NR 324 Adult Health I Final Exam Questions and Correct Answers, 2024/2025, Updated 100% Correct.

NR 324 Adult Health I Final Exam Questions and Correct Answers, 2024/2025, Updated 100% Correct. gastric lavage instillation of meds to help neutralize what is in the stomach and withdrawal of stomach contents with an NG tube, usually done if someone ingested a toxic amount of medication GERD (gastroesophageal reflux disease) Syndrome with chronic symptom of mucosal damage caused by a reflux of stomach acid into the lower esophagus Diagnosed by symptoms Causes of GERD obesity smoking hiatal hernia alcohol chocolate theobromine anticholinergics beta blockers calcium channel blockers diazepam morphine nitrates progesterone theophylline fatty foods pepper/spearmint caffeine Manifestations of GERD heartburn (pyrosis) chest pain mimicking angina dyspepsia, regurgitation wheezing coughing dyspnea disturbed sleep hoarseness sore throat globus sensation hypersalivation choking Complications of GERD esophagitis Barrett's esophagus (esophageal metaplasia) increased risk for esophageal cancer cough bronchospasm laryngospasm asthma chronic bronchitis pneumonia dental erosion Teaching for GERD Elevate HOB 30 degrees (4-6 blocks) Do not lay supine for 2-3 hours after a meal Stop smoking, avoid alcohol, and caffeinated beverages Low-fat diet with small, frequent meals Don't wear tight clothes around the waist or bend over Weight loss strategies Melena black tarry stool associated with upper GI bleed Teach to avoid OTC meds Patient teaching for gastritis Maintain non-irritating diet of 6 small meals a day Increase exercise to reduce stress Take H2 receptor blockers or proton pump inhibitors Avoid: alcohol, NSAIDs, stress, aspirin, smoking, milk What is the priority manifestation of peptic ulcer disease? Hematemesis - massive internal bleeding, projectile vomiting of blood Perform focused assessment and assess pt status What are the signs of peptic ulcer perforation? (SATA) Sudden, severe generalized upper abdominal pain that quickly spreads through the abdomen with radiation to back and shoulders Guarding of the abdomen (board-like, rigid abdomen) Shallow, rapid respirations Weak, rapid heart rate Bowel sounds usually absent Possible nausea and vomiting Nursing management for chronic gastritis Maintain 6 small nonirritating meals a day to avoid upset Corticosteroids are associated with peptic ulcers because? The rate of mucous cell renewal is decreased What is the rationale for treating acute exacerbation of peptic ulcers with an NG tube? Remove stimulation of HCl acid and pepsin secretion by keeping stomach empty (continuous aspiration and gastric decompression) What are the uses of antacids? (SATA) Neutralize HCL in the stomach Provide quick short-lived relief of heartburn May be given hourly in acute GI bleeding Which meds decrease gastric or HCI secretion? (SATA) Famotidine Omeprazole Misoprostol Teaching has been effective for peptic ulcer disease when the pt states what? "I have learned some relaxation strategies that decrease my stress." In acute exacerbation of peptic ulcers, what do you do first? Assess pt VS and abdomen What are the nursing interventions for enteral feeding? Enteral feedings usually through an NG or PEG tube Flush tube with 30 mL of tap water every 4 hours during continuous feedings or before and after each bolus feeding Flush tubes between each medication and after all medications are given If a person is severely immunocompromised, you may have to use sterile water to flush the tube How much gastric residual volume is too much in enteral feedings? Close to 200 mL - hold feeding Depends on facility What are the different types of formulas for feeding? Canned or Carton formulas Must clean the top of cans with alcohol before opening What are adverse effects of Ambien (Zolpidem)? daytime drowsiness dizziness agitation amnesia behavior changes sleep-walking hallucinations blurred vision double vision diarrhea nausea vomiting anaphylaxis dependence Sometimes given with IBD/IBS because these conditions can cause insomnia or anxiety Don't give too late at night because it can cause drowsiness the next day A patient has UC and anemia, what are some complications that can occur? Anemia is a complication due to chronic blood loss Others: increased incidence of colorectal cancer Increased incidence and severity of C. diff infection Perforation Toxic megacolon Strictures Rapid weight loss Tachycardia Dehydration What is the priority action for acute exacerbation of UC? Fluids and electrolytes Similarities in UC and Crohn's Do not require frequent surgeries, usual age of onset is teens to mid-30s or after 60, abdominal pain, diarrhea, rectal bleeding, increased incidence and severity of C. diff infection, perforation common Differences in UC and Crohn's UC: Fever only during acute attacks Minimal malabsorption/nutritional deficiencies Tenesmus is common Weight loss rare Location: usually in rectum and in continuous pattern up the colon Involves only the superficial bowel mucosa Areas of inflammation are continuous Toxic megacolon common Crohn's: Malabsorption and nutritional deficiencies are common Tenesmus is rare Weight loss common Abdominal pain Location: occurs anywhere along the GI tract, but the most common site is distal ileum Cobblestone pattern of the mucosa and healthy tissue is interspersed with areas of inflammation (skip lesions/segmented) Involves the entire thickness of the bowel Perianal abscess and fistulas common Toxic megacolon rare What is the priority action for IBS? Develop a trusting relationship with the patient to provide symptomatic care because there is no cure A 20 yo with Crohn's comes in with persistent diarrhea. What are characteristics of Crohn's? Weight loss Abdominal pain Segmented distribution Thickening of wall Other characteristics: cobblestone appearance, strictures, fistulas, diarrhea, cramping, rectal bleeding may occur What lab findings are expected with UC due to diarrhea and vomiting? Decreased Na, K, Mg, Cl, HCO3 Hypoalbuminemia (decreased albumin) from protein loss For those with IBD, which tx would be used to rest the bowel? (SATA) NPO IV fluids NG suction Liquid enteral feedings or parenteral nutrition What is the purpose of vitamin B12 and iron injections in IBD patients? Correct malnutrition What is a volvulus? Abnormal twisting of the bowel What is a nursing intervention for a pt with small intestinal obstruction with NG tube?