Elimination/GI/GU: Nursing I Exam 2
what are some common factors that can affect elimination?
Factors Affecting Elimination: -aging or developmental pattern -intimate/social factor -stress -neurological trauma -dementia -multiple sclerosis (affects muscle of the pelvic) -disease conditions (crohns disease) -irritable bowel syndrome -ulcerative colitis
What are the different non-inflammatory disorders of the GI/GU? (4)
Non-inflammatory Disorders of GI/GU: 1) Irritable Bowel Syndrome (IBS) 2) Herniation 3) Hemorrhoids 4) Malbsorption syndrome
this type of incontinence occurs in combination with a distended bladder. Common causes include fecal impaction, neurological disorders, and an enlarged prostate
Overflow incontinence: occurs in combination with a distended bladder. common causes include fecal impaction, neurological disorders, and an enlarged prostate
Peritonitis Signs and Symptoms (10)
Peritonitis Signs and Symptoms) 1) appears acutely ill 2) lying completely still, pain with movement 3) knees flexed, guarding 4) high fever 5) tachycardia 6) rebound tenderness 7) nausea and vomiting 8) diminished bowel sounds 9) fluid volume deficit 10) compromised respiratory status
what is the most common complication of appendicitis?
Peritonitis is the most common complication of appendicitis
genetic disease associated with fluid-filled cysts forming in nephrons of the kidney. Associated with hypertension, abdominal fullness and pain, kidney stone formation, infection. Can be acute or chronic.
Polycystic kidney disease: genetic disease associated with fluid-filled cysts forming in nephrons of the kidney. Associated with hypertension, abdominal fullness and pain, kidney stone formation, infection. Can be acute or chronic.
What preparation/interventions need to be assumed for any GU procedures?
Preparation/interventions for all GU procedures 1) NPO for 6-8 hours 2) meds should be taken in the AM 3) avoid anticoagulants, aspirin, NSAID's 4) monitor rate of respiration
bacterial infection in the kidney and renal pelvis. can be acute or chronic
Pyelonephritis: bacterial infection in the kidney and renal pelvis. can be acute or chronic
what are acute inflammatory disorders of the intestinal tract most commonly caused by?
acute inflammatory disorders of the intestinal tract are most commonly caused by contamination of the abdominal cavity
what type of medications reduce stress incontinence?
antidepressants reduce stress incontinence
what is the most common cause of right lower quadrant abdominal pain?
appendicitis is the most common cause of right lower quadrant abdominal pain
What is the most common risk of urolithiasis? What are the other risks (4)
1) Dehydration is the most common risk of urolithiasis 2) high intake of calcium 3) high intake of vitamin D 4) low urine volume, high urine acidity or alkaliity
A 70 year old client is seeing his primary care provider for an annual examination. Which assessment finding alerts the nurse to an increased risk for bladder cancer? a. a 5 year history of smoking 45 years ago b. difficulty starting and stopping the urine stream c. a 30 year occupation as a long distance truck driver d. a recent colon cancer diagnosis in his 72 year old brother
A 70 year old client is seeing his primary care provider for an annual examination. Which assessment finding alerts the nurse to an increased risk for bladder cancer? c. a 30 year occupation as a long distance truck driver (Rationale: lack of frequent and regular emptying of the bladder
what are the 5 types of mechanical obstruction?
5 Types of Mechanical Obstruction: 1) Adhesion 2) Tumor/cancer 3) Intussusception 4) hernia/protrusion 5) volvulus
What is the correct order of an abdominal assessment?
Abdominal Assessment Order: 1. Inspection 2. Auscultation 3. Percussion 4. Palpation
After abdominal surgery, which question should the nurse ask the patient to determine whether peristaltic movement is returning? a. "Have you passed flatus?" b. "are you hungry?" c. "do you have any nausea?" d. "is your pain level manageable?"
After abdominal surgery, which question should the nurse ask the patient to determine whether peristaltic movement is returning? a. "Have you passed flatus?"
Age-related changes in the GI/GU system (4)
Age-related changes in the GI/GU system 1. decreased absorption of vitamin b12 and iron 2. peristalsis decreases 3. Steatorrhea 4. decreased drug metabolism
type of obstruction in which peristalsis is commonly decreased as a result of neuromuscular disturbance and results in a slowing of movement or blockage of intestinal contents
non-mechanical obstruction
What is the primary type of med prescribed for diarrhea?
opioids are the primary type of meds prescribed for diarrhea
Bowel Incontinence nursing interventions (4)
Bowel Incontinence nursing interventions: 1) monitor pattern of bowel movements 2) provide bedpan or assist patient to bathroom at regular intervals 3) consider use of fecal incontinence pouch, moisture barrier cream 4) consider bowel training program
What are the signs and symptoms of bowel obstruction? (8)
Bowel obstruction signs and symptoms: 1) pain 2) nausea and vomiting 3) tachycardia 4) obstipation (no passage of stool) 5) fever 6) cramping and abdominal discomfort 7) long history of constipation
type of incontinence that is associated with dribbling and not being able to completely empty the bladder
overflow incontinence
what is the most common cause of upper GI bleeding?
peptic ulcers (and NSAID's) are the most common cause of upper GI bleeding
what is used to identify the potential cause of bowel obstruction?
CT or MRI used to identify potential cause of bowel obstruction
what are the causes of gastritis? (what is the most common cause) (4)
Causes of Gastritis: 1. h. pyloria bacteria (most common) 2. long term use of NSAID's 3. alcohol, caffeine, coffee 4. corticosteroids
What are symptoms of chronic pyelonephritis? (2)
Chronic pyelonephritis Symptoms: 1) hypertension 2) inability to conserve sodium
what diagnostic procedures are used for colorectal cancer?
Colorectal cancer diagnostic procedures: 1) fecal occult blood test 2) double-contrast barium enema 3) CT or MRI 4) colonoscopy
What is the common management for someone with hemorrhoids?
Common management for hemorrhoids is preventing constipation, increasing fiber intake, promoting peristalsis
What are concerns for incontinence? (6)
Concerns/Complications of Incontinence -Falls -Risk for infection -Alters skin integrity -diminished self-esteem -social isolation -depression
what are the concerns/risk of incontinence? (6)
Concerns/Risks of Incontinence: 1) fall risk 2) increased risk of infection 3) altered skin integrity 4) depression 5) diminished self-esteem 6) social isolation
Crohn's Disease Interventions/Care:
Crohn's Disease Interventions/Care: 1) monitor for peritonitis, small bowel obstruction, and nutritional and fluid imbalances 2) meds including monoclonal antibody drugs, glucocorticoids mask infection, immune suppression (azathioprine) 3) manage fistulas 4) risk for malnutrition, dehydration, hypokalemia 5) monitor urinary output and daily weights
Cystitis Signs and Symptoms:
Cystitis Signs and Symptoms: 1) foul-smelling or blood tinged urine 2) dysuria 3) onset of hypotension (with catheter use) 4) changes in mental status (with catheter use)
what is the difference between primary and secondary peritonitis?
primary peritonitis is when the infection is from the bloodstream secondary peritonitis is when injury or infection occurs from the abdominal cavity such as perforation leading to septicemia
Diarrhea Nursing Interventions:
Diarrhea Nursing Interventions: 1) teach proper hand-hygiene 2) avoid spicy and fatty foods, large quantities of raw fruits and vegetables 3) monitor stool frequency, color, amount, and consistency 4) monitor fluid balance: intake/output ratios, daily weight, vital signs 5) assess skin turgor and mucous membranes 6) monitor serum electrolyte levels 7) opiates are the primary anti-diarrheal that is prescribed. These are not recommended for acute diarrhea
what are common signs/symptoms of dumping syndrome?
Dumping Syndrome Signs/Symptoms: 1) desire to lay down 2) vertigo 3) tachycardia 4) syncope (fainting) 5) sweating 6) pallor 7) palpitations
rapid emptying of stomach contents into the small intestine
Dumping Syndrome: rapid emptying of stomach contents into the small intestine
what is the most common infecting organism in pyelonephritis?
E. coli is the most common infecting organism in pyelonephritis
Elimination nursing interventions (4)
Elimination nursing interventions 1) well balanced diet including 5 servings of grain, fruits, vegetables 2) drink at least 8-10 8oz glasses of water a day 3) engage in daily exercise, do not ignore urge to defecate 4) if experiencing constipation, choose bulking agents instead of over the counter laxatives, make sure water intake is high when on bulking agents
What is the expected sound upon percussion of the abdominal area?
Expected Percussion sound of Abdominal Area: -tympanic sound is expected -tymphanic sounds are hollow-drum like sounds that are produced when gas-containing regions are percussed.
What is the expected sound upon auscultation of the abdomen?
Expected auscultation sounds of the abdomen: -usually high-pitched
For which adverse drug effect does the nurse assess in a client who is hospitalized for an acute problem and is also prescribed an anticholinergic med to manage incontinence? (select all that apply) a. insomnia b. blurred vision c. constipation d. dry mouth e. loss of sphincter control f. increased sweating g. worsening mental function h. hypotension
For which adverse drug effect does the nurse assess in a client who is hospitalized for an acute problem and is also prescribed an anticholinergic med to manage incontinence? (select all that apply) b. blurred vision c. constipation d. dry mouth g. worsening mental function
For which adverse drug effects does the nurse assess in a client who is hospitalized for an acute problem and is also prescribed an anticholinergic drug to manage incontinence? a. insomnia b. blurred vision c. constipation d. dry mouth e. loss of sphincter control f. increased sweating g. worsening mental function h. hypotension
For which adverse drug effects does the nurse assess in a client who is hospitalized for an acute problem and is also prescribed an anticholinergic drug to manage incontinence? b. blurred vision c. constipation d. dry mouth g. worsening mental function
Functions/Role of the Kidneys/Renal System (5):
Functions/Role of the Kidneys/Renal System (5): 1) helps adjust blood pressure 2) regulate acid-base balance 3) produce erythropoieten for RBC synthesis 4) covert vitamin D to active form 5) maintain body fluid volume and composition
What is the leading cause of foodbourne disease and is a norovirus?
Gastroenteritis: leading cause of foodbourne disease and is a norovirus
What is the most common risk factor for gastric cancer?
H. pylori is the most common risk factor for gastric cancer
what is unnaturally swollen or distended veins in the lower rectum that cause pain and bleeding?
Hemmorrhoids: unnaturally swollen or distended veins in the lower rectum that cause pain and bleeding
what is weakness in the abdominal wall and the structure protrudes?
Herniation: weakness in the abdominal wall and the structure protrudes
What topics and questions are included in the history and physical assessment of the abdomen/GI/GU?
History Physical Assessment of abdomen GU/GI/Abdomen: 1) changes in appetite, weight, stool 2) pain 3) age, gender, culture 4) GI disorders and previous surgeries 5) Medications, herbs, and supplements 6) smoking history 7) travel history 8) nutrition
Identify the feature with either ulcerative colitis or Crohn's disease: -begins in rectum -involves rectum and small intestine -5 to 6 stools per day -10-20 stools per day -soft, loose stools -non-bloody stools -liquid, bloody stools -frequent need for surgery -complication of hemorrhage -complication of fistulas -anemia is common -fever and tachycardia present -severe diarrhea -malabsorption of nutrients -steatorrhea (fatty stools)
Identify the feature with either ulcerative colitis or Crohn's disease: Ulcerative Colitis: begins in rectum, 10-20 liquid, bloody stools, complication of hemorrhage, fever and tachycardia present Crohn's disease: 5-6 soft, loose, non-bloody stools, complication of fistulas, frequent need for surgery, involves rectum and small intestine, severe diarrhea, malabsorption of nutrients, anemia is common
In IBS, food intolerances include _______, ________, and _________
In IBS, food intolerances include dairy products, raw fruits, and grains
in acute glomerulonephritis, onset of symptoms occur _____ days from time of infection. Infection is noted before kidney symptoms
In acute glomerulonephritis, onset of symptoms occur 10 days from time of infection. Infection is noted before kidney symptoms
What labs are indicative of dehydration?
Indicative labs of dehydration: -elevated BUN -elevated creatinine -elevated hemaglobin (M: 13.8-17.2, F: 12.1-15.1) -elevated hematocrit -decreased sodium (136-144) -decreased potassium (3.7-5.2)
what are the inflammatory intestinal disorders? (3)
Inflammatory Intestinal Disorders 1) appendicitis 2) peritonitis 3) gastroenteritis
Why are inspection and auscultation performed before palpation during an abdominal assessment?
Inspection and auscultation are performed before palpation during abdominal assessment because palpation may disturb normal peristalsis and bowel motility
what disease is characterized by chronic diarrhea, constipation, pain, and bloating?
Irritable Bowel Syndrome (IBS)
What labs are indicative of ulcerative colitis?
Lab indicative of ulcerative colitis? -elevated WBC count (4500-10000) -low sodium (136-144) -low potassium (3.7-5.2)
What abdominal quadrant are the following structures located? -liver -appendix -descending colon -gall bladder -stomach -spleen -pancreas
Location of abdominal structures: liver: RU appendix: RL descending colon: LL gall bladder: RU stomach: LU spleen: LU pancreas: LU
condition that prevents the absorption of nutrients via the small intestine
Malabsorption syndrome: condition that prevents the absorption of nutrients via the small intestine
What medications may slow peristalsis/promote constipation/treat diarrhea?
Meds that slow peristalsis/promote constipation: -antacids -pain meds (especially opioids) -antimotility drugs (diphenoxylate) (used to treat diarrhea)
What are the most common interventions for constipation? (3)
Most common constipation interventions: 1) enema 2) digital removal 3) suppositories
degenerative kidney disorder that changes/affects blood vessels. Hypertension, atherosclerosis, and diabetes are all components
Nephrosclerosis: degenerative kidney disorder that changes/affects blood vessels. Hypertension, atherosclerosis, and diabetes are all components
an immune kidney disorder, glomerular permeability increases, massive protein loss and edema occurs, decreased levels of plasma albumin
Nephrotic Syndrome: an immune kidney disorder, glomerular permeability increases, massive protein loss and edema occurs, decreased levels of plasma albumin
Nurse Role in Assessment of GU System: -the priority for care is to check for the return of _____ after an upper endoscopic procedure before offering fluids and foods -remind patient ______ for endoscopic procedures -teach patient bowel must be ______ to allow visualization of the colon -instruct the patient to drink plenty of fluids and take _____ to eliminate barium if used during diagnostic testing -do not _______ because it may be life-threatening aortic aneurysm -assess patients who have endoscopies for ______, ________, and ________ -for individuals who have had a colonoscopy, check for passage of _____ before allowing fluids or foods
Nurse Role in Assessment of GU System: -the priority for care is to check for the return of the gag reflex after an upper endoscopic procedure before offering fluids and foods -remind patient have someone available to drive them for endoscopic procedures -teach patient bowel must be clear to allow visualization of the colon -instruct the patient to drink plenty of fluids and take laxatives to eliminate barium if used during diagnostic testing -do not palpate or auscultate any pulsating abdominal masses because it may be life-threatening aortic aneurysm -assess patients who have endoscopies for bleeding, fever, and severe pain -for individuals who have had a colonoscopy, check for passage of flatulence before allowing fluids or foods
Nurse Role in Care for Patients with Stomach Disorders: 1. Identify those at risk for peptic ulcer disease, especially those with _______ 2. Prevent PUD by avoiding _________ 3. ________ is a medical emergency 4. Proper admin of antacids (1-2 after meals), and they can interfere with certain drugs like phenytoin 5. h2 antagonists should be taken at _______ 6. observe for signs and symptoms of Dumping syndrome after _________
Nurse Role in Care for Patients with Stomach Disorders: 1. Identify those at risk for peptic ulcer disease, especially those with H. pylori and older adults who take lots of NSAIDS 2. Prevent PUD by avoiding caffeine, alcohol, coffee, smoking, aspirin, NSAIDS 3. Hematemesis (vomiting of blood) is a medical emergency 4. Proper admin of antacids (1-2 after meals), and they can interfere with certain drugs like phenytoin 5. h2 antagonists should be taken at bedtime 6. observe for signs and symptoms of Dumping syndrome after gastric surgery
Nurse Role in Care of Patients with Inflammatory Bowel Disorders: 1. Classic signs and symptoms of appendicitis include _________, ________, ________, and _________. 2. __________ requires immediate intervention 3. assess for key features of peritonitis which include _________, _________, ________, ________, _________, and _________ 4. administer ______ to decrease stools and prevent dehydration in patients with acute and chronic inflammatory bowel disorders 5. Be alert for _______ in patients with _______ 6. Patients with _______ are at high risk for malnutrition as a result of inability to absorb nutrients via small intestine 7. priority problems for patients with ulcerative colitis include ________, _______, and ________ 8. administer _______ to decrease inflammation in patients with ulcerative colitis 9. administer _____ for patients with Crohn's disease 10. Teach patients with _______ to eat high fiber diet, low fiber diet for ________ 11. instruct patients with anorectal disorders to use sitz bath salts, bulk-forming agents, and stool softeners to decrease pain
Nurse Role in Care of Patients with Inflammatory Bowel Disorders: 1. Classic signs and symptoms of appendicitis include abdominal pain, nausea and vomiting, abdominal tenderness on auscultation. 2. Perforation (rupture) requires immediate intervention 3. assess for key features of peritonitis which include diminished bowel sounds, rebound tenderness, high fever and tachycardia, fluid volume deficit, compromised respiratory status, nausea and vomiting 4. administer antidiarrheals to decrease stools and prevent dehydration in patients with acute and chronic inflammatory bowel disorders 5. Be alert for GI bleeding in patients with chronic IBD 6. Patients with Crohn's disease are at high risk for malnutrition as a result of inability to absorb nutrients via small intestine 7. priority problems for patients with ulcerative colitis include diarrhea, pain, potential for lower GI bleeding 8. administer 5 ASA drugs to decrease inflammation in patients with ulcerative colitis 9. administer infliximab (mononuclal agents) for patients with Crohn's disease 10. Teach patients with diverticulosis to eat high fiber diet, low fiber diet for diverticulitis 11. instruct patients with anorectal disorders to use sitz bath salts, bulk-forming agents, and stool softeners to decrease pain
Nurse Role/Interventions in Care for Urinary Problems: -use ______ precautions for any drainage from genitourinary tract -assess ______ for need of indwelling catheter -teach patients to clean perineal area _______, after _______, after ______, and after ______ -report immediately any condition that _______ -teach women who have stress incontinence to perform _______ -instruct patients with UTI to complete all prescribed antibiotic therapy even in absence of symptoms -assess patient ______ and ________ before teaching of intermittent self-catheterization
Nurse Role/Interventions in Care for Urinary Problems: -use contact precautions for any drainage from genitourinary tract -assess daily for need of indwelling catheter -teach patients to clean perineal area daily, after voiding, after bowel movements, and after sexual intercourse -report immediately any condition that obstructs urine flow -teach women who have stress incontinence to perform pelvic floor strength exercises -instruct patients with UTI to complete all prescribed antibiotic therapy even in absence of symptoms -assess patient cognitive awareness and dexterity before teaching of intermittent self-catheterization
Nurse Role/Interventions in Care for non-inflammatory intestinal disorders: -teach patients with IBS to avoid ________ and manage ________ -prevention and management of hemorrhoids includes _________ and ______ -bowel sounds are altered in patients with _______. absence of bowel sounds implies ________ -assess patient nasogastric tube every _______ -monitor patients with bowel obstruction for signs and symptoms of _______ -patients with _______ bowel obstruction are at greatest risk for fluid and electrolyte imbalances
Nurse Role/Interventions in Care for non-inflammatory intestinal disorders: -teach patients with IBS to avoid GI stimulants such as caffeine, alcohol, coffee, milk products and manage stress -prevention and management of hemorrhoids includes increasing fiber intake and avoid eating red meat, maintaining healthy weight -bowel sounds are altered in patients with bowel obstruction. absence of bowel sounds implies total obstruction -assess patient nasogastric tube every 4 hr -monitor patients with bowel obstruction for signs and symptoms of fluid and electrolyte imbalances -patients with small bowel obstruction are at greatest risk for fluid and electrolyte imbalances
Nurse role in care of patient with kidney diseases: 1. check blood pressure and ______ frequently 2. report immediately to provider any _________
Nurse role in care of patient with kidney dieases: 1. check blood pressure and urine output frequently 2. report immediately to provider any sudden decrease of urine output
Nursing Care/Interventions for Bowel Obstruction:
Nursing Care/Interventions for Bowel Obstruction: 1) monitor vital signs 2) listen for bowel sounds and assess abdomen for distention, flatulence 3) monitor fluid and electrolyte status 4) pain management and promote comfort 5) manage the nasogastric tube (irrigation, nasal cares, keep in semi-fowlers position, usually NPO
Nursing Care/Interventions for Gastritis (4)
Nursing Care/Interventions for Gastritis 1) meds such as h2 receptor antagonists block gastric secretions (antacids) PPI's (omeprazole) 2) limit caffeine, alcohol, and coffee 3) avoid NSAID's 4) encourage bland, nonspicy, small and frequent meals
Short-term Constipation nursing interventions: (6)
Short-term constipation nursing interventions: 1) increase fiber intake 2) increase fluid intake 3) increase physical activity 4) semi-fowlers position for bedrest patients 5) do not ignore urge to defecate 6) assess for complications such as hemmorhoids and impaction
What are the risk-factors for short-term constipation? (4)
Short-term constipation risk factors 1) decreased activity or bedrest 2) opioid and other meds that slow peristalsis 3) low fiber intake 4) low fluid intake
Signs and Symptoms of Upper GI bleeding:
Signs and Symptoms of Upper GI bleeding: 1) bright red/coffee ground vomit 2) melena (black, tarry stools) 3) tachycardia 4) hypotension 5) weak pulse 6) acute confusion 7) vertigo, dizziness 8) syncope (fainting) 9) low hemoglobin and hematocrit
Identify the sign/symptom with type of bowel obstruction (small or large bowel) -intermittent lower abdominal cramping -upper or epigastric abdominal distention -pain accompanied by visible peristaltic waves -nausea and vomiting -ribbon-like stools -severe fluid and electrolyte imbalances -metabolic alkalosis -metabolic acidosis -obstipation
Signs and symptoms of small v large bowel obstructions: Small Bowel: pain accompanied by visible peristaltic waves, upper or epigastric abdominal distention, nausea and vomiting, severe fluid and electrolyte imbalances, metabolic alkalosis Large Bowel: intermittent lower abdominal cramping, obstipation, ribbon-like stools, metabolic acidosis
what structures are located in the following abdominal quadrants: Right Upper: Right Lower: Left Upper: Left Lower:
Structures in each abdominal quadrant: Right Upper: most of the liver, gallbladder Right Lower: appendix Left Upper: stomach, spleen, some of pancreas Left Lower: descending colon
which type of gastritis is the following symptoms of? -hematemesis (vomiting blood) -dyspepsia (heart burn) -pernicous anemia -nausea and vomiting -abdominal tenderness -bloating -gastric hemmorhage -anorexia -melena (dark, sticky feces) -intolerance of spicy and fatty foods -relieved with food consumption
Symptoms of acute and chronic gastritis: Acute: hematemesis (vomiting blood), dyspepsia (heart burn), nausea and vomiting, abdominal tenderness, bloating, gastric hemmorhage, anorexia, and melena (dark, sticky feces) Chronic: pernicous anemia, nausea and vomiting, anorexia, intolerance of spicy and fatty foods, relieved with food consumption
The nurse is performing medication reconciliation for a client. The nurse recognizes which drugs contribute to signs and symptoms of gastritis? (select all that apply) a. aspirin, taken once daily to prevent cardiac concerns b. Naproxen, taken once daily for joint pain associated with arthritis c. amoxacillin, taken over a 10 day period for acute sinus infection d. bacitracin ointment (over the counter) applied to minor scrapes on the arms and legs e. prednisone, tapered over a 14 day period to decrease inflammation associated with sinus infection
The nurse is performing medication reconciliation for a client. The nurse recognizes which drugs contribute to signs and symptoms of gastritis? (select all that apply) a. aspirin, taken once daily to prevent cardiac concerns b. naproxen, taken once daily for joint pain associated with arthritis e. prednisone, tapered over a 14 day period to decrease inflammation associated with sinus infection
Who is more susceptible to prolonged gastroenteritis? (4)
Those who are more susceptible to prolonged gastroenteritis are: -older adults -immunocompromised -dehydrated -hypovolemia (low blood volume)
Treatment for urinary incontinence: (5)
Treatment for urinary incontinence: 1) behaviorial interventions such as timed voiding and Kegel exercises 2) meds such as topical estrogen and anticholinergics 3) devices such as indwelling devices 4) sacral nerve stimulation 5) surgical treatments such as bladder suspension and prostate resection
Ulcerative Colitis Treatment: -limit fiber, raw vegetables, smoking, alcohol, caffeine
Ulcerative Colitis Treatment: -limit fiber, raw vegetables, smoking, alcohol, caffeine -meds including anti-inflammatories, glucocorticoids (prednisone) for exacerbation, and anti-diarrheals -surgical: temporary or permanent ileostomy
what signs/symptoms of upper GI bleeding need to be immediately reported?
Upper GI bleeding Signs/Symptoms to Immediately Report: 1) black or bloody stools 2) sharp, severe, sudden epigastric or abdominal pain 3) bloody vomit or vomit that looks like coffee grounds
the presence of calculi (stones) in the urinary tract
Urolithiasis: the presence of calculi (stones) in the urinary tract
What medications may increase peristalsis/promote diarrhea/treat constipation?
What medications may increase peristalsis/promote diarrhea/treat constipation? -antibiotics -laxatives
What topics/questions should be considered in gathering information about elimination of a patient?
What topics/questions should be considered in gathering information about elimination of a patient? 1) pattern and frequency of bowel movement 2) color and consistency of stool 3) form (diarrhea or constipation) 4) presence of frank blood or tarry stools 5) what actions have they taken? 6) Psychosocial factors: stress, incontinence 7) diet patterns (fiber)
When administering a new GI medication to an older patient, the nurse anticipates what? a. a higher than normal dose may be needed b. close monitoring is needed because toxic levels may develop c. older adults always require a lower than normal dose than younger patients d. nausea and vomiting may develop rapidly and are common side effects in older adults
When administering a new GI medication to an older patient, the nurse anticipates what? b. close monitoring is needed because toxic levels may develop
Which emergency care does the nurse recognize that will be implemented for a client with malignant hyperthermia? Select all that apply. A. Removal of endotracheal tube B. Cessation (stopping) of surgery when possible C. Insertion of Foley catheter to monitor urine output D. Transfer of patient to intensive care unit when stabilized E. Assessment of arterial blood gases (ABGs) for respiratory alkalosis F. Use of active cooling techniques such as a cooling blanket and ice packs around the axillae and groin
Which emergency care does the nurse recognize that will be implemented for a client with malignant hyperthermia? Select all that apply. b. cessation (stopping) of surgery when possible c. insertion of Foley catheter to monitor urine output d. transfer patient to intensive care unit when stabilized f. use of active cooling techniques such as a cooling blanket and ice packs around the axillary and groin
Which patient statement alerts the nurse to perform a thorough GI history and assessment? a. "I don't like spicy foods" b. "I got dentures four years ago" c. "I experience occasional constipation" d. "I take ibuprofun 3x daily for arthritis"
Which patient statement alerts the nurse to perform a thorough GI history and assessment? d. "I take ibuprofun 3x daily for arthritis"
Which question does the nurse ask the client who has a urinary tract infection to assess the risk for possible pyelonephritis? A. What drugs do you take for asthma? B. How long have you had diabetes? C. How much fluid do you drink daily? D. Do you take your antihypertension drugs at night or in the morning?
Which question does the nurse ask the client who has a urinary tract infection to assess the risk for possible pyelonephritis? b. how long have you had diabetes?
Which question does the nurse ask the client who has an UTI to assess the risk for pyelonephritis? a. what drugs do you take for asthma? b. how long have you had diabetes? c. how much fluid do you drink daily? d. do you take your antihypertension drugs at night or in the morning?
Which question does the nurse ask the client who has an UTI to assess the risk for pyelonephritis? b. how long have you had diabetes?
Bending of knee and hip of in a patient who is suspected to have appendicitis that provides relief of pain and discomfort is indicative of what?
bending of knee and hip of a patient who is suspected to have appendicitis that provide relief of pain and discomfort is indicative of perforation of the appendix (peritonitis, life-threatening)
what is the preferred treatment for chronic constipation?
bulking agents are the preferred treatment for chronic constipation
Who is at high risk for diarrhea complications?
children and seniors are at high risk for diarrhea complications
what type of gastritis is relieved by food? what type is associated with rapid onset of pain and dyspepsia (heartburn)?
chronic gastritis is usually relieved by food, acute gastritis is associated with rapid onset of pain and dyspepsia (heartburn)
Constipation is common in which types of people? (3)
constipation is common in expecting moms, older people, and those with fluid volume loss deficit
inflammation of the bladder with or without infection
cystitis: inflammation of the bladder with or without infection
What factors can exacerbate IBS? (3)
diet, stress, and anxiety can exacerbate symptoms of IBS
Upon auscultation of the abdomen, what would dull like sounds potentially indicate?
dull sounds upon auscultation of the abdomen would potentially indicate fluid/feces blockage
During periods of exacerbation in IBS, should you increase or decrease fiber intake?
during periods of exacerbation in IBS, you should decrease fiber intake (prevent further impact of chronic diarrhea)
what is the most common report of upper GI bleeding?
dyspepsia (indigestion) is the most common report of upper GI bleeding
What does frank blood possibly indicate in GU assessment?
frank blood indicates a lower bleed in the intestines, the bleed is closer to the exit
type of incontinence that is associated with a mental or physical impairment that hinders you from making it to the toilet in time to urinate
functional incontinence
inflammation of the stomach lining
gastritis: inflammation of the stomach lining
how long does gastroenteritis typically last?
gastroenteritis typically lasts around 3 days and is self-limiting
What type of sounds will be present immediately prior to one's body trying to get an obstruction out of the way?
high-pitched sounds
When there is a partial block in obstruction, what may be present?
liquid diarrhea may be present in a partial block in obstruction
what are the most common symptoms of gastric cancer?
most common symptoms of gastric cancer are indigestion and abdominal discomfort
type of incontinence where radiation, cystitis, and bladder inflammation are common causes. Person does not realize bladder is full and doesn't have the urge to urinate
reflex incontinence: type of incontinence where radiation, cystitis, and bladder inflammation are common causes. Person does not realize bladder is full and doesn't have the urge to urinate
Someone with ulcerative colitis should have ______ fiber intake
someone with ulcerative colitis should have low fiber intake
stool that contains the presence of blood and mucus is indicative of ________
stool that contains the presence of blood and mucus is indicative of ulcerative colitis
stools that are less formed and more liquid like are _____ in the tract
stools that are less formed and more liquid like are higher in the tract
type of incontinence that is associated or induced by things like sneezing and coughing
stress incontinence
what is the preferred method of treatment for gastric cancer?
surgical resection is the preferred method of treatment for gastric cancer
what does tarry stools in stools possibly indicate in GU assessment?
tarry stools indicate the bleed is older, likely higher up/further away in the intestines farther from the exit point
type of incontinence that is short-term, resolves spontaneously. Medications and disease/illness are the causes of this type of incontinence
transient incontinence: short-term, resolves spontaneously. medications and disease/illness are the causes of this type of incontinence.
What are the 2 most common inflammatory bowel disease (IBD)?
ulcerative colitis and Crohn's disease are the 2 most common inflammatory bowel diseases
is ulcerative colitis acute or chronic? what are they at risk for?
ulcerative colitis is a chronic condition, they are at risk for fluid and electrolyte imbalances due to chronic diarrhea
inflammation of the rectum and colon
ulcerative colitis: inflammation of the rectum and colon