NSG 123 Exam 2
What is normal ranger value for AST (liver enzyme) lab value?
0-35
What is normal ranger value for Bilirubin lab value?
0.3-1 mg
What BMI is considered normal weight?
18.5-24.9
What BMI is considered overweight?
25-29.9
What is normal ranger value for Amylase lab value?
30-220
What BMI is considered severely obese?
35-39.9
What is normal ranger value for ALT (liver enzyme) lab value?
4-36
What is the BMI for the underweight classification?
<18.5
What is the most common cause of a small bowel obstruction?
Adhesions
The nurse is performing a rectal assessment and notices longitudinal tear or ulceration in the lining of the anal canal. The nurse documents the finding as which condition?
Anal fissure
What is another name for Sulcrafate?
Antacids
what is the treatment of Pylori (H-Pylori)?
Antibiotics, PPI's, &/or Bismuth Salts(a.k.a Pepto-Bismal)
What medication helps decreased intestinal spasm associated with diverticulitis?
Antispasmodic
What is the criteria for bariatric surgery?
BMI must we > or equal to 40kg or BMI must be > or equal to 35kg with one or more obesity-related complications
What weight loss surgery involves a intragastric balloon and is less invasive?
Bariatric surgery
What does GERD cause that are precancerous lesions?
Barrett Esophagus
What weight loss medication stimulate central nonadrenergic receptors, causing appetite suppression?
Benzphetamine (Didrex)
What weight loss surgery tends to result in the most postoperative weight loss, and is therefore more commonly indicated for patients with very high BMIs?
Biliopancreatic diversion with duodenal switch
Which drug is considered a stimulant laxative?
Bisacodyl
What type of stool do patients with UC experience?
Bloody diarrhea sometimes with mucous or pus.
IBD (inflammatory bowel disease) is most common in what race of people?
Caucasians
What diagnostic test is used to best view Ulcerative Colitis?
Colonoscopy
What diagnostic test is used to diagnose UC?
Colonoscopy
In a ___________ the patient may complain of constipation for weeks in advance.
Constipation
What symptoms are you going to have with an large bowel obstruction?
Cramping, diarrhea, & constipation
what disease involves inflammation of all the layers of the bowel wall?
Crohn's Disease
What IBD can occurs anywhere in the GI tract?
Crohn's disease
What IBD has crampy abdominal pain usually after meals?
Crohn's disease
What IBD requires a CT scan?
Crohn's disease
What disease has deep ulcerations that have a cobble stone appearance?
Crohn's disease
What type of stool occurs with duodenal ulcers?
Dark, tarry stools (melena)
What is the primary symptom of IBS?
Diarrhea
What are common symptoms of Crohn's disease?
Diarrhea, crampy abdominal pain (especially after meals), malnourishment, & secondary anemia.
Fissures( anal tears) likely require stool softener like?
Docusate also known as stool softener it hydrates the stool
What type of ulcer has pain that is relieved by meals?
Duodenal
What type of ulcer is more common?
Duodenal
What ulcer causes night time awakening?
Duodenal
When gastric analysis testing reveals excess secretion of gastric acid, the nurse recognizes which medical diagnoses is supported?
Duodenal ulcer
What other diseases can GERD cause?
Esophagitis, Barrett's esophagus, and Cancer of the Esophagus
What type of ulcer does vomiting occur?
Gastric
What type of ulcer has pain because of meals?
Gastric
What type of ulcer is not as common?
Gastric
What weight loss surgery is the least common?
Gastric banding
What are the two most common causes of Upper GI tract bleeding?
Gastritis & Hemorrhage from peptic ulcers
What is the major carbohydrate that tissue cells use as fuel?
Glucose
What is the biggest risk factor for people with Peptic Ulcer Disease?
H Pylori
do not use ________ for ____________.
H2 blocker for H Pylori
What time of day is best to take your H pylori meds?
HS (at bedtime)
What are dilated portions of anal veins?
Hemorrhoids
What are the best treatments for constipation?
High fiber/residue diet, establish healthy bowel habits, avoid holding your urge to dedicate, consider bulk-forming OTC's like Methylcellulose-Citrucel.
If a patient thinks they are constipated what is the first question you are going to ask them?
How many BM's do they have a week
What is the umbrella term for Crohn's disease & Ulcerative colitis?
IBD (Inflammatory Bowel Disease)
What are some risk factors for GERD?
Increasing age, IBS, Asthma, OPD, cystic fibrosis,PED, Angina, smoking, coffee, alcohol & gastric infection with H pylori
Crohn's disease is a condition of malabsorption caused by which pathophysiology process?
Inflammation of all layers of intestinal mucosa
What order should a nurse perform an abdominal assessment?
Inspection, auscultation, percussion, & palpation.
Where does UC start in the body?
It typically starts in the rectum and moves inward.
You will hear decrease or absent bowel sounds in what?
Large bowel obstruction
Marked distention happens later in this ________ obstruction. Bowels may be visible or palpated through the ___________.
Large bowel obstruction and abdominal wall.
What intestinal obstruction is going to have a decrease in bowel sounds or no bowel sounds?
Large bowel obstruction.
What BMI is considered underweight?
Less than 18.5
To define constipation how many bowel movements are you having a week?
Less than 3 BM's a week
Where is the pain located with Ulcerative Colitis?
Lower Left Abdominal Pain
What ethnicities are at greater risk for being obese?
Native American females, Hispanic females, & African American females & males.
What symptoms are you going to have with an small bowel obstruction?
Nausea and vomiting
What weight loss medication diminishes intestinal absorption and metabolism of fats, particularly triglycerides? Which you made need to take supplements for vitamins A, D,E, & K. It is a Lipase Inhibitor.
Orlistat (Xenical)
What BMI is considered obese?
Over 30
What BMI is considered morbidly obese?
Over 40
What is the leading benign (noncancerous) cause of gastric outlet obstruction?
PUD (peptic ulcer disease)
What is the leading benign cause of gastric outlet obstruction?
Peptic ulcers
______ occurs more commonly with duodenal ulcers then it does with gastric ulcers.
Perforation
_________ is the erosion of the ulcer through the gastric serosa into the peritoneal cavity without warning.
Perforation
What foods relieve constipation?
Prunes, apples, pears, kiwis, figs, citrus fruits, spinach, artichokes, & legumes
What is the enzyme that begins the digestion of starches?
Ptyalin
Where is the pain located for patients with Crohn's Disease?
Right lower quadrant
Which category of laxatives draws water into the intestines by osmosis?
Saline agents (e.g., magnesium hydroxide)
What weight loss surgery is the most common?
Sleeve gastrectomy
In a _____ bowel obstruction marked distension early on.
Small bowel obstruction
What intestinal obstruction is going to have an increase in bowel sounds?
Small bowel obstruction
What is it when you have colicky abdominal pain?
Small bowel obstruction
You are going to have increased bowel sounds when you have a what?
Small bowel obstruction
When you have a _______ bowel obstruction you are going to hold ________intake and a ____________ is often used to decompress.
Small bowel obstruction, oral intake, & NG tube
Irritates the colonic epithelium by stimulating sensory nerve endings and increasing mucosal secretions and decreasing large intestinal water absorption
Stimulant
What are the S & S of Perforation?
Sudden, severe upper abdominal pain (persisting and increasing in intensity); pain may be referred to the shoulders, especially the right shoulder, because of irritation of the phrenic nerve in the diaphragm Vomiting Collapse (fainting) Extremely tender and rigid (boardlike) abdomen Hypotension and tachycardia, indicating shock
What is a Dobhoff tube used for?
TPN feeding (external nutrition) patient who cannot met their nutritional requirements through oral intake.
A nurse understands that if the patient has blood in their stool, it will be which color?
Tarry black
Which symptom characterizes regional enteritis(Crohn's disease)?
Transmural thickening
What disease usually has the symptom of Tenesmus?
Ulcerative Colitis
The presence of mucus and pus in the stools suggest which condition?
Ulcerative colitis
What IBD has symptoms of bloody diarrhea and can also have mucus or out present?
Ulcerative colitis
Hydrates the stool by its surfactant action on the colonic epithelium
fecal softner
Nonabsorbable hydrocarbons soften fecal matter by lubricating the intestinal mucosa, the passage of stool is facilitated
lubricant
Cleanses colon rapidly and induces diarrhea
osmotic agent
Nonabsorbable magnesium ions alter stool consistency by drawing water into the intestines by osmosis, peristalsis is stimulated
saline agent
