Med Surg 44-48
Pyrosis
(heartburn) burning sensation in upper abdomen due to reflux of gastric acid
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.
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.
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.
portal hypertension
An increase in blood pressure within the portal vein due to increased resistance to blood flow.
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.
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
Panenoscopy
Examination of the pharynx, larynx, upper trachea, and esophagus with rigid and flexible endoscopes.
steatorrhea
Fat in the feces
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
hepatitis
INFLAMMATION OF THE LIVER
Gastrostomy
Making a new opening in the stomach
Odynophagia
Painful swallowing
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
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
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
Appendectomy
Surgical removal of the appendix
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.
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
Ulcerative Proctitis
____ refers to inflammation that is limited to the rectum
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
Chron's disease
bowel disease: chronic inflammation of parts of the intestinal tract
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
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
cholelithiasis
disorder in which stones are formed within the gallbladder.
hepatic lobectomy
excision of a lobe of the liver
Orogastric Intubation
insertion of a tube through the mouth into the stomach
Fistulotomy
surgical procedure involving incision of a fistula.
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."
cholecystitis
-inflammation of the gallbladder
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.
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
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
pancreatitis
INFLAMMATION OF THE PANCREAS
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
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
Ultrasonography
USE OF SOUND WAVES TO OBTAIN PICTURE
Fulminant colitis
a progression of severity of ulcerations associated with ulcerative colitis with severe pain, copious diarrhea, and potential dehydration and shock.
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.
Esophagitis
inflammation of the esophagus
Gastric Decompression
removal of gas and fluids from the stomach.
Lower gastrointestinal series
x-ray images of the colon and rectum obtained after injection of barium into 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?"
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"
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
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.
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.
Biliary colic
Gall stones that interfere with bile flow, causing bile duct contraction, may present without pain (in diabetics)
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
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
Gastritis
Inflammation of the stomach
Most common abdominal hernias
Inguinal
Percutaneous Endoscopic Gastrostomy
Insertion of a tube through the abdominal wall into the stomach under endoscopic guidance
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)
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.
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.
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.
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 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.
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.
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
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.
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.
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.
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
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.
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.
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
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
enterostomal therapist
health professional (usually a nurse) with special training and certification in the care of ostomies and related concerns
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
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.
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
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.
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
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.
Pancolitis
ulcerative colitis that affects the client's entire colon
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