N201 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS GRADED A++

N201 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS GRADED A++ S+S of left sided colon cancer (descending) —Alternating constipation & diarrhea —Rectal bleeding —Narrow, ribbon-like stool —Incomplete evacuation sensation —Lumen is smaller on L therefore obstruction occurs sooner S+S of right sided colon cancer (ascending) often asymptomatic Vague abd discomfort or cramping, colicky-like pain Weakness & fatigue from iron deficiency anemia Diagnostic tests for colorectal cancer Family History FIT test Colonoscopy Sigmoidoscopy Serum Tumor markers Right hemicolectomy Laparoscopic sx for CA in the cecum, ascending colon or transverse colon Left hemicolectomy Laparoscopic sx for CA in left transverse colon, descending, sigmoid, or upper rectum Goal of ERAS —reduce the bodies stress response to surgery and support organ function therefore improving post operative outcomes ERAS (pre-op and peri-op) protocols No bowel prep or limited prep Carbohydrate load & no pre-op fasting Thoracic epidural & spinal anesthesia Warming patient 1 hour prior to OR Laparoscopic approach ERAS post op protocols —Early mobilization —Non-opioid analgesia —Resume oral intake early —Gum chewing —Early removal of Foley —Monitor fluid balance diverticulum an outpouching of the mucosa through circular smooth muscle of the intestinal wall. Occur at any point in the GI tract (commonly in sigmoid colon) S+S of diverticulitis Often asymptomatic Crampy, abdominal pain in left lower quadrant Pain relieved by passing flatus or having a BM Anorexia Chills Constipation alternating with Diarrhea diagnostic tests for diverticulitis —Abdominal X-ray —CBC —CT scan with oral contrast * —Urinalysis and fecal occult blood —Barium enema —Colonoscopy interventions for diverticulitis Treated medically with high fiber diet, bulk laxatives, pain medication, & antibiotics Post op GI surgery concerns Atelectasis, pain, fluid and electrolyte imbalance, intra-abdominal infection, paralytic ileus mechanical bowel obstruction occlusion of the lumen from adhesions, hernias or c