Periop
Causes of absent bowel sounds...
What is general anesthesia, paralytic ileus, and bowel obstruction?
What is awake and alert pt, stable airway, adequate O2 saturation, & stable VS and hemodynamic status?
Gold standard sx for GERD
What is laparoscopic nissen fundoplication?
Gold standard test for cholecystitis
Dx test(s) to avoid with suspected diverticulitis
Bonus: Foods to avoid
What is barium enema (rupture diverticula) & colonoscopy (increases pressure)?
What is nuts, popcorn, & seeds in general?
Types (+ explanation) of surgery are...
What is emergency surgery, urgent sx, elective sx, exploratory (diagnostic) sx, & minimally invasive sx?
Surgeries that high fowler's is indicated for are...
What is cranial, shoulder, & breast procedures?
Differences between antiH2s and PPIs
What is...
H2: Reduces acid production (slow), treats H. Pylori, tolerance may develop, stepdown tx for uncomplicated GERD.
PPIs: Blocks acid production (last step in secretion), given before meals, relieves reflux symptoms, interferes with absorption of some medications, delayed onset + 24 hr duration, long-term use --> OSTEOPOROSIS, bone fx, heart & kidney disease...
The two types of cholecystitis
What is calculus (gallstones) & acalculus (no stones, ischemia, bile stasis)?
Role & considerations of NG tube as tx of bowel obstruction
What is removal of accumulated fluid & gas proximal to obstruction, decompression of the intestines, potassium loss, NPO status, flushing with NS, & elevating HOB?
Risk factors of PONV
What is young, female, nonsmoker, & hx of nausea and/or motion sickness?
Members and functions of the sterile team members are...
What is surgeon (leader of the sx, obtains informed consent), PAs, SFAs, RNFA, scrub nurse, surgical tech, OR tech (assists with OR setup & dismantling, helps don sterile gowns, counts supplies)?
Pathophysiology behind type 1 and type 2 hiatal hernia
What is...
Type 1: wear and tear on the GEJ from obesity, repetitive deep inspiration, positional changes, reflux & vomiting
Type 2: anatomical defect where stomach to properly anchor below the diaphragm (no reflex bc GEJ is intact)
What is patient should report hematemesis, take medications as prescribed (abx course), avoid irritants (NSAIDs, ASA, caffeine, citrus juice, spicy food), and GI rest (NPO for 6-12 hrs & slow reintroduction of food)?
Complications of ulcerative colitis
What is hemorrhage, nutritional deficiency (scarring interferes w absorption), tenesmus, pseudopolyps, perforation (toxic megacolon), & crypt abscesses.
The components of a the preoperative checklist are...
What is full medical history, preop assessment, preop orders (labs, IV), patient education, & initial timeout ("pause for cause")?
Components of patient teaching include...
What is duration of procedure, PACU stay, family updates on pt status, members of sx team, location of procedure, post op pain management, location of incisions, presence of drains & dressings + wound care, S/S of infection?
S/S of esophageal cancer
What is dysphagia, hemoptysis, vomiting, melena, hypercalcemia, or (burning) pain in the middle of the chest?
Differences between gastric and duodenal ulcers
What is...
Gastric: pain gets worse with eating, little or no relief with antacids or medications, pain improves with rest, & weight loss.
Duodenal: pain improves with eating, burning epigastric pain worsened by fasting, relieved by antacids, pain at night, & weight gain.
ROME IV & Manning Criteria
Rome IV: pt has recurrent abd pain/discomfort at least 1 day/wk for last 3 months; defecation, change in stool frequency and form/appearance
Manning criteria: more S/S means higher % of IBS; pain relieved w defecation, more frequent stools @ pain onset, looser stools, visible abd distention, passage of mucus, or incomplete evacuation
Components of a surgical pause (time out).
What is correct pt, procedure, surgeon, position, equipment, imaging studies, fire assessment?
The roles of the circulating nurse are...
What is observing sx procedure, initial OR assessment, assist anesthesiologist with positioning, assist surgeon with donning sterile PPE, opens sterile equipment packages, counts instruments & tools, & documentation of sx?
Postop patient education after laparoscopic nissen fundoplication
What is soft diet (1 wk), avoiding activities that cause air to be swallowed (carbonated beverages, straws), no heavy lifting, keeping dressings clean & dry, washing incisions with soap + water + pat dry, and notifying HCP when S/S of infection occur (>101 temp, N/V, severe bloating, unusual pain)?
Causes of gastritis
Bonus: for Acute vs. Chronic causes
Acute: What is chronic ingestion of irritating foods (alcohol, caffeine), complication of traumatic injuries (burns, organ failure), bacterial infection (H. pylori) or endotoxins (salmonella, staph, E. coli), overuse of NSAIDs or ASA, stress-induced (shock, severe trauma, major sx)?
Chronic: H. pylori, auto-immune (pernicious anemia), & atrophy?
S/S of appendicitis
What is McBurney's point (tenderness when palpating RLQ), elevated WBC count, Rovsing's sign (pain felt in RLQ when palpating left side of abd), nausea, pain that may be felt from right hip to umbilicus?