MedSurg Exam 3 Study Guide

Left

Prior to a colonoscopy, an enema should be done until the return is clear while patient is laying on ______ side

Polyps

A barium enema may be done to detect the presence of _________ which may be removed due to cancer risk

Upper endoscopy

What does EGD stand for

FOBT

Patient should avoid red meats, aspirin, Vitam C, and NSAIDS for 72 hours prior to what

Central

TPN nutrition requires a __________ line

Alkalosis

NG tube suctioning can lead to metabolic __________

Hypoglycemia

Stopping parental nutrition can lead to ______________ which is characterized by sweaty skin, palpitations, and decreased LOC

Peg tube

Tube that bipasses esophagus and goes directly into stomach for feeding

30

Patients recieving a G-tube feeding should be at ____ degreees

Skin breakdown

Patients recieving enteral feeding should be monitored for ________ _____________ due to diarrhea

Crohns disease

Cluster of ulcers in bowel that DONT bleed

**Diarrhea

Colonoscopy

Diverticulosis & diverticulitis is typically diagnosed using what

Ruptured diverticula

A complication of diverticulitis is _________ ___________ which causes distended & hard abdomen, pain when palpating

**Call doctor if suspected!!

Fiber & fluid

Patients with constipation should increase what

Potassium

A complication of diarrhea is low _________ leading to cardiac dysrhythmias

Weak pulse

Cardiac dysrhythmias can be auscultated and palpated for ______ ________

Acidosis

Diarrhea can lead to metabolic _________

Upper

Dark blood in feces indicate an _________ bleed

Rectum

Bright blood in feces indicates a hemorrhoid or polyp at the _________

Duodenum

Most common place for peptic ulcers

H. pylori

Most common cause of peptic ulcers

Proton pump inhibit (-prazole) & H2 histamine (-tidines)

Peptic ulcers (and GERD) from H. Pylori should be treated with

Ulcerative colitis

Deep ulcers with bleeding
**liquid stood with pus, mucus, or blood

Low

Bleeding from ulcerative colitis causes tachy pulse and _________ BP & RR

Low fat

Patients with GERD should be on what diet

Barretts esophagus

A complication of GERD is __________ ___________ which changes the lining of the esophagus and can lead to cancer

B12

Gastritis causes the malabsorption of which vitamin

Brain bleed

A severe headache following trauma can indicate what

**Call doctor

IV

After ensuring safety, an ______ should be started for a longer seizure

Multiple sclerosis

Disease charectorized by demyelination of nerves

Fatigue

Patients with multiple sclerosis should avoid strenuous activity and ________ and should rest often

Rest

Tremors in parkinsons increase during _______

Dyskinesia

Adverse effects of carbidopa-levodopa for Parkinsons
**Causes involuntary & erratic movement

Hypertension

#1 cause of hemorrhagic stroke

Thick

TIAs can be caused by clot, _______ blood, or vessel spasm

Carotid endarterectomy

Done after multiple TIAs to remove plaque from carotid artery

Pannus

In rheumatoid arthritis, ________ fills in synovial fluid

Gastric ulcers

Long term use of NSAIDs to treat rheumatoid arthritis can cause

Organs

Systemic lupus is an inflammatory disease effecting the _________

Uric acid

GOUT is a build up of _______ ______ at the joints

Purines

A decrease of ________ can help treat GOUT

Autoimmune

Fibromyalgia is an ___________ disease causing chronic pain

Achilles tendon

Signs of fibromyalgia include fibromyalgia pain points, pain when taking BP & when pinching __________ ________

Herniated disc

Sever pain while laying down and lifting leg cause mean

Noninflammatory

Osteoarthritis is a _________________ degenerative disorder of the joints

Tylenol

Orteoarthritis should be treated with _______

**Do not use NSAIDs bc osteoarthritis is noninflammatory

Forward

After a total hip arthroplasty limit hip flexion to 90 degrees and avoid bending _____________

Post-op day 1

After a total hip arthroplasty when should the patient begin ambulating

Abductor

After a total hip arthroplasty a __________ pillow should be used

Osteoporosis

Bone reabsorption is greater than bone formation

MRSA

Osteomyelitis, an infection of the bone, is often caused by _________

Pin

________ care for skin care of skeletal traction

Baseline

The goal of amputation is back to ____________ mobility

Phantom limb pain

Most common complication with amputation

Compartment syndrome

Occurs when a fracture has been casted too tightly --> decreased bloodflow

Pain, pulse, pallor, paralysis, parethesia

5 p's of cast assessment

Salivary enzyme

Amylase (begins breaking down carbs)

Gastric enzymes

Hydrochloric acid & pepsin

Small intestine enzymes

Amylase (carbs), lipase (fats), trypsin (protein), bile

Chyme

Combination of food and enzymes

Emulsification

Fat digestion

Dyspepsia

Indigestion- bloating or heavy feeling after eating

Barium

A __________ enema looks at GI motility

Left

Patients undergoing a colonoscopy should be placed on their ________ side

Hiatal hernia

Stretching of the diaphragm hole which causes food to back up (reflux)

Barrett esophagus

Cell lining of esophagus has changed due to GERD

15

A tube feeding must be off for ___ minutes before laying a patient flat to prevent aspiration

LUQ

Ascultation of the _______ should be done to check for proper placement of an NG feeding tube

Water

For pills being administed via NG tube, they should be crushed and warm ________ should be added to make a solution

30

The HOB should be at ___ degrees when a patient is recieving a tube feeding to prevent aspiration

NPO

Patients with gastritis are normally _______ for a few days to promote healing

H. Pylori

Peptic ulcers are often associated with

Duodenum

Where are peptic ulcers most commonly formed

4-8 weeks

How long should patients with peptic ulcer disease be on proton pump inhibitors

Bleeding

Symptoms of ___________ in the stomach include rapid shallowing breathing, tachy pulse, low BP

Hemorrhoids

Varicose veins in anal canal caused by excessive straining

Fissure

Cracks in the rectum

Rectal prolapse

Rectal walls can be seen outside of the body

Megacolon

Part of colon swells and causes blockage which can lead to perforation

Borborygmus

stomach growling often seen before diarrha

Tenesmus

The feeling that you need to pass stools, even though your bowels are already empty. It may involve straining, pain, and cramping.

Cardiac dysrhythmias

Diarrhea often causes decreased potassium leading to

Diverticulum

Sac-like herniation of the lining of the bowel

Diverticulosis

Multiple diverticula WITHOUT inflammation

Diverticulitis

Infection and inflammation of diverticula

Low-fiber

Diverticular disease is associated with a _____-_______ diet

Sigmoid

Most common site for diverticulitis

Clusters

Chrons disease is classified by ________ of ulcers

Deep

Ulcerative colitis is classified by ________ ulcers

Fistulas

Clusters of ulcers make a hole in skin surface
**Common in chrons

25-29.9

Overweight BMI

>30

Obese BMI

500

In order to loose 1 lb/ week you have to cut out ____ cals/day

Vagal

________ blocking stops the hunger hormone

Intragastric ballon therapy

Makes you feel full so you dont eat as much

Low fowlers

Patients with obesity should be in what position to maximize chest expansion

Bariatric

____________ surgery decreases the size of the stomach
**Results in weight loss of 10-35% within 2-3 years

Dumping syndrome

Rapid emptying of gastric contents into small intestines

Acidosis

Diarrhea causes metabolic _________

Alkalosis

NG suctioning can cause metabolic _________