NURS 3212 Exam 3 Test Questions Marking Scheme Current Update

NURS 3212 Exam 3 Test Questions Marking Scheme Current Update What is the most common cause of PUD? - Answers - H. pylori What should be limited/avoided with GERD? - Answers - - tight clothing - spicy foods - citric/acidic foods - caffeine - NSAIDs - lying down after eating - fatty foods - carbonated drinks What is Zollinger-Ellison syndrome? - Answers - condition where tumors form in the pancreas and cause the stomach to produce too much acid What are some risk factors for GERD? - Answers - - family hx - obesity - smoking - stress - pregnancy - H. pylori - NG tube - hiatal hernia What is the diagnostic test for GERD? - Answers - There are no definitive tests, dx is based on hx and clinical symptoms Your patient is scheduled for a barium swallow test. What are the correct nursing interventions? a. Make sure their breakfast tray has lots of protein b. keep them NPO after midnight c. administer anti-diarrheal d. educate them on how to change the dressing - Answers - B, they need to be NPO after midnight and you should encourage fluids and laxatives to prevent constipation. Barium swallow is noninvasive and will not require a dressing A pt comes in complaining of intense retrosternal pain. Your first thought is heart attack but the troponin levels are normal. What may be the cause of their pain? - Answers - GERD What is the first thing you should do for a pt with GERD? - Answers - raise the HOB, if in a home setting place blocks under the mattress What pt teaching should you do over GERD? - Answers - - elevate HOB - stay upright after eating/don't eat before bed - eat 6 small meals a day - quit smoking - avoid tight clothes - limit/avoid irritating food/drink T/F An expected nursing intervention after a Stretta procedure and bariatric surgery is inserting an NG tube - Answers - False, an NG tube should not be inserted for a month after the procedure an NG tube may already be inserted for bariatric surgeries but it should not be repositioned because it can bust the sutures What are the risk factors of PUD? - Answers - NSAIDs, family hx, H. pylori, and Zollinger-ellison syndrome, stress, smoking and alcohol A patient reports hematemesis and weight loss due to gnawing and sharp abdominal pain that starts about 30 minutes after they eat. What do you suspect is wrong? - Answers - They have a gastric ulcer Is melena (dark sticky/tarry stools) more common in gastric or duodenal ulcers? - Answers - duodenal A pt reports weight gain, pain during the night that is relieved by eating, and a burning sensation 2 hours after a meal. What do you suspect is the problem? - Answers - duodenal ulcer What is the post-op care specific to patients getting a procedure for PUD? - Answers - - fowler's position - NPO 1-3 days post op until peristalsis returns - monitor bowel sounds You are performing an abdominal assessment on a pt with a hx of PUD, they are experiencing sudden pain with a rigid/hard stomach. What do you suspect has happened? - Answers - An ulcer caused a perforation What surgical procedures are interventions for PUD? - Answers - - total gastrectomy - vagotomy - gastric resection - biliroth 1 & 2 - pyloroplasty T/F You just received a transfer from the ED, 22 yr old was in major motor vehicle accident. The HCP has put in an order for IV PPI. You need to hold the med and contact the HCP because this dangerously increases the risk of bleeding after trauma. - Answers - False, IV PPIs are recommended for patients experiencing major trauma or surgery to decrease the risk of stress ulcers T/F melena can occur with gastric and duodenal ulcers - Answers - True, but it more common in duodenal ulcers What is a urea breath test used for? - Answers - to detect presence of H. pylori What is the best way to diagnose PUD? - Answers - esophagogastroduodenoscopy (EGD) What medications would you expect a pt with H. pylori to be on? - Answers - PPI (lansoprazole, omeprazole, rabeprazole, pantoprazole, or esomeprazole) and 2 antibiotic s(metronidazole, tetracycline, amoxicillin, and/or clarithromycin) What dietary modifications should be made to help avoid dumping syndrome? - Answers - - eat more protein - eat more complex carbs - avoid fatty foods - avoid dairy - avoid sweets - avoid drinking with/30 minutes after meals What are the symptoms of dumping syndrome? - Answers - - weakness - dizziness/vertigo - diaphoresis - tachycardia - abd cramping - epigastric fullness What pt education should be given for management of dumping syndrome? - Answers - - eat 6 small meals a day - chew thoroughly - avoid sweets, dairy, salt and fatty foods - eat more protein - *lie down after eating* - don't drink with meals