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NUR 242 Exam 3 Study Guide: Latest Updated Solution
Intestinal obstruction is (Ans- a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through With obstruction (Ans- gas and fluid accumulate proximal to and within obstructed segment causing bowel distention A bowel obstruction is divided into two basic categories: (Ans- Mechanical and Non-mechanical Treatment of intestinal obstruction is directed toward (Ans- relieving symptoms, managing fluid and electrolyte imbalances, preventing complications, and treating the cause of obstruction
Surgery may be needed to relieve the obstruction if (Ans- gastric decompression does not relieve the symptoms, or if there are signs of bowel necrosis. The type of surgery will depend on the type and area of obstruction and may include intestinal resection with an anastomosis or creation of an ileostomy or colostomy If the small bowel obstruction is complete, the peristaltic waves become quite vigorous, assuming (Ans- reverse direction, propelling intestinal contents toward the mouth rather than the rectum Small bowel obstruction patient vomits (Ans- stomach contents first, then the bilious contents of the duodenum, and finally the fecal contents of the ileum A distended abdomen, a bloated sensation, and altered bowel sounds may indicate a (Ans- small bowel obstruction.
When the appendix becomes inflamed and fills with pus it is called (Ans- Appendicitis Obstruction of the appendiceal lumen causes (Ans- appendicitis If left untreated, an inflamed appendix will eventually (Ans- burst, or perforate, spilling infectious materials into the abdominal cavity. This can lead to peritonitis, a serious inflammation of the peritoneum that can be fatal unless it is treated quickly with strong antibiotics The classic symptom of appendicitis is (Ans- abdominal pain. Pain becomes sharper over several hours and worsens with coughing, walking or other jarring movements.
A sharp pain is felt in the lower right abdomen (RLQ) when the area is pressed on and then the pressure is quickly released. this is known as (Ans- rebound tenderness. Pain is relieved by bending the knees Peritonitis results from (Ans- contamination of a normal sterile peritoneal cavity with bacteria or chemical irritant Peritonitis: classically the patient will have an acute abdomen with abrupt onset of diffuse, (Ans- severe abdominal pain Peritonitis: Depending on signs and symptoms, treatment includes (Ans- nasogastric decompression, hyperalimentation, and colloids such as plasma and blood cells.
Gastroenteritis: Treatment should focus on (Ans- intravenous fluids and monitoring for cardiac dysrhythmias Inflammatory bowel disease refers to two chronic diseases that cause inflammation of the intestines: (Ans- Ulcerative colitis and Crohn's disease. Both have similar symptoms but are different in the manner in which they affect the digestive tract. When providing patient education for the patient who has had an ostomy the nurse needs to include many things. The nurse should discuss (Ans- dietary modifications related to nutritional status and provide referral to dietitian for diet planning (lean meats, legumes, water). Teach the importance of maintaining a high fluid intake and manifestations to recognize dehydration
Inflammatory Bowel Disease: The treatment is considered to have been effective if the patient has a decrease in (Ans- diarrhea, increases their nutritional intake and gains weight, pain is reduced or eliminated, complication do not occur, and they effectively manage stress. Crohn's disease involves all of the (Ans- intestines Ulcers and fissures develop in (Ans- Crohn's disease In Crohn's disease the pain is in the (Ans- lower right quadrant of the abdomen New therapies are beginning to be utilized for patients with Crohn's disease including (Ans- immune response modifiers such as therapeutic monoclonal antibody certolizumab pegol (Cimzia) and Adalimuab (Humira)
Ulcerative Colitis involves only the (Ans- large intestine. Hemorrhages and abscess occur in (Ans- ulcerative colitis Blood, mucous, and pus can be noted in the stools of the patient with (Ans- ulcerative colitis as well as an urgent sensation to defecate Ulcerative colitis patients report (Ans- weight loss, anorexia, fatigue, and weakness The patient with ulcerative colitis may experience a (Ans- fever Pain is in the lower left quadrant (LLQ) in (Ans- ulcerative colitis Ulcerative colitis Diagnostic studies include a (Ans- CBC to assess for anemia, leukocytosis from inflammation and abscess formation. Serum albumin and folic acid levels which may be low due to malabsorption. Stool examinations for blood and stool cultures are ordered to rule out infections Diverticulitis occurs when (Ans- one or more diverticula become inflamed or infected.
Diverticula are (Ans- small, bulging pouches that can form anywhere in the digestive system, including the esophagus, stomach, small intestine, and most commonly in the large intestine Diverticulitis medical treatment includes a (Ans- liquid or low-fiber diet and antibiotics. Rest is also needed. Over-the-counter pain reliever, such as acetaminophen (Tylenol) may be taken. Diverticulitis: Opioids are avoided if possible as the tend to be (Ans- constipating and may aggravate the problem Diverticulitis patients should void the use of (Ans- over-the-counter (OTC) laxatives to prevent constipation, monitor for signs of bleeding, and limit intake of dietary fat Hepatitis is a widespread inflammation of the (Ans- liver that results in degeneration and necrosis of liver cells Hepatitis A has an incubation period of (Ans- 15 to 50 days Hepatitis A is spread via the (Ans- fecal-oral route by fecal contamination either from person-to-person contact or by consuming contaminated food or water
Cholecystectomy is removal of the (Ans- gallbladder The laparoscopic cholecystectomy is the (Ans- gold standard and is preformed far more often than the traditional open approach Gall Bladder Disease: Patient education for patients with biliary disorders includes (Ans- diet teaching. Tell the patient to not skip meals and to exercise regularly. Foods not well tolerated include eggs, pork, onions, poultry, milk, coffee, oranges, corn, beans, and nuts. Complications associated with malnutrition in adults include (Ans- muscle wasting, lethargy, intolerance to cold, edema, dry skin, or dermatitis, poor wound healing, infection, and possible death Socioeconomic factors can have a negative effect on nutritional status the assessment should include details on (Ans- social isolation, access to food, depression, substance abuse, and poverty. Nutritional status is influenced by the ability to (Ans- swallow and the body's ability to absorb nutrients Nursing interventions to promote intake include providing (Ans- mouth care before meals, getting the patient up to a chair for meals if possible,
and trying to increase social interaction during meals. Six small meals a day consisting of high-calorie and nutrient-rich foods, such as milkshakes and cheese, are recommended. If the patient is unable to consume adequate nutrition by mouth, either (Ans- total enteral nutrition (TEN) or total parenteral nutrition (TPN) is needed. Total enteral nutrition (TEN) or tube- feeding refers to a method of (Ans- infusing nutrient solutions or formulas directly into the GI tract through tubes that enter through the nose, mouth, or abdominal wall Bariatric surgery is treatment for patients who have a (Ans- BMI > 40 The laparoscopic adjustable-banded gastroplasty (lab band) is a procedure where an (Ans- adjustable band is used to create a small pouch Lab Band: Postoperative care depends on the type of surgery. Special bariatric equipment such as an (Ans- extra wide bed and additional personnel for moving the patient may be required. If there is an NG tube, do not reposition, as it can disrupt the suture line
Pursed lip breathing inhibits airway collapse and decreases (Ans- dyspnea. Encourage the patients to pucker the lips as if to whistle or blow out a candle, they inhale through the nose and slowly exhale through the pursed lips. Bronchial breath sounds heard over the trachea has a (Ans- higher, louder pitch. Inspiration and expiration are equal and there is a pause between inspiration and expiration Bronchovesicular breath sounds are located between the (Ans- scapula and have a moderate-pitched, blowing, sound with equal inspiratory and expiratory phase. Vesicular breathing is heard over the (Ans- thorax, lower pitched and softer than bronchial breathing Apnea increases the the carbon dioxide levels and decreases pH levels in the blood, which stimulates the person to (Ans- awaken and resume respirations Risk factors for sleep apnea include (Ans- obesity as most people with sleep apnea are overweight. Other risk factors include a short or thick neck, smoking, enlarged tonsils or adenoids, oropharyngeal edema, and
chronic nasal congestion. Patients with diabetes and those who use alcohol, sedatives, or tranquilizers are also at increased risk. Sleep apnea: Patients exhibit symptoms of daytime (Ans- sleepiness and irritability with periods of apnea lasting at least 10 seconds. The airway can become obstructed by the tounge, leading to apnea. Mild cases of sleep apnea may improve with (Ans- change in sleeping position or weight loss. The treatment of choice for sleep apnea is (Ans- continuous positive airway pressure (CPAP), which delivers air pressure via an air compressor through a mask placed over the nose or prongs placed in the nares while asleep to prevent alveoli from collapsing Laryngeal obstruction is a potential life-threatening emergency due to (Ans- the interruption of airflow through the nose, mouth, pharynx, or larynx. Early recognition is essential to prevent further complications, including respiratory arrest Hoarseness and dramatic shortness of breath presents with acute onset of (Ans- laryngeal obstruction and progresses rapidly to respiratory arrest if a patent airway is not established. The patient may exhibit gagging, dysarthria, accessory muscle use with breathing, and coughing
Trach care, conducted (Ans- each shift, includes application of new ties prior to removing old ties and cleaning stoma with diluted hydrogen peroxide. Asthma (Ans- And inflammatory disorder of the airways Asthma causes (Ans- wheezing, shortness of breath, chest tightness, and coughing. A sudden absence of wheezing may indicate occlusion and warrant immediate medical intervention Asthma treatment goal is to help patients identify (Ans- triggers and avoid those substances and to decrease bronchial inflammation Asthma is treated with (Ans- long-term control and quick relief medicines. Long-tem control medicines help reduce airway inflammation and prevent asthma symptoms A common side effect from inhaled corticosteroids is (Ans- thrush. the use of a spacer can help to avoid thrush. Patient prescribed an albuterol metered-dose inhaler (MDI) with spacer should be instructed to (Ans- breath in slowly and deeply after releasing the medication into the spacer
Asthma: Discharge teaching includes the (Ans- use of rescue medication, using a bronchodilator prior to exercise, and seeking help if peak expiratory flow reaches the red zone or frequently remains in the yellow zone COPD is the leading cause of (Ans- death and illness worldwide Most COPD is caused by (Ans- long-term smoking and can be prevented by not smoking or quitting soon after starting COPD patients suffers from (Ans- chronic hypoxemia and hypercapnia. Other manifestations may be cyanosis around the lips, neck vein distention, and pitting peripheral edema. Patients using accessory muscles when breathing should be evaluated immediately COPD: Outcomes include improved breathing pattern, decreased inspiratory and expiratory wheezing and decreasing dry, nonproductive cough, an oxygen saturation (Ans- >90, and ability to demonstrate how and when to use inhaled medications. Patients with COPD are often fearful and feel isolated because of their decreased ability to (Ans- leave their homes. Suggest that they and their families join support groups where they can share their experiences and
