is typically high in fat and sugar.
Atherosclerosis and Its Manifestations
- Atherosclerosis is the hardening and narrowing of arteries due to plaque buildup.
- Atherosclerosis leads to decreased blood flow to the heart, causing symptoms such as chest pain (angina), shortness of breath, and fatigue.
- In severe cases, atherosclerosis may lead to a heart attack if an artery becomes completely blocked.
Angina vs. Myocardial Infarction (MI)
- Chronic stable angina presents as predictable chest pain during exertion, and it is relieved by rest or nitroglycerin.
- Angina is caused by a temporary decrease in oxygen supply to the heart.
- Myocardial Infarction (Heart Attack) involves sudden, intense chest pain that is not relieved by rest or nitroglycerin.
- Pain can radiate to the jaw, left arm, or back.
- Additional symptoms include nausea, sweating, and shortness of breath.
- Requires immediate emergency care.
Diagnostic Tests & Labs for CAD
- Important lab tests include Complete Blood Count (CBC), Cardiac Enzymes, Coagulation Studies, and Lipid Panel.
- A CBC checks for anemia or infection.
- Cardiac Enzymes (Troponin, CK-MB) are elevated in MI but normal in chronic angina.
- Coagulation Studies (PT, INR, PTT) are important if the patient is on anticoagulants.
- Lipid Panel checks cholesterol levels (LDL, HDL, triglycerides).
- Diagnostic tests, from least to most invasive, include Cardiac Stress Test and Angiography (Cardiac Cath).
- A Cardiac Stress Test evaluates heart function under stress, either through exercise or chemical inducement.
- Angiography (Cardiac Cath) is the gold standard and uses contrast dye to visualize artery blockages.
Pre- & Post-Angiography Nursing Management
- Before angiography (Pre-Procedure):
- Assess for allergies to contrast dye, shellfish, or iodine.
- Patient should be NPO (nothing by mouth) for 6-8 hours before the procedure.
- Obtain baseline vitals and assess kidney function (BUN, Creatinine).
- Establish IV access and administer possible sedation.
- After angiography (Post-Procedure):
- Monitor vital signs and the puncture site for bleeding.
- Encourage fluid intake to help flush out the contrast dye.
- Assess for chest pain or signs of stroke.
- If femoral access was used, instruct the patient to keep the leg straight.
Discharge Education for CAD & Chronic Angina
- Heart-healthy lifestyle recommendations include nutrition modifications, regular exercise, and smoking cessation.
Nutrition Recommendations
- Consume healthy unsaturated fats, such as olive oil, avocados, and nuts.
- Avoid trans and saturated fats found in fried foods and processed snacks.
- Limit dietary cholesterol found in egg yolks, full-fat dairy, and butter.
- Focus on plant-based proteins, lean meats, and fiber to help lower cholesterol.
- Limit red meat like beef, pork, and lamb, and choose lean poultry, fish, or plant-based proteins instead.
- Aim for a salt intake of ≤2,300 mg/day (1 tsp salt).
- Avoid processed foods, canned soups, and fast food, and use herbs & spices instead.
- Eat fatty fish such as salmon, mackerel, and tuna 2x per week or take supplements as advised.
- Omega-3s help reduce inflammation & improve heart health.
- Increase complex carbs such as whole grains, fruits, vegetables, and beans for better cholesterol control & blood sugar regulation.
- Avoid refined carbs like white bread, pastries, and sugary drinks.
Lifestyle Modifications
- Exercise: Aim for at least 150 minutes per week of moderate activity like walking, cycling, or swimming.
- Start slow and avoid overexertion, stopping if experiencing chest pain, dizziness, or severe shortness of breath.
- Smoking Cessation: Quitting smoking is one of the best ways to reduce heart disease risk.
- Nicotine increases blood pressure & heart rate, worsening CAD & angina.
- Smoking cessation options include nicotine patches, gum, counseling, and medications such as varenicline and bupropion.
Valvular Heart Disease Overview
- Valvular heart disease resembles heart failure.
- Early signs are often asymptomatic for years.
- First noticeable symptoms include fatigue and a murmur.
- Later symptoms include dyspnea, edema, orthopnea, and palpitations.
Risk Factors for Valvular Heart Disease
- Congenital defects
- Rheumatic fever (due to strep infection) can cause valve damage.
- Endocarditis (infection of the heart lining/valves)
- Aging-related degenerative changes in the valve
- History of hypertension, CAD, and heart failure
Mitral vs. Aortic Valve Dysfunction
- Mitral Valve (Between Left Atrium & Left Ventricle): Stenosis (narrowing) or regurgitation (leaky valve) causes blood to back up into the lungs (left atrium → pulmonary circulation), resulting in pulmonary congestion, dyspnea, orthopnea, and cough.
- Aortic Valve (Between Left Ventricle & Aorta): Stenosis or regurgitation causes blood to back up into the left ventricle, reducing forward flow to the body, resulting in fatigue, dizziness, syncope, and chest pain (angina).
Diagnostics for Valvular Heart Disease
- EKG detects arrhythmias & heart strain.
- CXR (Chest X-ray) shows heart enlargement & pulmonary congestion.
- Echocardiogram (Gold Standard!) visualizes valve function and stenosis/regurgitation severity.
Goals of Medication Regimen for Valvular Heart Disease
- Decrease workload of the heart by reducing heart rate, BP, and afterload.
- Reduce fluid volume to prevent pulmonary/systemic congestion.
Common Medications for Valvular Heart Disease
- Diuretics (Furosemide) reduce fluid overload & pulmonary congestion.
- Beta Blockers (Metoprolol) lower HR & BP, reducing strain on the heart.
- ACE Inhibitors/ARBs (Lisinopril, Losartan) cause vasodilation, lowering afterload.
- Anticoagulants (Warfarin for mechanical valves) prevent clots.
Surgical Management & Valve Replacements
- Mechanical Valve: Lasts longer (20+ years) but requires lifelong anticoagulation (Warfarin) due to thromboembolism risk.
- Biologic (Tissue) Valve: Does not need lifelong anticoagulation but wears out faster (10-15 years).
Lab Monitoring for Anticoagulation
- PT/INR (For Warfarin): Goal INR is 2.5-3.5 for mechanical valves.
Nursing Management & Patient Education for Valvular Heart Disease
- Monitor for heart failure symptoms such as fluid overload, lung sounds, and weight gain.
Medication Education
- Diuretics should be taken in the morning to avoid nighttime urination.
- Beta Blockers: Check HR & BP before taking.
- Warfarin (if mechanical valve): Monitor INR, avoid vitamin K-rich foods (leafy greens), and take bleeding precautions.
Post-Surgery Education
- Activity modifications include avoiding heavy lifting & straining.
- Infection prevention includes good oral hygiene to reduce the risk of endocarditis.
- Seek help for worsening fatigue, swelling, SOB, and chest pain.
Heart Failure (HF) Overview
- Heart Failure main issues:
- The heart’s inability to pump effectively to meet the body's needs.
Risk Factors for Heart Failure
- Primary Causes:
- Hypertension (HTN) increases workload on the heart.
- Coronary Artery Disease (CAD) reduces blood flow and weakens the heart.
- Myocardial Infarction (MI) damages the heart muscle, reducing pump function.
- Diabetes Mellitus leads to vascular damage and increased heart stress.
- Other Contributing Factors:
- Valvular heart disease.
- Arrhythmias (e.g., Atrial fibrillation).
- Obesity.
- Smoking, alcohol, drug use.
- High sodium diet (fluid retention).
Right-Sided vs. Left-Sided HF
- Left-Sided HF:
- Main Issue: Pulmonary Congestion – Blood backs up into the lungs.
- Key Symptoms: Dyspnea, crackles, orthopnea (difficulty breathing lying flat), pink frothy sputum (severe cases), fatigue.
- Right-Sided HF:
- Main Issue: Venous Back-Up – Blood backs up into systemic circulation.
- Key Symptoms: Peripheral edema, JVD (jugular vein distension), ascites, hepatomegaly (enlarged liver), weight gain.
Diagnostics for Heart Failure
- Echocardiogram: Measures ejection fraction (EF), valve function, chamber size.
- Chest X-ray (CXR): Shows fluid in lungs, heart enlargement.
- Stress Test: Assesses heart function under exertion.
- Angiography: Checks for coronary blockages.
- BNP (Brain Natriuretic Peptide): Elevated in HF due to fluid overload.
First-Line Medication Goals for Heart Failure
- Reduce workload of the heart (↓ BP, ↓ HR, ↓ afterload).
- Increase contractility (Help heart pump more effectively).
- Common Medications:
- ACE Inhibitors (Lisinopril): Vasodilation, ↓ BP, ↓ fluid retention.
- Beta Blockers (Metoprolol, Carvedilol): Slows HR, reduces cardiac workload.
- Diuretics (Loop = Furosemide, Thiazide = HCTZ): Removes excess fluid.
- Digoxin: Increases contractility (used in severe cases).
Education on K+ Wasting Diuretics & Fluid Removal
- Loop Diuretics (Furosemide/Lasix) & Thiazide Diuretics (HCTZ) cause K+ Loss.
- Watch for hypokalemia: Muscle cramps, weakness, arrhythmias.
- Monitor potassium levels (Normal: 3.5-5.0 mEq/L).
- Encourage potassium-rich foods: Bananas, oranges, spinach, potatoes.
- Rapid Fluid Removal Risks:
- Hypotension: Monitor BP closely.
- Dizziness, dehydration: Assess for dry mucous membranes, poor skin turgor.
- Ototoxicity (if IV Lasix pushed too fast!): Risk of hearing damage.
Patient Education for Heart Failure
- Low-Sodium Diet:
- Goal: < 2,000 mg/day to reduce fluid retention.
- Good Choices: Fresh fruits/vegetables, lean meats, whole grains, unsalted nuts.
- Avoid: Canned soups, processed meats, fast food, frozen meals, chips.
- Slowly Increase Exercise Tolerance:
- Start with low-intensity walking.
- Avoid overexertion—stop if dyspnea, dizziness, fatigue occur.
- Possible Fluid Restriction:
- Common limit: 1.5-2L/day (Check provider recommendations).
- Ways to manage thirst: Ice chips, sugar-free gum, lemon water.
GI Conditions Study Guide
Inflammatory Bowel Disease (IBD) Overview
- Includes Crohn’s Disease & Ulcerative Colitis (UC).
- Chronic, immune-mediated inflammation of the GI tract.
Crohn’s Disease vs. Ulcerative Colitis (UC)
- Crohn’s Disease:
- Location: Mouth to anus (any part of GI tract).
- Pattern of Disease: Skip lesions (patchy areas of inflammation).
- Bowel Layer Affected: All layers (transmural).
- Ulcerations: Deep ulcerations lead to fistulas, strictures, abscesses.
- Stools per Day: 5-6 loose stools/day.
- Nutritional Deficiencies: Common due to malabsorption.
- Surgical Cure: No – recurs even after surgery.
- Ulcerative Colitis (UC):
- Location: Only the large intestine (colon & rectum).
- Pattern of Disease: Continuous, uniform inflammation.
- Bowel Layer Affected: Only mucosa & submucosa.
- Ulcerations: Shallow ulcers, no fistulas.
- Stools per Day: ≥20 liquid, bloody stools/day (mucus present).
- Nutritional Deficiencies: Less common but still possible.
- Surgical Cure: Yes – colectomy is curative.
- Mnemonic:
- "Crohn’s Crawls" (through entire GI tract, skips around, deep ulcerations)
- "UC is Uniform" (spreads continuously, only affects colon & rectum)
Diagnostics
- Colonoscopy: Direct visualization of inflammation, ulcerations.
- Barium Enema: Identifies strictures, fistulas (Crohn’s) & extent of UC.
- Lab Tests:
- CBC: Check for anemia (blood loss from UC).
- CRP/ESR: Inflammation markers (↑ in active disease).
- Electrolytes: Risk of imbalances from diarrhea (K+, Mg2+).
Medical Management
- Medications:
- Aminosalicylates (5-ASA, e.g., Mesalamine): Decreases inflammation.
- Corticosteroids (Prednisone): Used for flare-ups, NOT long-term use.
- Immunosuppressants (Azathioprine, Methotrexate): Reduces immune response.
- Biologics (Infliximab, Adalimumab): Targets immune proteins causing inflammation.
- Nutrition & Supplementation:
- Small, frequent meals (prevent overloading GI tract).
- Low-residue diet (avoid high-fiber foods that worsen diarrhea).
- High-protein, high-calorie diet (prevent malnutrition).
- Vitamin B12, Iron, Calcium, Vitamin D (esp. Crohn’s due to malabsorption).
- Surgery:
- UC: Colectomy = Curative (removal of colon stops disease).
- Crohn’s: Surgery only for complications (not a cure).
Nursing Management & Education
- When to Call 911 (Emergent Symptoms):
- Severe abdominal pain & rigidity: Possible perforation.
- High fever, tachycardia: Infection/sepsis risk.
- Signs of dehydration: Extreme thirst, dizziness, decreased urine output.
- General Patient Education:
- Avoid triggers (spicy foods, dairy, alcohol, high-fat foods).
- Monitor stool patterns and keep a symptom journal.
- Encourage rest periods (avoid excessive fatigue).
- Hydration is KEY (esp. with frequent diarrhea).
Diverticulitis
- Diverticula are small outpouchings in the colon wall, often due to a low-fiber diet and straining.
- Diverticulitis is the inflammation or infection of these outpouchings.
- Mnemonic: "Diverticulitis = Diverticula + Inflammation"
Causes & Risk Factors for Diverticulitis
- Low-fiber diet slows stool transit time, increasing pressure in colon.
- Chronic constipation and straining weakens the colon wall.
- Obesity increases intra-abdominal pressure.
- Aging increases risk; more common in those >40 years old.
Clinical Manifestations of Diverticulitis
- Fever indicates infection.
- Left Lower Quadrant (LLQ) pain is classic symptom.
- Cramping and bloating may occur.
- Nausea and vomiting may occur if severe inflammation is present.
Complications of Diverticulitis
- Perforation can lead to sudden, severe abdominal pain with immediate relief, which requires calling 911.
- Abscess formation leads to swollen, pus-filled pockets requiring drainage.
- Peritonitis may occur if perforation leads to infection in the abdominal cavity.
Diagnostics for Diverticulitis
- Abdominal X-ray rules out free air, which indicates perforation.
- CT scan is the gold standard for confirming inflammation and abscesses.
Nursing Management (During Hospitalization) for Diverticulitis
- NPO (Nothing by Mouth) to rest the bowel.
- IV Fluids prevent dehydration.
- NG Tube is used if severe nausea/vomiting occurs.
- Pain Control: Avoid NSAIDs to reduce the risk of GI bleed; use acetaminophen instead.
- Antibiotics: Broad-spectrum, such as Metronidazole + Ciprofloxacin.
Discharge & At-Home Management for Diverticulitis
- Dietary Guidelines vary depending on the stage.
- During an Acute Flare-up: Follow a low-fiber diet including clear liquids, white bread, rice, eggs, yogurt.
- During Post-Flare Recovery: Slowly reintroduce fiber such as cooked veggies, soft fruits, and whole grains.
- For Maintenance: Follow a high-fiber diet to prevent future attacks.
- AVOID during flares: Nuts, seeds, popcorn, tough raw veggies because they are irritating.
- Lifestyle Changes are important
- Maintain a healthy BMI to reduce colon pressure.
- Hydration prevents constipation.
- Exercise promotes healthy digestion.
- When to Call 911
- High fever (>101°F/38.3°C) indicates possible infection.
- Severe abdominal pain lasting >3 days could be a sign of complications.
- GI bleeding (black/tarry stools, bright red blood) requires immediate attention.
Colorectal Cancer (CRC)
- Colorectal Cancer is cancer of the colon or rectum.
- It develops from polyps, which are abnormal tissue growths in the colon.
- Mnemonic: "Colon Cancer = Cancer from Colon Polyps"
Risk Factors for CRC
- Lifestyle & Health Conditions:
- High BMI (obesity increases risk).
- Alcohol & tobacco use damages the colon lining.
- Type 2 Diabetes Mellitus (T2DM) leads to chronic inflammation & insulin resistance.
- Inflammatory Bowel Disease (IBD) >10 years (Crohn’s, Ulcerative Colitis) increases risk.
- Genetic & Family History:
- Family history of CRC or polyps increases risk.
- Lynch Syndrome and Familial Adenomatous Polyposis (FAP) require early screening.
Clinical Manifestations
- General Symptoms:
- Fatigue results from chronic blood loss and anemia.
- Unexpected weight loss results from metabolic changes.
- Specific Symptoms:
- Abdominal pain or distention indicates tumor growth.
- Changes in bowel habits include diarrhea, constipation, and narrower stools.
- Red or black stool happens due to GI bleeding.
- Melena indicates black stool.
- Bright red indicates lower GI bleeding.
- A feeling of incomplete evacuation or tenesmus indicates rectal tumors.
Screening Guidelines
- For average-risk individuals (Ages 45-75):
- Fecal Occult Blood Test (FOBT) should be done annually.
- Sigmoidoscopy should be done every 5 years.
- Colonoscopy should be done every 10 years.
- For high-risk individuals:
- Start screening before age 45 (family history, IBD, genetic conditions).
Medical Management
- Chemotherapy shrinks tumors and destroys cancer cells.
- Radiation Therapy is used for rectal cancer or to shrink tumors pre-surgery.
- Surgical Options:
- Polypectomy (if early-stage) involves the removal of polyps.
- Colectomy involves partial or total colon removal (if advanced cancer).
- Colostomy/Ileostomy is used if bowel continuity cannot be maintained.
Nursing Considerations
- Post-Surgical Care:
- Monitor intake & output to watch for dehydration, ileus.
- Pain management includes PCA pumps and IV meds.
- Diet & fluid status progresses from NPO to clear liquids to a low-fiber diet and then slowly to a high-fiber diet.
- NG Tube (if needed) is used to decompress the stomach and prevent aspiration.
- Promote activity to prevent DVTs and improve GI motility.
- When to Call the Provider:
- Severe abdominal pain or bloating indicates obstruction risk.
- Signs of infection include fever and redness at the incision site.
- Persistent nausea/vomiting may indicate ileus.
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