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GI Questions 2Smeltzer (Med-Surg)

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Nausea, dizziness/syncope, diaphoresis, cramping (increased peristalsis), and diarrhea are vague symptoms, but can be indicative of what following abd surgery?
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Dumping syndrome
List these interventions for Dumping syndrome in order of priority: A) Lie patient down B) {Eliminate liquids with meals and 1 hr pre -- high PRO, high FAT, low CARB -- avoid milk, sweets, sugars --> small frequent meals} C) Antispamodic meds
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A, B, C Lying down will slow the movement of food. Always try to manage the diet before turning to medications.
Which vitamin would be beneficial for a patient with dumping syndrome?
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Vit B12
Your patient recently received a PEG tube. On your med list, you see enteric coated ASA is ordered. Is this a problem?
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Yes, enteric coated medications will clot the tube whenever they interact with liquids.
Before going to give a patient who has a PEG tube three medications, how many flushes will you anticipate needing?
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6
It is a very busy day at the hospital, and you'll finally gotten a chance to sit down and read the rounding doctor's orders. You see that one of your patients has been started on TPN. Which lab(s) will you pull up before starting?
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Albumin possibly, but definitely kidney function to anticipate their ability to clear the nitrogen
T/F: Enteral feeds should be refrigerated.
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False: they should be at room temperature. A cold solution will cause excessive cramping.
For the initial dose, the nurse knows he must dilute the feeding by _____ in order to prevent hypertonicity and diarrhea.
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25-50%
Mary Sue is going to change a enteral feeding for one of her patients. She walks into the room, correctly removes the completed bag, and skillfully hangs the new one. Was this correct?
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NO. She did not check the residual before starting the new bag. Residuals must be checked q 4 hrs and before each feeding. If the residual is >200, STOP the feeding
Which acid/base imbalance will you worry about with long term NG suction?
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Metabolic alkalosis. This is a reason why it's very important to put the residual back in if it's <200.
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Inflammatory bowel disease is an umbrella term encompassing which three diseases?
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Ulcerative colitis Crohn's disease Peritonitis
Ulcerative colitis affects what part of the bowel?
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Lower bowel
In ulcerative colitis, the patient would exhibit diarrhea and rectal bleeding. The other S/Sx are due to increased peristalsis and loss of E-lytes/vitamins. What are the rest?
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Abd pain & fever Wt - & vomiting Tenesumus/cramping Hypocalcemia & iron deficiency
What kind of inflammation will there be with Ulcerative Colitis?
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Chronic inflammation but no granulomas
Crohn's disease is different from ulcerative colitis in that it has ____ inflammation, _______, and ______ cobblestone appearance
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Crohn's disease has intermittent inflammation, granulomas, and a cobblestone appearance
T/F: Both Ulcerative Colitis and Crohn's disease will have bloody diarrhea
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False: Crohn's disease will NOT have bloody diarrhea
In administering a 5 aminosalicyclic acid drug, what must the nurse do to prevent kidney damage?
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Encourage fluids because if the patient is dehydrated, the sulfa will crystalize in the kidney
For an acute exacerbation, the first action of the nurse would be to?
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Make the patient NPO with an IV and promote bowel rest
After bowel rest is achieve, the nurse must address the second issue, which is?
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Pain control
Roberta is caring for a patient who has IBD. She overhears her patient ordering a lunch of pasta, garlic bread, and crackers. Is this an appropriate diet?
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No, the patient should be on a high protein, high fat, and low fiber (less residual).
  
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