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GERD Risk factors include - CORRECT ANSWER ✔✔Consumption of foods such as caffeine, alcohol, spicy or fried foods, chocolate, and tomatoes. Lifestyle factors play a big part especially alcohol and smoking. GERD the nursing assessment should include - CORRECT ANSWER ✔✔asking about a history of heartburn or atypical chest pain associated with the reflux of GI contents. GERD manifests differently depending on - CORRECT ANSWER ✔✔the patient and the severity of the disorder GERD most common symptoms - CORRECT ANSWER ✔✔-Heartburn (pyrosis) -Dyspepsia (Indigestion) (May be described as substernal burning moving up and down the chest) GERD pain usually develops within - CORRECT ANSWER ✔✔30- minutes after meals
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Severe heartburn pain can radiate to the neck, jaw, or back and patients may think they are having an MI GERD symptoms are exacerbated when - CORRECT ANSWER ✔✔lying down flat or bending over GERD regurgitation may lead to - CORRECT ANSWER ✔✔Aspiration or bronchitis These patients are at risk of aspirating when lying flat Symptoms of GERD include - CORRECT ANSWER ✔✔Coughing or wheezing at night, dysphagia, belching and nausea, hoarseness, and insomnia. Assess lungs for presence of crackles. Hiatal Hernia - CORRECT ANSWER ✔✔A condition where a part of the stomach that normally is located in the abdominal cavity protrudes through the esophageal hiatus to rest within the chest cavity Hiatal Hernia symptoms usually worsen after meals. These symptoms may be made worse when - CORRECT ANSWER ✔✔Lying flat and may resolve with sitting up or walking.
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Medical treatment for Gastritis depends on the specific cause. Patients will be instructed to stop taking irritating medications such as - CORRECT ANSWER ✔✔ASA and NSAIDS Gastritis medications to decrease the amount of hydrochloric acid in the stomach. these would include - CORRECT ANSWER ✔✔Antacids, H antagonists, and Proton pump inhibitors The patient with Gastritis is at risk for - CORRECT ANSWER ✔✔Deficient Fluid Volume A nursing priority is to access the patient's hydration status. Includes I&O, Daily Weights, &VS. Peptic Ulcers Disease - CORRECT ANSWER ✔✔are a break in the mucous lining of gastrointestinal tract from continued contact with gastric juice. This results in inflammation. Pain that is worsened by the ingestion of food. Ulcers in the mucosa of GI tract occur from several different causes. Duodenal ulcers are associated with a - CORRECT ANSWER ✔✔H. Pylori infection
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Gastric ulcer pain is described as - CORRECT ANSWER ✔✔a dull, aching pain, often right after a meal; eating does not relieve pain and may even worsen it. Pain may also occur late at night. Other symptoms associated with PUD are - CORRECT ANSWER ✔✔Nausea with or without vomiting, weight loss, anorexia, belching and dyspepsia (indigestion). Patient may report a distended abdomen that is painful. PUD increased risk factor in - CORRECT ANSWER ✔✔Smokers smoking contributes to the pathogenesis of peptic ulcer disease. Smoking causes an acceleration of gastric emptying of liquids, promotes of duodenogastric reflux and causes a reduction in mucosal blood flow. Patient should attend a smoking cessation course. Gastric Cancer - CORRECT ANSWER ✔✔Stomach cancers tend to develop slowly over many years. Before a true cancer develops, pre- cancerous changes often occur in the inner lining (mucosa) of the stomach. These early changes rarely cause symptoms and therefore often go undetected
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as this affects the autonomic nervous system and it innervation to the bowel. Nursing care for the patient with IBS focuses on - CORRECT ANSWER ✔✔education and emotional support. Help the patient implement lifestyle changes that reduce stress. Remind the patient about regular exercise, Discourage smoking while encouraging the need for regular physical examinations Intestinal obstruction is - CORRECT ANSWER ✔✔a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through With obstruction - CORRECT ANSWER ✔✔gas and fluid accumulate proximal to and within obstructed segment causing bowel distention A bowel obstruction is divided into two basic categories: - CORRECT ANSWER ✔✔Mechanical and Non-mechanical Treatment of intestinal obstruction is directed toward - CORRECT ANSWER ✔✔relieving symptoms, managing fluid and electrolyte imbalances, preventing complications, and treating the cause of obstruction
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Surgery may be needed to relieve the obstruction if - CORRECT ANSWER ✔✔gastric decompression does not relieve the symptoms, or if there are signs of bowel necrosis. The type of surgery will depend on the type and area of obstruction and may include intestinal resection with an anastomosis or creation of an ileostomy or colostomy If the small bowel obstruction is complete, the peristaltic waves become quite vigorous, assuming - CORRECT ANSWER ✔✔revers direction, propelling intestinal contents toward the mouth rather than the rectum Small bowel obstruction patient vomits - CORRECT ANSWER ✔✔stomach contents first, then the bilious contents of the duodenum, and finally the fecal contents of the ileum A distended abdomen, a bloated sensation, and altered bowel sounds may indicate a - CORRECT ANSWER ✔✔small bowel obstruction. Patients with Ileostomy who develop distention and cramping should apply - CORRECT ANSWER ✔✔warm, moist towels to abdomen or lightly massage abdomen
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The classic symptom of appendicitis is - CORRECT ANSWER ✔✔abdominal pain. Pain becomes sharper over several hours and worsens with coughing, walking or other jarring movements. A sharp pain is felt in the lower right abdomen (RLQ) when the area is pressed on and then the pressure is quickly released. this is known as - CORRECT ANSWER ✔✔rebound tenderness. Pain is relieved by bending the knees Peritonitis results from - CORRECT ANSWER ✔✔contamination of a normal sterile peritoneal cavity with bacteria or chemical irritant Peritonitis: classically the patient will have an acute abdomen with abrupt onset of diffuse, - CORRECT ANSWER ✔✔severe abdominal pain Peritonitis: Depending on signs and symptoms, treatment includes - CORRECT ANSWER ✔✔nasogastric decompression, hyperalimentation, and colloids such as plasma and blood cells.
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The plan of care will have been effective if the patient's peritonitis has - CORRECT ANSWER ✔✔been eliminated and the source removed without complications and the patient fluid balance and pain are effectively tolerated Gastroenteritis is an inflammation of - CORRECT ANSWER ✔✔the stomach and intestinal tract that primarily affects the small bowel. Gastroenteritis: The major clinical manifestations are - CORRECT ANSWER ✔✔diarrhea resulting in hypokalemia and abdominal pain and cramping Gastroenteritis Associated clinical manifestations are - CORRECT ANSWER ✔✔nausea, vomiting, fever, anorexia, distention, tenesmus, and borborygmi Gastroenteritis: Rapid propulsion of intestinal contents through the small bowels may lead to a serious - CORRECT ANSWER ✔✔fluid volume deficit and electrolyte imbalance Gastroenteritis: Treatment should focus on - CORRECT ANSWER ✔✔intravenous fluids and monitoring for cardiac dysrhythmias
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In Crohn's disease the pain is in the - CORRECT ANSWER ✔✔lower right quadrant of the abdomen New therapies are beginning to be utilized for patients with Crohn's disease including - CORRECT ANSWER ✔✔immune response modifiers such as therapeutic monoclonal antibody certolizumab pegol (Cimzia) and Adalimuab (Humira) While taking certolizumab pegol (Cimzia) and Adalimuab (Humira) Patients should report - CORRECT ANSWER ✔✔cold-like symptoms or sore throat, avoid public places while taking this medication, understand abdominal pain, nausea, and vomiting are common side effects of this medication, and learn to give self injection Crohn's disease: The patient who is acutely ill may need to have - CORRECT ANSWER ✔✔total bowel rest and receive parenteral nutrition. This usually is through hyperalimentation. Crohn's disease: Anxiety is - CORRECT ANSWER ✔✔common for newly diagnosed patients and therapeutic communication about the disease is critical to treatment
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When medical management for Ulcerative colitis is not successful surgical intervention will result in the patient having an - CORRECT ANSWER ✔✔ostomy A stoma is created on the abdomen where an appliance is applied to - CORRECT ANSWER ✔✔retain stool Stoma pouch is emptied at intervals and always before it is - CORRECT ANSWER ✔✔half full. Apply a skin barrier directly to stoma prior to application of pouch system Ulcerative Colitis involves only the - CORRECT ANSWER ✔✔large intestine. Hemorrhages and abscess occur in - CORRECT ANSWER ✔✔ulcerative colitis Blood, mucous, and pus can be noted in the stools of the patient with - CORRECT ANSWER ✔✔ulcerative colitis as well as an urgent sensation to defecate
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Diverticulitis medical treatment includes a - CORRECT ANSWER ✔✔liquid or low-fiber diet and antibiotics. Rest is also needed. Over- the-counter pain reliever, such as acetaminophen (Tylenol) may be taken. Diverticulitis: Opioids are avoided if possible as the tend to be - CORRECT ANSWER ✔✔constipating and may aggravate the problem Diverticulitis patients should void the use of - CORRECT ANSWER ✔✔over-the-counter (OTC) laxatives to prevent constipation, monitor for signs of bleeding, and limit intake of dietary fat Hepatitis is a widespread inflammation of the - CORRECT ANSWER ✔✔liver that results in degeneration and necrosis of liver cells Hepatitis A has an incubation period of - CORRECT ANSWER ✔✔ 15 to 50 days Hepatitis A is spread via the - CORRECT ANSWER ✔✔fecal-oral route by fecal contamination either from person-to-person contact or by consuming contaminated food or water
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Hepatitis a is more common in countries with - CORRECT ANSWER ✔✔poor sanitation (handwashing) are most at risk The hepatitis B virus is spread through - CORRECT ANSWER ✔✔unprotected sexual intercourse with an infected partner, sharing needles, accidental needle sticks, and hemodialysis. Use standard precautions when caring for a client who has hepatitis HBV. Hepatitis C is caused by a - CORRECT ANSWER ✔✔single-stranded RNA virus, has an incubation period of 7 weeks, and is transmitted via blood to blood Hepatitis C is usually spread by - CORRECT ANSWER ✔✔sharing needles, needle sticks, unsanitary tattoo equipment, and sharing of intranasal cocaine paraphermalia Cholelithiasis, or gallstones, develop due to the inflammation of the - CORRECT ANSWER ✔✔gallbladder, the inflammation is called cholecystitis Cholelithiasis: The nursing assessment will include dietary preferences focusing on consumption of - CORRECT ANSWER ✔✔fatty foods in relation to pain developing
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Socioeconomic factors can have a negative effect on nutritional status the assessment should include details on - CORRECT ANSWER ✔✔social isolation, access to food, depression, substance abuse, and poverty. Nutritional status is influenced by the ability to - CORRECT ANSWER ✔✔swallow and the body's ability to absorb nutrients Nursing interventions to promote intake include providing - CORRECT ANSWER ✔✔mouth care before meals, getting the patient up to a chair for meals if possible, and trying to increase social interaction during meals. Six small meals a day consisting of high-calorie and nutrient-rich foods, such as milkshakes and cheese, are recommended. If the patient is unable to consume adequate nutrition by mouth, either
- CORRECT ANSWER ✔✔total enteral nutrition (TEN) or total parenteral nutrition (TPN) is needed. Total enteral nutrition (TEN) or tube- feeding refers to a method of - CORRECT ANSWER ✔✔infusing nutrient solutions or formulas directly into the GI tract through tubes that enter through the nose, mouth, or abdominal wall
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Bariatric surgery is treatment for patients who have a - CORRECT ANSWER ✔✔BMI > 40 The laparoscopic adjustable-banded gastroplasty (lab band) is a procedure where an - CORRECT ANSWER ✔✔adjustable band is used to create a small pouch Lab Band: Postoperative care depends on the type of surgery. Special bariatric equipment such as an - CORRECT ANSWER ✔✔extra wide bed and additional personnel for moving the patient may be required. If there is an NG tube, do not reposition, as it can disrupt the suture line Lab Band Post-op: Clear liquids are introduced slowly at first. Pureed foods, juices and soups thinned with broth, water or milk are assed to the diet 24 to 48 hours after clear liquids are tolerated. During the first six weeks, intake is - CORRECT ANSWER ✔✔limited to liquid or pureed foods before regular food is introduced slowly. Lab Band Post-op: Leaks are the most common serious common serious complication and cause of death. Manifestations include - CORRECT ANSWER ✔✔pain in the back, shoulder, or abdominal area, restlessness, tachycardia, and oliguria.
