NR 341 Complex Adult Health CMS Exam Review 2024-2025 (100%Verified Solutions).
Complex Adult Health CMS Review
Resources - ATI: RN Adult Medical
... [Show More] 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. [Show Less]