NUR426 Exam 3 Study Guide UPDATED ACTUAL Questions
and CORRECT Answers
common lab/diagnostic test for GI disorders -Abdominal ultrasonography
-Barium swallow, small bowel series
-Bloodwork: Amylase, electrolytes, lipase, LFTs
-Esophageal manometry/esophageal pH probe
-Endoscopy (gastroscopy, colonoscopy)
-Hemoccult, stool sample/culture, stool O&P
-Hepatobiliary (HIDA) scan
-Liver biopsy
-Lactose tolerance test, urea breath test
Esophageal manometry - thin, pressure-sensitive tube is passed into the esophagus. As the client
swallows, the tube measures the pressure of the muscle contractions. This test is
used to determine the cause of dysphagia, to evaluate for signs of GERD, or when
there is chest pain that may be coming from the esophagus.
Hepatobiliary (HIDA) scan In a HIDA scan, radioactive material is injected into the venous system for
example, in a vein in the arm, and the
material will travel to the liver and through the biliary system, and this will allow
the hepatobiliary system to be visualized.
Mild dehydration Alert
Soft & flat fontanels
Normal eyes
Pink & moist oral mucosa
Elastic skin turgor
Normal HR & BP
Warm, pink extremities, brisk capillary refill
Urine output may be slightly decreased
Moderate dehydration Alert to listless
Sunken fontanels
Mildly sunken orbits
Pale and slightly dry oral mucosa
Decreased skin turgor
HR may be increased
Normal BP
Delayed capillary refill
Urine output < 1 mL/kg/h
, Severe dehydration Alert to comatose
Sunken fontanels
Deeply sunken orbits
Dry oral mucosa
Tenting
Increased HR, progressing to bradycardia
Normal BP, progressing to hypotension
Cool, mottled, or dusky extremities, significantly delayed capillary refill
Urine output significantly < 1 mL/kg/h
appendicitis patho obstruction of the appendix lumen
nursing care for appendicitis Pre-op:
-Maintain NPO status
-Monitor vitals and abdominal exam
-Administer IV fluids and prescribed antibiotics
Post-op:
-Monitor incision or laparoscopic sites for infection
-Assess bowel sounds and function
-Manage pain
-Encourage ambulation
-Advance diet slowly
-Educate on avoiding strenuous activity until cleared
s/s of appendicitis -periumbilical or diffuse abdominal pain (RLQ) at McBurney's point
-anorexia
-N/V
-low-grade fever
-rebound tenderness
-guarding and rigidity
-pain worsens with movement or coughing
appendicitis tx -surgical removal
-if ruptured: delay surgery until infection controlled
appendicitis diagnostic testing -lab test (increased WBC count, mild increase in C-reactive protein
-Abdominal ultrasound
-CT scan
-Urinalysis (to rule out UTI or kidney stones)
risk factors of appendicitis -Age: most common between 10-30 years
-Family hx of appendicitis
-Low-fiber diet
-GI infections that cause lymphoid hyperplasia
-Male sex
Intussusception patho telescoping of one portion of the intestine into another (usually the ileum into the
cecum
and CORRECT Answers
common lab/diagnostic test for GI disorders -Abdominal ultrasonography
-Barium swallow, small bowel series
-Bloodwork: Amylase, electrolytes, lipase, LFTs
-Esophageal manometry/esophageal pH probe
-Endoscopy (gastroscopy, colonoscopy)
-Hemoccult, stool sample/culture, stool O&P
-Hepatobiliary (HIDA) scan
-Liver biopsy
-Lactose tolerance test, urea breath test
Esophageal manometry - thin, pressure-sensitive tube is passed into the esophagus. As the client
swallows, the tube measures the pressure of the muscle contractions. This test is
used to determine the cause of dysphagia, to evaluate for signs of GERD, or when
there is chest pain that may be coming from the esophagus.
Hepatobiliary (HIDA) scan In a HIDA scan, radioactive material is injected into the venous system for
example, in a vein in the arm, and the
material will travel to the liver and through the biliary system, and this will allow
the hepatobiliary system to be visualized.
Mild dehydration Alert
Soft & flat fontanels
Normal eyes
Pink & moist oral mucosa
Elastic skin turgor
Normal HR & BP
Warm, pink extremities, brisk capillary refill
Urine output may be slightly decreased
Moderate dehydration Alert to listless
Sunken fontanels
Mildly sunken orbits
Pale and slightly dry oral mucosa
Decreased skin turgor
HR may be increased
Normal BP
Delayed capillary refill
Urine output < 1 mL/kg/h
, Severe dehydration Alert to comatose
Sunken fontanels
Deeply sunken orbits
Dry oral mucosa
Tenting
Increased HR, progressing to bradycardia
Normal BP, progressing to hypotension
Cool, mottled, or dusky extremities, significantly delayed capillary refill
Urine output significantly < 1 mL/kg/h
appendicitis patho obstruction of the appendix lumen
nursing care for appendicitis Pre-op:
-Maintain NPO status
-Monitor vitals and abdominal exam
-Administer IV fluids and prescribed antibiotics
Post-op:
-Monitor incision or laparoscopic sites for infection
-Assess bowel sounds and function
-Manage pain
-Encourage ambulation
-Advance diet slowly
-Educate on avoiding strenuous activity until cleared
s/s of appendicitis -periumbilical or diffuse abdominal pain (RLQ) at McBurney's point
-anorexia
-N/V
-low-grade fever
-rebound tenderness
-guarding and rigidity
-pain worsens with movement or coughing
appendicitis tx -surgical removal
-if ruptured: delay surgery until infection controlled
appendicitis diagnostic testing -lab test (increased WBC count, mild increase in C-reactive protein
-Abdominal ultrasound
-CT scan
-Urinalysis (to rule out UTI or kidney stones)
risk factors of appendicitis -Age: most common between 10-30 years
-Family hx of appendicitis
-Low-fiber diet
-GI infections that cause lymphoid hyperplasia
-Male sex
Intussusception patho telescoping of one portion of the intestine into another (usually the ileum into the
cecum
