Medical Surgical Nursing 2 - Exam 1
Questions and Answers
Skills for communicating with seriously ill patients and their families. - ANS-Develop
level of comfort and expertise in communicating with seriously/terminally ill
patients/families
Communication should be tailored to the level of understanding and values
Arrangements should be made to have the discussion at a time that is best for everyone
Create the right setting
Space should be conducive to seating all at the eye level
Tenet of palliative and end-of-life care
Nurses must be able to assess patient and family responses to serious illness and
support their values and choices throughout the continuum of care
First, nurses must consider their own experiences and values regarding illness and
death
Provide culturally and spiritually sensitive care to seriously ill patients and their families.
- ANS-Assess values, preferences, beliefs, expectations, and practices
Nurses set aside own assumptions and attitudes toward death and dying
Spiritually contains features of religiosity; however, the two concepts are not
interchangeable
Implement nursing measures to manage physiologic responses to terminal illness. -
ANS-Answer questions honestly and accurately in ways the patient can understand
Listen attentively
Support patient choices
Facilitate communication with family
Support imminently dying patients and their families. - ANS-Grief refers to the personal
feelings that accompany an anticipated or actual loss
Mourning refers to individual, family, group, and cultural expressions of grief and
associated behaviors
Bereavement refers to the period of time during which mourning for a loss takes place
GERD Overview - ANS-Common disorder marked by backflow of gastric or duodenal
contents into the esophagus that causes troublesome symptoms and/or mucosal injury
to the esophagus
Excessive reflux may occur because of an incompetent lower esophageal sphincter,
pyloric stenosis, hiatal hernia, or a motility disorder
, Incidence: increases with age; irritable bowel syndrome and obstructive airway
disorders (asthma, COPD, cystic fibrosis); Barrett esophagus, peptic ulcer disease, and
angina
Other risk factors: tobacco use, coffee drinking, alcohol consumption, gastric infection
with Helicobacter pylori
GERD Manifestations - ANS-Pyrosis
Dyspepsia
Regurgitation
Dysphagia
Hypersalivation
Esophagitis
**Symptoms may mimic those of a heart attack**
Dental Erosion
Ulcers, laryngeal damage, pulmonary complications, etc
GERD Assessment and Diagnostics - ANS-Pt. history
Endoscopy or barium swallow
To evaluate damage to esophageal mucosa
Esophageal pH monitoring
GERD Management - ANS-Low-fat diet
Avoid caffeine, tobacco, beer, milk, foods containing peppermint or spearmint, and
carbonated beverages
Avoid eating or drinking 2 hours before bedtime
Elevate the head of the bed by at least 30 degrees
Barrett Esophagus - ANS-Overview: A condition in which the lining of the esophageal
mucosa is altered.
Clinical Manifestations: Patients complain of symptoms of GERD, notably frequent
heartburn OR patient complains of symptoms related to peptic ulcers or esophageal
stricture.
Assessment/Diagnostic Findings: Endoscopy (EGD) and Biopsies
Management: Individualized to each patient, Endoscopic ablation
Gastrostomy (G-Tube) and J-Tube - ANS-Assessment of the Patient with a G-Tube or
J-Tube
- Patient knowledge and ability to learn
- Self-care ability and support
- Skin condition
- Nutrition and fluid status
- Inspection of the tube
Nursing Interventions
- Meet nutritional needs
Questions and Answers
Skills for communicating with seriously ill patients and their families. - ANS-Develop
level of comfort and expertise in communicating with seriously/terminally ill
patients/families
Communication should be tailored to the level of understanding and values
Arrangements should be made to have the discussion at a time that is best for everyone
Create the right setting
Space should be conducive to seating all at the eye level
Tenet of palliative and end-of-life care
Nurses must be able to assess patient and family responses to serious illness and
support their values and choices throughout the continuum of care
First, nurses must consider their own experiences and values regarding illness and
death
Provide culturally and spiritually sensitive care to seriously ill patients and their families.
- ANS-Assess values, preferences, beliefs, expectations, and practices
Nurses set aside own assumptions and attitudes toward death and dying
Spiritually contains features of religiosity; however, the two concepts are not
interchangeable
Implement nursing measures to manage physiologic responses to terminal illness. -
ANS-Answer questions honestly and accurately in ways the patient can understand
Listen attentively
Support patient choices
Facilitate communication with family
Support imminently dying patients and their families. - ANS-Grief refers to the personal
feelings that accompany an anticipated or actual loss
Mourning refers to individual, family, group, and cultural expressions of grief and
associated behaviors
Bereavement refers to the period of time during which mourning for a loss takes place
GERD Overview - ANS-Common disorder marked by backflow of gastric or duodenal
contents into the esophagus that causes troublesome symptoms and/or mucosal injury
to the esophagus
Excessive reflux may occur because of an incompetent lower esophageal sphincter,
pyloric stenosis, hiatal hernia, or a motility disorder
, Incidence: increases with age; irritable bowel syndrome and obstructive airway
disorders (asthma, COPD, cystic fibrosis); Barrett esophagus, peptic ulcer disease, and
angina
Other risk factors: tobacco use, coffee drinking, alcohol consumption, gastric infection
with Helicobacter pylori
GERD Manifestations - ANS-Pyrosis
Dyspepsia
Regurgitation
Dysphagia
Hypersalivation
Esophagitis
**Symptoms may mimic those of a heart attack**
Dental Erosion
Ulcers, laryngeal damage, pulmonary complications, etc
GERD Assessment and Diagnostics - ANS-Pt. history
Endoscopy or barium swallow
To evaluate damage to esophageal mucosa
Esophageal pH monitoring
GERD Management - ANS-Low-fat diet
Avoid caffeine, tobacco, beer, milk, foods containing peppermint or spearmint, and
carbonated beverages
Avoid eating or drinking 2 hours before bedtime
Elevate the head of the bed by at least 30 degrees
Barrett Esophagus - ANS-Overview: A condition in which the lining of the esophageal
mucosa is altered.
Clinical Manifestations: Patients complain of symptoms of GERD, notably frequent
heartburn OR patient complains of symptoms related to peptic ulcers or esophageal
stricture.
Assessment/Diagnostic Findings: Endoscopy (EGD) and Biopsies
Management: Individualized to each patient, Endoscopic ablation
Gastrostomy (G-Tube) and J-Tube - ANS-Assessment of the Patient with a G-Tube or
J-Tube
- Patient knowledge and ability to learn
- Self-care ability and support
- Skin condition
- Nutrition and fluid status
- Inspection of the tube
Nursing Interventions
- Meet nutritional needs
