Lower GI Jeopardy

Diagnostics

100

Two teaching points in prep for Barium Enema?

*Complete emptying of bowel day before, *Clear Liq day before, *NPO night before

200

Two Post Nursing Care teaching points for Barium Enema:

*increase fluids, *Stool will be chalky X 1-3 days, *May use laxatives to assist clearing,

300

Three things a stool sample might be tested for:

occult blood, ova, parsites, culture

400

Two teaching points for post Endoscopy:

* Must have ride home (sedation), * may have cramping s/t air injected into bowel

500

The difference between a laparotomy and laparoscopy.

Laparatomy : open surgery, Laparoscopy: endoscopy and light via slit in abdominal wall

Diarrhea

100

How must hands be cleaned after contact with patient with C diff?

soap and water

200

This type of antidiarrheal causes decreased bowel motility and increased absorption of fluid from stool

opioids and opioid derivatives

300

Three things to ask in history of patient with diarrhea.

* Stool description and pattern * Foreign Travel, * New foods or meds, * Recent hospitalization, * Stress, * Family/friends ill

400

Class of antidiarrheal that causes decreased secretions and provides a protective coating:

Bismuth Subsalicylates: Pepto-Bismol, Kaopectate

500

Five nursing care interventions for patient with diarrhea.

*avoid causative agent *increase fluids (IV or Gatoraid), *strict infection control, *ready access to BSC, *good skin care & use or protectants, *no solids X 24 hours, *reintroduce foods slowly

Constipation/ Fecal Incontinence

100

What is normal time range for bowel movements?

three times/day to every three days.

200

Two treatments for fecal incontinence:

*bulking agents/ fiber, *antidiarrheal agents *Increase fluids, *fecal disimpaction, *biofeedback, *Kegels *Bowel training program *Solesta injection

300

What is the mechanism by which constipation can cause fecal incontinence?

Constipation leads to straining -> weakens pelvic floor -> incontinence

400

How long does it take for a stool softener to act?

72 hours

500

Five patient teaching points for constipation.

* ↑ fiber, * ↑ fluids, * exercise regularly, * don't delay defication, * avoid laxatives/enemas *optimal position

Peritonitis/ Hemorrhoids

100

The pain felt upon release of abdominal palpation.

Rebound tenderness

200

Three symptoms of hemorrhoids.

rectal bleeding, pruritis, pain, prolapse

300

Four causes of peritonitis.

*cirrhoisis with ascites, *rupture of abdominal organ, *peritoneal dialysis, *gunshot & knife wounds

400

Predisposing conditions to hemorrhoids.

*Pregnancy, *Prolonged constipation, *Straining in defecation, *Heavy lifting, *Prolonged standing or sitting *Portal hypertension (cirrhosis)

500

What are the two priority areas for assessment for  a patient with peritonitis?

pain, s/s of shock

Intestional Obstruction/ Diverticular Disease

100

Lack of intestinal peristalsis. A normal finding after abdominal surgery.

Paralytic ileus

200

A patient with acute diverticulitis should eat this type of diet.

No diet! NPO to let colon rest

300

Most common type of small bowel obstruction.

Surgical adhesions

400

Where in the GI tract is diverticular disease most likely to occur?

Sigmoid colon

500

Four teaching points for diverticulosis.

*high fiber, *decrease fat & red meat, *weight reduction, *↑ activity, *avoid ↑intrabdominal pressure