GI Exam Study Guide

A greater risk for obesity is assessed by a waist circumference that is >___ inches for women and >____ inches for men.

35 in, 40 in

Gastric residual volumes are measured before intermittent feedings and every _______ hours during continuous feedings

4-6 hours

Intrinsic factor, which is secreted by the gastric mucosa, cannot be absorbed without the presence of vitamin ________.

B12

T/F: Cyclic feedings are administered into the stomach in large amounts and at designated intervals.

Bolus feedings

Elderly, acutely ill, or debilitated people with decreased salivary gland secretion from general dehydration or medications are at high risk for ____________ which is characterized by swelling.

Parotitis

T/F: A purpose of enteral feedings is to meet nutritional requirements of patients when oral intake is inadequate or not possible.

True

T/F: Absorption is the major function of the small intestine, and occurs when small molecules, vitamins, and minerals pass through the walls of the small intestine and into the bloodstream.

True

T/F: After bowel sounds have returned and oral intake is resumed following bariatric surgery, six small feedings consisting of a total of 600 to 800 calories per day should be consumed.

True

T/F: Barrett esophagus is a condition in which the lining of the esophageal mucosa is altered.

True

T/F: Chyme, which is partially digested food mixed with gastric secretions, can stay in the small intestine for up to 24 hours allowing for continued breakdown and absorption of nutrients.

True

T/F: Herpes simplex is an abnormal condition of the lips that is frequently seen in immunosuppressed patients.

True

T/F: Nursing interventions for impaired oral mucous membranes for the patient with oral cancer include gentle brushing and flossing, encourage fluid intake, and the use of synthetic saliva.

True

T/F: Obesity is associated with a 6- to 20-year decrease in life expectancy

True

T/F: Parenteral nutrition solution is a good medium for bacterial growth and precautions must be taken to reduce the risk of infection.

True

T/F: Patients with dumping syndrome after gastric surgery, should consume at least 16 ounces of fluid with each meal.

True

T/F: Preparation of a patient for a barium enema study may begin 48 hours prior to the test.

True

T/F: Ptyalin, an enzyme secreted by the salivary glands, has a direct effect on the digestion of proteins and fatty acids.

True

T/F: Visualizing the placement of a nasogastric or nasoenteric tube on x-ray is the only definitive way to verify its location.

True

Colonoscopy prep

a colonoscopy is to cleanse the bowel and prevent infection clear liquids 1-2 days prior NPO midnight before day of surgery enemas, laxatives til clear (neomycin/antibiotics if pre surgery)

The etiology of cancer of the colon and rectum is predominantly _____________________, a malignancy arising from the epithelial lining of the intestine.

adenocarcinoma

Currently, the most commonly used therapy for peptic ulcers is a combination of ____________, proton pump inhibitors, and bismuth salts that suppresses or eradicates H. pylori.

antibiotics

________________, the most common cause of acute surgical abdomen in the United States, is the most common reason for emergency abdominal surgery.

appendicitis

When administering continuous or cyclic tube feedings, a primary nursing responsibility is preventing _________ pneumonia by elevating the HOB 30 to 45 degrees.

aspiration

What are the key nursing management considerations for the patient with cancer of the oral cavity?

assess nutrition, enteral feedings, assess patent airway,

Causes of obesity are complex and multifactorial and include __________, environmental, physiologic, and genetic factors

behavioral/socioeconomic

In the immediate postoperative period following a neck dissection the nurse must assess for ________ which can be heard over the trachea with a stethoscope.

breath sounds

A ___________________ device is designed and used for long-term administration of medications and fluids into central veins.

central venous access

how to reduce risk of aspiration for tube feedings

check tube placement, keep bed head elevated to 30 degrees

Neck dissection: what are the postoperative complications of this procedure and nursing management of these complications?

complications: hemorrhage- vs, avoid stress, assess drainage, HOB 30 degrees fistula: milky drainage - parenteral nutrition, IV octreotide nerve injury: speech therapy

_______________ may occur a result any surgical procedure that involves the removal of a significant portion of the stomach or includes resection or removal of the pylorus.

dumping syndrome

________ is the most common symptom of esophageal disease and may vary from an uncomfortable feeling in the upper esophagus to acute pain on swallowing

dysphagia

T/F: Diverticula may occur anywhere in the small intestine or colon, but most commonly occur in the ascending colon.

false

T/F: In a radical neck dissection, the tumor and surrounding musculature are removed but the cervical lymph nodes are left intact.

false

T/F: The patient with a hiatal hernia should be instructed to lie down for at least 1 hour after eating.

false

T/F: Acute gastritis is a prolonged inflammation due to benign or malignant ulcers of the stomach.

false - chronic gastritis

T/F: The most common site for a peptic ulcer formation is in the pylorus.

false - duodenum

T/F: The patient with irritable bowel syndrome (IBS) should select foods low in fiber in order to minimize intestinal irritation.

false - high fiber

Gastritis and _____________ from peptic ulcer disease are the two most common causes of upper GI tract bleeding.

hemorrhage

Greater than 5 to 6 bowel sounds heard in less than 30 seconds is considered a standard used to document bowel sounds that are ________________.

hyperactive

The goals of parenteral nutrition are to _______ nutritional status and to attain a ________ nitrogen status.

increase nutrition positive nitrogen status

Following bariatric surgery, disruption at the surgical site may cause leakage of gastric contents into the peritoneal cavity, causing ______________ and possible sepsis

infection

The correct sequence to perform an abdominal assessment is to perform:

inspection, auscultation, percussion, palpation

Tumors of the small intestine are uncommon, of these approximately 64% are ______

malignant

Antiobesity medications work by inhibiting GI absorption of fat and altering central brain receptors to enhance _________ or reduce cravings.

metabolism

In order to prevent injury to the nasopharyngeal passages, the nasogastric tube is secured to the ______ with tape.

nose

what key parameters should the nurse focus on in collecting the patient's GI health history and physical assessment?

nutrition, exercise, history, medications, inspect, ascultate, palpate, percussion

The most frequent symptom of oral cancer is a __________ sore or mass that bleeds easily and does not heal.

painless

T/F: When administering oral medications to a patient receiving tube feedings, medications may be crushed and mixed with the feeding formula.

False

T/F: Traditionally, the term morbid obesity applies to adults whose body mass index (BMI) exceeds 30 kg/m2.

False, 40

Colonoscopy patient education

Pre: low residue diet, clear liquids, laxative, go-lytely Intra: 1 hour, mild sedation, may expereince bloating

Lifestyle modification is aimed at weight loss and ____

healthy life

__________ is a frequently occurring side effect of chemotherapy or radiation therapy.

severe ab cramps

T/F: Celiac disease is a disorder of malabsorption caused by an autoimmune response to consumption of products that contain the protein gluten.

true

_____________________is a chronic functional disorder characterized by recurrent abdominal pain associated with diarrhea, constipation, or both.

IBS

Digestive enzymes secreted by the pancreas include trypsin (aids protein digestion), amylase (aids starch digestion), and __________ which aids fat digestion.

Pancreatic Lipase

GERD patient teaching

- Avoid tight-fitting clothing - Avoid lying down for 2 hours after eating - Sleep with torso elevated - Avoid large meals and bedtime snacks - Encourage weight loss for overweight patients - Avoid trigger foods (citrus, spicy foods, carbonated beverages, fatty foods, caffeine, chocolate) - Avoid alcohol and nicotine products - Peppermint and spearmint flavors

nursing management postop NG feeding tube

30ml flush, infusion rate increased drainage record & measure provide skin care

In patients with gastric cancer a _______may be used to evaluate for the presence of anemia.

CBC

_____________, an abdominal discomfort associated with eating, is the most common symptom of patients with gastrointestinal dysfunction.

Dyspepsia

T/F: Decompression of the bowel through a nasogastric tube is necessary for all patients with small bowel obstruction.

true

T/F: Diarrhea is defined as the increased frequency of more than three bowel movements per day.

true

T/F: Most peptic ulcers result from infection with the gram-negative bacteria H. pylori, which may be acquired through ingestion of food and water.

true

T/F: The average weight loss following bariatric surgery is 35% to 50% of previous body weight over 2 to 3 years.

true

T/F: The best time to teach a client to take proton pump inhibitors is 30 minutes before a meal.

true

T/F: The vast majority of gastric cancers are acquired and not inherited.

true

In Crohn's disease, the common clinical manifestations include abdominal pain and _____________.

ulcerations

Straining at stool initiates the ____________ maneuver that results in a potentially dangerous increase in BP

valsalva

indications for parenteral nutrition

•Short bowel syndrome •Severe pancreatitis •Malabsorption disorders •Intestinal obstructions or fistulas •Severe burns or trauma •Critical illnesses or wasting disorders •Bone marrow transplants •Malnourished and high risk for aspiration