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GI Questions 2Smeltzer (Med-Surg)

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Question Answer
Loperamid (Imodium) are anti-diarrheals, because the activate the opiate receptors in the CNS. This results in?
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Decreased motility and increased absorption of fluid and sodium
Your patient Allen has IBD, and as soon as you arrive in the morning, he tracks you down to ask if he can get Imodium for his ulcerative colitis. He says he saw a commercial for it and thinks it "would be absolutely perfect!" Can you give it to him once you get the doctor's order?
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No. Imodium cannot be given to patients with IBD.
Which procedure allows visualization of the urethra, bladder, prostate, and ureters?
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Cystoscopy
Esophagogastroduodenoscopy (EGD) allows visualization of the?
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Liver, gallbladder, and bile ducts
Disregard other EGD question. An esophagogastroduodenoscopy (EGD) visualizes the?
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Oropharynx, esophagus, stomach, and duodenum
T/F: ERCP (endoscopic retrograde cholangiopancreatography)allows visualization of the liver, gallbladder, and bile ducts
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True
During scope procedures, the provider can perform _____, remove ______, or perform minor ____________
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biopsies, remove abnormal tissue, or perform minor surgery like cauterization
Before your patient undergoes a scope procedure, is is important to assess for prior use of?
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Barium. This may impede the provider's ability to see pertinent structures.
During an arthroscopy, the nurse correctly elevates the affected joint and puts the knee at a 45 degree angle. She makes note to herself that after the procedure she must continue to...?
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Keep the joint elevated, apply ice packs, monitor for INFx, and teach crutches if applicable.
A patient should be positioned in what position for a cystoscopy?
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Lithotomy. The stirrups.
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Philips is scheduled to undergo a cystoscopy, and asks if he can order lunch. What do you tell him?
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He may have clear liquids or a light meal, but he needs to make sure he voids before the procedure.
Similar to a bronchoscopy, for patients undergoing a EGD, the nurse must remove their _____, along with these nursing interventions?
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Dentures. NPO for at least 6 hrs.
Emily, a recent graduate, is caring for a patient who returned from a EGD procedure. What must Emily be sure to assess and report to the doctor?
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Any bleeding, abd/chest pain, or evidence of infarction
What is a concern with conscious sedation?
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Oversedation. Watch for difficulty arousing the patient, poor RR, hypoxemia, tachycardia, abnormal BP
With all scope procedures, an adverse complication can be ______, as evidenced by cool clammy skin, hpotension, tachycardia, dizziness, tachypnea.
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Bleeding. With an arthroscopy, the bleeding can result in swelling or a hematoma. *Key assessment is H&H*
The nurse knows that any procedure that uses conscious sedation or local anesthesia that affects gag reflex puts the patient at risk for ______.
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Aspiration. S/Sx include dyspean, tachycardia, adventitious breath sounds, fever.
______, evidenced by abd pain, fever, N/V, and distention, can happen after scope procedures.
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Perforation of the GI tract. *Monitor labs for INFx*
When receiving a Go-Lytely bowel prep, the patient asks, "Should I take my other medications with this?" You the nurse know his meds have been discontinued because...?
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The other medications will not get absorbed d/t the increased motility caused by the prep.
Arriving for your morning shift, you receive report that your patient in 43B just had an ileostomy. What is the normal postOp output you expect?
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Less than 1000 mL/day. May be bile-colored and liquid.
The same patient in 43B who just had a ileostomy asks if he will be "losing this much fluid" all the time. You reply...
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No, after several weeks, the output will decrease to 500-1000 mL/day. Instead of liquidy, it will turn more paste like because the SI begins to adapt and do the absorption the LI usually did.
Kyle Y. will be going to get a sigmoid colostomy tomorrow morning. He is concerned and asks you what his "elimination" will be like when he receive this. What should you say?
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By post-op day 4/5, there will be semi-formed stool with a small/mod amount of mucus. After several weeks, the output will routinely resemble semi-formed stool. Kyle can expect to resume a similar pre-op pattern.
  
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