Perioperative
Name the two types of consent that are required before a surgical procedure
Informed and Surgical
Name 3 causes of bowel obstruction.
Adhesions, hernia, intussusception, cancer/tumors, volvulus, vascular occlusion
A colostomy is created in the colon (large intestine). An ileostomy is created in the ileum (small intestine).
Manifestations of hiatal hernia are similar to which condition?
GERD
Name the two types of peptic ulcers.
Gastric and duodenal
Why is it important to obtain and document a thorough pre-op assessment?
To identify the patient's baseline
What is the most common cause of bowel obstruction?
When should a ostomy bag be emptied?
When it is 1/3-1/2 full
What is the LES and what does it do?
lower esophageal sphincter, it acts as a antireflux barrier between the stomach and esophagus.
What are the two main causes of peptic ulcers?
H. pylori infection and NSAID use
Which type of ostomy, ileostomy or colostomy, would you expect more liquidy or semi-liquid stool?
ileostomy
"rosy pink to red" (Lewis book)
Identify 2 foods/drinks that decrease LES pressure
alcohol, chocolate, peppermint, coffee/tea (caffeine), fatty foods
What is the most common complication of PUD?
GI bleeding
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.
Identify the initial interventions for a bowel obstruction.
NPO, NG tube, IV fluids, pain and nausea control
A patient with a new ileostomy is at high risk for what?
dehydration and electrolyte imbalance due to high, watery output
What are the two most common medications to treat GERD?
PPIs and H2 receptor blockers
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
Identify 3 interventions that can help prevent constipation in the postoperative period.
Ambulating, limit opioid use as tolerated, adequate fluid intake, stool softeners, fiber
Name an outcome that would indicate a bowel obstruction is resolved.
patient is able to pass gas and/or have a BM
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
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