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50 Cards in this Set
- Front
- Back
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Post Upper Endoscopy, first action by the nurse
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Keep NPO until gag reflex returns
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most common symptom in earliest stage of oral cancer
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oral ulcer that does not heal
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Abnormal nutritional-metabolic functional health pattern of an elderly pt
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consistent weight loss without change in dietary habits
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patient with total gastrectomy
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has altered absorption of cobalamin (vit. B12)
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Finding that may indicate a barium impaction
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48 hours after barium swallow abdomen presents with decrease sounds and no bowel movement post procedure.
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Auscultation of abdomen of a pt with perforation
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absent bowel sounds
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Health mgmt question for a pt with GERD
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Do you smoke or use other forms of nicotine?
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Indications of bulimia
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loss of dental enamel
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elderly patient with a fractured hip and confusion and unable to eat could benefit from
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enteral feeding with high calorie and high protein
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pt with PEG tube, to maintain the most safe and effective delivery of the tube feeding
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position the patient with the head elevated at least 30 degrees.
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Pt on parental nutrition
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Nurse plans to monitors blood glucose labs
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Pt unable to provide self oral care
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nurse should brush pts teeth after each meal with a soft-bristle brush
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Person with persisting vomiting, which ABGs should the nurse expect
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pH 7.6; PCO2 40mm; HCO3 40mEq/L - metabolic alkalosis
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Patient NPO, how should patient resume oral intake
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Clear liquids (ex.gingerale)
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GERD - Pt education
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use PPIs once a day, quit smoking, sleep with HOB elevated, no eating before bedtime.
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Appropriate action by nurse with a pt with sudden sharp pain in mid-epigastric
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if abdomen is tender and rigid notify the health care provider.
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How to assess effectiveness of meds given to a patient with upper GI bleed with a NG tube.
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Periodically aspirate and tests stomach contents for pH level.
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Most accurate test to find the source of an Upper GI bleed (coffee ground emesis)
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Endoscopy
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Priority ND - pt with Hx of achalasia with progressive dysphagia
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Imbalanced nutrition
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Pt undergoing removal of a benign colonic polyp - pt ed
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Follow up colonoscopy in three years is necessary because of the risk for developing more polyps in the future.
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Tx for peptic ulcer - pt ed
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to promote the effects of antacids and sucrafate (carafate) take sucralfate 30-60 minutes before each meal and antacids 1 and 3 hours after meals and at bedtime.
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Peptic Ulcer disease - Pt ed
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when teaching about nutritional mgmt, the pt should avoid foods that cause discomfort.
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Assessment of pt w/ acute gastritis
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Predisposition to this disorder would be a person who takes NSAIDs (ex. for arthriitis pain)
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Assessment of pt w/ duodenal ulcer
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First symptom would be melena
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Peptic Ulcer disease - Priority ND
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Pain
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Peptic Ulcer disease - dietary measures
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lean meats, whole grains, veggies, avoid soda, coffee, fried foods, ETOH
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Irreducible umbilical hernia
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strangulation is the complication at most risk for.
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chronic constipation - Tx/pt ed
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If using bulk fiber like Metamucil, stress to the pt that at least 3000ml of fluid must be taken to prevent impaction or bowel obstruction.
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Pt with gastroenteritis - possible complication
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Dehydration
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Pt with gastroenteritis - Priority NI
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replace fluids
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Purpose of NPO
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promote bowel rest and healing (ex. exacerbation of ulcerative colitis)
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Pt with ulcerative colitis - Tx/pt ed.
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when using Anti-inflammatory drugs like Sulfasalazine (Azulfidine®), instruct patient to monitor any signs of bleeding.
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Pt admits to being scared prior to a colonscopy - best response
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“You sound scared. Can you tell me more” - ask probing questions to explore feelings.
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Diverticulitis - pt ed
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eat high fiber diet.
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Initial post op assessment of a new stoma
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stoma should be brick red with moderate edema and small amount of blood oozing which would indicate a viable stoma with vascularity.
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Ileostomy - pt ed.
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maintain a normal diet, avoiding foods that cause gas or excessive odor.
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Hemorrhoidectomy - discharge ed.
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take prescribed stool softeners and pain medication prior to bowel movement.
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Hepatitis B - Tx of non vaccinated person
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Administer both hepatitis B vaccine and hepatitis B immunoglobulin (HBIG)
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Hepatitis C - highest risk factor
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IV drug use
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Why does a pt with chronic gallbladder inflammation and obstructive jaundice complain of itchy skin?
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bile salts accumulate on the skin causing it to itch
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Acute cholecystitis - discharge teaching
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instruct pt to conscume low-fat, low cholesterol diet
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Type 2 Diabetes - pt ed
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There is decreased insulin secretion and/or cellular resistance to insulin.
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diabetic screening glucose of 120 mg/dl
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indicates an impaired fasting glucose
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S/Sx of untreated Diabetes Mellitus
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Polyuria which is due to osmotic diuresis secondary to hyperglycemia
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Best indicator of a patient’s mgmt of diabetes
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Glycosylated hemoglobin level
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Type 2 Diabetes with HTN - pt ed
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possible side effect of if taking a sulfonylurea (Diabeta®) and taking a beta blocker (Lopressor) is increased hypoglycemia
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Diabetes - foot care
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if you see a diabetic pt wearing sandals, first best action would be to examine the feet for signs of injury.
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Type 1 Diabetes - dietary teaching
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eat scheduled meals and do not skip meals; eat a bedtime snack with an evening dose of NPH insulin; occasional alcoholic drink with meal plan.
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Diabetes - pt teaching
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teach pt that most beneficial in delaying the onset of microangiopathy and macroangiopathy complications is to keep blood glucose in normal range
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Diabetic Ketoacidosis - Priority NI
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Bolus IV fluids and low dose IV reg. Insulin
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