-
Painful ulcerations (canker sores) appear as inflammation and erosion of protective lining of mouth
Stomatitis
-
Most common form of stomatitis and caused by aphthous (nonifectious), herpes simplex, traumatic
Primary stomatitis
-
Form of stomatitis that results from viruses, fungi and bacteria such as Candida albicans
Secondary stomatitis
-
Hyperactive bowel sounds may be found with what conditions?
- gastroenteritis
- pyloric obstruction
- diarrhea
-
Absent bowel sounds can be indicative of what conditions?
- Peritonitis
- ileus
- obstruction
-
Stool of a patient with upper gi bleed or high iron content appears
dark, tarry (Melena)
-
Stool of a patient with lower GI bleed appears
Bright red d/t close proximity to rectum- not digested
-
stool of patient with billiary obstruction
Clay colored
-
Emesis from pt w/retained (partially digested) blood in stomach
Coffee ground emesis
-
Emesis that has presence of bile
green
-
stool of pt recently had barium contrast or biliary obstruction
white/gray glistening
-
stools with increased fat content
bulky,greasy,foamy,gray colored
steatorrhea-fatty stool
-
Diagnostic test that visualizes esophagus, stomach, duodenum and upper jejunum
UGI Tract study
- Swallow barium
- npo 6hrs
- laxative after to eliminate barium
Noninvasive
-
Xray of large intestines
Barium enema
- Contrast
- Bowel prep w/laxatives and enemas
- restrict dairy and follow liquid 24 hrs prior
- NPO 8hrs prior to test
- Laxative to remove
****If UGI and barium enama ordered, enema done first
-
Invasive test that puncture incision at belly button and CO2 used to inflate abdomen for better visualization
Laparoscopy
- NPO
- No prep unless ordered by MD
- Bandaids/steris
May have increased cramping, gas, chest pains after d/t CO2
-
Diag test that visualizes esophagus, gastric, and duodenal mucosa
Esophagogastroduodensoscopy (EGD)
Used to identify source of upper GI bleed, gastric malignancies and diff types of ulcers
-
Nursing interventions for EGD
- NPO for 8 hrs
- Pressure or fullness if CO2 used
- Conscious sedation
- Vital signs
- Ck gag reflex
- throat lozenges, saline gargles
- Watch for aspiration, perforation, bleeding
-
Diagnostic test that examines liver, gallbladder, pancreatic and biliary ducts
Endoscopic Retrograde Cholangiopancreatography (ERCP)
- May be used to release gallstones
- Care similar to EGD
-
What must nurse watch for with ERCP test?
S/S of pancreatitis
- Severe epigastric pain radiating to back
- Fever
- leukocytosis
- N/V
- Cullen's
- Turner's
- Elevated Amylase and Lipase
-
Visualization of anus, rectum, distal sigmoid colon
- Sigmoidoscopy-less $$$ than colonoscopy
- Sedation not necessary
- For polyps and tumors
- pretest procedures vary
- fleets/cleansing enemas
Watch for distention, tenderness, bleeding
-
Examination of entire colon
colonoscopy
- Diagnostic for colorectal cancer
- Bowel prep (Golytely)
- clear liquids
- laxative and enemas
- NPO 8 hrs
- Sedation
Monitor VS, report bleeding, fever and pain
-
What must a nurse assess for when CT called for?
What type of study must be conducted 4 days prior to CT or done after CT scan
Allergies to iodine, seafood
Barium studies
-
When is a MRI contraindicated?
- Pacemaker
- Heart valves
- internal metal clips
- implanted pumps
Cardiac stents are ok
-
What type of fluid imbalance may occur with hyperosmolar tube feeding that are not diluted properly?
Cellular dehydration may occur as fluid is pulled from intra to extracellular fluid
make sure pt gets enough free H2O to prevent
-
How often is intermittent bolus tube feeding?
q4-6hrs by gravity
-
how is a continuous tube feeding administered?
by pump
-
How often is a cyclic tube feedings given and when?
8-10 hrs overnight if unable to meet caloric needs
-
Intermittent hold if residual
>100-150 ml
-
continuous hold if residual is
2 times amount over last hour
-
Routes of tube feeding delivery
-
Fisk factors of Obesity
- Genetic
- Physical inactivity #1
- environmental-fast foods, high fat, high chole
- Psychological factors-low self esteem, abuse
-
Drugs that can promote obesity
- corticosteroids
- estrogen
- nsaids
- antihypertensive
- antiepileptic
- certain oral antidiabetic
-
BMI of ____________=obesity
> 30
-
BMI of ____________=morbidly obese
>40
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