Enteral Nutrition
Amount and solution used to flush NGT
30mls Water
BMI considered morbid obesity
>40
Hypo or hyperthyroid? Heat intolerance, nervousness, tachycardia, weight loss, HTN, diarrhea, fever, exophthalmos
hyperthyroid
The organ that produces and secretes insulin
Pancreas
2 classes of medications used to treat pain and burning from Diabetic Neuropathy
Anticonvulsants (gabapentin) and tricyclic antidepressants
Action that triggers gastric ulcer pain
Eating
Medical term for Gall Stones
Cholelithiasis
Patient position when receiving Tube feedings
HOB elevated at least 30 degrees
Highest nursing priority when caring for a post op bariatric surgery patient
Airway management
Hypo or hyperthyroid-Hashimoto's disease
Hypothyroid
Type of Diabetes that can be controlled with diet, exercise, and weight loss and therefore eliminate the need for medications
Type 2 Diabetes
The insulin that is NEVER mixed with other insulins in a syringe
Long-acting (Lantus and Levemir)
Priority nursing care for acute pancreatitis (3)
Maintain NPO status, NGT to keep the stomach empty, pain control.
2 common labs that indicate pancreatitis
Amylase and Lipase
Most serious adverse effect of feeding via NGT
Aspiration
post-op bariatric surgery patient dietary education should include:
eat frequent small meals equally spread out during the day, drink plenty of fluids to prevent dehydration
Most serious complication of hypothyroidism if left untreated or undertreated
Myxedema Coma
Immediate nursing intervention for an awake and alert patient with a blood glucose reading of 40, after rechecking BS level to confirm result.
Give a fast-acting glucose source (hard candy, honey, juice) followed by a more complex carb snack (graham crackers, peanut butter)
When mixing short and intermediate insulins, air gets injected into which insulin vial first
NPH (intermediate) acting insulin
Illness caused by the ingestion of fecal contaminated food or water and can be spread from person to person through saliva.
H. pylori
The cause of shoulder pain after laparoscopic cholecystectomy
Injection of CO2 into the abdomen during the procedure
Normal Gastric pH level
1-5.5
The 3 types of bariatric surgery
Gastric bypass, vertical sleeve, gastric band
The Endocrine system consists of these 8 glands
Thyroid, parathyroid, pituitary, pancreas, hypothalamus, adrenal, testes, ovaries
The major organ that converts insulin to active status and can also store glucose
Liver
Diabetic medication that must be held 24 hours before and 48 hrs after a CT scan
Metformin
3 types of Peptic Ulcers
Gastric, Duodenal, Stress
5 potential serious complications of pancreatitis if left untreated
Coagulopathy, pleural effusion, hypovolemia, shock, paralytic ileus
When calculating tube feedings, number of milliliters (ml) in each ounce
30
Morbid obesity negatively affects these 3 major body systems
Cardiovascular, respiratory, skeletal
Gland responsible for the secretion of Calcium and 3 s/s that it is not working properly
Parathyroid gland-
Dry skin, brittle nails, tetany, numbness or tingling
Classic assessment finding indicating that a diabetic patient is burning body fat to use an energy source
Fruity Breath
Types of Insulin used for sliding scale coverage
rapid and short-acting insulins (Novolog, Humalog, Humulin R, Novolin R)
Most serious complication of GERD
aspiration
Priority nursing care for a patient with pancreatitis in the first 24 hrs (3)
Maintain NPO status, place NGT, pain control,
4 methods for administering tube feedings
Continuous, cyclic, intermittent, bolus
Tachycardia, N/V, and abdominal cramping 15 minutes after eating are symptoms of this after bariatric surgery
Dumping syndrome
Teaching for a patient that received radioactive iodine treatment should include
Do not share utensils, plates, and cups with anyone else, avoid contact with pregnant women and children, avoid eating foods with cores or bones, wash clothing separately from others in the household, take a laxative on days 2 and 3 after receiving treatment to help excrete contaminated stool faster.
Macrovascular complication of Diabetes Mellitis (3)
CAD, CVA, PVD
When mixing insulin, clear before cloudy or cloudy before clear?
Clear before cloudy
Dietary teaching for a patient with GERD
low-fat diet avoiding alcohol, carbonated beverages, caffeine, and foods containing spearmint or peppermint
Risk Factors for cholelithiasis (8)
Female, obesity, age, pregnancy, high fat/high cholesterol diet, sedentary lifestyle, rapid weight loss, Diabetes.
3 most common symptoms of aspiration
Coughing, SOB, decreased O2 saturations
Nursing measures to prevent post-op complications after gastric surgery (8)
Use of bariatric equipment, abdominal binder, administer anticoagulants, remove foley after 24 hrs., SCD's, semi-fowler positioning, monitor O2 sats (C&DB), mobilization
Medication given to treat hypocalcemia
Calcium Gluconate
Microvascular complications of Diabetes Mellitis (3)
Retinopathy, neuropathy, nephropathy
Regular Insulin Onset, Peak and Duration
30 min, 2-3 hours, 3-6 hrs
Common symptoms of perforated ulcer (4)
severe upper abdominal pain, vomiting, tender/rigid abdomen, fetal positioning
common description of pancreatitis pain
Sudden, intense, severe abdominal pain, radiates to the back, L flank and shoulder
Improves in fetal position
NURSING ASSESSMENT to determine correct positioning of NGT consists of what (3)?
Auscultate air into NGT while listening for gurgling over the stomach, check that tube is inserted at the correct CM mark as last chest Xray, aspiration of gastric contents.
Ideal weekly weight loss to maintain a successful long term weight loss program
1 pound per week
Emergency equipment that should be readily available for a post-op thyroidectomy patient (3)
Oxygen, suctioning, tracheostomy
Hypo or hyperglycemia? Polydipsia, polyphagia, polyuria
Hyperglycemia-Excess thirst, excess hunger, and excess urine
Long acting Insulin Onset, Peak, Duration
2 hrs, no peak, 24 hrs
The pathophysiology of GERD
Relaxation of the lower esophageal sphincter (LES) allowing acidic gastric juices to flow back into the esophagus
S/S of levothyroxine toxicity (5)
HTN, tachycardia, arrhythmia (irregular heartbeat), anxiety, confusion.
HgbA1C level that indicates good control of blood sugars over the last 3 months
<7%
Drug therapy for GERD
Antacids (TUMS), Proton pump inhibitors (Prilosec), histamine blockers (Zantac)
3 labs drawn to assess the function of the thyroid gland
T3, T4, TSH