Lower GI

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Lower GI
2010-02-24 01:09:50
Lower GI Med Surg 2 Exam 2

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  1. What complications can result from diarrhea?
    • Dehydration
    • Acid/base imbalance
    • Skin breakdown
  2. How should the nurse assess for dehydration complications?
    • Decrease blood pressure, skin turgor, urinary output, sodium
    • Increase heart rate, BUN, Hematocrit
    • Dry mucosa
    • Sunken eyes
  3. Treatment of diarrhea:
    • Fluid replacement
    • BRAT diet

    • Loperamide (Imodium)
    • Diphenoxylate/Atropine (Lomotil)
  4. What assessing for constipation, be sure to ask the patient what are their normal __________
    Bowel patterns

    (can range from 3x/day or every third day)
  5. Name the four different types of laxatives:
    • Bulk forming
    • Stool softeners
    • Osmotics
    • Stimulants
  6. What is an example of bulk forming laxative?
    • Metamucil
    • Citrucel
    • Fiber-Con

    (must give with fluids)
  7. What is an example of a stool softener?
    Docusate (Colace)
  8. What is an example of osmotic laxatives?
    • Milk of Magnesia
    • Lactulose
  9. What is an example of a stimulant laxative?
    • Bisacodyl (Dulcolax)
    • Senna (Sennokot)

    (do NOT use if suspected obstruction)
  10. How will you monitor bowel function in a patient that had a laparotomy?
    • Bowel Sounds
    • Flatulence
  11. What post-op complications is a laparotomy patient at risk for?
    • Infection from incision
    • Pneumonia
    • Urinary tract infection from foley
    • Bleeding
    • DVT
  12. Irritable Bowel Syndrome Treatments:

    Dicyclomine (Bentyl)

    Tegaserod (Zelnorm)
  13. Ulcerative colitis is common for what age group?
    What are the S/S?
    Adolescents or young adults

    • Bloody diarrhea
    • Abdominal pain
  14. What are the differences between an ileostomy and colostomy?
    Colostomy has more formed stool
  15. What is the differences between diverticulosis and diverticulitis?
    Diverticulosis - out pouching of colon wall from chronic constipation

    Diverticulitis - obstructed pockets from infection
  16. A patient with acute diarrhea of 24 hours’ duration calls the clinic to ask for directions for care. In talking with the patient, the nurse should

    A. ask the patient to describe the character of the stools and any associated symptoms.
    B. advise the patient to use over-the-counter loperamide (Immodium) to slow GI motility.
    C. inform the patient that laboratory testing of blood and stool specimens will be necessary.
    D. advise the patient to drink clear liquid fluids with electrolytes, such as Gatorade or Pedialyte.

    D - need more information, keep the patient NPO
  17. A patient with Crohn’s disease develops a fever and symptoms of a urinary tract infection. The nurse recognizes that this complication may occur as a result of

    A. perianal irritation from frequent diarrhea.
    B. fistula formation between the bowel and bladder.
    C. extraintestinal manifestations of the bowel disease.
    D. impaired immunologic response to infectious microorganisms.
    B. fistula formation between the bowel and bladder.

    • C - Common with ulcerative colitis
    • D - Don't know what meds they have
  18. A patient hospitalized with an acute exacerbation of ulcerative colitis is having 14 to 16 bloody stools a day and crampy abdominal pain associated with the diarrhea. The physician orders the patient to be NPO on admission. The nurse recognizes that this order is important to

    A. prevent nausea and vomiting.
    B. decrease abdominal distention.
    C. promote bowel rest and healing.
    D. allow for diagnostic testing to be completed.
    C. promote bowel rest and healing.

    D - They know the person has the disease, no need for diagnostics