Adult Health I- Test 3
Low fiber diet
High fat diet
Risks for colon cancer
Withhold foods and liquids for 8 hours
Hold opioid and antincholinergics 24 hours
Instruct on preparations of opaque fluid and to drink at least 16 ounces
Explain the purpose of the rotating table
Teaching for barium studies
Stools may what what color following a barium study?
A patient should be advised to drink plenty of fluids after a barium study to assist in expelling the barium and prevent a _________________.
Check vital signs every 30 minutes until sedation wears off
Raise patient side rails
Patient NPO until gag reflex returns
No driving for patient after procedure
Lozenges may be used for hoarseness
Nursing interventions following EGD
What is a visual examination of the esophagus, stomach, and duodenum?
A continuing trend of ____________ may be related to oral cancer metastasis.
Protect surgical incision site to avoid infection
Ensure predetermined methods of communication is available
Nursing interventions for post-op radical neck resection
Give 1 hour before meals, 2-3 hours afters meals
Observe for constipation or diarrhea
Suggest combination or alternating use
Nursing interventions for Mylanta and Maalox
Tomato-based, mixed vegetable juices should not be taken with _________ as it may make the drug less potent.
Patients should be advised to report and neurologic or psychotropic side effects, such as restlessness, anxiety, ataxia, or hallucinations when taking ___________.
______________ can be opened and the granules mixed with applesauce or apple juice for those with dysphagia or a nasogastric tube.
____________ and _____________ should not be taken with any other IV drugs.
Protonix IV (pantoprazole) Nexium (esomeprazole)
___________ should not be given with digoxin, rabeprazole, or iron salts.
Stay upright after eating
Eat semi-soft to soft foods
Suck on lollipop for tongue strength
Patient teaching for those that have dysphagia or choking during meals
Worsening symptoms after eating or sitting in the recumbent position
Symptoms of hiatal hernia
A patient with esophageal diverticula should be advised to eat _______, small meals.
Meticulous oral/nasal hygiene every 2-4 hours
Check for patency and yellow/green drainage
If bright red blood 2nd day post op report immediately
Do not irrigate or reposition without request
Nursing interventions for post op NG tube
Provide information regarding informed consent
Specific preparations for surgery
Exercises post surgery
Plans for pain management
National Patient Safety Goals
H. pylori, salmonella, streptococci, staphlococci, E. coli
Prolonged use of NSAIDS or corticosteroids
Excessive stress, alcohol, smoking, caffeine use
Bile reflux disease
Causes of gastritis
Epigastric pain located at the midline between the umbilicus and the xiphoid process that radiates to the back may indicate a _____________ of a gastric ulcer.
Treatment for ___________ may include proton pump inhibitors, metronidazole and tetracycline, or clarithromycin and amoxicillin.
Patients undergoing testing for H. pylori should be advised to __________ medications such as bismuth, misoprostol, sucralfate, histamine2antagonists(Zantac, Pepcid, Axid), as these may interfere with the testing.
Hematemesis is a medical ____________ and should be treated promptly.
___________ is a rapid emptying of food into the small intestines, which shifts fluid into the gut causing abdominal distension.
H2 blockers should be taken at __________ to suppress nocturnal acid production.
A patient with ____________ should be advised to eat a high fiber diet, and stay away from potential triggers such as caffeine, alcohol, dairy, eggs, wheat products, and beverages that contain sorbitol or fructose.
Irritable Bowel Syndrome (IBS)
Lab finds for a patient with partial bowel obstruction will show increased BUN/Cr due to dehydration and metabolic ____________.
Constant, diffuse discomfort
Decreased to absent bowel sounds
Signs of nonmechanical obstruction
Midabdominal pain or
Alteration in bowel pattern and stool
Abdominal tenderness (Rebound)
Signs of mechanical obstruction
Explosive diarrhea, mucositis, leukopenia, mouth ulcers, and peripheral neuropathy are all common side effects of ___________.
Normal appearance of the stoma
Signs and symptoms of complications
Measurement of the stoma
Choice, use, care, and application of appropriate appliance to cover stoma
Measures to protect the skin
Dietary measures to control gas and odor
Resumption of normal activities
Care of colostomy
Stool is ____________ immediately after surgery but becomes more solid depending on where in the colon it comes from.
Stool from a colostomy in the _____________ colon is liquid.
Stool from a colostomy in the ____________ colon is pasty.
Stool from a colostomy in the _____________ colon is more solid.
Protocol for finding a polyp during a colonoscopy is a _____________.
Encourage fluid replacement
Orthostatic BP and other VS
0.45% Sodium chloride IV
Alternate rest and activity
Interventions for acute viral gastroenteritis
Ampicillin and ____________ are both the preferred antibiotics for salmonellosis.
Wheat bran, whole-grain breads and cereals
Fresh fruits and vegetables with high fiber content
Bulk forming laxatives (Metamucil)
Eliminate undigestable materials such as seeds, nuts, corn, popcorn, cucumbers, tomatoes, figs, and strawberries
Food choices for diverticular disease
Distention, masses, or visible peristalsis
Ulcerations, fissures, or fistulas in the perianal area
Decreased or absent bowel sounds
Muscle guarding, rigidity, or tenderness
Expected assessment findings in Crohn's disease
Loose, dark green liquid, with some blood in stool, and may have little odor or a sweet odor.
Effluent expectations of an ileostomy
____________ can be administered orally, followed by 2mg after each loose stool, up to 16mg daily.
___________ is an anitdiarrheal opiate agonist schedule IV drug that should not be used to treat colitis, diarrhea that causes electrolyte imbalances or is caused by organisms that penetrate the intestinal mucosa or. It can be administered for up to 48 hours only.
Increase fluids by 500mL or more to prevent dehydration
There may be burning during bowel elimination due to gastric acid not being absorbed
Avoid foods that cause odor or gas such as cabbage, asparagus, and beans
Avoid foods that are not well digested such as nuts and corn
Interventions for instructing the new patient on their ileostomy
High-caloric, high-protein, high-vitamin, low-fiber meals and supplements such as Ensure or Vivonex PLUS will help in the healing of a ___________ development in a Crohn's patient.
Salmonella, Staphylococcus, Escherichia coli, Shigella, and Botulism all cause _____________.