NUR 2349: Professional Nursing I Exam 2 Study Guide

Exam 2 Study Guide
NUR 2349: Professional Nursing I


MODULE 3: ELIMINATION
GI Elimination (Chapters 52 & 55-57):
 Assessment techniques
o Start at RUQ
o Inspection, auscultation, palpation
 Do NOT palpate if appendicitis or abdominal aneurysm is
suspected.
o Percussion and deep palpation: APRN’s & HCP’s
 Diagnostics (labs, endoscopy, ERCP, etc.)
o Labs
 CBC
 PT, LFT’’s, bilirubin, & ammonia
 Renal panel
 Amylase/Lipase
 Urine tests
 Stool tests
 Guiac fecal occult blood test (gFOBT)
 Fecal immunochemical test (FIT)
 Fecal Analysis
o Imaging
 X-rays
 Double-contrast barium enema
 CT scan or MRI
 Endoscopy
 Esophagogastroduodenoscopy (EGD)
 Endoscopic retrograde cholangiopancreatography (ERCP)
 Colonoscopy
 Ultrasound

 Disease processes (Gastritis, PUD, Bowel obstruction, colorectal cancer, Crohn’s
disease, UC, IBS, appendicitis, etc.)
o Gastritis – inflammation of gastric mucosa
 Health Promotion & Maintenance
 Balanced diet:
o Limit caffeine
o Limit acidic foods
o Small, frequent meals
o Avoid alcohol or tobacco
 Regular exercise
 Stress-reduction
 Avoid excessive use of aspirin, NSAIDs.
 Diagnosis:
 EGD w/ biopsy *gold standard*

,  Cytologic examination (of biopsy): r/o gastric CA
 Rapid urease testing: H. pylori
 Interventions
 Symptom relief
 Elimination of causative agents (NSAID’s, H. pylori)
 Fluid/blood replacement (for active bleeding)
 Medications:
o H2-receptor antagonists: Pepcid/Famotidine
o Proton Pump inhibitors: Omeprazole/Prilosec &
Pantoprazole/Protonix
o Vitamin B12 (chronic)
 Teaching!
o Diet, stress reduction, NSAID’s
o Peptic Ulcer Disease – PUD – mucosal lesion of stomach or duodenum
 Rigid abdomen w/rebound tenderness = perforation into peritoneal
cavity!!
 Interventions
 Pain management
 Bland diet w/ small, frequent meals
 Medications (same as gastritis): PPI, H2-receptor
antagonists, & antacids
o Pepto-bismol: inhibhts H. pylori from binding to
mucosal lining
 H. pylori treatment:
o PPI + 2 Antibiotics (flagyl, & tetracycline OR
clarithromycin & amoxicillin) x 10-14d
 CAM:
o Herbal supplements
o Relaxation techniques
o Intestinal obstruction
 Nursing Interventions:
 Pain management - opioids
 NPO/Ice chips
 NGT placement – low continuous suction
 IVF replacement
 Daily weights
 Monitor VS & lab values
 Surgical Interventions:
 Exploratory laparotomy
 Adhesion lysis, embolectomy, &/or colon resection w/
colostomy
o Colorectal Cancer
 Interventions
 Pain management
 Treat hemorrhage (if present)
 TNM Staging (tumor, nodes, metastasis)
 Radiation