Perioperative
Bowel Obstruction
Ostomy
GERD + Hiatal Hernia
PUD
100

Name the two types of consent that are required before a surgical procedure

Informed and Surgical

100

Name 3 causes of bowel obstruction. 

Adhesions, hernia, intussusception, cancer/tumors, volvulus, vascular occlusion

100
What is the main difference between a colostomy and an ileostomy?

A colostomy is created in the colon (large intestine). An ileostomy is created in the ileum (small intestine). 

100

Manifestations of hiatal hernia are similar to which condition?

GERD

100

Name the two types of peptic ulcers. 

Gastric and duodenal

200

Why is it important to obtain and document a thorough pre-op assessment?

To identify the patient's baseline 

200

What is the most common cause of bowel obstruction?

adhesions
200

When should a ostomy bag be emptied?

When it is 1/3-1/2 full

200

What is the LES and what does it do?

lower esophageal sphincter, it acts as a antireflux barrier between the stomach and esophagus. 

200

What are the two main causes of peptic ulcers?

H. pylori infection and NSAID use

300
Identify 3 post-op complications that can be prevented by early and frequent ambulation. 
Atelectasis/Pneumonia, DVT, paralytic ileus, constipation, pressure ulcers, pain, urinary retention
300

Which type of ostomy, ileostomy or colostomy, would you expect more liquidy or semi-liquid stool?

ileostomy

300
A healthy stoma is what color?

"rosy pink to red" (Lewis book)

300

Identify 2 foods/drinks that decrease LES pressure 

alcohol, chocolate, peppermint, coffee/tea (caffeine), fatty foods

300

What is the most common complication of PUD?

GI bleeding

400

Explain a major difference between general anesthesia and conscious/moderate sedation. 

The patient cannot maintain their own airway under general, but can maintain their own airway under conscious/moderate sedation. 

400

Identify the initial interventions for a bowel obstruction. 

NPO, NG tube, IV fluids, pain and nausea control

400

A patient with a new ileostomy is at high risk for what? 

dehydration and electrolyte imbalance due to high, watery output 

400

What are the two most common medications to treat GERD?

PPIs and H2 receptor blockers

400

When does discomfort occur after a meal for gastric ulcers and duodenal ulcers?

gastric 1-2 hours after eating

duodenal 3-5 hours after eating

500

Identify 3 interventions that can help prevent constipation in the postoperative period. 

Ambulating, limit opioid use as tolerated, adequate fluid intake, stool softeners, fiber

500

Name an outcome that would indicate a bowel obstruction is resolved. 

patient is able to pass gas and/or have a BM

500

Identify a psychosocial nursing diagnosis/problem that may be appropriate for a person with a new ostomy?

altered body image, denial, depression, low self-esteem

500

Identify 5 interventions to help manage symptoms of GERD

sleep with HOB elevated, avoid alcohol, eat small meals, drink liquids between meals, do not lay down for 2-3 hours after a meal, avoid smoking, eat a low fat diet, avoid bending at the waist after meals, lose weight if indicated, avoid bending at the waist after meals 

500
Conservative management of PUD includes what?
lifestyle modifications and medications
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