Nursing 2 test 1

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fisheatflies
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64304
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Nursing 2 test 1
Updated:
2011-02-06 22:00:18
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GI Endocrine
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  1. Dysphagia:
    Difficulty swallowing
  2. Types of Hiatal Hernias: (2)
    • Sliding (type I) *most common
    • Paraesophageal (type II, III, IV)
  3. NPH insulin onset, peak, duration:
    • O= 3hrs
    • P= 8hrs
    • D= 18hrs
  4. What kind of insulin can be administered IV?
    Regular (Humalog R)
  5. Oral Hypoglycemics:
    • Sulfonylureas (1st and 2nd generation)
    • Stimulates beta cells to secrete insuline
    • *(Diabinese) chlorpropamide
    • * (Amaryl) glimepiride
    • * (Glucotrol) glipizide
    • * (Micronase) glyburide
  6. ADPIE
    Assessment: Collecting subjective & objective data

    Diagnosis: Identify problems, diagnoses (nursing and collaborative)

    • Planning: Develop goals & outcomes
    • Implementation: Nursing interventons

    Evaluate: Pt.s response to interventions. Have outcomes been achieved?
  7. What/who provides information during the assessment?
    Patient, family, medical record,
  8. Why is data recorded during the assessment phase?
    • Continuity of care,
    • Communication,
    • Bases for evaluating care,
    • Legal/business record
    • Research
    • Education & planning
  9. Communication techniques:
    • Listening
    • Silence
    • Restating
    • Reflection
    • Clarification
    • Focusing
    • Humor
    • Information sharing
    • Suggesting
  10. What is the purpose for health education?
    • Promote behaviors that facilitate health
    • To provide up-to-date health information,
    • teach people to live the healthiest form.
  11. How do you determine learning readiness in a Pt.?
    Based on culture, personal values, physical & emotional status, past experience in learning.
  12. S/S of Hypoglycemia:
    • Cool, clammy skin
    • Rapid, weak pulse
    • Hungry/thirsty
    • Decreased BP
    • Anxious
    • Confusion
    • Headache
    • Blurred vision
  13. Lipodystrophy (from insulin injection):
    Tough, lumpy areas of fat (Rotate injection sites to avoid)
  14. Sick-day rules related to diabetes mellitus:
    • Monitor blood glucose q3-4hrs
    • Continue medications as usual
    • Diet of easily digested foods and liquids
    • Call provider is blood glucose >300 or unable to retain fluids
  15. Types of medications used for pt.s w/ DM2
    • Oral hypoglycemics:
    • -Sulfonylureas: stimulates beta cells to secrete insulin
    • -Biguanides: increase body tissue sensitivity to insulin, Inhibit production of glucose by liver
    • - Thiazolidinedilones: sensitize body tissue to insulin
  16. Sulfonylureas
    Oral hypoglycemic that stimulates beta cells to secrete insulin
  17. Biguanides
    • Oral hypoglycemic that…
    • -Increases body tissue sensitivity to insulin,
    • -Inhibit production of glucose by liver)
  18. Thiazolidinedilones:
    Oral hypoglycemic that sensitize body tissue to insulin
  19. Nutrition guideline for DM2
    • 50-60% Carbs (whole grain)
    • 20-30% Fat
    • 10-20% Protein
  20. Etiology of DM1
    Destruction of the beta cells of the pancreas possibly from infection/environment that triggers an autoimmune response.
  21. Complications of thyroidectomy:
    • Swallowing problems
    • Hypothyroidism
    • Parathyroid damage (hypo-function=low calcium)
  22. How are thyroidectomy complications manifested?
    • s/s hypothyroidism
    • low calcium
    • dysphagia
  23. Possible nursing Dx for Cushing’s syndrome:
    • Fluid volume excess r/t sodium retention manifested by edema, HNT
    • Risk for injury r/t weakness/fatigue
    • Risk for infection r/t impaired immune response.
  24. What 3 steroids does the adrenal cortex produce?
    • Glucocorticoids
    • Mineralcorticoids
    • Androgens
  25. What is the deficiency to cause Addison’s autoimmune or idiopathic?
    Adrenocortical/ cortical insufficiency
  26. Hashimoto’s thyroiditis:
    • An autoimmune disorder
    • Similar to hypothyroidism: fatigue, weight gain, anorexia, decreased body temp, hair loss
  27. Characteristics of Grave’s Disease:
    • Weight loss
    • Increased appetite
    • Heat intolerance
    • Tachycardia
    • Nervous/hyper
    • Dry itchy skin
    • Eyes bug-out
    • Goiter
    • Muscle weakness
  28. Patient teaching regarding Barrett’s esophagus:
    A pre-cancerous condition that must be assessed q6-12 months to rule out cancer
  29. Clinical manifestations of Esophageal Diverticulum:
    • Dysphagia
    • Regurgitate food
    • Sour taste in mouth
    • Halitosis (ass-breath)
  30. Patient teaching for esophageal reflux:
    • Sit up for at least 2 hrs after eating
    • Avoid carbonation, caffeine, milk, mint, alcohol, irritating food
  31. What manifestations indicate need for EGD?
    • Barrett’s esophagus (rule-out cancer)
    • Suspect upper GI bleed
    • Persistent dyspepsia
    • Dysphagia & odynophagia (painful swallowing)
  32. What are the possible mechanical complications from a NG tube?
    • Aspiration pneumonia
    • Tube displacement
    • Tube obstruction
    • Nasopharyngeal irritation
  33. Pathophysiology of peptic ulcer:
    An excavation that forms in the mucosal wall of the pylorus, duodenum, and/or esophagus. Cause linked with H. pylori.
  34. Clinical manifestations of a peptic ulcer:
    • Dull gnawing pain in mid-epigastric region
    • Pain relieved/reduced from eating
  35. Ranitidine (Zantac) Action of medication:
    • Inhibits gastric secretions (HCL) by blocking the H2 receptor
    • Decreases production of HCL
  36. Criteria for selecting bariatric surgery pt.:
    • Number of co-morbidities
    • BMI > 30 or 100 lbs overweight
    • Only after other methods of weight loss have been tried and failed
  37. Complications of gastrectomy:
    • Vit. & mineral deficiencies
    • Dumping syndrome
  38. Dumping syndrome:
    • Rapid stomach emptying into duodenum
    • Complication of gastric & bowel surgery
    • Caused when high sugar liquids are ingested
  39. Causes of Chronic gastritis:
    • Prolonged inflammation (H. pylori)
    • Diet
    • Chronic NSAIDs, ASA use
  40. Foods to avoid when taking Tetracycline:
    • Dairy products
    • Iron
    • Antacids
    • Calcium
  41. Stool characteristics of Ulcerative Colitis:
    Watery with blood and mucus
  42. Pt./family teaching for Ulcerative Colitis:
    • Diet: bland, high protein, high calories, high vit. Low residue
    • Relaxation techniques
    • Small meals
    • Avoid caffeine, alcohol, and smoking
    • Avoid skin breakdown by cleaning the tushy after each poop session
  43. Clinical manifestations of Small Bowel Obstruction:
    • Pain
    • N/V (sometimes feces)
    • Constipation
    • Diarrhea
    • Hypovolemia
    • Change in electrolytes
  44. Management of chronic constipation:
    • Exercise
    • Increase fiber diet
    • Increased fluids
    • Stool softener
  45. Clinical manifestations of appendicitis:
    • Severe pain starting in umbilicus moving to LRQ to Mcburney’s Point
    • N/V, fever
    • Rebound tenderness
  46. Medical management of diverticulitis:
    • High fiber diet
    • Low fat
    • Or
    • Clear liquid
    • Bowel rest
    • IV fluid
    • Antibiotics
  47. Nutritional therapy for Inflammatory Bowel Disease (IBD):
    • Bland
    • Low residue
    • High protein
    • High Calorie
  48. Mcburney’s point:
    • Roughly corresponds to most common location of base of appendix where it attaches to cecum.
    • Pain in the area sign of appendicitis
  49. Common cause of cirrhosis:
    Chronic alcohol use/abuse
  50. Where is jaundice observed on the body?
    • Skin
    • Sclera of the eye
    • Mucous membranes
  51. What are some dietary restrictions for Ascites?
    • Limit salt and fluids
    • No starches (rice, wheat)
    • Avoid alcohol
  52. What is Ascites?
    Excess fluid accumulation in the abdomen
  53. How is Hepatitis B transmitted?
    Bodily fluids
  54. What are some complications to a laparoscopic Cholecystectomy?
    Bile duct injuries
  55. Medications to combat H. Pylori:
    • Amoxil
    • Biaxin
    • Flagyl
    • Tetracycline
    • Pepto Bismol
    • Protein Pump Inhibitors

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