N2-Final-Exam-Study-Guide/Top Score 2023

1. Upper GI Tract Dysphagia – Difficulty swallowing. Major concern for older adult & victims of stroke. Has trouble swallowing liquids or solids, coughs after eating or drinking, speech difficulty (dysphonia) • Barium Swallow – Swallows radioactive dye that shows areas of dysfunction. • Endoscopic Evaluation TX = Thickened liquids/foods. Elevate HOB 30-45 degrees. 2. Lower GI Tract Obstruction – Poop can’t go forward . ABG: HCO3 up, pH up = metabolic alkalosis • Small Bowel S/S = Abdominal pain, distention, N/V, constipation, electrolyte imbalances, metabolic alkalosis • LARGE Bowel S/S = Lower abdominal cramping, constipation, ribbon like stools. What is contraindicated?! BARIUM ENEMA TX= Possible Surgery, NG Tube Suction, NPO, IV Therapy (fluids), Pain Control IBS (Irritable Bowel Syndrome) – Chronic diarrhea and/or constipation ABG: HCO3 low, pH low – metabolic acidosis • S/S = excess farting (flatulence), distention, cramps, pain, diarrhea/constipation, LLQ pain. • Treatment = AVOID triggers or fruit, berries, lettuce, lactose, caffeine, & alcohol. Increase fiber, relax, less stress, and exercise • Meds = Constipation (Metamucil, Fibercon), Diarrhea (Imodium, Lomotil) TX = Educate on avoiding triggers & fibrous foods Appendicitis – Infection of appendix organ • S/S = RLQ pain (McBurney’s Point), rebound tenderness, relief of pain after ruptured. o RUPTURED = think infection… chills, increased WBC, guarding, distention, shallow breathing, irritability, & restlessness. TX = Surgical removal, semi-fowler RIGHT side lying, no heat, no laxatives, cold compress Ulcerative Colitis – Inflammation of mucosa in colon & rectum. ABG: HCO3 low, pH low = metabolic acidosis • S/S = 10 liquid stools per day, abdominal pain, dehydration, tachycardia, anemia, distention. o Complications = hemorrhage, abscess, TOXIC MEGACOLON, obstruction, perforation