NSG 123 Medical Surgical Nursing Exam
2 QUESTIONS WITH ANSWERS
HERZING UNIVERSITY GRADED A 100%
VERIFIED
Main Cause Of Cholelithiasis - ANSWER-
Cholesterol Stones Account For Most Of The
Remaining 75% Of Cases Of Gallbladder Disease In
The United States.
Symptoms Of Cholelithias - ANSWER-Nausea
Vomiting
Right Upper Quadrant Abdominal Pain Or Epigastric
Pain That Radiates To The Right Shoulder
Especially After Meals When The Gallbladder Is
Stimulated To Release Bile.
Patient Teaching For Cholelithiasis - ANSWER-The
Diet Immediately After An Episode Is Usually Low-
Fat Liquids. These Can Include Powdered
Supplements High In Protein And Carbohydrate
Stirred Into Skim Milk.
,Purpose Of Medication In Cholelithiasis - ANSWER-
Purpose Of Medications: Reduces Hepatic
Production Of Cholesterol.
Lowers The Cholesterol Content Of Bile, Which In
Turn Facilitates The Gradual Dissolution Of
Cholesterol Gallstones.
Examples : Chenodiol (Chenodal, Chenix) Is A
Naturally Occurring Bile Acid .
Purpose Of Adding Fat To Emulsion To TPN -
ANSWER-Fat Emulsions (Lipids) Are Usually Given
To Clients Receiving TPN To Provide Supplemental
Kilocalories And Prevent Fatty Acid
Fat Emulsions Can Also Control Hyperglycemia
During Periods Of Stress.
Carbon Dioxide In Laparoscopic Cholecystectomy -
ANSWER-Carbon Dioxide Is Used During The
Procedure
Explain To The Patient That They Might Feel Pain In
The Right Shoulder Or Scapular Area (From
Migration Of The Carbon Dioxide Used To Insufflate
The Abdominal Cavity During The Procedure).
Laparoscopic Colecystectomy 3 Things To Do After -
ANSWER-Recommend A Heating Pad For 15 To 20
Minutes Hourly Or
,Encourage The Client To Ambulate Frequently To
Reduce The Bloating.
Manage Nausea Assess Bowel Sounds For Further
Complications.
Preoperative Assessment For Open
Cholecystectomy - ANSWER-Priority Assessment
Should Focus On The Client's Respiratory Status.
If A Traditional Surgical Approach Is Planned, The
High Abdominal Incision Required During Surgery
May Interfere With Full Respiratory Excursion.
The Nurse Notes A History Of Smoking, Previous
Respiratory Problems, Shallow Respirations, A
Persistent Or Ineffective Cough, And The Presence
Of Adventitious Breath Sounds.
CBC And BMP Should Also Be Assessed
4 Postoperative Complications Of Cholecystostomy -
ANSWER-After These Surgical Procedures, The
Client Is Observed For Indications Of Infection,
Leakage Of Bile Into The Peritoneal Cavity, And
Obstruction Of Bile Drainage.
If Bile Is Not Draining Properly, An Obstruction Is
Probably Causing Bile To Be Forced Back Into The
Liver And Bloodstream.
Because Jaundice May Result, The Nurse Should
Assess The Color Of The Sclerae. Yellow-Colored
Sclerae Or Skin Can Indicate Jaundice.
, Clay-Colored Stool Should Be Reported As This
Indicates A Complication.
Discharge Teaching For Open Cholecystectomy -
ANSWER-Usually, Only A Small Amount Of
Serosanguineous Fluid Drains In The Initial 24
Hours After Surgery; Afterward, The Drain Is
Removed.
The Drain Is Typically Maintained If There Is Excess
Oozing Or Bile Leakage.
Empty The Drainage Bag Attached At Least Every 8
Hours And As Needed, To Prevent Reflux Back Into
The Bile Duct.
Take Showers Not Baths To Prevent Infection Of
The Incision Site.
Bolus Vs. Cyclic Feeding - ANSWER-Bolus
Feedings Are Administered Into The Stomach In
Large Amounts And At Designated Intervals. Cyclic
Feedings Are Periodic Feedings Given Over A Short
Period Of Time
Complication Of UC - ANSWER-Toxic Megacolon
The Inflammatory Process Extends Into The
Muscularis, Inhibiting Its Ability To Contract And
Resulting In Colonic Distention. Symptoms Include
Fever, Abdominal Pain And Distention, Vomiting,
And Fatigue. If The Patient With Toxic Megacolon
Does Not Respond Within 72 Hours To Medical
2 QUESTIONS WITH ANSWERS
HERZING UNIVERSITY GRADED A 100%
VERIFIED
Main Cause Of Cholelithiasis - ANSWER-
Cholesterol Stones Account For Most Of The
Remaining 75% Of Cases Of Gallbladder Disease In
The United States.
Symptoms Of Cholelithias - ANSWER-Nausea
Vomiting
Right Upper Quadrant Abdominal Pain Or Epigastric
Pain That Radiates To The Right Shoulder
Especially After Meals When The Gallbladder Is
Stimulated To Release Bile.
Patient Teaching For Cholelithiasis - ANSWER-The
Diet Immediately After An Episode Is Usually Low-
Fat Liquids. These Can Include Powdered
Supplements High In Protein And Carbohydrate
Stirred Into Skim Milk.
,Purpose Of Medication In Cholelithiasis - ANSWER-
Purpose Of Medications: Reduces Hepatic
Production Of Cholesterol.
Lowers The Cholesterol Content Of Bile, Which In
Turn Facilitates The Gradual Dissolution Of
Cholesterol Gallstones.
Examples : Chenodiol (Chenodal, Chenix) Is A
Naturally Occurring Bile Acid .
Purpose Of Adding Fat To Emulsion To TPN -
ANSWER-Fat Emulsions (Lipids) Are Usually Given
To Clients Receiving TPN To Provide Supplemental
Kilocalories And Prevent Fatty Acid
Fat Emulsions Can Also Control Hyperglycemia
During Periods Of Stress.
Carbon Dioxide In Laparoscopic Cholecystectomy -
ANSWER-Carbon Dioxide Is Used During The
Procedure
Explain To The Patient That They Might Feel Pain In
The Right Shoulder Or Scapular Area (From
Migration Of The Carbon Dioxide Used To Insufflate
The Abdominal Cavity During The Procedure).
Laparoscopic Colecystectomy 3 Things To Do After -
ANSWER-Recommend A Heating Pad For 15 To 20
Minutes Hourly Or
,Encourage The Client To Ambulate Frequently To
Reduce The Bloating.
Manage Nausea Assess Bowel Sounds For Further
Complications.
Preoperative Assessment For Open
Cholecystectomy - ANSWER-Priority Assessment
Should Focus On The Client's Respiratory Status.
If A Traditional Surgical Approach Is Planned, The
High Abdominal Incision Required During Surgery
May Interfere With Full Respiratory Excursion.
The Nurse Notes A History Of Smoking, Previous
Respiratory Problems, Shallow Respirations, A
Persistent Or Ineffective Cough, And The Presence
Of Adventitious Breath Sounds.
CBC And BMP Should Also Be Assessed
4 Postoperative Complications Of Cholecystostomy -
ANSWER-After These Surgical Procedures, The
Client Is Observed For Indications Of Infection,
Leakage Of Bile Into The Peritoneal Cavity, And
Obstruction Of Bile Drainage.
If Bile Is Not Draining Properly, An Obstruction Is
Probably Causing Bile To Be Forced Back Into The
Liver And Bloodstream.
Because Jaundice May Result, The Nurse Should
Assess The Color Of The Sclerae. Yellow-Colored
Sclerae Or Skin Can Indicate Jaundice.
, Clay-Colored Stool Should Be Reported As This
Indicates A Complication.
Discharge Teaching For Open Cholecystectomy -
ANSWER-Usually, Only A Small Amount Of
Serosanguineous Fluid Drains In The Initial 24
Hours After Surgery; Afterward, The Drain Is
Removed.
The Drain Is Typically Maintained If There Is Excess
Oozing Or Bile Leakage.
Empty The Drainage Bag Attached At Least Every 8
Hours And As Needed, To Prevent Reflux Back Into
The Bile Duct.
Take Showers Not Baths To Prevent Infection Of
The Incision Site.
Bolus Vs. Cyclic Feeding - ANSWER-Bolus
Feedings Are Administered Into The Stomach In
Large Amounts And At Designated Intervals. Cyclic
Feedings Are Periodic Feedings Given Over A Short
Period Of Time
Complication Of UC - ANSWER-Toxic Megacolon
The Inflammatory Process Extends Into The
Muscularis, Inhibiting Its Ability To Contract And
Resulting In Colonic Distention. Symptoms Include
Fever, Abdominal Pain And Distention, Vomiting,
And Fatigue. If The Patient With Toxic Megacolon
Does Not Respond Within 72 Hours To Medical
