NUR 2349: Professional Nursing I Exam 2 Study Guide
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
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
