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53 Cards in this Set
- Front
- Back
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Meconium is usually passed
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In the first 24 hours
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A newborn who has jaundice for 2 weeks, the diagnosis is
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Physiologic jaundice
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A baby has blackish-greenish stools 24 hours after birth, what should the nurse do?
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should the nurse do? Record data in nursing notes, this is completely normal.
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Physiology of pyloric stenosis is
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Hypertrophy of the pylorus.
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How do you feed a baby with pyloric stenosis?
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Small, frequent feedings given slowly. Prop the baby upright slightly on the right side.
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The clinical manifestation of pyloric stenosis is (3)
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A paristolic wave that goes from right to left, weight loss and projectile vomiting.
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How long should a patient sit in a sitz bath?
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20 minutes.
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gastroesophageal reflux disease (GERD)
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acidic contents of stomach move upwards into esophagus
causes heartburn & may lead to ulcers esophageal ulcers caused by loosening of lower esophageal sphincter |
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H2-receptor antagonist
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drug that inhibits effects of histamine at receptors in stomach
usually first choice for treating peptic ulcers |
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proton pump inhibitors
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drugs that reduce acid secretion in stomach by binding irreversibly to enzyme H+,K+-ATPase
widely used in short-term therapy of peptic ulcers |
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antacids
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alkaline substances used to neutralize stomach acid
effective at reducing s/s of reflux dx |
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What are 2 symptoms of Irritable Bowel Syndrome?
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Altered Bowel Functions (Change in frequency or consistency)
Abdominal Pain in the left lower quadrant. |
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What is the cause of Irritable Bowel Syndrome?
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No definite cause.
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Other symptoms of IBS besides pain and altered bowel functions.
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nausea, belching, bloating, anorexia.
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What is the diagnostic tool for IBS?
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Barium enema - picks up spasms in colon and rules out other bowel disorders.
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What are the risk factors for colorectal cancer?
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Genetics, Age, Polyps, Diet, Inflammatory Bowel Disease
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Facts about the genetic risk factor for Colorectal Cancer.
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With an immediate relative w/colorectal CA, chance is 3-4 times greater than with no relatives with Colorectal CA.
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What is the typical age for colorectal cancer?
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Over 50 years of age.
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What is the biggest risk factor in the diet for colorectal cancer?
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High fat foods, fried or broiled meats (release carcinogens), and refined carbs (pastries)
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What are the symptoms of colorectal cancer?
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Change in bowel habits (consistency or frequency), blood in stool and anemia, symptoms of obstruction.
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What are the diagnostic tools of colorectal cancer?
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CBC (H&H dec. if bleeding), Chemistries (liver enzymes elevated), fecal occult blood, carcinoembryonic antigen (CEA), Radiographic (barium enema)
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What is a nursing intervention before giving a client a fecal occult blood test for colorectal cancer?
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Tell the patient to not eat red meat 48 hours prior to the test.
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Why would liver enzymes be elevated when testing for colorectal cancer?
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If the cancer metastasized to the liver.
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What are nursing interventions for fecal occult blood test?
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Avoid vitamin C supplements, avoid aspirin products, avoid meat 48 hrs. prior to test.
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What is the routine for submitting stool specimens to check for colorectal cancer?
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Submit specimens for 3 consecutive days.
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What are side effects to radiation treatment of colorectal cancer?
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Extreme fatigue and diarrhea.
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What are side effects for chemotherapy in the treatment of colorectal cancer?
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Bone marrow depression, anemia (assess blood counts), low WBC's, problems with mucous membranes and skin breakdown.
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Why is skin breakdown a problem with chemotherapy in colorectal cancer treatment?
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Chemotherapy targets rapidly dividing cells such as in the skin, bone marros, and mucous membranes)
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What is an anastomosis?
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The two healthy ends of the bowel are joined together
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Why is an NG tube inserted after colorectal cancer surgery?
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For decompression.
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What is the post-op care for client with ostomy?
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Same as abdominal surgery + stoma assessment and management, diet, psychosocial issues
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What are diet considerations for client with ostomy?
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Stay away from gas-forming foods (cabbage, onions, turnips, mushrooms, beans, brussel sprouts, spinach, cheese, eggs, beer, carbonated beverages, fish, highly seasoned foods, some fruit drinks, corn, pork, peas, coffee, high-fat foods)
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How do the stools look for each type of ostomy?
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Small bowel - liquid
Ascending colon - liquid Transverse colon - semi-solid Descending, sigmoid colon - solid |
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Definition of intestinal obstruction.
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Partial or complete blockage of small or large bowel that impedes the digestive process.
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What are the 3 causes of intestinal obstruction?
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Mechanical (tumor, adhesions)
Nonmechanical (nothing physical) Vascular insuffiency (thrombus or embolus) |
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What are the assessments for an intestinal obstruction?
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Abdominal pain, nausea/vomiting, bowel changes, distention, altered bowel sounds, visible peristaltic waves.
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What are the S&S of a complete obstruction?
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No flatus or stool.
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What is the definitive test for intestinal obstruction?
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There is no diagnostic test that definitively diagnoses intestinal obstruction.
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What is the management of intestinal obstruction?
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NPO, NG or NI tube for decompression, F&E replacement, pain management, antibiotics.
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What intervention is done to replace F&E that are lost during an intestinal obstruction?
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IV fluids.
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Why is pain management difficult with an intestinal obstruction?
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Narcotic analgesics are avoided so symptoms are not masked. Also a side effect of narcotic analgesics is the slowing down of peristalsis.
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When are antibiotics given to a patient with an intestinal obstruction?
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If there is a possibility of strangulation.
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How is a nasointestinal tube used?
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Inserted by physician, extends into small bowel, weight on end allows peristalsis to move it through the small bowel, may have order to advance tube at intervals.
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What are 2 surgical techniques used in intestinal obstruction?
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Tumor removal, correction of a twisted intestine.
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What causes changes in the mucosal lining?
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Inflammatory Bowel Disease
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Where is McBirney's point?
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Midway between umbilicus and anterior illiac crest on the right side.
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What are nursing interventions pre-op for appendectomy?
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NPO, IV Fluids, pt. in Semi Fowlers position to facilitate drainage into lower abdomen. NO HEAT - can lead to perforation.
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What is peritonitis?
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Inflammation of the epitheleal lining of the abdominal cavity (normally sterile)
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What are some S&S of Peritonitis?
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Abdominal pain, tenderness, rigid distended abdomen (filling w/gas & fluid), N, V, Anorexia, Dec. bowel sounds, dec. urine output, inc. WBC's, + blood cultures, respiratory difficulties.
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What are post-op nursing interventions for appendectomy?
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Drainage tube if abcess formation, NG tube for decompression if peritonitis, post-op antibiotics.
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What are non-surgical measures for peritonitis?
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NPO, NG tube, IV fluids & antibiotics, analgesics, O2 PRN, I&O, daily weight.
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What is the surgical management of peritonitis?
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Repair the cause of peritonitis and remove additional fluid and foreign material.
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Post-op nursing interventions for peritonitis?
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Semi fowler's position to promote drainage and facilitate breathing.
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