NSG 123 Exam 2 - Questions and Answers

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NSG 123 Exam 2 - Questions and Answers Main Cause of Cholelithiasis Cholesterol stones account for most of the remaining 75% of cases of gallbladder disease in the United States. Symptoms of Choleli... thias Nausea Vomiting Right upper quadrant abdominal pain or epigastric pain that radiates to the right shoulder especially after meals when the gallbladder is stimulated to release bile. Patient Teaching for Cholelithiasis The diet immediately after an episode is usually low-fat liquids. These can include powdered supplements high in protein and carbohydrate stirred into skim milk. Purpose of Medication in Cholelithiasis Purpose of Medications: reduces hepatic production of cholesterol. Lowers the cholesterol content of bile, which in turn facilitates the gradual dissolution of cholesterol gallstones. Examples : Chenodiol (Chenodal, Chenix) is a naturally occurring bile acid . Purpose of Adding Fat to Emulsion to TPN Fat emulsions (lipids) are usually given to clients receiving TPN to provide supplemental kilocalories and prevent fatty acid Fat emulsions can also control hyperglycemia during periods of stress. Carbon Dioxide in Laparoscopic Cholecystectomy Carbon dioxide is used during the procedure Explain to the patient that they might feel pain in the right shoulder or scapular area (from migration of the carbon dioxide used to insufflate the abdominal cavity during the procedure). Laparoscopic Colecystectomy 3 Things to do After Recommend a heating pad for 15 to 20 minutes hourly or Encourage the client to ambulate frequently to reduce the bloating. Manage nausea assess bowel sounds for further complications. Preoperative Assessment for Open Cholecystectomy Priority assessment should focus on the client's respiratory status. If a traditional surgical approach is planned, the high abdominal incision required during surgery may interfere with full respiratory excursion. The nurse notes a history of smoking, previous respiratory problems, shallow respirations, a persistent or ineffective cough, and the presence of adventitious breath sounds. CBC and BMP should also be assessed 4 Postoperative Complications of Cholecystostomy After these surgical procedures, the client is observed for indications of infection, leakage of bile into the peritoneal cavity, and obstruction of bile drainage. If bile is not draining properly, an obstruction is probably causing bile to be forced back into the liver and bloodstream. Because jaundice may result, the nurse should assess the color of the sclerae. Yellow-colored sclerae or skin can indicate jaundice. Clay-colored stool should be reported as this indicates a complication. Discharge Teaching for Open Cholecystectomy Usually, only a small amount of serosanguineous fluid drains in the initial 24 hours after surgery; afterward, the drain is removed. The drain is typically maintained if there is excess oozing or bile leakage. Empty the drainage bag attached at least every 8 hours and as needed, to prevent reflux back into the bile duct. Take showers not baths to prevent infection of the incision site. What disease is characterized by possible malnourishment (anemic) and frequenct diarrhea? Crohn's disease The disease characterized by blood sools and left lower quadrent pain Ulcerative Colitis What GI disease would be best diagnosed with colonoscopy? Ulcerative Colitis What testing would you expect to see from a patient recieving parenteral nutrition? Blood Glucose What time of day should Famotidine (pepcid) be administered? Bed time What is an intragastric balloon used for? Non-invasive weight loss The nurse needs to check Mg++ before administration of what drug? Magnesium hydroxide/aluminum hydrate MAALOX Which weight loss drug requirres a fat soluble vitamin supplement? Orlistat (XENICAL) What do you give to treat traveler’s diarrhea? Bismuth Salts-pepto bismol This conditon is charcterized by perianal vascular congestion from straining to have a bowel movement? Hemorrhoids How often should 30mL of water be flushed through an NG tuve for assessment of function? Every 4 hours A patient is experiencing diarrhea secondary to ulcerative colitis, do you treat it? No, their body is flushing out the infection Bulk forming laxative Citrucel or Metamucil A patient has a NG tube placed and running suction. What lab should the nurse monitor? BMP, fluid and electrolytes What do you give a patient receiving a TPN to prevent hypoglycemia? D5W or D10W What are most gallstones comprised of? Cholesterol A patient needs to receive enteric feeding, what type of tube should be placed? Dobhoff Tube What condition will you administer the drug Chenodiol? Cholesterol Gallstones. 2 Key S/S of Crohn's Disease Malnourishment Anemia Definite Diagnostic Study for Crohn's Disease CT Scan Definite Diagnostic Study for Ulcerative Colitis Colonoscopy What surgery can cure Ulcerative Colitis? Protocholectomy (removal of colon and rectum) [Show More]

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