NSG123/ NSG 123 Exam 2: (New 2024/ 2025 Update) Med Surg 1 Review| Questions and Verified, Exams of Health sciences

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NSG123/ NSG 123 Exam 2: (New 2024/ 2025 Update) Med Surg 1 Review| Questions and Verified Answers| 100% Correct|All Units Covered| A Grade – Herzing QUESTION NG feeding tube care Answer: - irrigate every 4 hours with 30mL of water to maintain patency*** - assess placement before irrigating - check residual volumes every 4 hours, before feedings, and before giving medication - flush with 30mL of water after feedings*** - aspirate all stomach contents and measure amount - whatever you pull out, you have to put back in to prevent excessive fluid and electrolyte loss - flush with 5mL of water between each medication*** - ensure feedings are room temperature*** QUESTION Nursing care for TPN Answer: - usually in a PICC or central line*** - obtain daily weights - monitor electrolytes and I&Os - monitor glucose levels every 6 hours*** - use sterile technique*** - tubing changed every 24 hours - nothing else can run in the same tube as TPN*** - be aware of increased infection rate*** - D5W or D10 can be run if TPN runs dry and next bag is not available*** QUESTION Why are lipids given through TPN? Answer: - supplement caloric needs - prevent fatty acid deficiency to improve vitamin absorption QUESTION Crohn's disease Answer: - chronic autoimmune inflammatory disorder that can occur anywhere in the digestive tract from the mouth to the rectum - cobblestone appearance of intestine w/ normal tissue between areas of inflammation - attacks all 3 layers of intestine QUESTION Ulcerative colitis Answer: - chronic autoimmune inflammatory disorder that affects the rectum and colon - attacks only the mucosal layer of intestine QUESTION signs and symptoms of Crohn's disease Answer: - right lower quadrant abdominal cramps/pain*** - diarrhea - anemia*** - malnutrition*** - weight loss - fatigue QUESTION 25-29.9: overweight >30: obese >40: extremely obese QUESTION What is the most important aspect for treating obesity? Answer: patient must have motivation to make lifestyle changes QUESTION patient education following gastric surgery (SATA***) Answer: - smaller, more frequent meals - high nutrient foods - consume fat as tolerated - ensure low carbohydrate intake - eat two protein snacks daily - chew slowly - eat in low Fowler position and remain in that position for 20-30 minutes after eating - avoid drinking fluids with meals - drink plenty of water throughout the day - take prescribed dietary supplements - follow up with PCP for monthly B12 injections & iron - walk for at least 30 minutes daily - do not use straws QUESTION appetite suppressing medications Answer: - Benzphetamine (Didrex): releases norepinephrine and dopamine*** - Orlistat (Xenical, Alli): blocks fat breakdown and absorption (patient will need to supplement with vitamins since fat is being excreted***) - interacts with Warfarin (Coumadin)*** QUESTION patient education about medications for obesity Answer: - medication will not cure obesity*** - changes in food intake and exercise are necessary - appropriate use and side effects of medications QUESTION What is the least invasive non-surgical treatment for obesity? Answer: intragastric balloon placed endoscopically QUESTION appendicitis Answer: - most frequent cause of abdominal pain - inflammation of the appendix due to kink or occlusion QUESTION symptoms of appendicitis Answer: - periumbilical pain that moves to the RLQ - nausea and vomiting - low grade fever - rebound tenderness at McBurney's point QUESTION management of appendicitis (pre & post op) Answer: pre-op: - NPO - fluids - pain relief - bed rest post op: - prevent atelectasis (use incentive spirometer) - maintain skin integrity - attain optimal nutrition - antibiotics QUESTION diverticulum Answer: abnormal sac-like herniations in the intestinal wall of the bowel QUESTION diverticulosis Answer: multiple diverticula without inflammation QUESTION diverticulitis Answer: infection and inflammation of the diverticula Answer: - low Fowler position - care of biliary drainage system - watch for s/s of jaundice - wound care (larger incision) - ambulation QUESTION post operative care for laparoscopic cholecystectomy Answer: - ambulation*** - wound care (multiple small incisions) - discuss with patient about effects of CO2 used during surgery (shoulder pain) - may need to pass gas or belch to relieve QUESTION definition of constipation Answer: less than 3 bowel movements per week QUESTION assessment questions for patients with constipation Answer: - how many bowel movements do you have per week - how much fluid are you consuming - do you exercise - what foods do you eat QUESTION constipation prevention Answer: - increase fiber intake - increase fluids - do not suppress urge to defecate - exercise - do not force daily bowel movements QUESTION complications of constipation Answer: - hemorrhoids - anal fissures*** - abdominal distention - rectal mucosal ulcers - diverticulosis QUESTION medication treatment for anal fissures Answer: docusate sodium (Colace) QUESTION treatment for constipation Answer: - bulk forming laxative (Metamucil, Citrucel)*** - increase fluids and fiber - increase exercise - stool softener (docusate sodium) QUESTION causes of small bowel obstruction Answer: - adhesions*** - hernia - cancer - intestinal kink - absent peristalsis (paralytic ileus) QUESTION causes of large bowel obstruction Answer: - colorectal cancer - diverticular disease - ischemia QUESTION Nursing assessment for small bowel obstruction Answer: - frequently assess for resolution*** - monitor for bowel sounds - ask patient if they have passed flatus - assess I&O QUESTION What should a nurse monitor for a patient with an NG tube for a small bowel obstruction? Answer: fluids and electrolytes QUESTION Answer: - pain during the night - pain 2-3 hours after eating QUESTION diagnostic tests for peptic ulcer disease Answer: - endoscopy - H pylori test - labs (CBC to check for ANEMIA) - stool sample QUESTION treatment for peptic ulcer disease Answer: - Misoprostol (improves blood supply to area of ulcer) - adequate rest - avoid alcohol, caffeine, smoking - dietary modifications (avoid extremely hot or cold foods) - avoid NSAIDs or aspirin unless given with a PPI, H2 blocker - antibiotics if patient has H. pylori - eat 3 meals per day QUESTION complications from GERD Answer: - Barrett's esophagus (pre-cancerous)*** - esophagitis - cough - dental erosion QUESTION Patient education for GERD Answer: - elevate HOB - low-fat diet - avoid acid-producing foods and caffeine - decrease alcohol intake - eat small, frequent meals - stop smoking - avoid eating close to bedtime - avoid tight-fitting clothing - weight reduction - avoid milk QUESTION What lab is important to check for patients taking antacids such as Maalox? Answer: magnesium level QUESTION patient education for H2 antagonists Answer: - take at bedtime - take whole - do not take with antacids - treatment may be up to a year QUESTION PPI examples Answer: - Omeprazole (Prilosec) - Lansoprazole (Prevacid) - Pantoprazole (Protonix) QUESTION patient education for PPIs Answer: - may be taken any time of the day but stay consistent each day - reduces acid production QUESTION patient education for Sucralfate Answer: - take before meals since it coats the esophagus and stomach - take 1-2 hours before or after antacid - binds with Cimetidine, Digoxin, Warfarin, Phenytoin, & Tetracycline QUESTION H2 antagonist examples Answer: - Cimetidine (Tagamet) - Ranitidine (Zantac) - Famotidine (Pepcid) QUESTION assessment questions for patients with diarrhea Answer: - have you been on antibiotics recently***