Med-Surg CH 44-48

Peptic Ulcer

A crater like lesion that forms in areas exposed to gasric juice. This can lead to bleeding and anemia.

Virtual colonoscopy

A noninvasive imaging procedure to obtain multi-dimensional views of the entire colon is the CT colonography.

Panenoscopy

Examination of the pharynx, larynx, upper trachea, and esophagus with rigid and flexible endoscopes.

steatorrhea

Fat in the feces

Biliary colic

Gall stones that interfere with bile flow, causing bile duct contraction, may present without pain (in diabetics)

effluent

Liquid output from an ileostomy

a client is being prepared to undergo laboratory and diagnostic testing to confirm the diagnosis of cirrhosis. Which test with the nurse expect to be used to provide definitive confirmation of the disorder?

Liver Biopsy

What is an example of an opiate-related antidiarrheal agent?

Loperamide (Imodium)

hepatorenal syndrome

a unique form of prerenal failure associated with advanced cirrhosis or acute liver failure. The kidneys are structurally normal but fail due to splanchnic vasodilation and profound renal vasoconstriction. Mortality >90%

a client with a gastrojejunostomy is beginning to take solid food. What would lead the nurse to suspect that the client is experiencing dumping syndrome?

abdominal cramps

Diverticula

abnormal side-pockets in the intestinal wall

Upper gastrointestinal series

administration of barium contrast material to visualize esophagus, stomach and duodenum (barium swallow)

Jejunostomy

an opening through the abdominal wall into the jejunum

a nurse is caring for a client with the diarrhea. Which intervention would help to ensure that the client's perineal tissue remains intact?

apply ointment with vitamin A and D to the perianal area.

Chron's disease

bowel disease: chronic inflammation of parts of the intestinal tract

ostomate

client with an ostomy.

T-tube

device used to drain bile while the surgical wound from an opening and exploration of the common bile duct heals.

appliance

device worn over a stoma to collect feces or urine

Balloon Tamponade

use of balloons placed within the esophagus and proximal portion of the stomach and inflated to compress bleeding vessels (esophageal and gastric varices)

Colonoscopy

visual examination of the colon (with a colonoscope) from the cecum to the rectum

The nurse is preparing to interview a client with Linux cirrhosis. based on understanding of this disorder, which question would be most important to include?

"How often do you drink?"

A client with a colostomy is asking the nurse about what he shouldn't eat and drink. What kind of liquid should they drink and how much?

"Drink 8-10 cups of fluid per day."

the nurse is talking with a client who is scheduled for a computed tomography or CT colonography. Which client statement would indicate to the nurse to the client needs additional teaching about the procedure?

"My doctor will be able to remove any polyps he finds"

Pyrosis

(heartburn) burning sensation in upper abdomen due to reflux of gastric acid

cholecystitis

-inflammation of the gallbladder

A client undergoes surgery for Kock pouch and returns to the nursing unit. The nurse anticipates that the ileal catheter will be removed in about?

10-14 days

the nurse is checking the residual content for a client who is receiving intermittent feedings. What residual content would lead the nurse to delay the feeding?

120mL

A client with peptic ulcer disease who is receiving histamine - 2 antagonist therapy, has a nasogastric tube in place. The nurse test the pH of aspirated gastric fluid. Which pH finding with the nurse interpret as indicating effectiveness of the client's medication therapy?

3.0

A client weighs 215 pounds and is 5 feet 8 inches tall. The nurse would calculate this client's body mass index as which of the following?

32.7 (Weight and divide by inches squared X 703)

Encopresis

A childhood disorder characterized by repeated defecating in inappropriate places, such as one's clothing

Hernia

A protrusion of tissue under the skin through a weakened area of the body wall.

Cholangiography

A radiographic examination of the bile ducts with the use of a contrast medium.

Toxic megacolon

A severe complication of several conditions that involves a large dilation of the colon wit possible local bacterial overgrowth. Rupture of the colon is a possibility and has a 50% mortality. Emergency treatment for this condition is necessary and can prevent sepsis, shock, and possibly death.

Diverticulum

A small pouch or sac occurring in the lining or wall of a tubular organ such as the colon.

What is the cause of functional obstruction?

Abdominal surgery

Ascites

Abnormal accumulation of fluid in the abdomen.

choledocholithiasis

Abnormal condition of stones in the common bile duct.

Diverticulosis

Abnormal outpouchings in the intestinal wall.

Fistula

Abnormal passage, usually between 2 internal organs, or leading from an internal organ to the surface.

Barium Swallow

Also called an upper GI series, used to diagnose abnormalities in the esophagus, stomach, and small intestine. The patient swallows a liquid containing barium, and X-rays are taken to record the diagnostic images.

segmental resection

An anatomical resection of the liver in which segments divided by specific blood vessels and biliary ducts are removed.

portal hypertension

An increase in blood pressure within the portal vein due to increased resistance to blood flow.

Barium Enema

An x-ray exam using an opaque contrast medium to examine the lower GI tract

Extreme Obesity

BMI > 40

A client with GERD develops esophagitis. Which diagnostic test with the nurse expect the physician to order to confirm this diagnosis?

Barium Swallow

Melena

Black tarry stool

What would a nurse expect to assess in a client with peritonitis?

Board-like abdomin

A client with a colostomy asks the nurse for suggestions for foods to help decrease the odor. Which of the following foods would the nurse suggest? cheese, eggs, garlic or buttermilk?

Buttermilk

A client with a feeding tube is receiving medication. The medication supplied is an enteric coated tablet. What action should the nurse take regarding this medication?

Check with the pharmacist to see if there is a liquid form available.

which of the following instructions should the nurse include in the teaching plan of a client who has undergone colostomy?

Chew food well

What activity is contraindicated for a client undergoing Ultrasonography during the test?

Chewing gum.

cirrhosis

Chronic disease of the liver

A client is scheduled for an esophagogastrogastroduodenscopy (EGD) to detect lesions in the gastrointestinal tract. The nurse will assess the client for what during this procedure?

Client's tolerance for pain and discomfort.

Gastroesophageal reflux disease (GERD)

Commonly presents as heartburn and regurgitation upon lying down. May also present with nocturnal cough and dyspnea.

Fissure

Crack in the skin that penetrates the epidermis, such as chapped hands or lips.

The nurse is providing care to a client who has had a percutaneous liver biopsy. The nurse would monitor the client for what?

Signs and symptoms of bleeding.

Dyspepsia

Difficult digestion; indigestion

esophageal varices

Dilated submucosal veins in the lower esophagus

a client ingested a carbohydrate solution as part of the hydrogen breath testing. The nurse would need to monitor this client for what?

Dizziness and confusion

A client with an ileostomy is receiving medication in the slow release capsule form. The nurse would be alert for the following?

High blood pressure

A client with a history of constipation is instructed to consume a high-fiber diet. What foods should they eat and avoid?

High fiber-White bread, Dried lentils, Popcorn. Low fiber-Brown Rice

a group of students is receiving information about oral cancers in preparation for an examination. The students demonstrate a need for additional review when they identify which of the following is as risk factors?

History of GERD

When reviewing the history of a client with pancreatic cancer, the nurse would identify which of the following is a possible risk factor?

History of pancreatitis

hepatitis

INFLAMMATION OF THE LIVER

pancreatitis

INFLAMMATION OF THE PANCREAS

Dumping Syndrome

In response to the sudden influx of hypertonic fluid, the small intestine pulls fluid form the extracellular space to convert the hypertonic fluid to an isotonic fluid

Which of the following laboratory test results would the nurse associate with obstructive jaundice

Increased direct bilirubin

Diverticulitis

Infected or inflamed pouch (diverticulum) in the colon. Common in older persons; Low-fiber diet and constipation are risk factors.

Pilonidal sinus

Infection in the hair follicles in the sacrococcygeal area above the anus.

Appendicitis

Inflammation of the appendix

Peritonitis

Inflammation of the peritoneum

Gastrostomy

Making a new opening in the stomach

When performing a physical examination of a client with cirrhosis the nurse notices the client's abdomen is enlarged. What nursing intervention should the nurse conduct?

Measure abdominal girth according to a set routine.

laproscopic cholecystectomy

Most common method of cholecystectomy; Small abdominal incisions allow insertion of surgical instruments and small video camera; Surgeon performs procedure by watching monitor and manipulating instruments; Stomach muscles are not cut, healing is quicker

a client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glyco/electrolyte solution as a part of the test preparation. Which measure should the nurse take once the solution is administered?

Only clear liquids.

Odynophagia

Painful swallowing

Name the organs of the GI tract:

Parotid gland. Sublingual gland. Submandibular gland. Pharynx. Trachea. Esophagus. Diaphram. Stomach. Spleen. Pancreas. Liver. Gallbladder. Duodenum. Pancreatic Duct. Ascending Colon. Transverse colon. Small intestine. Descending colon. Sigmoid colon. Rectum. Anus.

Irritable bowel syndrome

Paroxysmal mobility syndrome primarily affecting the colon, causing constipation and diarrhea.

cholestasis

Patient presents with chalky stool, and impaired secretion of conjugated bilirubin

Has had surgery to create an ileal nail reserved surgery. which instruction with the nurse give to reduce the risk for bowel incontinence?

Perform perineal exercises.

a client with nausea and vomiting is to receive an antiemetic that inhibits the vomiting center in the brain. Which of the following would the nurse expect to physician to order most likely?

Prochlorperazine (Compazine)

The nurse is assisting a client with a colostomy to change his appliance. After the old appliance and face plate are removed, which of the following was a nurse assist a client to do next?

Protect the perostomal area from the drainage.

Hiatal or diaphramatic hernia

Protrusion of part of the stomach through the diaphram.

an older client expresses anxiety before undergoing a barium enema. which of the following measures should the nurse take to relieve him of his anxiety before the test?

Provide education materials

What is the opening between the stomach and duodenum?

Pyloric Sphincter

A client is admitted with a diagnosis of acute appendictis. When assessing the abdomen, the nurse would expect to find rebound tenderness at what location?

RLQ

A client comes to the emergency department because he's noticed a bulging in his groin area when he coughs. He states that he noticed this ever since he lifted a heavy bag of gardening mulch last week. The physician determines that the client has an inguinal hernia and applies manual pressure to replace the routing structures back into the abdominal cavity. The nurse understands that this procedure indicates that the hernia is of which type?

Reducible

Percutaneous liver biopsy

Removal of liver tissue by using a needle to puncture the skin overlying the liver.

Colectomy

Removal of the colon

A client being treated for pancreatitis faces the risk of atelectasis. which of the following interventions would be important to implement to minimize the risk?

Reposition the client Q2 hrs.

caput medusae

Result of portal hypertension - dilation of abdominal veins. Increased pressure causing dilation of collateral veins radiating over abdomen

The nurse is inspecting a client's stoma. What finding would the nurse need to report to the physician?

Retraction beneath the skin

ostomy

SURGICALLY CREATED OPENING

What should a patient receiving a barium swallow avoid the day before the procedure?

Smoking.

which of the following medications would a nurse expect the physician to order for a client with cirrhosis who develops portal hypertension?

Spironolactone (Aldactone)

a client with Crohn's disease is prescribed medication therapy. Which of the following with the nurse expect to administer as a first-line agent?

Sulfasalazine

the nurse is preparing to examine the abdomen of a client complaining of a change in his bowel pattern. The nurse would place the client in which position?

Supine with knees flexed

Bariatric Surgery

Surgery on part of the GI tract performed as a treatment for morbid obesity

Segmental resection

Surgical procedure in which the cancerous portion of the colon is removed; the remaining portions are rejoined to restore normal intestinal continuity.

Fundoplication

Surgical procedure to reduce the opening to the fundus of the stomach so the child cannot vomit.

Hernioplasty

Surgical procedure where weakened area is reinforced with wire, fascia, or mesh to prevent recurrence.

Appendectomy

Surgical removal of the appendix

Herniorrhaphy

Surgical repair of a hernia

Hemorrhoids

Swollen, painful rectal veins; often a result of constipation

Intussusception

Telescoping of one part of the intestine into an adjacent part.

Enteroclysis

The injection of a nutrient or medicinal liquid into the bowel; the introduction of barium directly into the small bowel through a nasogastric tube.

A client has undergone ileostomy surgery. The nurse suggested the use of a temporary appliance in the immediate postoperative phase based on what rationale?

The size of the stoma changes in the postoperative phase.

ileoanal reservoir

This is when the large intestine is removed but the anus is intact and disease free. The internal reservoir is from the last few inches of the ileum to the anus.

Ultrasonography

USE OF SOUND WAVES TO OBTAIN PICTURE

Paralytic ileus

Usually temporary paralysis of intestinal wall that may occur after abdominal surgery or peritoneal injury and that causes cessation of peristalsis; leads to abdominal distention and symptoms of obstruction

Esophagogastroduodenoscopy

Visual examination of the esophagus, stomach, and duodenum

A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery?

Vitamin K

Ulcerative Proctitis

____ refers to inflammation that is limited to the rectum

wound, ostomy, and continence nurse

a nurse that is specialized that assists the physician with placement of an ostomy and provides pt with teaching about the ostomy.

Fulminant colitis

a progression of severity of ulcerations associated with ulcerative colitis with severe pain, copious diarrhea, and potential dehydration and shock.

a client with cirrhosis is at risk for developing esophageal varices. Which of the following instructions should a nurse provide the client to minimize the risk?

don't drink

Flexible sigmoidoscopy

examination using a fiberoptic endoscope to visualize the sigmoid colon and the descending colon

hepatic lobectomy

excision of a lobe of the liver

enterostomal therapist

health professional (usually a nurse) with special training and certification in the care of ostomies and related concerns

Esophagitis

inflammation of the esophagus

Orogastric Intubation

insertion of a tube through the mouth into the stomach

loop colostomy

large opening made in the abd; loop of bowel is pulled thru the opening onto the abd. An opening is made in the bowel; the proximal end drains stool; the distal end drains mucus; only 1 stoma

single-barrel colostomy

opening to the colon that has a single stoma through which fecal matter is released.

Tenesmus

painful spasm of the anal sphincter along with an urgent desire to defecate without the significant production of feces

Nasogastric inubation

placement of a tube that passes through the nose, and esophagus into the stomach.

Nasoenteric intubation

placement of a tube that passes through the nose, esophagus, and stomach to the small intestine.

injection sclerotherapy

procedure in which a physician passes an endoscope orally to locate an esophageal varix, then passes a thin needle through the endoscope and injects a sclerosing agent directly into the varix to stop circulation through it

Cholecystography

process of obtaining x-ray of the gallbladder

Radionuclide imaging

radio nuclide substance is injected IV or orally. A radio scanner is passed over the structure that needs visulaized. Helping on determining organ size, defects, tumors.

Skip lesions

randomly occurring inflamed areas of the bowel alternating with healthy tissue.

Fistulectomy

removal of a fistula

Gastric Decompression

removal of gas and fluids from the stomach.

Abdominoperineal resection

removal of the colon and rectum through both abdominal and perineal approaches; performed to treat colorectal cancer and inflammatory diseases of the lower large intestine

abdominoperineal resection

removal of the colon and rectum through both abdominal and perineal approaches; performed to treat colorectal cancer and inflammatory diseases of the lower large intestine

Alpha-fetoprotein

serum protein normally produced during development that is a marker, indicating a primary malignant liver tumor.

open cholecystectomy

surgical procedure in which a gall bladder is removed through an abdominal incision.

Fistulotomy

surgical procedure involving incision of a fistula.

Pancolitis

ulcerative colitis that affects the client's entire colon

Percutaneous Endoscopic Gastrostomy

Insertion of a tube through the abdominal wall into the stomach under endoscopic guidance

anastomosis

A surgical connection between two hollow or tubular structures

colostomy

A surgical operation that creates an opening from the colon to the surface of the body to function as an anus

ileostomy

A surgical procedure that creates an opening from the ileum through the abdominal wall to function as an anus allowing stool to bypass the entire large intestine

Volvulus

A twisting of the gut which cuts off blood supply to that area.

lithrotripsy

a treatment, typically using ultrasound shock waves, by which a kidney stone or other calculus is broken into small particles that can be passed out by the body.

Gastritis

Inflammation of the stomach

Most common abdominal hernias

Inguinal

The physician orders the insertion of a single lumen nasogastric tube. When gathering the equipment for the insertion, the nurse would get which tube?

Levin tube

the nurse is caring for a client with hepatitis which of the following would lead the nurse to suspect the client is in the prodromal phase?

Rash

a client with anorexia complains of constipation. What nursing measure would be most effective in helping the client reduce constipation?

assist client to increase dietary fiber

hepatic encephalopathy

central nervous system dysfunction resulting from liver disease; frequently associated with elevated ammonia levels that produce changes in mental status, altered level of consciousness, and coma

cholelithiasis

disorder in which stones are formed within the gallbladder.

Gallbladder series

test used to identify the presence of stones in the gallbladder or bommon blie duct and tumors or other obstructions, and to determine the ability of the gallbladder to concentrate and store an iodine-based, radiopaque contrast medium.

continent ileostomy

liquid stool or urine; surgically created pouch; contents are siphoned off; no appliances needed; must be drained every 4-6 hours

Short bowel syndrome

loss of absorptive surface resulting from the surgical removal of a large amount of the intestine.

partial or total pancreatectomy

surgical procedure in which some or all of the pancreas is removed

radical pancreatoduodenectomy

surgical procedure to resect a tumor at the head of the pancreas; also called a Whipple procedure

Gastrectomy

surgical removal of all or part of the stomach

Hemorrhoidectomy

surgical removal of hemorrhoids

stoma

surgically created created opening on the exterior abdominal surface

fetor hepaticus

sweet, slightly fecal odor to the breath, presumed to be of intestinal origin; prevalent with the extensive collateral portal circulation in chronic liver disease

the nurse is monitoring a client who has had colostomy surgery. Which of the findings would the nurse need to report to the physician?

temp of 102.6 F

Lower gastrointestinal series

x-ray images of the colon and rectum obtained after injection of barium into the rectum