NR 324 Comprehensive Exam with
Complete Solutions
Impact of malnutrition - ✔✔Low mood
Weight loss
Low energy
Muscle wasting
Increased risk of fractures
Increased risk of hospital admissions
Confusion
Infections
Reduced independence
Increased risk for falls
Reduced mobility
Risks associated with obesity - ✔✔Type 2 DM
Dyslipidemia
Cancer
Mood disorders
Heart disease
Reproductive disorders
Liver disease
Hypertension
Promotion of normal elimination - ✔✔(POOPER SCOOP)
Position (upright, sitting)
,Outpput (adequate hydration)
Offer fluids
Privacy
Exercise
Report results
Size (amount)
Consistency
Occult blood
Odor
Peristalsis
Foods that prevent constipation - ✔✔Fresh fruit
Whole wheat toast
Expected findings with prolonged diarrhea - ✔✔Hypotension
Elevated temperature
Poor skin turgor
GERD - ✔✔Gastroesophageal reflux disease
Acid splashing in esophagus, burning tissue
Risks for GERD - ✔✔Obesity
Smoking
Pregnancy
Drinking alcohol
Acidic foods
,Gastric reflux - ✔✔Lower esophageal sphincter open allowing acid reflux
GERD ssx - ✔✔Heart burn
Abdominal cramping
Nausea/vomiting
Tooth decay
GERD trigger foods - ✔✔Foods difficult to digest
Gas forming foods
GMO foods
Things that relax LES (spicy, acidic, ETOH)
Refined carbohydrates
Food additives
Acid containing foods
Mint
Sugar alcohols
Too much sugar
Goals for tx of GERD - ✔✔Eliminate symptoms
Heal esophageal mucosa
Maintain remission for a lifetime
Manage or prevent complications
Nursing care for GERD - ✔✔Sit patient up during and after meals
Tums/Antacids
H2 receptor blockers
, PPIs
Tums/Antacids - ✔✔Neutralize pH
H2 receptor blockers - ✔✔Pepcid
Decreases acid production
PPIs - ✔✔Blocks proton pumps to block acid
Stronger than H2 receptor blocker
GERD education - ✔✔Avoid triggers
Eat small frequent meals and not before bed
Untreated can lead to permanent damage
Expected finding for a patient with GERD - ✔✔Loss of tooth enamel
Risk factors for PUD - ✔✔Stress
H. Pylori
Alcohol
Smoking
Duodenal ulcers - ✔✔Most common
Well nourished
Pain 2-3 hours after eating
Food main decrease pain
Stress ulcers - ✔✔Physiological stress shock
Complete Solutions
Impact of malnutrition - ✔✔Low mood
Weight loss
Low energy
Muscle wasting
Increased risk of fractures
Increased risk of hospital admissions
Confusion
Infections
Reduced independence
Increased risk for falls
Reduced mobility
Risks associated with obesity - ✔✔Type 2 DM
Dyslipidemia
Cancer
Mood disorders
Heart disease
Reproductive disorders
Liver disease
Hypertension
Promotion of normal elimination - ✔✔(POOPER SCOOP)
Position (upright, sitting)
,Outpput (adequate hydration)
Offer fluids
Privacy
Exercise
Report results
Size (amount)
Consistency
Occult blood
Odor
Peristalsis
Foods that prevent constipation - ✔✔Fresh fruit
Whole wheat toast
Expected findings with prolonged diarrhea - ✔✔Hypotension
Elevated temperature
Poor skin turgor
GERD - ✔✔Gastroesophageal reflux disease
Acid splashing in esophagus, burning tissue
Risks for GERD - ✔✔Obesity
Smoking
Pregnancy
Drinking alcohol
Acidic foods
,Gastric reflux - ✔✔Lower esophageal sphincter open allowing acid reflux
GERD ssx - ✔✔Heart burn
Abdominal cramping
Nausea/vomiting
Tooth decay
GERD trigger foods - ✔✔Foods difficult to digest
Gas forming foods
GMO foods
Things that relax LES (spicy, acidic, ETOH)
Refined carbohydrates
Food additives
Acid containing foods
Mint
Sugar alcohols
Too much sugar
Goals for tx of GERD - ✔✔Eliminate symptoms
Heal esophageal mucosa
Maintain remission for a lifetime
Manage or prevent complications
Nursing care for GERD - ✔✔Sit patient up during and after meals
Tums/Antacids
H2 receptor blockers
, PPIs
Tums/Antacids - ✔✔Neutralize pH
H2 receptor blockers - ✔✔Pepcid
Decreases acid production
PPIs - ✔✔Blocks proton pumps to block acid
Stronger than H2 receptor blocker
GERD education - ✔✔Avoid triggers
Eat small frequent meals and not before bed
Untreated can lead to permanent damage
Expected finding for a patient with GERD - ✔✔Loss of tooth enamel
Risk factors for PUD - ✔✔Stress
H. Pylori
Alcohol
Smoking
Duodenal ulcers - ✔✔Most common
Well nourished
Pain 2-3 hours after eating
Food main decrease pain
Stress ulcers - ✔✔Physiological stress shock
