Pain
A nursing pain assessment should always include what question to a patient that is replied as a number?
How is your pain on a scale of 0-10
What is the best indicator for infection in older adults?
Changes in mental status
Define an ABG?
Arterial Blood Gas
What can cause a low or high heart rate in older patients?
Atrial Fibrillation
What is normal BP highest limits for systolic and diastolic?
Less than 119 systolic
Less than 79 diastolic
Direct visualization of the large intestine
What is Hepatitis?
Inflammation of the liver-may be caused by viral, or other toxin
What is gastritis?
Inflammation of the stomach lining?
Diagnostic tests for GERD/Hiatal Hernia?
EGD-Esophagastroduodenoscopy
What is a colostomy?
Surgically created opening in the abdomen (called a stoma)that brings stool from the LARGE intestine
What is meant by characteristic of pain?
Is it shooting, stabbing, sharp?
Why are older adults at greater risk of infection?
Impaired immunity
Define hypoxemia
decrease in oxygen in theblood
Name a vascular risk associated with Atrial Fibrillation?
Blood Clots
Effects of nicotine on the vascular system?
Vasoconstriction
True or False:
The small intestine absorbs fluid to solidify and transport fecal matter
False:
The large intestine absorbs water and transports
Fungal infection of the mouth or other yeast populated area of the esophagus
Often called oral thrush
Irritants such as NSAIDS or Bacteria (H.Pylori)
What medication is a Proton Pump Inhibitor?
It is a medication that inhibits gastric secretion in the stomach
Is a colostomy easier to manage high in the colon or lower in the colon?
Lower-
The higher the harder
What is most widely used class of pain medication to treat moderate to severe pain?
Opiates
Possible effects of surgery on older adult?
Postop confusion
Why are elderly at greatest risk for lung infection?
Decreased respiratory function
What nodes are associated with Atrial Fibrillation?
S and AV Nodes
What is Hypertensive Crisis? (BP Value)
BP Greater than 180/120
Dark blood in the stool is indicative of :
Old or slow bleeding in the rectal or intestinal tract
How is oral candida albicans treated??
Anti-fungals-such as magic mouthwash (misture of anti fungal and benadryl and steroid)
How is Gastritis treated?
Antacids and H2 receptor blockers
.H Pylori is treated with multiple medications-antibiotics and gastric acid blockers
How do we help a patient manage GERD?
elevation of the bed to at least 4-8 inches
dietary adjustments
No reclining for 1 hour after meals
What is Diverticulosis?
Multiple diverticulum:
(which are sac like herniations in the lining of the bowel)
What are principles of pain management for the elderly with regqrds to respiratory?
Start low and go slow
How is postoperative confusion managed with regards to safety in the older adult?
Fall risk precautions
What is cyanosis?
Bluish discoloration of the skin and /or mucosa related to low oxygen levels in the blood
Define the major effect of Nitroglycerine tablets on the vascular system?
Vasodilation
True or False:
Sleep Apnea is a primary risk for Hypertension
False:
Secondary Risk
True or False
Bright red bleeding in stool is considered a normal event post colonoscopy:
Preop teaching-use of communication board-
What can be an issue with body PH with overuse of Antacids?
Alkalosis-the PH is affected by too much buffer
Clinical PEARL!!!!!!!!!!!
How can a nurse help differentiate a patient's chest pain by giving Mylanta and Lidocaine orally?
In chronic chest pain patients, or patients presenting with chest pain that does not appear cardiac related, the Mylanta and Lidocaine mixture given orally will reduce or eliminate pain in GERD--but not cardiac.
Can colostomy be reversed?
Yes-it is called an anastomosis (when two sections are joined together)
When should pain medication be administered for the best outcome?
At the onset-as ordered.
Why are compression socks used for patients in operative conditions?
Promotion of circulation/prevention of clots
What is hypoxia?
Hypoxia is defined as the absence of enough oxygen in the tissues
What is the purpose of a coronary artery stent?
To support the coronary artery structure and allow blood to flow
True or False:
Diabetics are often more sensitive to chest pain as related to cardiac emergency?
False:
Diabetics often do not perceive chest pain as non-diabetics-placing them at risk for not seeking care quickly
How is the liver assessed physically?
Palpation under lower right ribcage
What is the relationship between dental abscess and an oral emergency?
Abscessed teeth can be deadly as they can lead to cellulitis and jaw infection-infection can spread-sepsis can occur
What is GERD?
GastroEsophageal Reflux Disease
Can it mimic cardiac chest pain???? YES!
What are the effects of Proton Pump Inhibitors long term on the body?
Calcium absorption
(Risk for Cdif, Pneumonia, Fractures, Dementia, Hypomagnesia, Kidney Disease)
What vitamin will often be deficient after intestinal removal?
B12
But others such as A and Ad are also affected
What is meant by adjuvant medication?
An additional medication used to assist another
Evisceration refers to:
Opening of a surgical incision site with protrusion of organs
What is the risk of applying too much O2 to a COPD patient?
Death.
What should a patient with a pacemaker be taught to avoid?
Magnets (esp MRI) as well as certain electronics
Why is morphine usually a drug of choice for cardiac patients?
It is considered safe to manage pain after use of nitroglycerine
What is essential to watch for after liver biopsy?
Bleed or Infection
Gum disease can affect the cardiac system. How?
The similar organisms in the gums can migrate to the heart and cause muscle damage
What is a hiatal hernia?
The diaphragm becomes enlarged and a portion of the stomach protrudes into the region
What is IBD?
Inflammatory Bowel Disease
What is parenteral nutrition?
Nutrition via IV route
(Example: Fluids, electrolytes, lipids)
Usually requires Central line but can be given peripheral