Disorders, Infection Control, Skin & Pressure Ulcers | Q&A
GERD | Hiatal Hernia | PUD | Gastroenteritis | Gastrectomy & Dumping Syndrome | IBS | Peritonitis | Appendicitis | Bowel
Obstruction | Ulcerative Colitis | Crohn's Disease | Diverticular Disease | Cholecystitis | Hepatitis | Ileostomy | TPN |
Incontinence (Stress, Urge, Retention) | Cystitis | Urolithiasis (Kidney Stones) | Lithotripsy | Acute Pyelonephritis | Acute
Glomerulonephritis | Polycystic Kidney Disease | BPH | TURP | Contact/Droplet/Airborne Precautions | ABCDE Skin
Assessment | Pressure Ulcer Staging (1-4) | Psoriasis | Lab Values (BUN 10-20, Creatinine 0.6-1.2)
SUBJECT COURSE FOCUS
Med-Surg / GI / GU / Infection Control NUR 170 Exam 4 GI Disorders, GU Disorders, Infection
/ Skin Control, Skin & Pressure Ulcers
Q1
GERD: risk factors, signs/symptoms, interventions?
ANSWER
R/F: obesity, pregnancy, NGT, acidic foods. S/S: belching, metallic taste, pyrosis (heartburn),
dysphagia, water brash. Interventions: no food 3 hrs before bed, elevate HOB, lose weight, small meals,
avoid caffeine/fatty foods/smoking.
RATIONALE
• GERD occurs when stomach acid backs up into esophagus causing pain and inflammation.
Q2
Hiatal hernia: what is it and post-op considerations after Nissan fundoplication?
ANSWER
Weak diaphragm allowing stomach to slide into esophagus. Post-op: patient will NO LONGER
belch/vomit; dysphagia should improve (not worsen); DON'T touch NG tube; watch for aspiration;
assess NG tube every 4-8 hours.
RATIONALE
• Nissan procedure wraps stomach around esophagus to prevent reflux.
, Q3
Peptic Ulcer Disease (PUD): risk factors, signs/symptoms, complications?
ANSWER
R/F: H. pylori, NSAIDs, stress/ICU setting, caffeine, steroids. S/S: pain 3 hours after meal, sharp
burning pain, indigestion. Complications: upper GI bleed (low BP, increased HR, hematemesis (bright
red or coffee ground), melena (dark/tarry stool)); perforation (peritonitis: rebound tenderness, rigid
board-like abdomen, fetal position).
RATIONALE
• Avoid NSAIDs, caffeine, steroids.
Q4
Gastroenteritis: cause, duration, interventions?
ANSWER
Inflammation of stomach/small intestine from virus or bacteria. Self-limiting 3-4 days. Norovirus
(Norwalk) Nov-April. Interventions: watch for dehydration/electrolyte imbalance, replace fluids
(Powerade, Gatorade, Pedialyte), wash hands, contagious, no meds (let it run its course).
RATIONALE
• Notify PHCP if lasts more than 3 days.
Q5
Dumping Syndrome after gastrectomy: what is it, signs/symptoms, interventions?
ANSWER
Fluid pulled into small intestine from eating. S/S: syncope, vertigo, desire to lay down after eating,
sweating. Interventions: eat THEN drink (not together), lay down after eating, high fat & protein diet.
RATIONALE
• Gastrectomy decreases intrinsic factor leading to Vit B12, iron, calcium, folic acid deficiencies.