Ginas Study Guide Nuero 5 GI Biliary8

8/17/2019 Ginas Study Guide Nuero 5 GI Biliary8

1/20

April 23, 2016, – Up date

STUDY GUIDE FOR

MODULES 5 & 8

1. Understand and know how to evaluate a patient’s level of consciousness using theGlasgow o!a "cale. #now at what level $comatose” is deter!ine

Glasgow oma Scale! a "#$c% pact$cal a'd sta'dad$(ed s)stem *o assess$'g t+eLO,

T+ee aeas assessed- .t/s a0$l$t) to1

23, spea%

43, O0e) omma'ds

3, Ope' t+e e)es w+e' a 6e0al o pa$'*#l st$m#l#s 7ste'al #03 $s appl$ed

T+ee $'d$catos o* espo'se ae e6al#ated123, Ope'$'g o* t+e e)es

43, est 6e0al espo'se

3, est moto espo'se

Spec$*$c 0e+a6$os o0se6ed as espo'ses to t+e test$'g st$m#l#s ae g$6e' '#me$c 6al#es,

9s a :#se; )o# espo's$0$l$t) $s to el$c$t t+e 0est espo'se o' eac+ o* t+e scales,

T+e +$g+e t+e scoes t+e +$g+e t+e le6el o* 0a$' *#'ct$o' a'ge *om !25

omatose $s detem$'ed at a le6el 8 o 0elow,

2. #now the pri!ar% responsi&ilities of the nurse caring for a client with a sei'ure disorder.


2/20

(hen a "ei'ure occurs)

*&serve and record details of event

+ote all aspects(hat event preceded the sei'ure

(hen did the "ei'ure occur

-ow long did each phase last.odomal /e!ission stage &efore an% "" of sei'ure

9#al "u&ective to pt, hase in sensor% warning

Ictal! ull "ei'ure

.ost$ctal hase after sei'ure, rest and recover%

(hat occurred during each phase

4oth su&ective 5aural stage and o&ective data are i!portant

+ote the e7act onset 5which &od% part was affected first and howourse and nature of sei'ure activit% 5loss of consciousness, tongue &iting, auto!atis!,

stiffening, erking, total lack of !uscle tone

8he &od% parts involved and their se9uence of involve!ent

Autono!ic signs such as):ilated pupils

;7cessive salivationAltered &reathing

%anosis

lushing diaphoresis"upil si'e and position

?e!or% loss

?uscle soreness"peech disorder 5aphasia, d%sarthria

(eakness or paral%sis

"leep periodAnd duration of each sign and s%!pto!

3. #now and full% understand all aspects of the ad!inistration of :ilantin 5esp

including teac+$'g; and what possi&le adverse reactions 5signs@s%!pto!s in the pt.,

!ight occur w+e' to


3/20

. 4e a&le to identif% the cl$'$cal ma'$*estat$o's o* a spec$*$c se$(#e t)pe when given

specific client signs and s%!pto!s. BBB =;A"; review under Generali'ed "ei'ures?%oclonic, si!ple focal; comple< *ocal; and t%pical a&sence. lease st#d)=e6$ew the

se$(#e powe po$'t,

SEI>URE DISORDERS 9:D E.ILE.SY

9 seizure $s a paoenous irritation, pain, and

thro!&ophle&itis.

;7travasation can causetissue necrosis

Teac+$'g1


4/20

Se$(#es ae d$6$ded $'to two ma@o classes1 ge'eal$(ed a'd *ocal,

Generalized seizures

$'6ol6e 0ot+ s$des o* t+e 0a$' a'd ae c+aacte$(ed 0) 0$lateal s)'c+o'o#s

ep$lept$c d$sc+ages $' t+e 0a$', eca#se t+e e't$e 0a$' $s a**ected at t+e o'set o*t+e se$(#es; t+ee $s 'o wa'$'g o a#a,

Tonic-clonic seizure

Loss o* co'sc$o#s'ess a'd *all$'g to t+e go#'d $* t+e pat$e't $s

#p$g+t

Followed 0) st$**e'$'g o* t+e 0od) 7to'$c p+ase3 *o 2? to 4? seco'ds

S#0se"#e't @e%$'g o* t+e e


5/20

eg$'s s#dde'l) a'd peso' *alls

o'sc$o#s'ess #s#all) et#'s 0) t$me peso' +$ts go#'d,

a' es#me 'omal act$6$t) $mmed$atel)

Geat $s% *o +ead $'@#)

Tonic seizures

o I'6ol6e s#dde' o'set o* ma$'ta$'ed $'ceased to'e $' t+e e


6/20

Mag'etoe'cep+alogap+) $' co'@#'ct$o' w$t+ EEG

o Geate se's$t$6$t) *o detect$'g small mag'et$c *$elds ge'eated 0) 'e#o'al

act$6$t)

; se#m c+em$st$es; l$6e a'd %$d'e) *#'ct$o'; U9 to #le o#t meta0ol$c

d$sodes

MRI; T; .ET

.$ma) d#gs *o teatme't o* ge'eal$(ed to'$c!clo'$c a'd *ocal se$(#es

.+e')to$' 7D$la't$'3

D$6alpoe< 7Depa%ote3

a0ama(ep$'e 7Tegetol3

.+e'o0a0$tal 7L#m$'al3

.$m$do'e 7M)sol$'e3

7a0ama(ep$'e; p+e'o0a0$tal; a'd p$m$do'e 'egat$6el) a**ect cog'$t$6e *#'ct$o',

D#g $'teact$o's w$t+ ca0ama(ep$'e; p+e')to$'; p+e'o0a0$tal3

.$ma) d#gs #sed to teat a0se'ce a'd m)oclo'$c se$(#es

Et+os#($m$de 7>ao't$'3

D$6alpoe< 7Depa%ote3

lo'a(apam 7lo'op$'3

9't$se$(#e d#gs s+o#ld 'ot 0e d$sco't$'#ed a0#ptl) as t+$s ca' pec$p$tate se$(#es,

ommo' s$de e**ects $'6ol6e

t+e :S a'd $'cl#de d$plop$a; dows$'ess; ata


7/20

C. Understand all the nursing i!plications involved with the procedure laparoscopic

:$sse' F#'dopl$cat$o',

5G;/: and -A

ain control

9ssess

o /esp rate, and rh%th!,

o ulse rate and rh%th!

o "igns of neu!othora7 5d%spnea, chest pain, c%anosis

H+e' pe$stals$s et#'s; o'l) *l#$ds ae g$6e' $'$t$all)

o ?easure


8/20

, #now the commo' d#gs used to treat peptic ulcers and what their therapeutic effect

should &e as well as an% specific nursing i!plications as it relates to side effects,

ad!inistration ti!es, and interactions with other !edications.

eptic !lcer "isease

• Peptic ulcer disease 5U: is a condition characteri'ed &% erosion of the G< !ucosa fro!

the digestive action of h%drochloric acid and pepsin.

• U: is classified as acute 5"U;/


9/20

..I/s1 =ong ter! use or high doses !a% increase the risk of fractures of hip wrist andspine. Also increased risk of :iff in hospitali'ed pt’s. =ong ter! use is also associated

with +A.

. 4e a&le to identif% a specific t%pe of ulcer 5duodenal, gastric given a client’s signs s%!pto!s.

Hypercalcemia, kidney stones,decreases absorption oftetracycline, phenytoin andiron salts, Increases Digitaliseects. Use cautiously with

renal and cardiac patient


10/20

D. Understand and know the pathoph%siolog%@etiolog% of holec%stitis holelithiasis)

and, what happens when the co!!on &ile duct is o&structed as far as a&sorption of certain

!inerals@vita!ins 7*at!sol#0le 6$tam$'s3, (hat possi&le s$g's & s)mptoms !ight the pt. e7hi&it with a deficienc% in an% of these vita!ins.

C#olelit#iasis C#olecystitis"tones in the Gall 4ladder


11/20

• "tones !a% &e lodges in the neck of

the gall &ladder or the c%stic duct.

• :evelops when the &alance that keeps

cholesterol, &ile salts, and calciu! in

solution is altered and precipitationoccurs.

• ?a% produce severe s%!pto!s or

none at all, depending on whether thestones are stationar% or !o&ile and

whether o&struction is present

• Ultrasonograph% is co!!onl% used to

diagnose gallstones

• 8reat!ent

o =aparoscopic cholec%stecto!% is

the treat!ent of choice for

s%!pto!atic holelithiasis.

o ?edical dissolution therap% is

reco!!ended for patients withs!all radiolucent stones who are

!ildl% s%!pto!atic and are poor

surgical risks.

• Acute or chronic

• Usuall% associated with holelithiasis

or &iliar% sludge 5a !i7ture ofcholesterol cr%stals and calciu! salts.

•?anifestations of cholec%stitis var%fro! indigestion to !oderate to severe

pain, fever, and aundice

•


12/20

.


13/20

J, Understand and &e a&le to identif% the nutritional reco!!endations for such disorders asG;/:, -iatus -ernia, eptic Ulcer, and holec%stitis. KKMost $mpota'tl); review

I'g#$'al e'$a and the nursing care of the patient postoperativel% 7Lew$s; pg, JJ!

JJ3,GERD Low Fat D$et; eat small *e"#e't meals;

a6o$d alco+ol a'd smo%$'g a'd

ca**e$'e; Do 'ot l$e dow' *o 4! +o#s

a*te eat$'g; a6o$d eat$'g +o#s

0e*oe 0edt$me, Sleep w$t+ +ead

ele6ated; 9OID c+ocolate;

peppem$'t; tomatoes; *att) *oods;

co**ee a'd tea 7 deceases LED

pess#e3 Lso a6o$d m$l% espec$all) at

"+s 7 $'ceases gast$c ac$d secet$o's3

96o$d co'st$ct$'g game'ts$at#s e'$a! +e'$at$o' o* t+e pot$o'

o* t+e stomac+ $'to t+e esop+ag#s

t+o#g+ a' ope'$'g o +$at#s; $' t+e

d$ap+agm,

Low Fat D$et; eat small *e"#e't meals;

a6o$d alco+ol a'd smo%$'g a'd

ca**e$'e; Do 'ot l$e dow' *o 4! +o#s

a*te eat$'g; a6o$d eat$'g +o#s

0e*oe 0edt$me, Sleep w$t+ +ead

ele6ated; 9OID c+ocolate;

peppem$'t; tomatoes; *att) *oods;

co**ee a'd tea 7 deceases LED

pess#e3 Lso a6o$d m$l% espec$all) at

"+s 7 $'ceases gast$c ac$d secet$o's3

96o$d co'st$ct$'g game'ts, 96o$dl$*t$'g a'd sta$'$'g

.ept$c Ulce 96o$d $$ta'ts s#c+ as ca**e$'e;

el$m$'ate alco+ol, 96o$d +ot a'd sp$c)

*oods; peppe; ca0o'ated d$'%s a'd

0ot+ 7meat e


14/20

Moe commo' $' me'

S#ge) $s t+e teatme't o* c+o$ce *o +e'$as,

I* t+e +e'$a 0ecomes sta'g#lated; t+e pat$e't w$ll e


15/20

5overgrowth of hair

9S9 5aspirin Antiplatelet

Dos$'g) 16032C !g orall%within Dhours of event

5"econdar% proph%la7is C to

100 !g *rall% dail%

S+o#ld 'ot $'gest geate

t+a' 25?mg=%g o ,5 g o*

asp$$',

G< Upset, and tinnitus ?ild to !oderate 8o7icit%) G<upset, tinnitus, tach%pnea, and

respirator% alkalosis.

Se6ee To


16/20

9RE1

.T=OT=Speec+ t+eap) to ma


17/20

a' esol6e spo'ta'eo#sl)

T+eap)

:rug therap%

Anticholinesteraseorticosteroids

"urgical therap%)8h%!ecto!% th%!us tu!or re!oval

*ther therapies

las!apheresis e7change plas!a 5short ter! therap%

A/;):on’t take !eds on e!pt% sto!ach

8ake !eds &efore food 5C !inutes to help ease feeding

8ake !eds*2, suction, e9uip!ent


18/20

?/<

"


19/20

o ?;:


20/20

'o de*$'$t$6e tests

&.

Fat$ga0$l$t) w$t+ #pwad ga(e 7e)es almost closed3

M#scle wea%'ess! $mpo6e a*te est

o EMG; 7electom)ogap+)3

o S$'gle *$0e EMGo Tes's$lo' test!

o a d$ag'ost$c tec+'$"#e *o 6e$*)$'g t+e s$g's o* m)ast+e'$a ga6$s 0) test$'g

t+e powe o* s%eletal m#scles 0e*oe a'd a*te $'@ect$o' o* edop+o'$#m

+)doc+lo$de,

o e6eals $mpo6ed m#scle co'tact$l$t) a*te $'@ect$o' 7e'dop+o'$#m

c+lo$de3 #sed to +elp co'*$m d$ag'os$s 7w+at ae t+e cl#es to d$ag'ose

d$sease3

o I' m)ast+e'$a ga6$s; t+ee ae too *ew eceptos *o acet)lc+ol$'e o' t+e

m#scle, T+e acet)lc+ol$'e $s 0o%e' dow' 0e*oe $t ca' *#ll) st$m#late t+$s

ed#ced '#m0e o* eceptos; a'd; as a es#lt; t+e m#scle $s wea%, )

0loc%$'g t+e act$o' o* acet)lc+ol$'estease; Te's$lo' polo'gs t+e m#scle

st$m#lat$o'; a'd tempoa$l) $mpo6es ste'gt+, I'ceased ste'gt+ *ollow$'g

a' $'@ect$o' o* Te's$lo' sto'gl) s#ggests a d$g'os$s o* MG, T+e Te's$lo' test

$s most e**ect$6e w+e' eas$l) o0se6ed wea%'ess $s pese't; a'd $s less #se*#l

*o 6ag#e o *l#ct#at$'g compla$'ts,

o Atropine is t#e antidote

Sol$d d< e"#$es

Seolog)1 9cet)lc+ol$'e ecepto 9't$0od$es 7alo'g w$t+ com0$'at$o'

w$t+ ot+e tests3

+est !a)

T

Date post:	06-Jul-2018
Category:	Documents
Upload:	gina-armenta-contreras
View:	227 times
Download:	0 times

Ginas Study Guide Nuero 5 GI Biliary8

Documents