Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 | Registered Nurse (RN) School Study Aid
Intestinal Obstruction
- Severe Abdominal Pain
- Vomiting
- High Pitched Bowel Sounds
- Abdominal Distention
- Increased Peristalsis
- Absent Bowel Sounds
- Paralytic Ileus
Types of Intestinal Obstruction
- Adhesions
- Hernia
- Volvulus
- Intussusception
- Tumor
- Mesenteric Artery Occlusion
- Spinal Injury
- Paralytic Ileus
Metabolic Alkalosis Assessment
- Increased pH > 7.45
- Increased HCO3 > 26
- Excitable State
- Arrhythmias
- Paresthesias
- Muscle Cramps
- Muscle Weakness
- Decreased Respiratory Effort
Metabolic Acidosis Assessment
- Decreased pH < 7.35
- Decreased HCO3 < 22
- Abdominal Pain
- CNS Depression
- Coma
- Hypotension
- Arrhythmias
- Increased Respirations
- Kussmaul Respirations
- Flushed, Warm, Dry Skin
- Muscle Weakness
Intussusception
- Telescoping of Bowel Segments
- Lead Point
- Episodic Abdominal Pain
- Diarrhea
- Sausage-Shaped Mass
- Red Currant Jelly Stools
- Ultrasound/CT
- Target Sign
- More Common in Children
- Rotavirus Vaccine Contraindicated
- Air or Hydrostatic Enema
- Surgical Reduction
Colorectal Cancer Assessment
- 3rd Most Common Cancer
- Change in Bowel Habits
- Bowel Obstruction
- Rectal Bleeding
- Anemia
- Weight Loss
- Ascites
- Colonoscopy
- FOBT and FIT
Colorectal Cancer Interventions
- Surgical Colon Resection
- Radiation
- Chemotherapy
- Bowel Cleansing
- Screening
- Colostomy
- Dietary Consult
- Body Image
Colostomy Care
- Wash with Warm Water
- Cut 1/8 inch Around Stoma
- Decreases Skin Irritation
- Empty When 1/3 to 1/2 Full
- Change 3-7 Days
- Avoid Odor Causing Foods
- Irrigate at Same Time
Irritable Bowel Syndrome (IBS) Assessment
- Abdominal Pain
- Relieved by Defecation
- Alternating Diarrhea and Constipation
- Fatigue
- Excessive Flatulence
- Sensation of Incomplete Evacuation
- Stressors
- Food Intolerances
- More Common in Women
- Rule Out Other Disorders
Irritable Bowel Syndrome (IBS) Interventions
- Identify Triggers
- Increase Fiber Intake
- Probiotics
- Anticholinergics
- Tricyclic Antidepressants (TCAs)
- Loperamide
- Linaclotide
- Tegaserod (Zelnorm)
- Lubiprostone (Amitiza)
- Alosetron (Lotronex)
Tricyclic Antidepressants (TCAs)
- Inhibits Reuptake of Norepinephrine and Serotonin
- Depression
- Bipolar Disorder
- Fibromyalgia
- Sedation
- Orthostatic Hypotension
- Anticholinergic Effects
- Cardiac Toxicity
- Delayed Effect
- Do Not Stop Abruptly
Tricyclic Antidepressants (TCAs) Indications
- Major Depression
- Bedwetting
- Fibromyalgia
- OCD
- -Iptyline or -Ipramine Suffix
- Amitriptyline
- Desipramine
- Clomipramine
- Imipramine
- Nortriptyline
Types of Hernias
- Hiatal
- Gastroesophageal Reflux Disease (GERD)
- Inguinal
- Men
- Femoral
- Women
- Incisional
- Umbilical
- Strangulation
Hernia Interventions
- Reduce Intra Abdominal Pressure
- Avoid Straining and Lifting
- Open Mouth Sneezing
- Excision
- Herniorrhaphy
- Hernioplasty
- Scrotal Support
Cobalamin (Vitamin B12)
- Vitamin B12
- Vitamin Deficiency
- Pernicious Anemia
- Hypokalemia
- Arthralgia
- Dizziness
- IM Injection for Pernicious Anemia
- Never Give IV
Interventions for Impaired Skin Integrity
- Signs of Skin Breakdown
- Pain
- Redness
- Decreased Skin Turgor
- Bleeding
- Bony Prominences
- Reposition Q2H
- Pressure Relief
- Maintain Clean and Dry Skin
- Adequate Nutrition and Hydration