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NCLEX RN Chapter 52 GI system
Terms in this set (76)
A ______ ______ is a procedure that uses a small wireless camera shaped like a medication capsule that the client swallows; the test will detect bleeding or changes in the lining of the small intestine.
What is another name for esophagogastroduodenoscopy?
upper gastrointestinal endoscopy
For a fiberoptic colonoscopy, a ____ _____ diet is started on the day before the test. Most medications are withheld before the test. The client is NPO after ______ on the day before the test.
The client receiving enemas or colon cleansing agents is at risk for _____ and _____ imbalances
fluid and electrolyte
After a client has had a colonoscopy, monitor for signs of a bowel perforation and peritonitis which include restlessness, guarding of the _____, progressive abdominal _____ and abdominal ______, increased _____ and chills, tachycardia and tachypnea, and pallor.
After an endoscopic retrograde cholangiopancreatography, monitor for the return of the _____ reflex and for signs of perforation or ________.
Following endoscopic procedures, monitor for the return of a gag reflex before giving the client any _____ substance. If the gag reflex has not returned, the client could ______.
The rapid removal of fluid from the abdominal cavity during paracentesis leads to decreased abdominal pressure which can cause ________ and resultant _______.
Liver biopsy: a needle is inserted through the _____ _____ to the liver to obtain a tissue sample.
Preprocedure for liver biopsy: it is most important to check results of ______ tests? (what three tests are included in this?)
partial thromboplastin time
Liver biopsy: note that the client is placed in the _______ or left lateral position during the procedure to expose the right side of the upper abdomen.
Postprocedure for liver biopsy: maintain bed rest for time frame as prescribed, usually ____ hours.
Following a liver biopsy, place the client on the _____ side with a pillow (or agency-approved pressure item such as a sandbag) under the costal margin to decrease the risk of hemorrhage; the client is instructed to avoid ______ and ______.
What kind of ulcers have these symptoms: gnawing, sharp pain in or to the left of the midepigastric region occurs 30 to 60 minutes after a meal (food ingestion accentuates the pain). Hematemesis is more common that melena.
What kind of ulcer has this data collection: Burning pain in the mid epigastric area 1 ½ - 3 hours after a meal and during the night ( often awakes the client). Melena is more common than hematemesis. Pain is often relieved by the ingestion of food.
Clients with peptic ulcers should avoid consuming what three substances?
Can they have aspirin or NSAIDs?
Patients with peptic ulcer disease, postoperative interventions: Maintain NPO status as prescribed for ___ to ___ days until ______ returns.
Peptic ulcer disease, postoperative interventions: monitor for postoperative complications of hemorrhage, ______ syndrome, diarrhea, hypoglycemia, and vitamin B12 deficiency.
Following gastric surgery, why should you not remove a nasogastric tube unless specifically ordered to by the doctor? Monitor closely to ensure proper functioning of the NG Tube to prevent strain on the anastomosis site. Contact the hcp if the tube is not functioning properly.
because of the risk for disruption of the gastric sutures
What is dumping syndrome?
a group of symptoms, including weakness, abdominal discomfort, and sometimes abnormally rapid bowel evacuation, occurring after meals in some patients who have undergone gastric surgery.
Preventing dumping syndrome: Avoid sugar, ____, and ______. Eat a high-_____, high-_____, and low-______ diet. Eat small meals and avoid consuming fluids with meals. What position should the patient be in after meals? Take antispasmodic medications as prescribed to delay gastric emptying.
The following Data collection is for what syndrome? Symptoms Occurring 30 minutes after eating period, nausea and vomiting, feelings of abdominal fullness and abdominal cramping, diarrhea, palpitations and tachycardia, perspiration, weakness and dizziness, borborgymi (loud gurgles indicating hyperperistalsis).
The following Data collection is for what vitamin deficiency? Severe pallor, fatigue, weight loss, smooth, beefy red tongue, slight jaundice, paresthesias the hands and feet, disturbances with gait and balance.
Bariatric surgery: older clients are at increased postoperative risk for _________ (organ related) and ___________ complications and death.
Bariatric surgery: The client needs to agree to modify his or her lifestyle, lose ______and keep the _____ (same as above) off, and obtain support for available Community Resources.
Client education following bariatric surgery: avoid _____, high-_____ foods, and foods high in _____ and ______. Eat ____(speed) and chew food well. Progressive food types and amounts as prescribed. Take nutritional _____ as prescribed, which may include calcium, iron, multi-vitamins, and vitamin B12. Monitor and Report signs and symptoms of complications, such as _____ and _____ leak (persistent abdominal pain and nausea and vomiting).
Should the amount of liquid be restricted for patients who have hiatal hernias? Should a client recline or lay down after meals?
Epigastric pain that radiates to the scapula 2-4 hours after eating fatty foods and may persist for 4-6 hours is data collection for what?
Cholecystitis is inflammation of the _____ that may occur as an acute or chronic process.
Data collection for cholecystitis: cannot take a deep breath when the examiner's fingers are passed below the hepatic margin because of pain. This is called ______ sign?
Cholecystitis: Jaundice, dark orange and foamy urine, statorrhea and clay-colored feces, and pruritus all occur because of ____ ostruction.
Postoperative interventions for a cholecystectomy or choledocholithotomy: monitor for _______ complications caused by pain at the incisional site.
Postoperative interventions for a cholecystectomy or choledocholithotomy: maintain _____ status (diet) and nasogastric tube _____ as prescribed
What is this: A chronic, progressive disease of the liver characterized by diffuse degeneration and destruction of hepatocytes.
Cirrhosis can lead to ______ hypertension: a persistent increase in pressure in the portal vein that developed as a result of obstruction to flow.
What is this: dilated and tortuous veins in the submucosa of the esophagus. Caused by portal hypertension, are often associated with liver cirrhosis, and are at high risk for rupture if portal circulation pressure rises.
If esophageal varices begin to _____, this is an emergency.
Stages of viral hepatitis:
_________ stage: 1st stage of hepatitis, preceding the appearance of jaundice; includes flu-like symptoms
________ stage: 2nd stage of hepatitis; includes the appearance of jaundice and associated symptoms such as elevated bilirubin levels, dark or tea-colored urine, and clay-colored stools
_______ stage: 3rd stage of hepatitis, in which the jaundice decreases and the color of the urine and stool returns to normal.
Icterus is synonymous with jaundice.
How do you remember what causes Hepatitis A?
-apples, anuses, and airplanes
-apples (contaminated fruit, vegetables)
-anuses (fecal oral)
-airplanes (person to person)
What are three ways to prevent hepatitis A?
strict hand washing
Stool and needle precautions
treatment of water supplies
Strict and frequent ____ _____ is key to preventing the spread of all types of hepatitis.
How do you remember what causes Hepatitis B?
Babies! (sex) and less commonly needles
What are three ways to prevent hepatitis B?
-strict hand washing
-avoid intimate sexual contact if positive for hepatitis B
-screening blood donors
How do you remember what causes hepatitis C?
Cool tattoos! (needles) and less frequently sex
What are three ways to prevent hepatitis C?
-strict hand washing
-screening of blood donors
How do you remember what causes hepatitis D?
-same as B
sex and blood products
Prevention of ______ infection with vaccine also prevents HDV infection, because HDV depends on _____ for repilication.
How do you remember what causes hepatitis E?
Eww! fecal, oral
Hepatitis E virus also has the same causes as which hepatitis?
What are two ways to prevent hepatitis E?
strict hand washing
treatment of water supplies and sanitation measures
Data collection: abdominal pain, including a sudden onset at the midepigastric or left upper quadrant location with radiation to the back. Pain aggravated by a fatty meal, alcohol, or by lying in a recumbent position. Abdominal tenderness and guarding. Nausea and vomiting, weight loss, absent or decreased bowel sounds. What is the disease?
_____ sign is the discoloration of the abdomen and periumbilical area. _______ sign is the bluish discoloration of the flanks. Both signs are indicative of _______.
Acute pancreatitis: maintain _____ status (diet) and assist to maintain hydration with _____ fluids as prescribed.
Acute pancreatitis: reinforce instructions to notify the HCP if acute _____ pain, jaundice, ____-____ stools, or _____ urine develops.
This is data collection for what disease: abdominal pain and tenderness, left upper quadrant mass, steatorrhea and foul-smelling stools that may increase in volume as pancreatic insufficiency increases. Weight loss, muscle wasting, jaundice, signs and symptoms of diabetes mellitus.
For a client with chronic pancreatitis, ____ and _____ intake may be limited. (Food groups)
Ulcerative colitis data collection: severe diarrhea that may contain _____ and ______. Malnutrition, dehydration, ______ imbalances.
Interventions during acute phase of ulcerative colitis: maintain ______ status and assist to administer fluids and electrolytes ______ or via parenteral nutrition as prescribed.
Preoperative colostomy and ileostomy interventions: reinforce instructions to eat a low-_____ diet for ___-___ days before surgery as prescribed.
What will the consistency of stool be for colostomy in the ascending colon? transverse colon? and descending colon?
loose to semi-formed
close to normal
Patients with Crohn's disease have diarrhea that may contain what two things?
mucus and pus
What three things will result from diarrhea caused by crohn's disease?
dehydration, electrolyte imbalances, malnutrition
Is malnutrition worse in people with crohn's or ulcerative colitis?
A sign of appendicitis is abdominal pain that is most intense where?
at McBurney's point
Data collection for patient with appendicits: client is in ___-lying position with abdominal _____ and legs _____.
Avoid the application of ____ to the abdomen of a patient with appendicitis. This can cause rupture of the appendix leading to peritonitis, a life-threatening condition.
Postoperative interventions for appendectomy: if rupture of the appendix occured, expect a ____ to be inserted, or the incision may be left ____ to heal from the inside out.
Postoperative interventions for appendectomy: position the client in a ____ side-lying or low to _________ position, with legs _____, to facilitate drainage.
Left lower quadrant abdominal pain that increases with coughing, straining, or lifting, blood in stools, and elevated temperature are all data collection for what?
diverticulosis or diverticulitis
Invertentions for diverticulitis/osis: monitor for ____, _____, fistulas, and abcesses.
Data collection for hemorrhoids: ______ _____ bleeding with defecation
bright red bleeding
The following are symptoms for what syndrome? vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to laydown
pg. 612 Qs 472, 473, 477, 479, 480, 482, 484
What are the normal colors of a stoma? This indicates _____ vascularity.
pink to bright red
What does a pale pink stoma indicate?
What does a purple-black stoma indicate?
low hemoglobin and hematocrit levels.
Compromised circulation- call doc
What level of activity should patients with diverticulitis/osis participate in? Will they have blood in their stool?
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