NSG 123 Medical Surgical Nursing Exam 2
Jeremiah
Terms in this set (121)
Cholesterol stones account for most of the remaining 75% of cases of gallbladder
Main Cause of Cholelithiasis
disease in the United States.
Nausea
Vomiting
Symptoms of Cholelithias
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.
The diet immediately after an episode is usually low-fat liquids. These can include
Patient Teaching for Cholelithiasis
powdered supplements high in protein and carbohydrate stirred into skim milk.
Purpose of Medications: reduces hepatic production of cholesterol.
Lowers the cholesterol content of bile, which in turn facilitates the gradual dissolution
Purpose of Medication in Cholelithiasis
of cholesterol gallstones.
Examples : Chenodiol (Chenodal, Chenix) is a naturally occurring bile acid .
Fat emulsions (lipids) are usually given to clients receiving TPN to provide supplemental
Purpose of Adding Fat to Emulsion to TPN kilocalories and prevent fatty acid
Fat emulsions can also control hyperglycemia during periods of stress.
Carbon dioxide is used during the procedure
Carbon Dioxide in Laparoscopic Explain to the patient that they might feel pain in the right shoulder or scapular area
Cholecystectomy (from migration of the carbon dioxide used to insufflate the abdominal cavity during
the procedure).
Recommend a heating pad for 15 to 20 minutes hourly or
Laparoscopic Colecystectomy 3 Things to
Encourage the client to ambulate frequently to reduce the bloating.
do After
Manage nausea assess bowel sounds for further complications.
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.
Preoperative Assessment for Open
The nurse notes a history of smoking, previous respiratory problems, shallow
Cholecystectomy
respirations, a persistent or ineffective cough, and the presence of adventitious breath
sounds.
CBC and BMP should also be assessed
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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
4 Postoperative Complications of
back into the liver and bloodstream.
Cholecystostomy
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.
Usually, only a small amount of serosanguineous fluid drains in the initial 24 hours after
surgery; afterward, the drain is removed.
Discharge Teaching for Open The drain is typically maintained if there is excess oozing or bile leakage.
Cholecystectomy 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 Crohn's disease
malnourishment (anemic) and frequenct
diarrhea?
The disease characterized by blood sools Ulcerative Colitis
and left lower quadrent pain
What GI disease would be best diagnosed Ulcerative Colitis
with colonoscopy?
What testing would you expect to see from a Blood Glucose
patient recieving parenteral nutrition?
What time of day should Famotidine (pepcid) Bed time
be administered?
What is an intragastric balloon used for? Non-invasive weight loss
The nurse needs to check Mg++ before Magnesium hydroxide/aluminum hydrate MAALOX
administration of what drug?
Which weight loss drug requirres a fat Orlistat (XENICAL)
soluble vitamin supplement?
What do you give to treat travelers diarrhea? Bismuth Salts-pepto bismol
This conditon is charcterized by perianal Hemorrhoids
vascular congestion from straining to have a
bowel movement?
How often should 30mL of water be flushed Every 4 hours
through an NG tuve for assessment of
function
A patient is experiencing diarrhea secondary No, their body is flushing out the infection
to ulcerative colitis, do you treat it?
Bulk forming laxative Citrucel or Metamucil
A patient has a NG tube placed and running BMP, fluid and electrolytes
suction. What lab should the nurse monitor?
What do you give a patient recieving a TPN D5W or D10W
to prevent hypoglycemia?
What are most gallstones comprised of? Cholesterol
A patient needs to recieve enteric feeding, Dobhoff Tube
what type of tube should be placed?
NSG 123 Medical Surgical Nursing Exam 2
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