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NUR 201 ( LATEST 2024 / 2025 ) TEST 1 | COMPLETE QUESTIONS & ANSWERS (SOLVED) 100% CORRECT
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NUR 201 ( LATEST 2024 / 2025 ) TEST 1 | COMPLETE QUESTIONS & ANSWERS (SOLVED) 100% CORRECT
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Voorbeeld 4 van de 56 pagina's
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NUR 201 Test 11. Mechanical obstruction of the bowel can result from
Answer
-Outside the bowel problem (such as ADHESIONS)
-In the bowel wall (such as CHRON'S Disease)
-Or in the intestinal lumen (such as Tumors)
2. Non-mechanical obstruction
Answer
AKA Paralytic ileus/adynamic ileus.
-Does not involve a physical obstruction in or outside the intestine. Instead peristalsis is decreased
or absent as a result of neuromuscular disturbance, resulting in a slowing of the movement or a
backup of intestinal contents. (SHUTDOWN)
3. With obstructions what is compromised?
Answer
Elimination
4. The type of complications from obstructions depend on....
Answer
The location of the obstruction.
5. If you have an obstruction that is high in the small intestine, which complication will you
have?
Answer
Loss of acid due to vomiting, leading to Metabolic Alkalosis.
6. If you have an obstruction below the duodenum/above the large intestine you will have....
Answer
A loss of both ACID AND BASE
,7. If you have an obstruction towards the end of the small bowel/lower intestine you will
have a loss of....
Answer
BASE-Leading you to Metabolic Acidosis. Remember losing a lot of stool will lead to acidosis.
8. What is the complication of obstruction that may lead to acute kidney injury?
Answer
Hypovolemia. Severe hypovolemia can result in AKI, or even death.
9. what is peritonitis?
Answer
acute inflammation of the peritoneum
10. Why does bleeding occur in the intestines?
Answer
Perforation or ruptured intestines . Remember this will lead to peritonitis.
11. What are the causes of mechanical obstruction?
Answer
-Scar tissue (adhesions) from surgeries/pathology
-Benign or malignant tumor
-Hernias
-Fecal impactions. (Especially in your older adults) due to decreased mobility, decreased GI
motility, may not be eating enough or drinking enough.
-Crohn's disease which is an inflammatory disease.
-Volvulus-Twisting of the intestine
-Intussusception
Answer
Telescoping of a segment within itself.
12. Causes of non-mechanical obstruction
,Answer
-Post-op ileus
-Peritonitis
-Intestinal ischemia.
13. What will intestinal ischemia lead to?
Answer
Bowel death, it NEVER comes back.
14. Paralytic ileus is most commonly caused by
Answer
Handling of the intestines during abdominal surgery. In post-op ileus patients functions is lost for
a few hours to
several days. Electrolyte disturbances, especially HYPOKALEMIA, predispose the patient to
this problem.
15. Why does peritonitis cause an ileus?
Answer
Because leakage of colonic contents causes severe irritation and triggers an inflammatory
response and INFECTION.
16. Assessment of the patient with a suspected obstruction?
Answer
-A hx of GI disorders, surgeries, and treatment
-Recent N&V (especially color of emesis)
-thorough pain assessment with particular attention to the onset, aggravating fac- tors,
alleviating factors, and patterns or rhythms of the pain.
-Do they have gas?
-Character and consistency of the last BM. And WHEN?
-Hiccups (common with all types of intestinal obstruction)
-Ask about diet and family hx.
-Ask about medications (don't forget HERBALS)
, 17. Severe pain that then stops and changes to tenderness on palpation...
Answer
-
May indicate perforation and must be reported promptly to the physician.
18. Physical assessment of mechanical obstructions?
Answer
-Generalized abdominal distention
-Possible, visible peristalic waves.
-High pitched sounds (borborygmi) or absent sounds
-Tender upon palpation. Minimal rigidity. May be able to feel inflated bowel.
-Mild abdominal pain, cramping.
-If it is strangulation
Answer
Pain is more localized and steady.
-Vomiting
-Obstipation
Answer
No passage of stool
-Diarrhea with PARTIAL obstructions.
19. Physical assessment of non-mechanical obstructions>
Answer
-Abdominal disten- sion
-Decreased bowel sounds early; absent bowel sounds later.
-Pain is associated with vascular insufficiency or infarct
-Colicky pain/ cramping
-OBSTIPATION- permanent loss of function which is worse than constipation.
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