Gastrointestinal Surgery Quiz - Module 14
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Questions and Answers

What is the primary reason for assessing a patient's pain tolerance in the postoperative setting?

  • To create a surgical history report
  • To evaluate the need for teaching or tools for pain management (correct)
  • To determine the patient's anxiety level
  • To establish a baseline for postoperative vitals

    • What should be confirmed pre-, intra-, and post-operatively regarding blood products?

  • The patient's blood type and availability of blood products (correct)
  • The surgeon's preference for blood type
  • The cost of the blood products
  • The location of the nearest blood bank

    • Which position is typically associated with gastrointestinal surgeries?

  • Supine or modified lithotomy position (correct)
  • Lateral decubitus with head elevated
  • Sitting position
  • Prone position

    • What is the purpose of the initial major count in surgical procedures?

    <p>To ensure all instruments are present before starting</p> Signup and view all the answers

    What type of blanket is used during surgeries to prevent hypothermia?

    <p>Forced-air warming blanket</p> Signup and view all the answers

    What is the primary purpose of gastrointestinal surgery?

    <p>To establish a diagnosis and manage disease</p> Signup and view all the answers

    Which instruments are specifically used for clamping the stomach during surgery?

    <p>Special gastric soft clamp instruments</p> Signup and view all the answers

    Which artery supplies the large intestine from the left colic flexure to the upper part of the rectum?

    <p>Inferior mesenteric artery</p> Signup and view all the answers

    Why is the continuous assessment of a patient's temperature necessary during surgery?

    <p>To ensure normothermia and prevent hypothermia</p> Signup and view all the answers

    What is an important consideration in the nursing assessment for gastrointestinal surgery?

    <p>Evaluating skin for risk of breakdown</p> Signup and view all the answers

    What is the recommended collaboration role of the perioperative nurse during surgery?

    <p>Ensuring the patient is safely positioned</p> Signup and view all the answers

    Which of the following best describes a key aspect of bowel technique in gastrointestinal surgery?

    <p>Isolating and handling the bowel with care</p> Signup and view all the answers

    Which surgical technique involves the use of various staplers for the GI tract?

    <p>Both open and minimally invasive surgeries</p> Signup and view all the answers

    What is the main challenge during a laparoscopic Nissen full fundal wrap procedure?

    <p>Achieving the correct amount of suturing tension</p> Signup and view all the answers

    What is meant by 'perioperative nursing considerations' in the context of GI surgery?

    <p>Care and monitoring throughout the surgical process</p> Signup and view all the answers

    What are the implications of unexpected outcomes during gastrointestinal surgery?

    <p>They pose a risk for injury and impact patient outcomes</p> Signup and view all the answers

    What is the most popular method for gastrostomy tube placement?

    <p>Percutaneous endoscopic gastrostomy (PEG)</p> Signup and view all the answers

    Which of the following is NOT a reason for performing gastrointestinal surgery?

    <p>Enhancing physical appearance</p> Signup and view all the answers

    What procedure is indicated for increasing the diameter of the pyloric sphincter?

    <p>Pyloromyotomy</p> Signup and view all the answers

    What type of gastrectomy removes the entire stomach?

    <p>Total gastrectomy</p> Signup and view all the answers

    What is the main purpose of bariatric surgery?

    <p>To promote weight loss or reduction</p> Signup and view all the answers

    What does Roux-en-Y gastric bypass achieve in a bariatric surgery context?

    <p>Allows food to bypass part of the small intestine</p> Signup and view all the answers

    Which type of gastrectomy specifically involves connecting the stomach to the duodenum?

    <p>Billroth 1</p> Signup and view all the answers

    In a laparoscopic Nissen fundoplication, what can happen if the wrap around the esophagus is too loose?

    <p>Persistent gastroesophageal reflux disease (GERD)</p> Signup and view all the answers

    What is the main purpose of mesenteric repair during bowel removal?

    <p>To prevent bowel entrapment and obstruction</p> Signup and view all the answers

    What type of suture is typically used for repairing the internal serosa?

    <p>Absorbable vicryl or polysorb suture</p> Signup and view all the answers

    What is the role of the dilator in the open Nissen fundoplication procedure?

    <p>To prevent accidental suturing of the esophagus</p> Signup and view all the answers

    What is the main concern with the blood supply during mesenteric defect repair?

    <p>Preventing ischemia in the removed bowel</p> Signup and view all the answers

    Which surgical technique is specifically developed for managing GERD?

    <p>Nissen Fundoplication</p> Signup and view all the answers

    What is the characteristic feature of the Nissen Fundoplication procedure?

    <p>Wrapping the upper part of the stomach around the lower esophagus</p> Signup and view all the answers

    Which sutures are commonly used for external serosa repair?

    <p>Permanent sutures like silk</p> Signup and view all the answers

    What condition does GERD primarily result from?

    <p>Dysfunction of the lower esophageal sphincter</p> Signup and view all the answers

    What is the primary reason for creating a temporary colostomy or ileostomy?

    <p>To allow the bowel to rest or let an anastomosis heal</p> Signup and view all the answers

    What does the Hartmann Colostomy involve?

    <p>Bringing the distal bowel out through the skin while closing the proximal stump</p> Signup and view all the answers

    In which situation is an Abdominoperineal Resection typically required?

    <p>When a rectal tumor is too close or large for preservation of the anus</p> Signup and view all the answers

    What is created during the Ileal Anal Pull Through procedure?

    <p>A side-to-side anastomosis of a small bowel pouch to the remaining rectum</p> Signup and view all the answers

    What characterizes a permanent colostomy after bowel resection?

    <p>It results from cancer treatment leading to significant bowel resection</p> Signup and view all the answers

    What happens during the closure of a Hartmann Colostomy?

    <p>The blind closed mucous fistula is anastomosed back with the proximal section</p> Signup and view all the answers

    Which procedure eliminates the need for an ileostomy in patients with ulcerative colitis?

    <p>Ileal Anal Pull Through</p> Signup and view all the answers

    What is a primary function of a temporary colostomy in emergency scenarios?

    <p>To decompress a bowel that is likely to perforate</p> Signup and view all the answers

    Study Notes

    Gastrointestinal Surgery Overview

    • Gastrointestinal (GI) surgery addresses conditions of the esophagus, stomach, small intestine, large intestine, and rectum for diagnosis, disease prevention, symptom relief, restoration of function, and palliative care.
    • Subspecialty under general surgery aimed at surgical management of GI conditions.

    Anatomy and Blood Supply

    • Superior mesenteric artery: Supplies intestines from duodenum and pancreas to left colic flexure.
    • Inferior mesenteric artery: Supplies large intestine from left colic flexure to upper rectum.

    Perioperative Nursing Considerations

    • Risk assessments should be performed to anticipate potential complications and unexpected outcomes.
    • Preoperative skin assessments identify high-risk areas for pressure injuries.
    • Bariatric patients require special attention due to comorbidities influencing surgery risk.
    • Blood product availability must be confirmed pre-, intra-, and post-operatively, especially during extensive tissue dissection.

    Patient Positioning

    • Typically, patients are positioned supine or in modified lithotomy depending on the procedure.
    • Positioning aids like bean bags and bolsters may be utilized, and safety protocols must be strictly followed.

    Instrumentation and Counting

    • Use of basic laparotomy instrument sets and specialized instruments as per surgical preference.
    • Major counts (initial and closing) ensure no instruments or sponges are retained in the body.

    Equipment and Monitoring

    • Forced-air warming blankets are crucial for preventing hypothermia due to extensive skin exposure during surgery.
    • Continuous temperature monitoring is necessary to maintain normothermia.

    Surgical Techniques and Procedures

    • GIA Stapler: Used for creating side-to-side anastomosis during bowel resection.
    • Mesenteric defect repair: Required when bowel is removed to prevent postoperative complications.

    Types of Surgeries

    • Nissen Fundoplication: Addresses GERD by wrapping the upper stomach around the lower esophagus; can be performed open or laparoscopically.
    • Gastrostomy (PEG): Flexible gastroscope used for tube placement under moderate sedation.
    • Gastrectomy: Involves total or partial removal of the stomach; can lead to Roux-en-Y anastomosis.

    Bariatric Surgery

    • Aims to assist in weight loss; typically performed laparoscopically.
    • Roux-en-Y gastric bypass is a common technique reducing stomach size and altering nutrient absorption.

    Colostomy and Ileostomy Creations

    • Temporary Colostomy: Allows healing or rest of the bowel.
    • Permanent Colostomy: Created in emergency situations or cancer cases leading to bowel resection.
    • Hartmann Procedure: Emergency colostomy due to perforation risks, involving subsequent closure depending on patient recovery.
    • Ileal Anal Pull Through: Applicable for ulcerative colitis, where the large bowel and part of the rectum are removed, creating a pouch from the small intestine.

    Closure Techniques

    • Manual suturing may be required post-stapling; absorbable sutures for internal serosa and permanent for external serosa.

    Key Takeaways

    • GI surgery involves complex procedures that require thorough preparation, awareness of anatomical structures, and careful management of patient positioning and monitoring.
    • Understanding surgical techniques and post-operative care is essential for effective patient outcomes.

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    Description

    Test your knowledge on gastrointestinal surgery with this quiz based on Module 14 of Alexander’s Care of the Patient in Surgery and ORNAC Standards 2023. Assess your understanding of anatomy, procedural considerations, and different surgical staplers. Ideal for medical students and surgical practitioners.

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