NR 324 ADULT HEALTH 1 EXAM 3 FINAL UPDATED
ACTUAL QUESTIONS AND CORRECT ANSWERS
Question:
Barium enema
Answer:
examination of large intestine;
Before: give laxatives and enemas until clear of stool evening before -clear liquid diet
evening before -NPO 8hr before After: give fluids, laxatives or suppositories to assist in
expelling barium -observe stool for passage of contrast medium -educate pt stool may
be white for up to 72 hr
Question:
With a barium enema what do you want to explain to the patient in regards of what
they might feel
Answer:
They might feel cramping and the urge to defecate may occur -pt will be placed in
various positions
Question:
What is Enteral nutrition (EN) Indications
Answer:
Tube feeding -nutritionally balanced liquefied food or formula into the stomach,
duodenum, or jejunum Indications:
-anorexia -orofacial fractures -head/neck cancer -neurologic -psychiatric conditions
-extensive burns -critical illness -chemotherapy -radiation therapy
Question:
Contraindications to enteral nutrition
Answer:
-intentional obstruction -ileus -peritonitis -bowel ischemia -intractable vomiting and
diarrhea
Question:
Enteral nutrition formulas and delivery options
Answer:
-variety of formulas for patients with diabetes, liver, kidney, and lung disease
-concentrations from 1 to 2 cal/mL -osmolarity, amount of protein, sodium, and fat vary
Delivery options:
-continuous infusion by pump -cyclic feeding by pump -intermittent by gravity
-intermittent bolus by syringe
,Question:
Esophagastroduodenoscopy (EGD)
Answer:
Visualize esophagus, stomach, duodenum -detects inflammation, ulcerations, tumors,
varices, or mallory-weiss tears Before:
-NPO for 8 hrs -explain that local anesthesia may be sprayed on throat -verify signed
consent After:
-keep NPO after procedure until gag reflex returns -gently tickle back of throat to test
gag reflex -use warm saline gargles for relief of sore throat -check temp q15-30min for
1-2 hr
,Question:
Colonoscopy
Answer:
Examination of colon, biopsies and polyps removed; bowel prep before and observe for
perforation Before: low residue or full liquid diet the day before until bowel cleansing
begins -pt drinks 2L dose of oral polyethylene glycol the night before -second 2L 4-6 hr
before procedure -explain pt will be side-lying position and sedation given After:
observe for complications -monitor vital signs
Question:
Complications of a colonoscopy
Answer:
-Abdominal cramps -Rectal bleeding -Perforation (malaise, abdominal distention,
tenesmus)
, Question:
Nasogastric tube
Answer:
Nutrition, medication and decompression; proper technique during use, verify
placement -bc of small diameter they are more easily clogged when feedings are thick
and are more difficult to use for checking residual volumes They are particularly prone
to obstruction when oral drugs have not been thoroughly crushed and dissolved in
water before administration -Can be dislodged by vomiting or coughing -Can be
knotted/kinked in GI tract
Question:
NG tube management
Answer:
Check Aspiration risk before inserting Obtain x-ray to confirm tube placement If
intermittent delivery is used HOB should remain elevated 30-60 min after feedings
Check gastric residual volumes before each feeding and every 4 hours during the first
48 hrs Mark exit site at time of initial x-ray and check tuber external length at regular
intervals Observe for negative pressure when attempting to withdraw fluid from
feeding Provide skin care around tube and assess daily (rinse with sterile water)
Question:
What are the main complications of tube feedings?
Answer:
Vomiting Dehydration Diarrhea Constipation -Elevate HOB a minimum of 30 degrees
but preferably 46 degrees to decrease complications and risk for aspiration
ACTUAL QUESTIONS AND CORRECT ANSWERS
Question:
Barium enema
Answer:
examination of large intestine;
Before: give laxatives and enemas until clear of stool evening before -clear liquid diet
evening before -NPO 8hr before After: give fluids, laxatives or suppositories to assist in
expelling barium -observe stool for passage of contrast medium -educate pt stool may
be white for up to 72 hr
Question:
With a barium enema what do you want to explain to the patient in regards of what
they might feel
Answer:
They might feel cramping and the urge to defecate may occur -pt will be placed in
various positions
Question:
What is Enteral nutrition (EN) Indications
Answer:
Tube feeding -nutritionally balanced liquefied food or formula into the stomach,
duodenum, or jejunum Indications:
-anorexia -orofacial fractures -head/neck cancer -neurologic -psychiatric conditions
-extensive burns -critical illness -chemotherapy -radiation therapy
Question:
Contraindications to enteral nutrition
Answer:
-intentional obstruction -ileus -peritonitis -bowel ischemia -intractable vomiting and
diarrhea
Question:
Enteral nutrition formulas and delivery options
Answer:
-variety of formulas for patients with diabetes, liver, kidney, and lung disease
-concentrations from 1 to 2 cal/mL -osmolarity, amount of protein, sodium, and fat vary
Delivery options:
-continuous infusion by pump -cyclic feeding by pump -intermittent by gravity
-intermittent bolus by syringe
,Question:
Esophagastroduodenoscopy (EGD)
Answer:
Visualize esophagus, stomach, duodenum -detects inflammation, ulcerations, tumors,
varices, or mallory-weiss tears Before:
-NPO for 8 hrs -explain that local anesthesia may be sprayed on throat -verify signed
consent After:
-keep NPO after procedure until gag reflex returns -gently tickle back of throat to test
gag reflex -use warm saline gargles for relief of sore throat -check temp q15-30min for
1-2 hr
,Question:
Colonoscopy
Answer:
Examination of colon, biopsies and polyps removed; bowel prep before and observe for
perforation Before: low residue or full liquid diet the day before until bowel cleansing
begins -pt drinks 2L dose of oral polyethylene glycol the night before -second 2L 4-6 hr
before procedure -explain pt will be side-lying position and sedation given After:
observe for complications -monitor vital signs
Question:
Complications of a colonoscopy
Answer:
-Abdominal cramps -Rectal bleeding -Perforation (malaise, abdominal distention,
tenesmus)
, Question:
Nasogastric tube
Answer:
Nutrition, medication and decompression; proper technique during use, verify
placement -bc of small diameter they are more easily clogged when feedings are thick
and are more difficult to use for checking residual volumes They are particularly prone
to obstruction when oral drugs have not been thoroughly crushed and dissolved in
water before administration -Can be dislodged by vomiting or coughing -Can be
knotted/kinked in GI tract
Question:
NG tube management
Answer:
Check Aspiration risk before inserting Obtain x-ray to confirm tube placement If
intermittent delivery is used HOB should remain elevated 30-60 min after feedings
Check gastric residual volumes before each feeding and every 4 hours during the first
48 hrs Mark exit site at time of initial x-ray and check tuber external length at regular
intervals Observe for negative pressure when attempting to withdraw fluid from
feeding Provide skin care around tube and assess daily (rinse with sterile water)
Question:
What are the main complications of tube feedings?
Answer:
Vomiting Dehydration Diarrhea Constipation -Elevate HOB a minimum of 30 degrees
but preferably 46 degrees to decrease complications and risk for aspiration
