NR 341 Complex Adult Health CMS Exam Review (100%Verified Solutions).

NR 341 Complex Adult Health CMS Exam Review (100%Verified Solutions). Complex Adult Health CMS Review Resources - ATI: RN Adult Medical Surgical Nursing Edition 11 Expected findings of peptic ulcer disease - • Dyspepsia: heart burn, bloating, N/V (may feel like uncomfortable fullness ohunger) - • Dull gnawing pain or burning sensation at mid epigastric or back - • pain after eating - • Pain or epigastric tenderness or abdominal distension - • Blood emesis or stools - • Weight loss Nursing care for peptic ulcer disease - • Esophagogastroduodenoscopy - • If NG is placed monitor fluid amount & color - • Avoid foods that cause distress (coffee, tea, carbonated beverages) - • Orthostatic changes in VS = bleeding of perforation - • Encourage rest periods - • Saline lavage via NG tube When would a client be considered for surgery from PUD? - If ulcers do not heal following 12-16 weeks of medical treatment What signs/ symptoms are seen when a peptic ulcer perforates? - • Severe epigastric pain spreading across abdomen - • Pain can radiate into shoulders (especially right) - • Tender abdomen that is rigid (board like) - • Rebound tenderness - • Hyperactive to diminished bowel sounds - • manifestations of shock, hypotension, & tachycardia NR 341 Complex Adult Health CMS Exam Review Dumping syndrome - Shift of fluid after ingestion of food (high carbs) - Manifestations: full sensation, weakness, diaphoresis, palpitations, dizzinessdiarrhea vasomotor manifestations: 10-90 min after meal - pallor, perspiration, palpitations, feeling of warmth, headache, dizziness, drowsiness • NO LIQUIDS WITH MEALS or 1 hr prior to or after • AVOID MILKS AND SUGARS • can occur after gastrectomy Emergency care of a GI bleed - • NPO - • monitor for shock - • If responsive- ABCs - • If unresponsive- CAB Bright red blood: fresh bleed Dark red (coffee ground): old blood What test confirms GI bleeding? And what can A positive finding be indicative of? - • three repeats of a positive guaiac Fecal Occult Blood Test confirms GI blee- • Positive results are indicative of Ulcer, Colitis, Cancer What drugs are given during angina and MI - MONA - Beta blocker Nitroglycerin teaching - • can take up to 3 - • sit or lie down to take - • call EMS if needs to take a 2nd pill - • medicine is light sensitive - • once open, only good for 3 months - • headache is common - • change positions slowly What is seen on ECG with angina? - ST depression, and/or T-wave inversion indicates presence of ischemia Expected findings of angina - • Anxiety, feeling of impending doom - • Chest pain (may radiate down shoulder or arm or jaw) - • “crushing” or “aching” - • N/V - • Pale, clammy skin - • Tachycardia, Tachypnea, heart palpitations, SOB - • Diaphoresis, LOC - • FEMALE: pain between shoulders, ache in jaw, sensation of choking with exertion Cardiac catheterization Invasive diagnostic procedure used to evaluate presence & degree of coronary artery blockage - • catheter inserted into femoral artery (maybe brachial) and threaded into vessel - • identified by injection of contrast media under fluoroscopy - • assess renal function prior - • may need to withhold metformin up to 48 to prevent hypoglycemia - • pressure held on site after - • bed rest in supine position ** NPO 8hrs prior ** assess for iodine/ shellfish allergy • fluid to flush out kidneys.