Exam (elaborations)
NUR 201 GI Exam Questions and answers | Latest 2024/25 RATED A+
NUR 201 GI Exam Questions and answers | Latest 2024/25 RATED A+
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_________ colostomies are usually performed in the *transverse colon* and are usually ll ll ll ll ll ll ll ll ll ll ll
*temporary* while _________ stomas are constructed when a colostomy is intended to be
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*permanent*, usually in the *descending or sigmoid colon* - Correct Answers loop
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colostomies; end stomas
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_____________ ____________ is a chronic inflammatory disease of the small intestine ll ll ll ll ll ll ll ll ll ll
(most often), the colon, or both. It presents as *INFLAMMATION* that causes a *thickened
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bowel wall*. - Correct Answers Crohn's disease (CD)
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-can affect the GI tract from the mouth to the anus but most commonly affects the *terminal
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ileum*
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-multiple areas of normal secretions in b/w disease areas (*skip lesions*)
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-Like UC, this disease is *recurrent with remissions and exacerbations* and similar
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complications
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-results in *severe diarrhea and malabsorption* ll ll ll ll ll
- cause is unknown but may include *genetic, immune, and environmental factors*
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_____________ ______________ is the preferred surgery for tumors *smaller than 3cm* ll ll ll ll ll ll ll ll ll ll
in diameter; a __________ ____________ (or the Whipple procedure) is performed for
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*larger* tumors. - Correct Answers partial pancreatectomy
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radical pancreatectomy (*Whipple* --> pancreaticoduodenectomy)
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_________________ is a term to describe inflammation of the gallbladder while ll ll ll ll ll ll ll ll ll ll
_______________ is a term that refers to gallstones - Correct Answers cholecystitis;
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cholelithiasis
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*Colicky* cramping is NOT characteristic of what type of obstruction? - Correct Answers
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nonmechanical --> more of a *constant, diffuse discomfort*
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(it is characteristic of mechanical)
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*pain RT vascular insufficiency or infarction = severe and constant*
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A ____________________ obstruction doesn't involve a physical obstruction in or outside
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of the intestine; instead, ______________ is decreased or absent as a result of
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*neuromuscular disturbance*, resulting in a *slowing of the movement or a backup of
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intestinal contents*. - Correct Answers nonmechanical (aka paralytic ileus or adynamic
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ileus)
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*peristalsis is decreased* ll ll
,*contents accumulate at & above the area of obstruction* ll ll ll ll ll ll ll ll
A fetal position with legs drawn up to the chest will promote comfort in a patient with what GI
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problem? - Correct Answers pancreatitis
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A newer procedure, _________________ can be
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performed via the *anus or vagina* for selected patients with UC. Patients may have ll ll ll ll ll ll ll ll ll ll ll ll ll
*moderate sedation
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or general anesthesia* for MIS procedures, and are *often not admitted to critical care
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units* for continuing postoperative care. - Correct Answers natural orifice transluminal
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endoscopic surgery (*NOTES*)
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A patient can be prescribed Ketoralac for a maximum of _______ days for relief of pain
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associated with cholecystitis - Correct Answers 10 days
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A temperature higher than 100* F (with or without guarding) and a sustained elevation in
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pulse could indicate what? - Correct Answers strangulated obstruction or peritonitis
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After a cholesystectomy, what should you instruct patients to avoid in their diets? - Correct
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Answers fatty foods
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(clients with biliary system issues should avoid diets high in fat & cholesterol)
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An _______________ is a procedure in which a *loop of the ileum* is placed through the
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abdominal wall for drainage of fecal material into a pouching system - Correct Answers
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ileostomy
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-monitor the ileostomy stoma (should *protrude 3/4 in [2cm] from the abdominal wall*, and
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should be *pinkish to cherry red* to ensure an adequate blood supply)
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---->if the stoma looks *pale, bluish, or dark*, report findings immediately!!!!!!
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-*skin care around the ostomy is a priority*
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An obstruction __________ in the small intestine causes a loss of *gastric hydrochloride*
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which can lead to metabolic _____________; an obstruction at the *end* of the small
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intestine and *lower* in the intestinal tract causes loss of *alkaline fluids*, which leads to
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metabolic ______________. - Correct Answers high obstructions = metabolic alkalosis
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low obstructions = metabolic acidosis
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Anemia is common with which IBD? - Correct Answers CD (usually from iron deficiency
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or malabsorption issues)
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,At the onset of treatment for *UC*, why is activity is generally *restricted*? - Correct
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Answers because rest can reduce intestinal activity, provide comfort, and promote
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healing
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(many measures are used to relieve symptoms and to reduce intestinal motility, decrease
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INFLAMMATION, and promote intestinal healing) ll ll ll ll
Bacteria lies stagnant in the obstructed intestine. This is not a problem unless the blood
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flow to the intestine is compromised; _______________ obstruction or a
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______________ obstruction have a greater risk for *peritonitis*. - Correct Answers
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*closed-loop obstruction* (blockage in two different areas)
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*strangulated obstruction* (obstruction w/ compromised blood flow) (surgery *always* ll ll ll ll ll ll ll ll
required)
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Because patients with pancreatitis often avoid or limit the intake of food to avoid increased
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pain, which makes nutritional maintenance difficult to achieve. To maintain weight, he or
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she needs an *increased number of calories*, up to ______ - ________ calories/day -
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Correct Answers 4,000-6,000 calories/day
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(foods high in carbs & proteins help with healing but foods high in fat cause diarrhea)
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Besides jaundice, what are other S/S of pancreatic cancer? - Correct Answers -possible
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fixed mass in LUQ
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-abdominal pain (vague, dull, radiates to back) (sign of advanved disease) ll ll ll ll ll ll ll ll ll ll
-weight loss/anorexia ll
-N/V
-glucose intolerance ll
-splenomegaly
-flatulence
-GI bleeding (esophageal/gastric varices)
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-ascites
-leg/calf pain (thromboembolus) ll ll
-*weakness/fatigue* (most common concern --> decreased energy level, increased need ll ll ll ll ll ll ll ll ll
for rest, inability to perform usual activities)
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Besides POI, what are the other common causes of a nonmechanical obstruction? -
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Correct Answers -*peritonitis* (leakage of contents causes irritation and triggers an
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inflammatory response & infection)
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-*intestinal ischemia* (vascular insufficiency to the bowel) ll ll ll ll ll ll
Bile obstruction (cholecystitis) leads to what disorder? - Correct Answers *jaundice* (=
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dark urine & clay colored stools)
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extrahepatic obstructive jaundice --> caused by edema of the ducts or gallstones blocking ll ll ll ll ll ll ll ll ll ll ll ll
bile flow
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, intrahepatic obstructive jaundice --> inflammation of liver's bile channels/ducts = increase ll ll ll ll ll ll ll ll ll ll
in circulating levels of bilirubin
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*pruritis due to excessive bile salts accumulating in the skin* ll ll ll ll ll ll ll ll ll
Colon tumors can also spread by ______________ __________ during surgical resection
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of the tumor when cancer cells break off from the tumor into the peritoneal cavity. - Correct
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Answers peritoneal seeding
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CRC (tumors) in the *transverse* & *descending* colon result in what kind of symptoms? -
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Correct Answers S/S of obstruction b/c passage of stool is blocked
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*pt reports "gas pains", cramping, or incomplete evacuation*
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Crohn's disease is made worse by _____________ _____________. - Correct Answers
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bacterial infection
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Diet is not a major factor in the inflammatory process, but some patients with UC find that
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_____________ and _____________ increase diarrhea and cramping. - Correct Answers
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caffeine & alcohol
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Explain how the Whipple procedure manipulates the GI system. - Correct Answers
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*removes*:
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-proximal head of pancreas ll ll ll
-duodenum
-portion of jejunum ll ll
-stomach (partial or total gastrectomy) ll ll ll ll
-gallbladder
(maybe the spleen) ll ll
*anastomosis to jejunum*: ll ll
-pancreatic duct (pancreaticojejunostomy) ll ll
-common bile duct (choledochojejunostomy) ll ll ll
-stomach (gastrojejunostomy) ll
Fistulas places the client with Crohn's disease at risk for what electrolyte imbalance? -
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Correct Answers hypokalemia (normal = 3.5-5)
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-can lead to serious dysrhythmias ll ll ll ll
For an EGD, a client is given sedation. What does the nurse do if respirations fall below
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normal range or become shallow? - Correct Answers first action is to provide a
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stimulation (*sternal rub*)
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