HURST EVALUATION QUESTIONS AND ANSWERS
SURE A+
✔✔LETS GET NORMAL STRAIGHT FIRST!
protein -----> breaks down _____________- ----> the LIVER converts ammonia to
____________ ------> KIDNEYS excrete to the urea - ✔✔- ammonia
- urea
✔✔peptic ulcers - ✔✔- common cause of gi bleeding
- erosion is present
✔✔what are the s/s of peptic ulcers? - ✔✔- burning pain usually mid gastric
- heart burn ( dyspepsia)
✔✔another word for heartburn? - ✔✔- dyspepsia
✔✔what does the diagnosis show when dealing with peptic ulcers? - ✔✔- NPO pre-
procedure
- NPO until what returns? gag reflex
- watch for perforation by watching for PAIN, bleeding or if they are having trouble
SWALLOWING
✔✔upper GI looks at what? - ✔✔- esophagus ad stomach with dye
- NPO past midnight
- no smoking
✔✔smoking increases stomach ______________, which will affect the test - ✔✔mobility
✔✔smoking ______________ stomach secreations, which will increase the chance of
aspiration - ✔✔increases
,✔✔what is the treatment for upper GI peptic ulcers? - ✔✔- antacids- LIQUID ( coat
stomach)
- protein pump inhibitors ( P, P= pantoPRAZOLE , esomePRAZOLE, omePRAZOLE
- H2 antagonist ( ranitIDINE, famotIDINE)
- antibiotics for hy. Pylori
✔✔what is the client teaching for someone with upper GI peptic ulcer? - ✔✔- decrease
stress
- stop smoking
- avid caffeine
✔✔gastric ulcers appear how to the pt.? - ✔✔- malourished
- pain is usually half hour to 1 hour after meals, food doesnt help, but VOMITING does;
vomit blood
✔✔duodenal ulcers appear how to the pt? - ✔✔- well nourished; night time pain is
common and also occurs 2-3 hours after meals; food helps; blood in stools
✔✔hiatal hernia - ✔✔hole in the diaphragm is too large so the stomach moves up into
the thoracic cavity
- common cause is a large abdomen
✔✔what are some S/S of hiatal hernia? - ✔✔- heartburn
- fullness after eating
- dysphagia ( difficulty swallowing)
✔✔what is the treatment for hiatal hernia? - ✔✔Small, frequent meals, sit for one hour
after eating, elevate the HOB, surgery, teach life style changes and a healthy diet
✔✔sit up 1 hour after eating and elevate HOB means keeping the stomach in what
position? - ✔✔- DOWN
✔✔dumping syndrome - ✔✔stomach empties too quickly after eating and the client
experiences many uncomfortable to severe side effects.... usually secondary to gastric
bypass, gastrectomy, or gallbladder disease
✔✔what is the S/S of dumping syndrome? - ✔✔- fullness
- weakness
- palpatations
- cramping
✔✔which side should one lay on to keep food in stomach? - ✔✔- left
,✔✔when you lay on the left side for your stomach it does what to do the food? - ✔✔-
leaves it in
✔✔when you lay on the right side for your stomach it does what do food? - ✔✔-
releases it
✔✔what is the treatment for dumping syndomre? - ✔✔- no fluids with meals ( drink in
between meals)
- avoid foods high in CARBS and electrolytes ( empty fast)
✔✔ulcerative colitis - ✔✔ulcerative inflammatory bowel disease
- just in the large intestines
✔✔chrons disease - ✔✔also called regional enteritis; inflammation and erosion of the
ileum ( small intestines) , but it can be found anywhere in the small or large intestines
✔✔what are some s/s of ulcerative colitis and chrons disease - ✔✔- diarrhea
- dehydration
- rectal bleeding
✔✔what is rebound tenderness? - ✔✔- push in ---> let go ----> and it hurts
✔✔what does rebound tendernes mean? - ✔✔peritoneal inflammation
✔✔what is the most common test for diagnosing chrons/ulcerative colitis? - ✔✔-
colonscopy
✔✔what should the pt follow before a colonscopy? - ✔✔- clear liquid diet for 12-24
hours pre-procedure
- NPO 6-8 hours pre-procedure
- laxatives or enemas until clear
✔✔what is something to watch for post colonscopy? - ✔✔- watch for perforation
- ASSUME the worst! the signs of perforation are pain or unusual discomfort
✔✔what is the treatment for chrons / ulcerative colitis? - ✔✔- diet
- medications
- surgery
✔✔when a pt has chrons disease/ulcerative colitis what kind of diet should one follow? -
✔✔- low residue
- avoid cold foods and smoking ( these can INCREASE motility)
✔✔what kind of medication is prescribed for ulcerative colitis/chrons ? - ✔✔- antibiotics
, - steroids ( decrease inflammation)
✔✔what kind of surgery does one have for ulcerative colitis? - ✔✔- total colectomy (
proctocolectomy), an ileostomy is formed
✔✔kocks pouch has a nipple valve that opens and closes to what? - ✔✔empty
intestines
✔✔the IPAA procedure removes what? - ✔✔- colon and attaches the ileum to the
rectum ( most popular)
✔✔when one does surgery for chrons remove only what? - ✔✔affected
✔✔when a pt has chrons the client may end up with a what? - ✔✔- ileostomy or a
colostomy ( just depends on the affected area)
✔✔an ostomy in the ileum is called what? - ✔✔- ileostomy
✔✔an ostomy in the colon is called a what? - ✔✔- colostomy
✔✔what kind of care is given for a ileostomy - ✔✔its going to drain liquid all the time
- dont have to irrigate ileostomies
- avoid foods hard to digest and rough foods, these increase motility
✔✔what happens as waste moves through the colon? - ✔✔water and nutrients are
being absorbed and the stool is forming
✔✔colostomy -----> ascending and transverse -----> - ✔✔liquid stools
✔✔colostomy ------> descending or sigmoid -----> - ✔✔semi formed or formed
✔✔which colostomy do you irrigate? - ✔✔- descending & sigmoid
✔✔why irrigate a colostomy? - ✔✔- regularity
✔✔when is the best time to irrigate? - ✔✔same time everyday, after a meal
✔✔the further down the colon the stoma is, the more formed the stool will be because
_________ is being drawn out. the stool is more normal. - ✔✔water
✔✔when irrigating an ostomy, use the same principles as if adminstering an
______________ - ✔✔enema
SURE A+
✔✔LETS GET NORMAL STRAIGHT FIRST!
protein -----> breaks down _____________- ----> the LIVER converts ammonia to
____________ ------> KIDNEYS excrete to the urea - ✔✔- ammonia
- urea
✔✔peptic ulcers - ✔✔- common cause of gi bleeding
- erosion is present
✔✔what are the s/s of peptic ulcers? - ✔✔- burning pain usually mid gastric
- heart burn ( dyspepsia)
✔✔another word for heartburn? - ✔✔- dyspepsia
✔✔what does the diagnosis show when dealing with peptic ulcers? - ✔✔- NPO pre-
procedure
- NPO until what returns? gag reflex
- watch for perforation by watching for PAIN, bleeding or if they are having trouble
SWALLOWING
✔✔upper GI looks at what? - ✔✔- esophagus ad stomach with dye
- NPO past midnight
- no smoking
✔✔smoking increases stomach ______________, which will affect the test - ✔✔mobility
✔✔smoking ______________ stomach secreations, which will increase the chance of
aspiration - ✔✔increases
,✔✔what is the treatment for upper GI peptic ulcers? - ✔✔- antacids- LIQUID ( coat
stomach)
- protein pump inhibitors ( P, P= pantoPRAZOLE , esomePRAZOLE, omePRAZOLE
- H2 antagonist ( ranitIDINE, famotIDINE)
- antibiotics for hy. Pylori
✔✔what is the client teaching for someone with upper GI peptic ulcer? - ✔✔- decrease
stress
- stop smoking
- avid caffeine
✔✔gastric ulcers appear how to the pt.? - ✔✔- malourished
- pain is usually half hour to 1 hour after meals, food doesnt help, but VOMITING does;
vomit blood
✔✔duodenal ulcers appear how to the pt? - ✔✔- well nourished; night time pain is
common and also occurs 2-3 hours after meals; food helps; blood in stools
✔✔hiatal hernia - ✔✔hole in the diaphragm is too large so the stomach moves up into
the thoracic cavity
- common cause is a large abdomen
✔✔what are some S/S of hiatal hernia? - ✔✔- heartburn
- fullness after eating
- dysphagia ( difficulty swallowing)
✔✔what is the treatment for hiatal hernia? - ✔✔Small, frequent meals, sit for one hour
after eating, elevate the HOB, surgery, teach life style changes and a healthy diet
✔✔sit up 1 hour after eating and elevate HOB means keeping the stomach in what
position? - ✔✔- DOWN
✔✔dumping syndrome - ✔✔stomach empties too quickly after eating and the client
experiences many uncomfortable to severe side effects.... usually secondary to gastric
bypass, gastrectomy, or gallbladder disease
✔✔what is the S/S of dumping syndrome? - ✔✔- fullness
- weakness
- palpatations
- cramping
✔✔which side should one lay on to keep food in stomach? - ✔✔- left
,✔✔when you lay on the left side for your stomach it does what to do the food? - ✔✔-
leaves it in
✔✔when you lay on the right side for your stomach it does what do food? - ✔✔-
releases it
✔✔what is the treatment for dumping syndomre? - ✔✔- no fluids with meals ( drink in
between meals)
- avoid foods high in CARBS and electrolytes ( empty fast)
✔✔ulcerative colitis - ✔✔ulcerative inflammatory bowel disease
- just in the large intestines
✔✔chrons disease - ✔✔also called regional enteritis; inflammation and erosion of the
ileum ( small intestines) , but it can be found anywhere in the small or large intestines
✔✔what are some s/s of ulcerative colitis and chrons disease - ✔✔- diarrhea
- dehydration
- rectal bleeding
✔✔what is rebound tenderness? - ✔✔- push in ---> let go ----> and it hurts
✔✔what does rebound tendernes mean? - ✔✔peritoneal inflammation
✔✔what is the most common test for diagnosing chrons/ulcerative colitis? - ✔✔-
colonscopy
✔✔what should the pt follow before a colonscopy? - ✔✔- clear liquid diet for 12-24
hours pre-procedure
- NPO 6-8 hours pre-procedure
- laxatives or enemas until clear
✔✔what is something to watch for post colonscopy? - ✔✔- watch for perforation
- ASSUME the worst! the signs of perforation are pain or unusual discomfort
✔✔what is the treatment for chrons / ulcerative colitis? - ✔✔- diet
- medications
- surgery
✔✔when a pt has chrons disease/ulcerative colitis what kind of diet should one follow? -
✔✔- low residue
- avoid cold foods and smoking ( these can INCREASE motility)
✔✔what kind of medication is prescribed for ulcerative colitis/chrons ? - ✔✔- antibiotics
, - steroids ( decrease inflammation)
✔✔what kind of surgery does one have for ulcerative colitis? - ✔✔- total colectomy (
proctocolectomy), an ileostomy is formed
✔✔kocks pouch has a nipple valve that opens and closes to what? - ✔✔empty
intestines
✔✔the IPAA procedure removes what? - ✔✔- colon and attaches the ileum to the
rectum ( most popular)
✔✔when one does surgery for chrons remove only what? - ✔✔affected
✔✔when a pt has chrons the client may end up with a what? - ✔✔- ileostomy or a
colostomy ( just depends on the affected area)
✔✔an ostomy in the ileum is called what? - ✔✔- ileostomy
✔✔an ostomy in the colon is called a what? - ✔✔- colostomy
✔✔what kind of care is given for a ileostomy - ✔✔its going to drain liquid all the time
- dont have to irrigate ileostomies
- avoid foods hard to digest and rough foods, these increase motility
✔✔what happens as waste moves through the colon? - ✔✔water and nutrients are
being absorbed and the stool is forming
✔✔colostomy -----> ascending and transverse -----> - ✔✔liquid stools
✔✔colostomy ------> descending or sigmoid -----> - ✔✔semi formed or formed
✔✔which colostomy do you irrigate? - ✔✔- descending & sigmoid
✔✔why irrigate a colostomy? - ✔✔- regularity
✔✔when is the best time to irrigate? - ✔✔same time everyday, after a meal
✔✔the further down the colon the stoma is, the more formed the stool will be because
_________ is being drawn out. the stool is more normal. - ✔✔water
✔✔when irrigating an ostomy, use the same principles as if adminstering an
______________ - ✔✔enema
