GI
nursing management for patients with constipation vs diarrhea
constipation: increase fluids, increase fiber, ambulation, assess medications causing constipation, stool softeners, bowel management program (go at same time each day)
diarrhea: assess for recent travel, medications, increase fluids, avoid caffeine/ETOH, monitor for dehydration and electrolyte imbalance, monitor for arrythmias, bowel training
what are signs and symptoms of a UTI?
urgency, nocturia, pain on urination, fever, cloudy/foul smelling urine, lower abdominal discomfort, N/V
what nursing interventions should be implemented after an ORIF surgery?
- neurovascular checks every hour
- increase calories, protein, and calcium to facilitate bone healing
- keep the dressing sterile
- monitor for orthostatic hypotension
what is the time window to give tPA (alteplase) after the initial onset of symptoms?
3-4.5 hours
cannot give if "woken up" with symptoms, onset unknown. contraindications: presence of active bleeding, get to CT STAT!!!
what medications are given for IBS diarrhea?
what medications are given for IBS constipation?
diarrhea: loperamide, psyllium, alosetron
constipation: lubiprostone, linaclotide
choose 3 foods a patient with celiac disease can eat.
- wheat bread
- apples
- chicken parmesan
- chocolate cake
- black beans
- certified gluten free oats
- apples
- black beans
- gluten free oats
avoid gluten!!
trick question, its asymptomatic. it is usually accidentally diagnosed
- assess for allergies to radioisotope
- have patient empty bladder to promote visualization of pelvic bones
- increase fluids postop for excretion of the radioisotope
- scans are repeated at 24, 48, and 72hrs
what type of seizure occurs when muscle tone is lost, resulting in falling and there is a period of confusion afterwards?
atonic or akinetic
what procedure stabilizes a bone early on, facilitates early ambulation and fracture healing, and decreases the risk of prolonged immobility complications?
open reduction internal fixation
what causes peritonitis? and what is its hallmark sign?
infection of the peritoneum from perforation of abdominal organs and spillage of contents. hallmark sign is rigid board like abdomen
flank pain, diaphoresis, tachycardia, and hematuria are signs related to what GU disorder?
urolithiasis (kidney stones)
4-6 hours
list the stages of classic migraine with aura
prodromal stage: awareness of findings for hours to days before onset (irritability, cravings)
aura stage: minutes to hour with neuro s/s (tingling, confusion, visual disturbances)
second stage: really bad stage for hours (N/V, vertigo)
third stage: dull headache for 4-72 hrs
differentiate the 3 different types of strokes
hemorrhaghic: from ruptured artery or aneurysm, has a poor prognosis from increased ICP
ischemic:from a blood clot on atherosclerotic plaque in cerebral artery, evolves over hours to days
embolic:caused by moving embolus traveling to cerebral artery (neuro deficits or instant los of consciousness)
identify at least 3 teaching interventions for a patient with UC or crohns disease.
- importance of taking vitamin supplements (B12, folic acid)
- regular colonoscopy screenings (increased risk of colon cancer)
- identifying foods that trigger exacerbations of UC
- monitoring F/E and signs of hypokalemia
- eat a high protein, low fiber diet to encourage healing
A patient has a CBI with an irrigation solution of 3000 mL per bag. During a nurse's shift, three empty irrigation bags were used, and the total drainage collected was 8,700 mL.
What is the patient's urine output for this shift?
-300
300mL remains inside the patient, this warrants a call to the provider
when are fat embolisms most common?
following a hip fracture, 72hrs after pelvic fracture/surgery, 12-48hrs after long bone fractures, or joint arthroplasty
a patient who has just had a supratentorial craniotomy done for a meningioma should lay in what position?
head of bed elevated to 30 degrees and neck in neutral alignment
what is a safe level of prostate specific antigen? and what is a EPCA2 value that suggests prostate cancer
less than 4 is safe for PSA
a value above 30 is suggestive of prostate cancer
what frequent serious complication of gastric bypass surgery is a life-threatening emergency? s/s are increasing pain, restlessness, tachycardia, and oliguria
anastomotic leak
list at least 5 nursing interventions for patients with kidney/ureter stones?
- administer pain medications
- strain all urine
- monitor I&O
- encourage fluids (3L/day)
- hot baths
- encourage ambulation to promote passage of stone
what are some nursing interventions following a hip arthroplasty?
- monitor neurovascular status
- check dressing site frequently
- transfer out of bed from unaffected side
- use assistive and adaptive devices
- use abduction pillow between legs
what are some potential complications of spinal cord tumors?
respiratory compromise if in the cervical area, urinary retention, incontinence, CSF leakage
list the diseases for patients with LLQ pain vs RLQ pain.
LLQ pain
- IBS, diverticulitis, ulcerative colitis
RLQ pain
- appendicitis, crohns disease