Term
|
Definition
| An abnormal infrequency or irregularity of defecation |
|
|
Term
| What does constipation interfere with? |
|
Definition
| mucosal transport, myoelectric activity, or the processes of defecation |
|
|
Term
| What are the risk factors of constipation? |
|
Definition
| medications, disease, age, low fiber intake |
|
|
Term
| What is the treatment of constipation? |
|
Definition
| education, bowel habit training, increased fiber and fluid intake, and careful use of laxatives |
|
|
Term
| What are the complications of constipation? |
|
Definition
| hypertension, fecal impaction, hemorrhoids, fissures (tissue folds), and megacolon |
|
|
Term
Is the following statement true or false?
The first line of intervention for a patient who is experiencing constipation should be a stimulant laxative. |
|
Definition
False
Rationale: Because of the potential for dependence, laxatives should normally be introduced after measures such as increased fluid and fiber intake have proven ineffective. |
|
|
Term
A client admitted to the hospital is diagnosed with a large toxic megacolon. Which of the following client findings is most important for the nurse to follow up on first?
A. The client reports shoulder tip pain and abdominal pain that was intense but is now relieves without an analgesic.
B. No bowel sounds are auscultation and the patient has obstipation.
C. The client’s morning laboratory values are: potassium 3.5 mEq/L, sodium 135 mg/dL, and BUN 20 mg/dL
D. The client’s vital signs are: lying b/p 128/88 mm Hg, pulse 100 beats/min, standing b/p 120/80, pulse 110 beats/min |
|
Definition
| A. The client reports shoulder tip pain and abdominal pain that was intense but is now relieves without an analgesic. |
|
|
Term
An 80-year old client is a long-term resident in a nursing home. Which of the following would be an early indication the client has a stool impaction causing a large intestine obstruction?
A. The client states he had a bowel movement yesterday.
B. The client has small amounts of liquid stool.
C. The client has a slightly distended abdomen and is flatulent
D. The client indicates he vomited this morning |
|
Definition
| B. The client has small amounts of liquid stool. |
|
|
Term
Identify which of the following food choices are appropriate for a client instructed to increase dietary fiber. (Select all that apply)
Bran cereal
Fresh pear
Chicken
Frozen spinach
Yogurt
Orange
White toast
Baked potato |
|
Definition
Bran cereal
Fresh pear
Frozen spinach
Orange
Baked potato |
|
|
Term
|
Definition
| An increased frequency of bowel movements of more than three per day, an increased amount of stool or abnormally liquid stool |
|
|
Term
| What are the types of diaaa? |
|
Definition
| secretory, osmotic, and mixed diarrhea |
|
|
Term
|
Definition
| controlling symptoms, preventing complications, and eliminating or treating the underlying disease |
|
|
Term
| What are the nursing priorities? |
|
Definition
| assessing and monitoring the characteristics and pattern of diarrhea |
|
|
Term
| What is an important lab in diarrhea? |
|
Definition
| serum electrolyte levels closely |
|
|
Term
| What is fecal incontenince? |
|
Definition
| The involuntary passage of stool from the rectum |
|
|
Term
| What are priority cares for fecal incontinence? |
|
Definition
| bowel retraining (when possible) and meticulous skin care |
|
|
Term
|
Definition
A change in motility caused by a neuroendocrine dysregulation, infection or irritation, or a vascular or metabolic disturbance
BOTH CONSTIPATION AND DIARRHEA! |
|
|
Term
| What is the primary symptom of IBS? |
|
Definition
| Primary symptom is an alteration in bowel patterns |
|
|
Term
| What are the goals to treatment of IBS? |
|
Definition
| relieving abdominal pain, controlling the diarrhea or constipation, and reducing stress |
|
|
Term
A client is on prednisone following exacerbation of IBD. Which of the following client findings is the greatest concern?
The client indicates the scratch on his arm is taking longer to heal.
The client’s glucose is 140 mg/dL
The client reports having flu-like symptoms and a temperature of 38’C (100.4’F)
The client indicates he has gained weight since starting the prednisone |
|
Definition
| The client reports having flu-like symptoms and a temperature of 38’C (100.4’F) |
|
|
Term
A client is admitted for an exacerbation of IBD. Which of the following are appropriate nursing actions? (Select all that apply)
Monitor the client’s b/p lying and standing
Encourage intake of fresh raw fruits and vegetables
Inform the client that sulfasalazine (Azulfidine) can be weaned after the symptoms stop.
Obtain a stool culture to determine the causative organism for the client’s diarrhea.
Teach the client on prednisone to discontinue the medication abruptly. |
|
Definition
Monitor the client’s b/p lying and standing
Teach the client on prednisone to discontinue the medication abruptly. |
|
|
Term
|
Definition
| The inability of the digestive system to absorb one or more of the major vitamins, minerals, and nutrients |
|
|
Term
| What does malabsoprtion cause? |
|
Definition
| Typically causes diarrhea or frequent, loose, bulky, foul-smelling stools |
|
|
Term
| What is the treatment of malabsorption? |
|
Definition
| avoiding dietary substances that aggravate malabsorption and supplementing nutrients that have been lost |
|
|
Term
Which of the following health problems may potentially have an etiology that results from the patient’s pre-existing malabsorption syndrome?
Type 1 diabetes
Colon cancer
Osteoporosis
Stroke |
|
Definition
|
|
Term
|
Definition
| The appendix becomes inflamed and edematous as a result of becoming kinked or occluded |
|
|
Term
| What treats appendiciits? |
|
Definition
| Immediate surgery is typically indicated if appendicitis is diagnosed |
|
|
Term
| What is the major complication of appendicitis? |
|
Definition
| perforation of the appendix |
|
|
Term
Which of the following assessment findings indicate early appendicitis?
Nausea and vomiting
Periumbilical pain
Tense posturing
Abdominal rigidity |
|
Definition
|
|
Term
Which of the following statements by the client having a exploratory laparoscopy indicates correct understanding of the procedure and/or postoperative care?
“Bed rest will be necessary to minimize the pain.”
“Pain medication should be avoided to prevent constipation.”
“I will have drains to help with healing”
I will have several small incision or punctures.” |
|
Definition
| I will have several small incision or punctures.” |
|
|
Term
In preparing a client for an appendectomy, the nurse should anticipate which of the following interventions? (select all that apply)
Administer an enema
Maintain NPO status
Deliver IV fluids
Apply heat to abdomen
Obtain surgical consent |
|
Definition
Maintain NPO status
Deliver IV fluids
Obtain surgical consent |
|
|
Term
The client returns to the nursing unit following surgery for a ruptured appendix. The client has an NG tube connected to low suction. AN IV of NS is infusing at 100 ml/hr. In providing postoperative care, the nurse should anticipate assisting with which of the following interventions (select all that apply)
Monitoring of the abdominal incision
Administration of a full-liquid diet
Administration of opioid analgesics
Measurement of intake and output
Maintenance of bed rest with frequent repositioning |
|
Definition
Monitoring of the abdominal incision
Administration of opioid analgesics
Measurement of intake and output |
|
|
Term
|
Definition
Food and bacteria retained in a diverticulum produce infection and inflammation:
Can usually be treated on an outpatient basis with diet and medication.
In acute cases with significant symptoms, hospitalization and surgery may be required |
|
|
Term
|
Definition
| A sac-like herniation of the lining of the bowel that extends through a defect in the muscle layer |
|
|
Term
|
Definition
| Multiple diverticula are present without inflammation or symptoms |
|
|
Term
| What is the FIBER diet for Diveritculitis? |
|
Definition
F - Fiber
I - intake of fat and red meat should be decreased
B - Bulk laxatives and stool softners
E - Encourage fluids
R - Remember to increase physical activity |
|
|
Term
| What kind of diet does IBS have? |
|
Definition
|
|
Term
| What is the low residue diet? |
|
Definition
L - Limited fat
O - Zero milk
R - real fish/ground meat
E - eggs boiled
S - strained foods |
|
|
Term
|
Definition
| Inflammation of the peritoneum caused by leakage of contents from abdominal organs into the abdominal cavity |
|
|
Term
| What is peritonitis usually a result of? |
|
Definition
|
|
Term
| What are the symptoms of peritonitis? |
|
Definition
|
|
Term
| What is the treatment of peritonitis? |
|
Definition
| fluids, pain relief, and antibiotics |
|
|
Term
|
Definition
| Regional enteritis (Crohn’s disease) and ulcerative colitis |
|
|
Term
|
Definition
| A subacute and chronic inflammation of the GI tract wall that extends through all layers |
|
|
Term
| What are the symptoms of Crohn's? |
|
Definition
prominent lower right quadrant abdominal pain unrelieved by defecation and diarrhea
Weight loss, malnutrition, and secondary anemia often occur |
|
|
Term
| What are the complications of Crohn's? |
|
Definition
| intestinal obstruction or stricture formation, perianal disease, fluid and electrolyte imbalances, malnutrition from malabsorption, and fistula and abscess formation |
|
|
Term
A female client is admitted to the hospital with the diagnosis of Crohn’s disease exacerbation. Which of the following assessment findings is most important for the nurse to follow up?
The client had15 diarrhea stools yesterday
The client is cramping and reports 7/10 abdominal pain
The client reports a new onset of reddish-brown vaginal discharge
The client’s BUN is 20 mg/dl and wbc is 10,000/mm3 |
|
Definition
| The client reports a new onset of reddish-brown vaginal discharge |
|
|
Term
| What is ulcerative colitis? |
|
Definition
| A recurrent ulcerative and inflammatory disease of the mucosal and submucosal layers of the colon and rectum |
|
|
Term
| What is ulcerative colitis characterized by? |
|
Definition
| multiple ulcerations, diffuse inflammations, and desquamation or shedding of the colonic epithelium, causing bleeding |
|
|
Term
| What is the cycle of ulcerative colitis? |
|
Definition
| Involves a pattern of exacerbations and remissions |
|
|
Term
| What is the complication of ulcerative colitis? |
|
Definition
| toxic megacolon, perforation, and bleeding |
|
|
Term
Is the following statement true or false?
Both Crohn’s disease and ulcerative colitis exclusively affect the colon and rectum. |
|
Definition
False
Rationale: Ulcerative colitis affects the rectum and descending colon, but Crohn’s disease usually affects the patient’s ileum and ascending colon. |
|
|
Term
A client is in sulfasalazine for ulcerative colitis. Which of the following laboratory results indicate a need for follow up?
Potassium 3.5 mEq/L, sodium 135 mEq/L
WBC 10,500/mm3
glucose 130 mg/dL, hgb 11 g/dL
Hct 50%, BUN 50 mg/dL |
|
Definition
|
|
Term
| What is the medical and nursing care of both crohn's and UC? |
|
Definition
Reducing inflammation
Suppressing inappropriate immune responses
Providing rest for a diseased bowel so that healing may take place
Improving quality of life |
|
|
Term
| What are the interventions of Crohn's/UC? |
|
Definition
| dietary modifications, medication administration, and postsurgical care |
|
|
Term
|
Definition
| The surgical creation of an opening into the ileum or small intestine |
|
|
Term
| What are the postoperative priorities of care for an ileostomy? |
|
Definition
| involve skin care, education for device management, nutrition promotion, prevention of complications, and facilitation of coping |
|
|
Term
What symptoms may be suggestive of an intestinal obstruction in a patient with an ileostomy?
Continuous flow of liquid stools and belching
Hypervolemia and hyperkalemia
Muscle spasms and numbness of the extremities
Nausea and abdominal distention |
|
Definition
D. Nausea and abdominal distention
Rationale: Nausea and abdominal distention, which may indicate that ileostomy output is blocked. Dehydration and electrolyte deficiencies may occur due to fluid losses through the ileostomy. The drainage from an ileostomy is a continuous liquid from the small intestine because the stoma does not have a controlling sphincter. Numbness of the extremities and belching do not indicate an intestinal obstruction, and muscle spasms may be related to electrolyte deficiencies. |
|
|
Term
| What is known about ileostomy/colostomy care? |
|
Definition
| tap water, don't irrigate, liquid stool, stoma should not be dusky, not as stinky |
|
|
Term
A nurse is assessing a client in the immediate postoperative period after an ostomy. The nurse notes the stoma appears red and moist. The appropriate action by the nurse at this time is to:
A. notify the health care provider immediately.
B. Check the client’s oxygenation
C. Document the findings
D. Place the patient on their right side |
|
Definition
|
|
Term
A client had a sigmoid colostomy placed several months ago. The client reports he is having problems with odor and flatulence. Which of the following dietary changes should the nurse recommend?
A. Avoid fruits and vegetables.
B. Limit the amount of dairy products and dark green leafy vegetables.
C. Increase the amount of dark green leafy vegetables.
D. Drink plenty of carbonated beverages. |
|
Definition
| B. Limit the amount of dairy products and dark green leafy vegetables. |
|
|
Term
A nurse notes that a client with a sigmoid colostomy has not had any output from her ostomy 3 days after surgery. The nurse recognizes that:
A. The client has an obstruction and needs immediate intervention.
B. This finding is expected at this point in the postoperative period.
C. The client needs to increase activity and fluid intake.
D. The client should not drink at this point. |
|
Definition
| B. This finding is expected at this point in the postoperative period. |
|
|
Term
| What does colorectal cancer start as? |
|
Definition
| May start as a benign polyp but may become malignant, invade and destroy normal tissues, and extend into surrounding structures |
|
|
Term
| What are the symptoms of colorectal cancer? |
|
Definition
| insidious, resulting in late diagnosis and low survival |
|
|
Term
| What are the treatments of colorectal cancer |
|
Definition
| chemotherapy, radiation therapy, and immunotherapy |
|
|
Term
| What are the surgical treatments of colorectal cancer? |
|
Definition
Segmental resection with anastomosis
Abdominoperineal resection with permanent sigmoid colostomy
Temporary colostomy followed by segmental resection and anastomosis
Permanent colostomy or ileostomy
Construction of a colonic J pouch |
|
|
Term
| What are the nursing priorities of a patient undergoing colorectal cancer surgery? |
|
Definition
Preparing the patient for surgery
Providing emotional support
Maintaining nutrition
Providing wound care
Monitoring and managing complications
Supporting a positive body image
Discussing sexuality issues |
|
|
Term
Postoperative care for the client following colon resection for colorectal cancer includes which of the following? (Select all that apply)
Discourage the client from turning, coughing, and deep breathing.
Monitor and treat pain, evaluate pain-relief measures.
Start a full liquid diet upon return to the medical unit.
Provide wound care using surgical aseptic technique.
Advise the client to use stool softeners to prevent straining |
|
Definition
Monitor and treat pain, evaluate pain-relief measures.
Provide wound care using surgical aseptic technique.
Advise the client to use stool softeners to prevent straining. |
|
|
Term
| Where can an obstruction occur? |
|
Definition
| May occur in the small bowel or large bowel |
|
|
Term
| What does a small bowel obstruction have? |
|
Definition
| a more rapid onset and is treated with nasogastric decompression |
|
|
Term
| What does a large bowel obstruction have? |
|
Definition
| a more gradual onset and may require the creation of a colostomy |
|
|
Term
A client is admitted to the hospital is diagnosed with a small bowel obstruction. A nasogastric tube is inserted. Which of the following are appropriate actions for the nurse to take in managing this client's care? (select all that apply)
A. Include NG drainage as part of the client’s output.
B. Irrigate the NG with 20 ml NS every 2 hours as ordered.
C. Assess the client’s bowel sounds every shift and prn
D. Provide oral care every shift and prn
E. Clamp the NG while the client ambulates to the bathroom |
|
Definition
A. Include NG drainage as part of the client’s output.
B. Irrigate the NG with 20 ml NS every 2 hours as ordered.
C. Assess the client’s bowel sounds every shift and prn
D. Provide oral care every shift and prn
E. Clamp the NG while the client ambulates to the bathroom |
|
|
Term
A client admitted to the hospital is diagnosed with a small bowel obstruction. Which of the following is not an expected assessment finding for this diagnosis?
A. The vomitus is more than 500 ml and has a fecal odor.
B. The client’s abdominal pain is persistent and colicky.
C. The client states the pain is improved after vomiting.
D. The client’s abdomen is firm, rigid, and has positive rebound tenderness |
|
Definition
| D. The client’s abdomen is firm, rigid, and has positive rebound tenderness |
|
|
Term
A client admitted to the hospital is diagnosed with a small bowel obstruction. The nurse should validate the primary care provider is aware of which of the following findings? (select all that apply)
A. The client reports symptoms of abdominal pain rated at 7/10.
B. The client has a profuse emesis prior to insertion of the NG tube.
C. The client’s urine specific gravity reading is 1.040 and hematocrit is 60%
D. The client’s serum potassium is 3.0 mEq/L
E. The client’s oral temperature is 38.5’ C (99.5’F) and WBC is 1`0,000 mm3 |
|
Definition
C. The client’s urine specific gravity reading is 1.040 and hematocrit is 60%
D. The client’s serum potassium is 3.0 mEq/L |
|
|
Term
| What are the Diseases of the Anorectum? |
|
Definition
Anal fistulas and fissures
Hemorrhoids
Sexually transmitted anorectal diseases
Pilonidal cysts |
|
|
Term
| What is not allowed in the Celiac diet? |
|
Definition
|
|
