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NSG 123 Medical Surgical Nursing Exam 2 questions with correct answers.
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NSG 123 Medical Surgical Nursing Exam2 questions with correct answers.
Main Cause of Cholelithiasis ANS - Cholesterol stones account for most of the remaining 75% of cases
of gallbladder disease in the United States.
Symptoms of Cholelithias ANS - Nausea
Vomiting
Right upper quadrant abdominal pain or epigastric pain that radiates to the right shoulder especially
after meals when the gallbladder is stimulated to release bile.
Patient Teaching for Cholelithiasis ANS - The diet immediately after an episode is usually low-fat liquids.
These can include powdered supplements high in protein and carbohydrate stirred into skim milk.
Purpose of Medication in Cholelithiasis ANS - Purpose of Medications: reduces hepatic production of
cholesterol.
Lowers the cholesterol content of bile, which in turn facilitates the gradual dissolution of cholesterol
gallstones.
Examples : Chenodiol (Chenodal, Chenix) is a naturally occurring bile acid .
Purpose of Adding Fat to Emulsion to TPN ANS - Fat emulsions (lipids) are usually given to clients
receiving TPN to provide supplemental kilocalories and prevent fatty acid
Fat emulsions can also control hyperglycemia during periods of stress.
Carbon Dioxide in Laparoscopic Cholecystectomy ANS - Carbon dioxide is used during the procedure
Explain to the patient that they might feel pain in the right shoulder or scapular area (from migration of
the carbon dioxide used to insufflate the abdominal cavity during the procedure).
Laparoscopic Colecystectomy 3 Things to do After ANS - Recommend a heating pad for 15 to 20
minutes hourly or
,Encourage the client to ambulate frequently to reduce the bloating.
Manage nausea assess bowel sounds for further complications.
Preoperative Assessment for Open Cholecystectomy ANS - Priority assessment should focus on the
client's respiratory status.
If a traditional surgical approach is planned, the high abdominal incision required during surgery may
interfere with full respiratory excursion.
The nurse notes a history of smoking, previous respiratory problems, shallow respirations, a persistent
or ineffective cough, and the presence of adventitious breath sounds.
CBC and BMP should also be assessed
4 Postoperative Complications of Cholecystostomy ANS - After these surgical procedures, the client is
observed for indications of infection, leakage of bile into the peritoneal cavity, and obstruction of bile
drainage.
If bile is not draining properly, an obstruction is probably causing bile to be forced back into the liver and
bloodstream.
Because jaundice may result, the nurse should assess the color of the sclerae. Yellow-colored sclerae or
skin can indicate jaundice.
Clay-colored stool should be reported as this indicates a complication.
Discharge Teaching for Open Cholecystectomy ANS - Usually, only a small amount of serosanguineous
fluid drains in the initial 24 hours after surgery; afterward, the drain is removed.
The drain is typically maintained if there is excess oozing or bile leakage.
Empty the drainage bag attached at least every 8 hours and as needed, to prevent reflux back into the
bile duct.
Take showers not baths to prevent infection of the incision site.
What disease is characterized by possible malnourishment (anemic) and frequenct diarrhea? ANS -
Crohn's disease
The disease characterized by blood sools and left lower quadrent pain ANS - Ulcerative Colitis
, What GI disease would be best diagnosed with colonoscopy? ANS - Ulcerative Colitis
What testing would you expect to see from a patient recieving parenteral nutrition? ANS - Blood
Glucose
What time of day should Famotidine (pepcid) be administered? ANS - Bed time
What is an intragastric balloon used for? ANS - Non-invasive weight loss
The nurse needs to check Mg++ before administration of what drug? ANS - Magnesium
hydroxide/aluminum hydrate MAALOX
Which weight loss drug requirres a fat soluble vitamin supplement? ANS - Orlistat (XENICAL)
What do you give to treat travelers diarrhea? ANS - Bismuth Salts-pepto bismol
This conditon is charcterized by perianal vascular congestion from straining to have a bowel movement?
ANS - Hemorrhoids
How often should 30mL of water be flushed through an NG tuve for assessment of function ANS - Every
4 hours
A patient is experiencing diarrhea secondary to ulcerative colitis, do you treat it? ANS - No, their body is
flushing out the infection
Bulk forming laxative ANS - Citrucel or Metamucil
A patient has a NG tube placed and running suction. What lab should the nurse monitor? ANS - BMP,
fluid and electrolytes
What do you give a patient recieving a TPN to prevent hypoglycemia? ANS - D5W or D10W
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