NUR 170 Concepts of Medical-Surgical Nursing
Exam 4
Question:
IBS management
Answer:
Chronic/recurrent diarrhea, constipation, and/or abdominal pain and bloating & belching right after meal (post prandial)▪ NO wt loss, NO vomiting, NO fatty stools (steatorrhea) ▪ Eat, go to bathroom, feel fine after, repeat
- Tx: increase fiber, probiotics, fluids▪ Med therapy: alosetron
(antidiarrheals), laxatives, lubiprostone/alostide (constipation)
diet, boiled chicken w brown rice steamed broccoli n apple juice for alosetron assess for constipation, ischemic collitis
lubiprostone take w foos n water to prevent constipation
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Question:
Cholecystitis / Cholelithiasis management
Answer:
Patho: inflammation of gallbladder
▪ Acute: gallstones
▪ Chronic: inefficient bile emptying & fibrotic/contracted gallbladdero S/S: epigastric pain > R shoulder, RUQ pain (high fat/high volume meal), Murphy's sign (cannot breathe when fingers passed below hepatic margin), tachycardia, indigestion, belching, N&V o S/S cholelithiasis: jaundice(clay colored stool)
dark orange foamy urine, steatorrhea ( fatty feces), prurituso Tx: surgery
(laproscopy)
Question:
ERCP (Endoscopic Retrograde Cholangiopancreatography)
Answer:
Numbing spray for pt is suppose make their throat feel numb Monitor for return of gag reflex before giving pt any oral substance, if NOT, pt could ASPIRATE Can cause acute pancreatitis due to dye injection in pancreatic duct ▪ Monitor respiratory complications, cough and deep breathe & IS Q2, splint abdomen, maintain NPO/ NG as prescribed, clear liq --> solids as tolerated
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Question:
Diverticulosis management
Answer:
o Patho: outpouching/herniation of intestinal mucosa; can occur in any part
but most common in sigmoid colon where arteries are weak points = high risk for bleeding
o s/s: LLQ pain (increases w/ coughing, straining, lifting), fever, N&V,
abdominal distention, tenderness, palpable tender rectal mass, blood in stool
o Dx: X-ray, abdominal assessmento Bedrest, NPO/ Clear liq, or soft high
fiber diet, increase fluids 2500-3000mL, avoid increasing intra-abdominal pressure (strain, lift, cough, bend, tight clothes), avoid gas forming foods, avoid
seeds, nuts, popcorn,o Tx: anticholinergics, analgesics, Abx, colostomy,
colon resection w/ primary anastomosis
Question:
Hepatitis A (acute)
Answer:
survives on hands
Question:
hepatitis c
Answer:
contaminated through iv needle sharing
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