Podcast
Questions and Answers
A patient with cirrhosis and ascites is scheduled for a paracentesis. Which nursing intervention is most important to implement prior to the procedure?
A patient with cirrhosis and ascites is scheduled for a paracentesis. Which nursing intervention is most important to implement prior to the procedure?
- Administer a broad-spectrum antibiotic.
- Place the patient in a supine position with knees flexed.
- Instruct the patient to empty their bladder. (correct)
- Ensure the patient has signed informed consent.
A patient is receiving Total Parenteral Nutrition (TPN) via a central line. If the TPN infusion is suddenly interrupted and a new TPN bag is unavailable, which intervention is the priority?
A patient is receiving Total Parenteral Nutrition (TPN) via a central line. If the TPN infusion is suddenly interrupted and a new TPN bag is unavailable, which intervention is the priority?
- Check the patient's blood glucose level every 4 hours.
- Administer a bolus of intravenous insulin.
- Hang a bag of normal saline or dextrose intravenously. (correct)
- Monitor the patient for signs of fluid overload.
A nurse is providing post-operative care for a patient who underwent a bariatric surgery. Which nursing intervention is most important for preventing complications?
A nurse is providing post-operative care for a patient who underwent a bariatric surgery. Which nursing intervention is most important for preventing complications?
- Maintaining a high-fat, low-protein diet.
- Encouraging large, infrequent meals.
- Monitoring for signs of dumping syndrome. (correct)
- Administering pain medication only when requested.
A patient with acute pancreatitis is complaining of severe left upper quadrant pain. Which laboratory finding would the nurse expect to see elevated?
A patient with acute pancreatitis is complaining of severe left upper quadrant pain. Which laboratory finding would the nurse expect to see elevated?
A patient with hepatic encephalopathy exhibits asterixis and increasing confusion. What is the priority nursing intervention?
A patient with hepatic encephalopathy exhibits asterixis and increasing confusion. What is the priority nursing intervention?
A patient undergoing an endoscopy reports a history of GERD and dysphagia. Besides these, what other condition would justify the use of an endoscopy?
A patient undergoing an endoscopy reports a history of GERD and dysphagia. Besides these, what other condition would justify the use of an endoscopy?
A patient is scheduled for a colonoscopy to screen for colorectal cancer. What instructions should be given about bowel preparation?
A patient is scheduled for a colonoscopy to screen for colorectal cancer. What instructions should be given about bowel preparation?
Following a barium enema, a patient expresses concern about having clay-colored stools. What is the appropriate nursing response?
Following a barium enema, a patient expresses concern about having clay-colored stools. What is the appropriate nursing response?
Which combination of risk factors most significantly increases the likelihood of developing oral cancer?
Which combination of risk factors most significantly increases the likelihood of developing oral cancer?
A patient with a duodenal ulcer reports that their abdominal pain is relieved after eating. How does this presentation differ from that of a gastric ulcer?
A patient with a duodenal ulcer reports that their abdominal pain is relieved after eating. How does this presentation differ from that of a gastric ulcer?
A client who underwent a gastrectomy is experiencing rapid gastric emptying, leading to dumping syndrome. Which dietary modification is most appropriate for managing their symptoms?
A client who underwent a gastrectomy is experiencing rapid gastric emptying, leading to dumping syndrome. Which dietary modification is most appropriate for managing their symptoms?
A patient with Irritable Bowel Syndrome (IBS) reports frequent episodes of bloating and alternating diarrhea and constipation. What specific dietary change is most likely to help manage these symptoms?
A patient with Irritable Bowel Syndrome (IBS) reports frequent episodes of bloating and alternating diarrhea and constipation. What specific dietary change is most likely to help manage these symptoms?
During an acute exacerbation of ulcerative colitis, what dietary modification is most beneficial for a patient experiencing bloody diarrhea and abdominal pain?
During an acute exacerbation of ulcerative colitis, what dietary modification is most beneficial for a patient experiencing bloody diarrhea and abdominal pain?
Flashcards
Normal Stoma Appearance
Normal Stoma Appearance
Red, moist, and protruding.
Total Parenteral Nutrition (TPN)
Total Parenteral Nutrition (TPN)
IV nutrition requiring a central line, monitor glucose, and taper when discontinuing.
Large Bowel Obstruction Signs
Large Bowel Obstruction Signs
Severe constipation and respiratory distress.
Hepatic Encephalopathy Signs
Hepatic Encephalopathy Signs
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Acute Pancreatitis Symptoms
Acute Pancreatitis Symptoms
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Endoscopy
Endoscopy
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Colonoscopy Perforation Signs
Colonoscopy Perforation Signs
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Expected stool color after barium enema
Expected stool color after barium enema
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Early signs of Oral Cancer
Early signs of Oral Cancer
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PUD Pain Relief (Duodenal)
PUD Pain Relief (Duodenal)
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Triple Therapy for H. pylori
Triple Therapy for H. pylori
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Dumping Syndrome Symptoms
Dumping Syndrome Symptoms
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Ulcerative Colitis Diet (Exacerbation)
Ulcerative Colitis Diet (Exacerbation)
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Study Notes
- These notes cover adult health topics, specifically focusing on diagnostic procedures and common gastrointestinal disorders.
Endoscopy
- It is indicated for GERD, ulcers, dysphagia, suspected GI bleeding, and tumors.
- Patients should be NPO for 6-8 hours before the procedure.
- Check for allergies to sedation or contrast.
- Obtain informed consent before the procedure.
- Assess for anticoagulant use because of increased bleeding risk.
- Check vital signs every 30 minutes for 2 hours post-procedure.
- Monitor for pain, fever, or difficulty swallowing, which indicates perforation.
- Observe for bleeding, black stools, or hypotension.
- Ensure gag reflex returns before resuming oral intake.
Colonoscopy
- Screens for for colorectal cancer, IBD, polyps, and unexplained GI bleeding.
- Patients should be taught to follow a clear liquid diet 24 hours before and to utilize laxatives like polyethylene glycol for bowel prep.
- Patients should be NPO after midnight.
- Post-procedure, patients can expect abdominal cramping and gas.
- Complications include perforation (severe pain, fever, bleeding) and bleeding (monitor stools).
Barium Enema Sigmoidoscopy
- It is indicated for detecting polyps, tumors, and diverticula.
- Bowel prep is required, including laxatives, enemas, and clear liquids.
- Assess for barium allergy before the procedure.
- White or clay-colored stool is expected post-procedure due to barium contrast.
- Encourage fluid intake to expel barium.
Oral Cancer
- Major causes include tobacco, alcohol use, and HPV.
- Early signs include persistent mouth sores, difficulty swallowing, and red or white patches.
Malabsorption Syndrome
- Symptoms include chronic diarrhea, weight loss, bloating, and steatorrhea.
Peptic Ulcer Disease (PUD)
- Main causes include H. pylori, NSAIDs, and stress.
- Epigastric pain is a main symptom (relieved with eating in duodenal ulcers, worsens with eating in gastric ulcers).
- Diagnosed via endoscopy and H. pylori testing.
- Avoid NSAIDs, smoking, and alcohol.
- Triple therapy includes PPI + 2 antibiotics (clarithromycin, amoxicillin/metronidazole).
- Follow a diet of small, frequent meals and avoid spicy/acidic foods.
Dumping Syndrome
- Symptoms include nausea, diarrhea, dizziness, and tachycardia after meals.
Gastritis
- Symptoms include nausea, vomiting, and upper abdominal pain.
Gastric Cancer
- Patients are typically asymptomatic in early stages.
- Clean the surgical site daily post-gastrectomy to prevent infection.
Irritable Bowel Syndrome (IBS)
- Symptoms include alternating diarrhea/constipation and bloating.
- Avoid trigger foods like caffeine and dairy, and manage stress.
Ulcerative Colitis
- Symptoms include bloody diarrhea and abdominal pain.
- During exacerbation, follow a high protein, low fiber diet.
Bowel Obstructions
- Small bowel obstruction presents with abdominal distension, nausea, and vomiting.
- Nursing interventions include NG tube insertion and monitoring fluid/electrolytes.
- Large bowel obstruction presents with severe constipation and respiratory distress.
- Interventions include surgery and IV fluids.
Diverticulitis
- Symptoms include fever, LLQ pain, and nausea.
Colostomy Care
- A normal stoma should be red, moist, and protruding.
- An abnormal stoma will be pale, black, or recessed, in which case the provider should be contacted.
- Educate patients on skin care and appliance changes.
Appendicitis
- Symptoms include RLQ pain, fever, and nausea.
Hemorrhoids
- Symptoms include rectal pain and bleeding.
Obesity & Bariatric Surgery
- Class II Obesity is classified as a BMI of 35-39.9.
- Provide nutritional counseling pre-surgery.
- Post-surgery, monitor for complications and encourage small frequent meals.
Total Parenteral Nutrition (TPN)
- Requires a central line for IV administration.
- Monitor blood glucose due to risk of hyperglycemia and rebound hypoglycemia.
- When TPN is discontinued, administer NS or Dextrose IV fluids.
NG Tube Care
- Check placement before use.
- Monitor for dumping syndrome.
Cholecystectomy with T-Tube
- Clay-colored stool is an expected finding.
Cirrhosis & Ascites
- A complication of cirrhosis is ascites.
- A procedure to help treat this is paracentesis.
- Ask the patient to void before paracentesis.
- Monitor for hypotension post-paracentesis.
- Encourage a low-sodium diet and diuretics.
Hepatic Encephalopathy
- Symptoms include flapping tremor (asterixis) and confusion.
- Severe LOC change is a complication, in which case the provider should be contacted.
Celiac Disease
- Symptoms include diarrhea and bloating.
- Follow a gluten-free diet, avoiding wheat, rye, and barley.
Pancreatitis
- Acute symptoms include severe LUQ pain, nausea, and vomiting.
- Labs show increased amylase and lipase.
- Chronic symptoms include ecchymosis in flank (Grey-Turner sign).
- Advanced pancreatic cancer care focuses on comfort measures and emotional support.
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