Med Surg Chapter 48 Quiz

The nurse is irrigating a colostomy. The catheter should be advanced into the stoma __________ to _______ inches.

2 to 3

The recommended dietary intake of fiber is _________ grams/day. This intake along with 1.5 to 2 Liters of fluids daily, should prevent constipation that occurs with fever than ________ bowel movements per week.

20 - 30 g/day; three

A chemotherapeutic agent used to treat colon cancer

5-FU

The majority of large bowel obstructions are caused by _________________.

Adenocarcinoid tumors

Name the hallmark signs of malabsorption syndrome.

Diarrhea or frequent loose, bulky, foul smelling stools that have increased fat content and are often grayish (steatorrhea)

The most common baxter associated with peritonitis

E. Coli

A tubular fibrous tract that extend form an opening beside the anus into the anal canal.

Fistula

The most popular over the counter medication purchased in the United States

Laxatives

A patient is not having daily bowel movements and has begun taking a laxative for this problem. What should the nurse educate the patient about regarding laxative use?

Laxatives should not be routinely taken due to destruction of nerve endings in the colon

The nurse is assessing a patient with appendicitis. The nurse is attempting to elicit a Rovsing's sign. Where should the nurse palpate for this indicator of acute appendicitis?

Left Lower quadrant

The nurse is caring for an older adult patient experiencing fecal incontinence. When planning the care of this patient, what should the nurse designate as a priority goal?

Maintaing skin integrity

Name four complications associated with diverticulitis

Periotonits Abscess formation Fistulas bleeding

The most common complication of cancer

Peritonitis

An ileal outlet on the abdomen

Stoma

Straining at stool

Valsalva Maneuver

The three most common causes of small bowel obstruction are _______________, _______________, and _______________.

Adhesions, hernias, neoplasms

Intestinal rumbling

Borborygmus

The nurse is performing an abdominal assessment for patient with diarrhea and auscultates a loud rumbling sound in the left lower quadrant. What will the nurse document this sound as on the nurse's notes?

Borborygmus

Another term for fecal matter

Effluent

The nurse is caring for a patient who has malabsorption syndrome with an undetermined cause. What procedure will the nurse assist with that is the best diagnostic test for this illness?

Endoscopy with mucosal biopsy

Describe the physiologic response that occurs when a patient has a Valsalva maneuver while straining during defecation.

Forcible exhalation against a closed glottis followed by a rise in intrathoracic pressure and subsequent possible dramatic rise in arterial pressure

The nurse is admitting a patient with a diagnosis of diverticulitis and assesses theta the patient has a board like abdomen, no bowel sounds, and complains of severe abdominal pain. What is the nurse's first action?

Notify the physician

The most common site for the presence of diverticulitis is the _______________.

Sigmoid

Intravenous nutrition used for inflammatory bowel disease

TPN

Painful straining at stool

Tenesmus

Malabsorption diseases may affect the ability of the digestive system to absorb the major water-soluble __________________.

Vitamin b12

A patient arrives in the emergency department with complaints of right lower abdominal pain that began 4 hours ago and is getting worse. The nurse assesses rebound tenderness at McBurney's point. what does this assessment date indicate to the nurse?

Appendicitis

What medications may be prescribed for the patient with constipation that will enhance colonic transit by increasing propulsive motor activity?

Cholinergic agents (bethanechol (Urecholine) Cholinesterase inhibitors (Neostigmine (Prostigmin) Prokinetic agents (Metoclopramide (reglan) **Prokinetic agents including serotonin receptor agonists like prucalopride (Resolor) and prostones like lubiprostone (Amitiza) stimulate chloride channels in the gut. Medical probiotics may help some constipated individuals by creating improved bacterial balance

The nurse is irrigating a colostomy when he patient says, "You will have to stop, I am cramping so badly." What is the priority action by the nurse?

Clamp the tubing and give the patient a rest period

The most common bacteria found in antibiotic associated diarrhea is _________________.

Clostidium difficile

A patient is suspected to have diverticulosis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling?

Colonoscopy

Another food to avoid for patient with an ileostomy

Corn

Another name for regional enteritis

Crohn's Disease

Common clinical manifestation of Crohn's disease are ____________ and _______________.

Abdominal pain, diarrhea

A highly reliable blood study used to diagnose appendicitis

CEA

A patient with irritable bowel syndrome has been having more frequent symptoms lately and is not sure what lifestyle changes amy have occurred. What suggestion can the nurse provide to identify a trigger for the symptoms?

Keep a 1 to 2 week symptom and food diary to identify food triggers

A disorder of malabsorption that inactivates pancreatic enzymes is ______________________.

Zollinger- Ellison syndrome

A food to avoid for a patient with an ileostomy

Celery

A patient is having a diagnostic workup for complaints of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of?

Crohn's Disease

List the common bacteria found in a patient who has developed peritonitis.

Escherichia coli, Klebsiella Proteus Pseudomonas

The nurse is caring for patient who has had an appendectomy. What is the best position for the nurse to maintain the patient in after the surgery?

High Fowlers

The two diseases of the colon that are commonly associated with constipation are _________________________ and ______________________

Irritable bowel syndrome, diverticular disease

A patient is being seen in the clinic for complaints of painful hemorrhoids. The nurse assesses the patient and observes the hemorrhoids are prolapsed but able to be placed back int he rectum manually. The nurse documents the hemorrhoids as what degree?

Third Degree

A patient is admitted to the hospital after not having a had a bowel movement in several days. The nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. What complication can this patient develop related to this problem?

Bowel perforation

Name at least four factors that may be associated with the development of irritable bowel syndrome.

Hereditary psychologica stress ro conditions such as depression and anxiety, and a diet high in fat and stimulating or irritating foods, alcohol consumption, and smoking

List six risk factors for colorectal cancer that the nurse can educate the public about.

Increasing age Family history of colon cancer or polyps Previous colony cancer or adenomatous polyps High consumption of alcohol Cigarette smoking Obesity History of gastrectomy History of IBD High fat Hight protein Low fiber diet Genital cancer Brest cancer

Dilated and atonic colon caused by a fecal mass

Megacolon

The nurse is assigned to care for patient 2 days after an appendectomy due to a a ruptured appendix with resultant peritonitis. The nurse has just assisted the patient with ambulating to the bedside commode when he patient points to the surgical site and informs the nurse that "something gave way." What does the nurse suspect may have occurred?

Wound Dehiscence has occurred