MS1 Exam 5 Study Guide

Acute/Chronic Pancreatitis

• Characterized by inflammation of the pancreas, either sudden (acute) or long-lasting (chronic).
• Clinical manifestations include severe abdominal pain, nausea, vomiting, and elevated pancreatic enzymes.
• Risk factors encompass gallstones, chronic and excessive alcohol consumption, and certain medications.
• Patient education should include avoiding trigger foods, alcohol cessation, and importance of regular follow-ups.
• Nursing actions involve pain management, monitoring vital signs, and assessing for complications.
• Recommended diet is low in fat and high in carbohydrates to reduce pancreatic workload.

NG Tube Insertion

• Gather necessary equipment (NG tube, lubricant, syringe, tape).
• Position the patient in a high-Fowler’s position.
• Measure tube length from nose to earlobe to xiphoid process; mark with tape.
• Lubricate the tube tip and insert gently through the nostril, aiming downward.
• Advance the tube as the patient swallows water to facilitate passage.
• ConfirmPlacement with an x-ray or pH testing, and secure the tube.

Ostomy Care

• Regularly assess skin integrity around the stoma to prevent breakdown.
• Look for signs of bleeding, pain, or abnormal stoma color (should be pink/red).
• Monitor the consistency of stool based on ostomy type (e.g., ileostomy = more liquid; colostomy = more formed).

Colostomy

• Assessment includes stoma appearance, output consistency, and surrounding skin condition.
• Normal findings involve a moist, pink stoma; abnormal signs include pallor or excessive bleeding.
• Nursing care includes proper hygiene, change of the ostomy bag, and skin protection.
• Contact physician if stoma is dark, shows signs of necrosis, or if there’s ileus or obstruction.

Colon Cancer

• Assessment may reveal changes in bowel habits, unexplained weight loss, and abdominal discomfort.
• Findings include rectal bleeding or melena, and iron deficiency anemia.
• Risk factors involve age, family history, and dietary habits (high fat, low fiber).
• Management includes surgery, chemotherapy, radiation, and regular screening.
• Diagnostic tests may include colonoscopy and biopsy.

Inflammatory Bowel Disease (IBD) - Ulcerative Colitis/Crohn's

• Ulcerative colitis involves inflammation of the colon’s innermost lining, while Crohn's can affect any part of the GI tract.
• Complications include bowel obstructions, fistulas (Crohn's), and colon cancer (UC).

Bowel Obstruction/Paralytic Ileus

• Bowel obstruction is a blockage preventing food and fluids from passing; paralytic ileus is a temporary cessation of bowel activity.
• Improvement can be indicated by return of bowel sounds, passage of gas, and resumption of bowel movements.

Irritable Bowel Syndrome (IBS)

• Types include IBS with diarrhea, IBS with constipation, or mixed.
• Treatment may involve dietary changes, medications (antidiarrheal, laxatives), and stress management.
• Nursing interventions focus on patient education, symptom diary, and dietary modification.

Diverticulitis

• Involves inflammation or infection of diverticula in the intestine.
• Clinical manifestations include mild to severe abdominal pain, fever, and changes in bowel habits.
• Treatment comprises antibiotics, dietary modifications, and potentially surgery.
• Patient teaching should emphasize high-fiber diet to prevent recurrence.

Dumping Syndrome

• Occurs after gastric surgery; rapid gastric emptying causes symptoms like diarrhea, sweating, and tachycardia.
• Patient education involves eating smaller meals, avoiding sugar, and lying down after eating.

Gastroenteritis

• Characterized by inflammation of the stomach and intestines, leading to vomiting and diarrhea.
• Clinical manifestations include watery diarrhea, abdominal cramps, nausea, and fever.

Peptic Ulcer Disease

• Risk factors include H. pylori infection, NSAID use, alcohol, and smoking.
• Clinical manifestations involve burning stomach pain, bloating, and indigestion.
• Treatment may include proton pump inhibitors, antacids, and avoiding irritants.
• Nursing intervention focuses on pain management and lifestyle modifications.

GI Bleed

• Recognize origins based on symptoms: upper GI bleeds may present as vomit with blood/coffee grounds; lower GI bleeds may present as bloody stool.
• Nursing interventions include monitoring vital signs, administering IV fluids, and preparing for possible procedures.

GERD

• Risk factors include obesity, smoking, pregnancy, and dietary choices.
• Treatment involves lifestyle modifications, medications (antacids, H2 blockers), and possibly surgery for severe cases.
• Patient education should emphasize dietary adjustments and proper positioning after meals.

Nissen Fundoplication

• A surgical procedure to treat GERD by wrapping the top of the stomach around the lower esophagus.
• Nursing interventions focus on post-operative care, monitoring for complications, and educating patients on diet and lifestyle changes.

Hepatitis

• Pathophysiology includes inflammation of the liver, often viral (A, B, C).
• Clinical manifestations encompass jaundice, fatigue, and abdominal pain.
• Treatments vary based on type and may include antivirals or supportive care.
• Nursing interventions involve education on transmission prevention and liver health.

Cirrhosis

• Progressive liver disease characterized by scarring (fibrosis).
• Clinical manifestations include jaundice, ascites, and esophageal varices.
• Patient teaching emphasizes avoidance of alcohol, nutrition management, and monitoring liver function.

Musculoskeletal System with Aging

• Changes include reduced bone density, joint stiffness, and decreased muscle mass.
• Increased risk of fractures and osteoarthritis necessitates regular exercise and proper nutrition.

Scoliosis

• A lateral spinal curvature, detected through physical exam and imaging.
• Screening often occurs during adolescence; intervention may involve braces or surgery for severe cases.

Kyphosis

• A forward rounding of the back, which can be age-related or due to conditions like osteoporosis.
• Management may include physical therapy, pain management, or surgery in advanced cases.

Lordosis

• An exaggerated inward curve of the spine, often observed in the lower back.
• Treatment focuses on physical therapy and pain relief measures.

This study guide covers key topics related to acute and chronic pancreatitis, NG tube insertion, ostomy care, and colon cancer. It includes essential assessments, clinical manifestations, patient education, and nursing actions. Ensure you're familiar with risk factors, expected orders, and dietary considerations for each topic.