Download NCLEX Hurst Review, Gastrointestina 87 Questions and Answers 2024.Assured Grade A+. and more Exams Nursing in PDF only on Docsity!
NCLEX Hurst Review, Gastrointestina 87 Questions
and Answers 2024.Assured Grade A+
what are the 2 separate functions of the pancreas? - Correct answer endocrine-insulin exocrine-digestive enzymes what are the #1 and #2 causes of acute pancreatitis? - Correct answer #1=alcohol #2=gallbladder disease what is the #1 cause of chronic pancreatitis? - Correct answer alcohol what is happening with pancreatitis? - Correct answer auto-digestion of the pancreas; basically it is eating itself in pancreatitis, does pain increase or decrease with eating? why? - Correct answer increase; more enzymes are produced signs and symptoms of pancreatitis: - Correct answer pain with eating; abdominal distention/ascites (losing protein rich fluids like enzymes and blood into abdomen); abdominal mass (swollen pancreas); rigid, board-like abdomen (guarding or bleeding); cullen's sign (bruising around umbilical area); Gray Turner's sign (flank area); fever; n/v; jaundice; hypotension= bleeding or ascites what is Cullen's sign and what is it seen in? - Correct answer bruising around umbilical area caused by pancreatitis what is Gray Turner's sign and what is it seen in? - Correct answer bruising around the flank area (below ribs and above hip) caused by pancreatitis
in someone with pancreatitis, what would hypotension indicate? - Correct answer bleeding or ascites how is pancreatitis diagnosed? - Correct answer serum lipase and amylase โ WBCs โ Blood sugar โ ALT, AST โ Pt, aPTT- longer Serum bilirubin โ H/H โ or โ treatment goal for pancreatitis: - Correct answer control pain how do you control pain by decreasing gastric secretions in someone with pancreatitis? - Correct answer NPO, NGT to suction, bed rest what kinds types of medications do you want to treat pancreatitis with? - Correct answer pain meds (narcotics to control pain) steroids (to decrease inflammation) anticholinergics (to dry up secretions) GI protectants (ex. pantoprazole, ranitidine, famotidine, antacids) why would you want to give insulin to someone with pancreatitis? - Correct answer if they are on steroids, this causes blood sugar to increase; TPN; pancrease is sick testing strategy: if your liver is sick, what is your #1 concern? - Correct answer bleeding
list post-procedure interventions for a liver biopsy: - Correct answer have client lie on right side; vital signs (worried about hemorrhaging) what medications are used to treat cirrhosis? - Correct answer antacids, vitamins, diuretics treatment of cirrhosis: - Correct answer no more alcohol (whether caused by alcohol or not); I&O/ daily weight, rest, prevent bleeding (bleeding precautions), measure abdominal girth, paracentesis, monitor jaundice, avoid narcotics what type of medications should a person with cirrhosis avoid: - Correct answer narcotics; liver can't metabolize drugs well when it's sick diet for a person with cirrhosis: - Correct answer decrease protein, low sodium diet testing strategy: if you give a liver client narcotics, what will happen? - Correct answer it's the same thing as double dosing them describe the process of protein excretion: - Correct answer the protein is broken down into ammonia --> the liver converts ammonia into urea --> the kidneys excrete the urea when there's a problem with the liver, how does this affect protein consumption? - Correct answer the liver can't convert the ammonia (which is broken down protein) to urea so ammonia builds up in the blood in liver problems, what chemical builds up in the blood? what clinical manifestation does this cause? - Correct answer ammonia; โ LOC signs and symptoms of hepatic coma: - Correct answer minor mental changes/motor problems; difficult to awaken; asterixis; handwriting changes (tremors); decreased reflexes; slow EEG; fetor (breath smells like ammonia); anything that increases the ammonia level will aggravate the problem
what precautions should someone with cirrhosis be on? - Correct answer bleeding treatment of hepatic coma: - Correct answer lactulose (decreases serum ammonia); cleansing enemas; *decrease protein in the diet; monitor serum ammonia patho of bleeding esophageal varices: - Correct answer high BP in liver (portal HTN) forces collateral circulation to form anytime someone is anemic, what is needed? - Correct answer oxygen treatment for esophageal varices: - Correct answer replace blood; VS; CVP; oxygen; octreotide to lower BP; balloon tamponade; cleansing enema to get rid of blood out of GI tract; lactulose to decrease ammonia; saline lavage to get blood out of stomach what type of tube is used for a balloon tamponade in a client with esophageal varices? what is this purpose? how long should it be used for? - Correct answer Sengstaken-Blakemore Tube; used to hold pressure on bleeding varices; should not be used for more than 12 hours what medication is used to lower BP in the liver? - Correct answer Octreotide in esophageal varices, there is often bleeding in what 3 areas? - Correct answer esophagus, stomach, rectum what is a common cause of GI bleeding? - Correct answer peptic ulcers where can peptic ulcers form? - Correct answer esophagus, stomach, or duodenum sign/symptoms of peptic ulcers: - Correct answer burning pain usually in the mid-epigastric area/back; heartburn (dyspepsia)
signs/symptoms of hiatal hernia: - Correct answer heartburn, fullness after eating, regurgitation, dysphagia (difficulty swallowing) what is dumping syndrome? - Correct answer the stomach empties too quickly after eating and the client experiences many uncomfortable to severe side effects dumping syndrome is often secondary to what? - Correct answer gastric bypass, gastrectomy, or gall bladder disease treatment for hiatal hernia: - Correct answer small frequent meals, sit up 1 hour after eating, elevate HOB (these all keep stomach in down position), surgery, teach life style changes treatment for dumping syndrome: - Correct answer semi-recumbent with meals, lie down after meals, no fluids with meals, meals should be small and frequent, avoid foods high in carbs and electrolytes (these empty fast) in dumping syndrome, avoid foods high in: - Correct answer carbs and electrolytes (these empty fast) rebound tenderness in UC or Crohn's indicates what? - Correct answer peritoneal inflammation what tests are used to diagnose IBD? - Correct answer CT, colonoscopy, barium enema for a colonoscopy, what diet should someone be on 12-24 hours before the procedure and then for 6-8 hours before? - Correct answer clear liquid diet then NPO what type of medications should be avoided before a colonoscopy? - Correct answer NSAIDs what can you do to help your client drink a colon prep more easily? - Correct answer make it cold but don't freeze it
post-op colonoscopy, what are you mainly going to watch for? what are the signs of this? - Correct answer perforation; pain or unusual discomfort should a person with IBD be on a high or low fiber diet? why? - Correct answer low; we are trying to limit GI motility to help save fluid types of medications to give IBD clients: - Correct answer anti-diarrheals, antibiotics, steroids, what type of surgeries can be used for UC? - Correct answer total colectomy (ileostomy formed), Knock's ileostomy, or a J Pouch what is a J Pouch procedure? - Correct answer removes colon and attaches the ileum to the rectum post-op ileostomy care: - Correct answer avoid foods hard to digest/rough foods; gatorade or other electrolyte replacement drink in summer; at risk for kidney stones (always a little dehydration) which does not require irrigation: ileostomies or colostomies? - Correct answer ileostomies (they drain fluid all the time) which ostomies do you irrigate? - Correct answer descending and sigmoid colostomies when is the best time to irrigate colostomies? - Correct answer same time everyday; after a meal when irrigating an ostomy or administering an enema, if the client starts to cramp, what do you do? - Correct answer stop the fluids, lower the bag and/or check the temp of the fluid
