NUR 2392 MDC2 Final Exam Study Guide

NUR 2392 MDC2 Final Exam Study Guide *The exam questions are not limited to only what is listed on this guide. Please refer to your chapter readings, recordings, and module materials. ATI has additional practice questions for review in Learning Systems RN 3.0. Ch. 53 – Care of Patients with Oral Cavity Problems • Stomatitis and care o What is stomatitis? ▪ Inflammation within the oral cavity. o Assessment of Stomatitis: ▪ Blisters in the oral cavity with pain and swelling ▪ Fever ▪ Difficulty Eating and drinking. o Nursing Interventions: ▪ Provide frequent oral care (q 2hrs) • Mouth rinsing with saline, baking soda ▪ Monitor VS (temp) ▪ Monitor I&O ▪ Be alert for sx of dysphagia (risk for aspiration) ▪ Offer bland, nonacidic foods – cool liquids ▪ Apply topical analgesics o Meds: ▪ Tetracycline Syrup ▪ Minocycline, chlorhexidine mouthwash ▪ Acyclovir ▪ Nystatin oral suspension • Leukoplakia vs. Erythroplakia o Leukoplakia: thickened, white patches that cannot be easily flaked off ▪ Usually benign o Erythroplakie: red, velvety mucosal leasion ▪ Considered precancerous ▪ Most commonly on floor of mouth Ch. 54 – Care of Patients with Esophageal Problems • GERD risk factors and treatment o Risk factors: ▪ Obesity/overweight ▪ Hiatal hernias o Treatment: ▪ Nutrition Therapy, lifestyle changes and drug therapy. ▪ Nutrition: eliminate foods that decrease LES pressure (peppermint, chocolate, alcohol, fatty foods, caffeine, carbonated beverages, spicy/acidic food) ▪ Lifestyle changes: smoking cessation, decrease size of meals, avoid eating atleast 3 hours before bed. Sleed 6-12 elevated. ▪ Drug therapy: Antacids, histamine receptor antagonists, PPI’s ▪ Surgical Management: Nissen fundoplication • Hiatal hernia symptoms o Symptoms: ▪ Heartburn, regurgitation, CP, dysphagia, belching • Endoluminal fundoplication (hiatal hernia repair) vs. Nissen fundoplication (GERD surgical management) Ch. 55 – Care of Patients with Stomach Disorders • Types of ulcers (gastric vs. duodenal) o Gastric Ulcers: ▪ Develop in the atrum of the stomach near acid-secreting mucosa o Duodenal ulcers ▪ Upper portion of the duodenum that penetrate through the mocsa and submucosa. ▪ High gastric acid secretion • Complications of ulcers o Hemorrhage – usually in gastric ulcers ▪ massive bleeding = hematemesis ▪ Minimal bleeding: tarry stool o Perforation ▪ Ulcer becomes deep and thickness of stomach is worn away ▪ Sx include sudden sharp pain in the epigastric region. ▪ Stomach contents leak into peritoneal cavity • Health promotion and avoidance of triggers (balanced diet, limit spicy foods, tobacco, alcohol, NSAIDS, etc.) • Treatment (pain relief, triple therapy) Ch. 56 – Care of Patients with Noninflammatory Intestinal Disorders • Nonmechanical (ileus) vs. mechanical obstruction (intussusception, volvulus, etc.) o Mechanical: ▪ Bowel is physically blocked by problems such as tumors and adhesions ▪ Intussusception is telescoping of intestines ▪ Volvulus is twisting of intestin o Nonmechanical: ▪ Due to peristalsis and back up of stool. • Colorectal cancer labs (CEA), diagnostics o CEA: carcinoembryonic antigen ▪ Normal value 5ng/mL – usually elevated in pts with CRC ▪ Used to monitor effectiveness of tx and ID dz recurrence. o FOBT: fecal-occult blood test ▪ Indicates bleeding in GI tract. o Sigmoidoscopy, Colonoscopy. o CT/MRI o Double-contrast barium enema ▪ Provide visualization of polys and lesions. • Irritable bowel syndrome health teaching and testing (hydrogen breath test) o Hydrogen Breath Tests: ▪ When bacterial overgrowth occurs, excess of hydrogen is produced. ▪ Patients with IBS often ehale inc. amount of H o Breath test patient teaching: ▪ NPO for 12 hours ▪ Blow into hydrogen analyzers and small amounts of sugar are ingested. Samples are taken q15 mins for 1-5 hours o IBS patient health teaching: ▪ Increase dietary fiber (30-40 g/day) , drink 8-10 glasses of water ▪ Chew food slowly ▪ Decrease tress ▪ Probitoics Ch. 57 – Care of Patients with Inflammatory Intestinal Disorders • Peritonitis symptoms o CARDINAL S/S: Abdominal pain, tenderness (rebound) and distention. o Abdominal rigidity and pain – localized, poorly localized, or shoulder/chest o n/v anorexia o diminished bowel sounds o Inability to pass stool or flatus o Fever, dehydration, hiccups o Compromise in respiratory status • Appendicitis o Acute inflammation of vermiform appendiz o Sx: RLQ pain – cramping pain in the epigastric/periumbilical area o +McBurneys point tenders – RLQ between anterior iliac creast and umbilicus • Ulcerative colitis vs Crohn’s disease o Ulcerative Colitis: ▪ Widespread inflammation of the rectum and rectosigmoid colon