NUR 265
FINAL EXAM STUDY GUIDE
Medical-Surgical Nursing
Galen College of Nursing
, Exam 4
GI
GI Assessment:
-Inspect, auscultate(bowl sounds/ check all quadrants) and
-palpate (do not do deep palpation-assess for pain and what it may feel like),
-psychosocial assessment because of body image of the s/s such as farting (smell)
Drugs used for GI
Antimicrobials: take with food and no alcohol
PPI: decrease acid productions
Mucosal barriers: suppress h pylori and assist in healing mucosal lesions
Antiacids: buffer stomach acids
Imaging: CT, MRI, Endo, KUB (kidney, ureter, and bladder x-ray), US, barium contrast
enema (thick contrast: makes pt. constipation push fluids and ambulate) endoscopy. EGD,
ultra sound, colonscopy
GERD: smoking, obesity, diet, stress, NGT insertion, hiatal hernia, medication
:effect the sphincter, there’s a back flow and goes back into the esophagus
Cause: gastric distention (over eating), eating something that is over carbonated,
prolonged vomiting, obesity (pressure from the stomach), acidic foods
-S/S: dyspepsia(indigestion), coughing, hoarseness, wheezing (not expected
finding-aspiration warning sign)
-Complications: erosion, aspiration, cancer, structure (narrow of the esophagus:
food could get stuck) dental decay
-Tx: PPI (p for protonts), H2, diet changes, lifestyle changes, decrease weight
Hiatal Hernia: diaphragm weakness, obesity, lifting, over-eating
-S/S: fullness, dyspepsia, GERD S/S, discomfort, feel like they can’t breathe
(small stomach above)
-Tx: PPI, H2, small frequent meals, HOB elevated, lay on right side, sit up after
eating, surgery, lifestyle changes, remain upright after meals
Gastritis: inflammation of the stomach
-Causes: H. pylori, Aspirins, NSAIDS, smoking, ETOH, poisons, caffeine
, -S/S: epigastric fullness, anorexia (b/c it doesn’t feel good to eat, abdominal pain,
melena (dark stool), increase food pain, some bleeding in stool (occult blood)
Complication: frank bleeding
-Tx: antibiotics, PPI, mucosal barriers, lifestyle changes
Peptic Ulcer Disease: ulcer in stomach (break in mucosal barrier or stomach lining)
-Causes: stress, smoking, H. pylori, Aspirins, NSAIDS
-S/S: N/V, abdomen pain (with or without eating) GI bleed, hematemesis
(vomiting blood), melena (dark stool)
-Gastric: weight loss (anorexia), food increase pain (30 mins after
meals)
-Duodenal: well nourished, food decreases pain (2-3 hours after meals)
Complication: frank blood/ coffee ground emesis= upper GI bleed/ CRISIS
Assess the individuals with acute symptoms, assess s/s of hypovolemia –
tachycardia, low bp, syncopey, weakness) Peritonitis rigidity
-Tx: antibiotics, PPI, H2, IVF, increase fluids, mucosal barriers, diet, monitor
H/H (b/c increased risk of bleeding), severe: removal of stomach
-Hemoglobin: M 14-18, F 12-16
-Hematocrit: M 42-52%, F37-47%
-electrolytes imbalance especially w/ diarrhea
-Complications: GI bleed, coffee ground emesis (CRITICAL CALL MD STAT)
Gastric Surgery:
-B12 supplement (sub q injections)
-semi-fowlers position
-NGT: surgery (do not manipulate)
-measure I&O’s
-flush tubing 20-30 mL with water
-Whipple
NGT: monitor electrolytes (metabolic alkalosis), do not lay patient flat, high risk
for GERD,
-Stoma: redness and beefy
-No good: black, purple, or white,
-Ileostomy: small bowels
-No enteric coated medication
Assessment post op: are you passing gas, NPO until patient has bowl sounds.
FINAL EXAM STUDY GUIDE
Medical-Surgical Nursing
Galen College of Nursing
, Exam 4
GI
GI Assessment:
-Inspect, auscultate(bowl sounds/ check all quadrants) and
-palpate (do not do deep palpation-assess for pain and what it may feel like),
-psychosocial assessment because of body image of the s/s such as farting (smell)
Drugs used for GI
Antimicrobials: take with food and no alcohol
PPI: decrease acid productions
Mucosal barriers: suppress h pylori and assist in healing mucosal lesions
Antiacids: buffer stomach acids
Imaging: CT, MRI, Endo, KUB (kidney, ureter, and bladder x-ray), US, barium contrast
enema (thick contrast: makes pt. constipation push fluids and ambulate) endoscopy. EGD,
ultra sound, colonscopy
GERD: smoking, obesity, diet, stress, NGT insertion, hiatal hernia, medication
:effect the sphincter, there’s a back flow and goes back into the esophagus
Cause: gastric distention (over eating), eating something that is over carbonated,
prolonged vomiting, obesity (pressure from the stomach), acidic foods
-S/S: dyspepsia(indigestion), coughing, hoarseness, wheezing (not expected
finding-aspiration warning sign)
-Complications: erosion, aspiration, cancer, structure (narrow of the esophagus:
food could get stuck) dental decay
-Tx: PPI (p for protonts), H2, diet changes, lifestyle changes, decrease weight
Hiatal Hernia: diaphragm weakness, obesity, lifting, over-eating
-S/S: fullness, dyspepsia, GERD S/S, discomfort, feel like they can’t breathe
(small stomach above)
-Tx: PPI, H2, small frequent meals, HOB elevated, lay on right side, sit up after
eating, surgery, lifestyle changes, remain upright after meals
Gastritis: inflammation of the stomach
-Causes: H. pylori, Aspirins, NSAIDS, smoking, ETOH, poisons, caffeine
, -S/S: epigastric fullness, anorexia (b/c it doesn’t feel good to eat, abdominal pain,
melena (dark stool), increase food pain, some bleeding in stool (occult blood)
Complication: frank bleeding
-Tx: antibiotics, PPI, mucosal barriers, lifestyle changes
Peptic Ulcer Disease: ulcer in stomach (break in mucosal barrier or stomach lining)
-Causes: stress, smoking, H. pylori, Aspirins, NSAIDS
-S/S: N/V, abdomen pain (with or without eating) GI bleed, hematemesis
(vomiting blood), melena (dark stool)
-Gastric: weight loss (anorexia), food increase pain (30 mins after
meals)
-Duodenal: well nourished, food decreases pain (2-3 hours after meals)
Complication: frank blood/ coffee ground emesis= upper GI bleed/ CRISIS
Assess the individuals with acute symptoms, assess s/s of hypovolemia –
tachycardia, low bp, syncopey, weakness) Peritonitis rigidity
-Tx: antibiotics, PPI, H2, IVF, increase fluids, mucosal barriers, diet, monitor
H/H (b/c increased risk of bleeding), severe: removal of stomach
-Hemoglobin: M 14-18, F 12-16
-Hematocrit: M 42-52%, F37-47%
-electrolytes imbalance especially w/ diarrhea
-Complications: GI bleed, coffee ground emesis (CRITICAL CALL MD STAT)
Gastric Surgery:
-B12 supplement (sub q injections)
-semi-fowlers position
-NGT: surgery (do not manipulate)
-measure I&O’s
-flush tubing 20-30 mL with water
-Whipple
NGT: monitor electrolytes (metabolic alkalosis), do not lay patient flat, high risk
for GERD,
-Stoma: redness and beefy
-No good: black, purple, or white,
-Ileostomy: small bowels
-No enteric coated medication
Assessment post op: are you passing gas, NPO until patient has bowl sounds.
