Ch 44
What is the anatomy and physiology of the GI tract
Mouth, Esophagus, Stomach, Small Intestine, Large Intestine
What is the first region of the small intestine and contains the opening for the common bile duct and the primary pancreatic duct which allow bile and pancreatic enzymes to enter.
The duodenum
What are the most reliable means to assess placement of a nasogastric tube prior to medication administration?
Measure of pH of aspirates
X-ray is used when inserting an NG tube but for medication administration you can measure the pH
Define Gastritis
Inflammation of the stomach lining. Can be acute or chronic
Serum PH
7.35-7.45
Your patient has an acute ankle sprain. What actions should the nurse take.
Rest, Ice, Compression, and Elevation
What action should the nurse do for a patient with acute asthma attack?
Administer Bronchodilator
What membrane lines the inner abdomen
Peritoneum
What movement helps propel food to go through the intestine?
Peristalsis
What BMI is it for someone who is obese
BMI of 40 or higher
What things can obesity contribute to the human body
obesity can contribute to poor wound healing, infection, and wound dehiscence.
WBC
5,000-10,000
What characteristics would appear on a patient who has psoriasis?
Silvery white scales
What resources can the nurse consult in regards a client who is terminally ill for end of life care choices?
Living will, Five wishes document, durable power of attorney for healthcare
What metabolic activities does the LIVER do?
It forms and releases bile, processes vitamins, proteins, fats, and carbohydrates, stores glycogen, contributes to blood coagulation, metabolizes and biotransforms many chemicals INCLUDING DRUGS.
What is a percutaneous liver biopsy?
MD obtains a small core of liver tissue by placing a needle through the clients lateral abdominal wall directly into the liver.
patient is constipated what nursing interventions should the nurse do?
increase dietary fiber
Define peptic ulcer
Circumscribed loss o tissue in an area of the GI tract that is in contact with hydrochloric acid and pepsin.
Potassium
3.5-5 mEq/L
What diet would the nurse emphasize in a patient with osteoporosis?
Calcium
What should a patient report following a tonsillectomy?
Excessive swallowing
What is the function of Gallbladder?
Aids in the absorption of fats, fat-soluble vitamins, iron, and calcium. Bile also activates the pancreas to release its digestive enzymes and an alkaline fluid that neutralizes stomach acids that reach he duodenum.
What is the purpose of the Gastrointestinal Endoscopy?
Gastrointestinal Endoscopy is the direct visual examination of the lumen of the GI tract.
Most Patients with Peptic ulcer disease Have what type of bacteria most of the time.
H. pylori.
The goal of treatment is to eradicate the bacteria and reduce the acid levels in the digestive system to relieve pain and promote healing.
patient has esophageal cancer and has difficulty swallowing. How would we help patients improve nutrition?
Give high protein, semiliquid foods.
Sodium
136-145 mEq/L
I have abnormal lateral curvature of the spine. What am I
Scoliosis
Patient was stated and is presenting with dyspnea, tachypnea and SUCKING NOISE heard on inspiration and expiration. What should the nurse do to the wound?
Apply airtight dressing
What is the sequence for assessing a patient abdomen?
Inspection, auscultation, percussion and palpation
What teaching need to be given for a patient following a Barium swallow?
* Encourage patient to drink fluids
* Stool will appear white or streaky from the barium
* The nurse must wait to obtain stool specimens until the client has fully excreted the barium
What nursing process for a client with a hiatal hernia related to difficulty swallowing should a nurse be aware of?
Encourage small frequent well-balanced
Inform client to remain upright for at least 2 hours after meals.
Discourage the client from eating before bedtime
What is bariatric surgery
Weight loss surgery or gastric bypass surgery are procedures designed to help clients reduce their weight through surgical changes to the upper GI digestive system
Calcium
9-10.5 mg/dL
Patient needs to have a color vision test. What chart does the nurse use to check this?
Ishihara polychromatic plates
What lab values should be monitored with a patient taking furosemide to promote urinary excretion of excess fluids for a client with cirrhosis?
Sodium Level
How to measure the abdominal girth?
Measurement of abdominal girth is done at the widest point (usually at the umbilicus)
What studies does a patient need before a Percutaneous Liver Biopsy?
The patient must have coagulation studies ( aPTT, PT, INR, and platelet count)before the procedure because a major complication after a liver biopsy is bleeding.
Patient had oral surgery and is experiencing difficulty breathing deeply and coughing secretions. What nursing measures will help ease the clients discomfort?
Keep head of bed elevated recovering from anesthesia.
What are the beginning symptoms of esophageal cancer
Beginning symptoms are mild, with vague discomfort and difficulty swallowing some food.
Magnesium
1.3-2.1 mEq/L
Patient taking opioids should be instructed about what Adverse effects?
Constipation and to increase fiber in diet.
Follow a bowel regimen
What complication can a patient have with extended daily use of NSAIDS?
Gastrointestinal bleeding
What is a barium swallow or an upper GI series?
A Fluoroscopic study of the entire upper GI tract. Barium sulfate is a radiopaque solution used as a contrast agent.
What finding will the nurse expect to see with a patient with cholelithiasis?
Urine to appear dark brown
What are the short term and long term medical interventions for anorexia
Short term- usually requires no medical intervention
Long term- High calorie diet, high-calorie supplemental feedings, tube feedings, and total parenteral nutrition TPN.
What diet should the nurse anticipate a patient with Nausea and vomiting will be placed on?
NPO
Chloride
98-106 mEq/L
Patient developed a pulmonary embolism. What intervention is priority for the nurse to take?
Begin oxygen therapy
What is important for the nurse to be aware when corticosteroids are administered?
Doses need to be tapered when discontinuing
What does the barium swallow do to the patients stool
Turns the stool milky white to clay colored.
Patient has had diarrhea for 3 days. What major problems associated with severe or prolonged diarrhea should the nurse monitor for when caring for this patient.
Dehydration
electrolyte imbalances
Vitamin deficiencies
T/F- CAN PREDNISONE CAUSE THINNING OF THE GASTRIC LINING
TRUE
What antiemetic medication inhibits the vomiting center in the brain.
Prochlorperazine
PaCO2
80-100 mm Hg
What nursing teaching should be given with a female patient who has been prescribed recombinant interferon alpha-2b?
Use strict birth control methods for this medication can cause birth defects.
I am presenting with right upper abdominal discomfort, nausea, and frequent belching especially after eating a meal high in fat. What disorder am I?
Cholelithiasis