Download NSG123/ NSG 123 Exam 2: (New 2024/ 2025 Update) Med Surg 1 Review| Questions and Verified and more Exams Health sciences in PDF only on Docsity!
NSG123/ NSG 123 Exam 2: (New 2024/ 2025
Update) Med Surg 1 Review| Questions and
Verified Answers| 100% Correct|All Units
Covered| A Grade – Herzing
QUESTION
NG feeding tube care Answer:
- irrigate every 4 hours with 30mL of water to maintain patency***
- assess placement before irrigating
- check residual volumes every 4 hours, before feedings, and before giving medication
- flush with 30mL of water after feedings***
- aspirate all stomach contents and measure amount
- whatever you pull out, you have to put back in to prevent excessive fluid and electrolyte loss
- flush with 5mL of water between each medication***
- ensure feedings are room temperature***
QUESTION
Nursing care for TPN Answer:
- usually in a PICC or central line***
- obtain daily weights
- monitor electrolytes and I&Os
- monitor glucose levels every 6 hours***
- use sterile technique***
- tubing changed every 24 hours
- nothing else can run in the same tube as TPN***
- be aware of increased infection rate***
- D5W or D10 can be run if TPN runs dry and next bag is not available***
QUESTION
Why are lipids given through TPN?
Answer:
- supplement caloric needs
- prevent fatty acid deficiency to improve vitamin absorption
QUESTION
Crohn's disease Answer:
- chronic autoimmune inflammatory disorder that can occur anywhere in the digestive tract from the mouth to the rectum
- cobblestone appearance of intestine w/ normal tissue between areas of inflammation
- attacks all 3 layers of intestine
QUESTION
Ulcerative colitis Answer:
- chronic autoimmune inflammatory disorder that affects the rectum and colon
- attacks only the mucosal layer of intestine
QUESTION
signs and symptoms of Crohn's disease Answer:
- right lower quadrant abdominal cramps/pain***
- diarrhea
- anemia***
- malnutrition***
- weight loss
- fatigue
QUESTION
QUESTION
treatment for Crohn's disease Answer:
- rest the bowel (possibly TPN)
- corticosteroids***
- immunosuppressants
- no good surgical procedure because the disease is spotty
QUESTION
Nutritional goals for ulcerative colitis and Crohn's disease Answer:
- identify specific foods that exacerbate symptoms
- patient will need to keep a food diary***
- prevent weight loss
- replace fluid and electrolyte losses
- vitamin and mineral supplements
QUESTION
Who is most at risk for obesity? Answer:
- African Americans***
- Hispanics
QUESTION
BMI ranges Answer: <18.5: underweight 18.5-24.9: normal
25 - 29.9: overweight
30: obese 40: extremely obese
QUESTION
What is the most important aspect for treating obesity? Answer: patient must have motivation to make lifestyle changes
QUESTION
patient education following gastric surgery (SATA***) Answer:
- smaller, more frequent meals
- high nutrient foods
- consume fat as tolerated
- ensure low carbohydrate intake
- eat two protein snacks daily
- chew slowly
- eat in low Fowler position and remain in that position for 20 - 30 minutes after eating
- avoid drinking fluids with meals
- drink plenty of water throughout the day
- take prescribed dietary supplements
- follow up with PCP for monthly B12 injections & iron
- walk for at least 30 minutes daily
- do not use straws
QUESTION
appetite suppressing medications Answer:
- Benzphetamine (Didrex): releases norepinephrine and dopamine***
- Orlistat (Xenical, Alli): blocks fat breakdown and absorption (patient will need to supplement with vitamins since fat is being excreted) - interacts with Warfarin (Coumadin)
QUESTION
management of appendicitis (pre & post op) Answer: pre-op:
- NPO
- fluids
- pain relief
- bed rest post op:
- prevent atelectasis (use incentive spirometer)
- maintain skin integrity
- attain optimal nutrition
- antibiotics
QUESTION
diverticulum Answer: abnormal sac-like herniations in the intestinal wall of the bowel
QUESTION
diverticulosis Answer: multiple diverticula without inflammation
QUESTION
diverticulitis Answer: infection and inflammation of the diverticula
QUESTION
treatment for diverticular disease Answer:
- Increase fiber intake
- increase fluids to at least 2L per day
- exercise
- bulk laxatives
- stool softeners
QUESTION
signs and symptoms of diverticular disease Answer:
- change in bowel habits (alternating constipation & diarrhea)
- abdominal distention
- nausea
- anorexia
- acute left lower quadrant pain
- low-grade fever
- decreased appetite
- watch for peritonitis symptoms
QUESTION
medications to treat appendicitis and diverticulitis Answer:
- broad-spectrum antibiotics
- antiemetics
- analgesics
- IV fluids
- NOT LAXATIVES***
QUESTION
cholelithiasis
Answer:
- low Fowler position
- care of biliary drainage system
- watch for s/s of jaundice
- wound care (larger incision)
- ambulation
QUESTION
post operative care for laparoscopic cholecystectomy Answer:
- ambulation***
- wound care (multiple small incisions)
- discuss with patient about effects of CO2 used during surgery (shoulder pain) - may need to pass gas or belch to relieve
QUESTION
definition of constipation Answer: less than 3 bowel movements per week
QUESTION
assessment questions for patients with constipation Answer:
- how many bowel movements do you have per week
- how much fluid are you consuming
- do you exercise
- what foods do you eat
QUESTION
constipation prevention
Answer:
- increase fiber intake
- increase fluids
- do not suppress urge to defecate
- exercise
- do not force daily bowel movements
QUESTION
complications of constipation Answer:
- hemorrhoids
- anal fissures***
- abdominal distention
- rectal mucosal ulcers
- diverticulosis
QUESTION
medication treatment for anal fissures Answer: docusate sodium (Colace)
QUESTION
treatment for constipation Answer:
- bulk forming laxative (Metamucil, Citrucel)***
- increase fluids and fiber
- increase exercise
- stool softener (docusate sodium)
QUESTION
signs and symptoms of bowel obstruction Answer:
- abdominal pain
- nausea and vomiting
- distention, visible loops of bowel on abdomen***
- constipation for more than 2 weeks for LBO
QUESTION
Dobhoff tube Answer:
- tube used ONLY for feeding
- very thin and clog easily
- obtain an x-ray for placement verification before any feeding
QUESTION
Jejunostomy tube Answer:
- feeding tube inserted into the jejunum of the small intestine
- bypasses the stomach
- obtain an x-ray for placement verification before any feeding
QUESTION
peptic ulcer disease Answer:
- acute: erosion of the protective mucosal lining of the lower esophagus, stomach, or duodenum
- chronic: erosion of mucosal lining and muscular wall, risk for perforation
QUESTION
primary causes of esophageal ulcer
Answer: history of GERD
QUESTION
risk factors for gastric and duodenal ulcers Answer:
- H. pylori
- NSAID use
- corticosteroid use
- alcohol use
- smoking
- caffeine
- stress
QUESTION
signs and symptoms of gastric ulcer Answer:
- epigastric discomfort 1 - 2 hours after eating
- burning/dull pain in mid-epigastric area or back
QUESTION
treatment for esophageal ulcers Answer:
- antacids
- H2 blockers
- PPIs
QUESTION
signs and symptoms of duodenal ulcer
QUESTION
Patient education for GERD Answer:
- elevate HOB
- low-fat diet
- avoid acid-producing foods and caffeine
- decrease alcohol intake
- eat small, frequent meals
- stop smoking
- avoid eating close to bedtime
- avoid tight-fitting clothing
- weight reduction
- avoid milk
QUESTION
What lab is important to check for patients taking antacids such as Maalox? Answer: magnesium level
QUESTION
patient education for H2 antagonists Answer:
- take at bedtime
- take whole
- do not take with antacids
- treatment may be up to a year
QUESTION
PPI examples
Answer:
- Omeprazole (Prilosec)
- Lansoprazole (Prevacid)
- Pantoprazole (Protonix)
QUESTION
patient education for PPIs Answer:
- may be taken any time of the day but stay consistent each day
- reduces acid production
QUESTION
patient education for Sucralfate Answer:
- take before meals since it coats the esophagus and stomach
- take 1 - 2 hours before or after antacid
- binds with Cimetidine, Digoxin, Warfarin, Phenytoin, & Tetracycline
QUESTION
H2 antagonist examples Answer:
- Cimetidine (Tagamet)
- Ranitidine (Zantac)
- Famotidine (Pepcid)
QUESTION
assessment questions for patients with diarrhea Answer:
- have you been on antibiotics recently***
QUESTION
signs and symptoms of peritonitis Answer:
- abdominal tenderness and rigidity
- guarding
- increased temperature 103 - 104
- rigor (shaking)
- increased RR & HR
- nausea and vomiting
- diminished peristalsis
QUESTION
What diarrhea medication should be taken while traveling? Answer: bismuth salts
