Exam 4 med surg 2024 Questions and Updated Answers

Exam 4 med surg 2024 Questions and Updated Answers restrictive - right answer --reduce size of stomach. pt eats le ss food malabsorptive - right answer --less calories absorbed in small intestine combination - right answer --both restrictive and malabsorption. roux en y post op bariatric - right answer --24hr pca pump asses pt q4hrs NGT do not move no bed rails touchi ng obese pt semi fowlers lines ant tubes DVT prophylaxis - right answer --enoxaparin 40mg qd in flanks SCD how long clear liquid diet? - right answer --24-48hrs anastomotic leaks - right answer --GI fluids in perineal space s/s of anastomotic leaks - right answer --back, shoulder, abdominal pain, restlessness, high HR, low urine output what vitamin deficiency is related to bariatric surgery? - right answer --B12 may need for life B12 needed for? - right answer --RBC maturation and myeline sheath protection anemia and neurological problems may develop if low Hepatitis A &E transmitted? - right answer --Fecal oral Hep A &E require which precaution if the patient is incontinent? - right answer --Contact Hepatitis B, C, D transmit ted? - right answer --sex and blood Hep D is dependent on? - right answer --Hep B Hepatitis requires which precaution? - right answer --standard Hep B and C can cause? - right answer --Cancer (Hepatocellular) oncogenic Gastroesophageal Reflux Disease (GERD ) - right answer --Backflow of stomach acid into the esophagus GERD cause? - right answer --caused by excessive relaxation of lower esophageal shincter GERD long term can lead to? - right answer --cancer GERD risk factors - right answer --Overweight/obese à increased pressure Pregnant GEr increased pressure Caffeinated/carbonated beverages Alcohol Smoking Nitrates, hormones, anticholinergics Hiatal hernia Nasogastric tube GERD s/s - right answer --Heartburn that's worse after eating Chest pain Dysphagia Odynophagia à painful swallowing Metallic taste in mouth Regurgitation (into pharynx) Poor dentition Wheezing, hoarseness, coughing à acid can get into airway and cause irritation/inflammation à extraesophageal symptoms GERD Dx - right answer --Based on reported s/s Esophagogastroduodenoscopy (EGD) [Barrett's Esophagus] 24-hour pH monitoring and manometry If hiatal hernia upper GI series, CT GERD Tx - right answer --Elevate HOB Diet modificat ion à avoid triggers of heartburn à this is patient dependent Avoid alcohol and smoking Weight loss No tight clothing Avoid eating 2 -3 hours before bedtime Sleep left or right lateral Meds for GERD - right answer --H2 blocker famotidine (Pepcid) PPI -Prazole PPI long term use complications? - right answer --may lead to malabsorption B12, calcium and Vitamin D deficiencies Bone loss