HESI MED SURG STUDY GUIDE

Pneumonectomy - Removal of the entire lung; position client on operative side or back

Intussusceptions - Telescoping of the gut within itself

Neurogenic causes of intestinal obstruction - Paralytic ileus and spinal cord lesion

Vascular causes of intestinal obstruction - Mesenteric artery occlusions which can lead to gut infarct

Mechanical bowel obstruction - Due to disorders outside the bowel caused by disorders within the bowel
or by blockage of the lumen in the intestine

Nonmechanical bowel obstruction - Due to paralytic ileus, which doesn't involve any actual physical
obstruction but results from inability of the bowel itself to function

Nursing assessment of bowel obstruction - Sudden onset of abdominal pain, tenderness or guarding;
history of abdominal surgeries; history of obstruction; distention; increased peristalsis when obstruction
first occurs, then peristalsis becoming absent when paralytic ileus occurs; bowel sounds that are high-
pitched with early mechanical obstruction and diminished to absent with neurogenic or late mechanical
obstruction

Blood gas analysis: alkalotic state - Will show ?? if the bowel obstruction is high in the small intestine
where gastric acid is secreted

Blood gas analysis: acidic state - Will show ?? if the bowel obstruction is in the lower bowel where base
solutions are secreted

Bowel obstruction nursing plans and interventions - NPO with IV fluid and electrolyte therapy; I&O;
implement NG tube; document pain; assess abdomen regulary for distention, rigidity, change in status of
bowel sounds

Nasogastric intubation - Attach to low suction (intermittent 80mmHg); document output every 8 hours;
irrigate with normal saline

Cantor, miller-Abbott or harris tubes - Passed through the nose and into the stomach; advance tube every
1-2 hours; do not secure to nose until tube reaches specified position; repositioning client q2h to assist
with placement of tube; connect to suction; irrigate with air only; note amount, color, consistency and any
unusual odor or drainage

Colorectal cancer - Tumors occurring in the colon

Recommended diet to prevent bowel cancer - Eat more cruciferous vegetables, increase fiber intake,
maintain average body weight, eat less animal fat

Nursing assessment for colorectal cancer - Rectal bleeding, change in bowel habits, sense of incomplete
evacuation, abdominal pain, nausea, vomiting, weight loss, cachexia, family history of cancer, history of
polyps

Nursing plans and interventions for colorectal cancer - Prepare client for surgery; prepare client for bowel
preparation; provide high calorie, high protein diet; prevention of constipation with high fiber diet; early
detection by screening with hemoccult tests