Exam 11: Gastrointestinal Surgery

Exposure of intra-abdominal anatomy in laparoscopy is crucial to safe surgery and employs varied instruments,applications of highly technical energy sources,patient manipulations,light,and imaging.Review the list below and select the technique that is initiated to promote exposure.

Select the statement/s that best describe the properties of the gastrointestinal (GI)tract.

As the surgeon prepared to clamp and transect the bowel during a small bowel resection for tumor,the scrub person transferred instruments from the Mayo stand to the back table and prepared the sterile field for bowel isolation technique.Review the list below and select the nursing diagnosis that is most closely related to bowel isolation technique.

Review the list below and select the answer that reflects the correct match between the procedure and the disease.

Which statement about the McBurney incision is most correct?

Select the option that pairs the correct surgical diagnosis with the surgical/endoscopic procedure for diseases of the abdomen.

A 42-year-old woman has been diagnosed with severe gastroesophageal reflux disease (GERD)without the dysplastic changes of Barrett's esophagus.Her GERD is unresponsive to proton pump inhibitors and histamine blockers.She also has a history of endometriosis with multiple surgeries for ablation of endometrial implants on her small bowel and adhesiolysis.Her surgeon is hesitant to pursue an open or a laparoscopic Nissen fundoplication surgical approach.Which procedure might her surgeon consider in lieu of a Nissen?

When setting up for a Billroth I gastrectomy,the scrub person will ensure that the appropriate vascular instruments are available to clamp and ligate the:

Two patients are scheduled to have a gastrojejunostomy for obstruction.How will perioperative planning differ for a patient weighing 280 lb.as compared to that for a 120-lb patient?

A 55-year-old woman has arrived for an outpatient esophagogastroduodenoscopy.She is assessed by the perioperative nurse to be in good health and is listed as American Society of Anesthesiologists (ASA)class I.The patient changes into her gown and awaits transfer to the procedure room when she is informed that she will not be transferred to the procedure room until __________ and must wait for ________.

Triangular orientation is a term used to describe the method used to provide instrument access to the anatomy during abdominal surgery.It is uniquely associated with which surgical incision?

A 38-year-old female has been admitted through the emergency department (ED)for severe abdominal pain,distended abdomen,and fever.The surgery service has been consulted and has scheduled her for exploratory surgery.The patient has undergone two open abdominal surgeries in the past for "female problems" and states that she has a tendency to form keloids.Review the list below and select the most likely preoperative diagnosis for the patient based on her surgical history and symptoms.

During a laparoscopic colectomy,the scrub person carefully placed the endoscopic electrosurgery instruments on the Mayo stand after inspecting the integrity of the insulation along the shaft.This practice is designed to meet the expectation for the following nursing outcome: the patient will be free from injury due to:

When compared with open and laparoscopic techniques,the potential benefits of natural orifice transluminal endoscopic surgery (NOTES)include no visible scars,possibly less pain,and potentially shorter hospital stays.Select a complication that is the most typical risk associated with NOTES.

Pure natural orifice transluminal endoscopic surgery (NOTES)procedures are procedures performed using flexible endoscopes and instruments passed through the scopes' working channels.Many surgeons use a hybrid NOTES technique.What is the difference between the pure NOTES and hybrid technique?

A patient consulted a noted colorectal surgeon after experiencing episodes of rectal bleeding over the last 2 weeks.The patient had a screening colonoscopy 5 years ago with several adenomatous polyps and mild diverticular disease.She presents to the endoscopy suite after a successful bowel prep and NPO since midnight.The GI endoscopist is confident that he will find tumor growth in the rectum and decides to employ further diagnostic applications to determine potential for metastasis.Which of the following endoscopic procedures best describes the patient's procedure?

A 19-year-old male has suffered from subsacral pain and swelling for 2 weeks and finally was referred to a colorectal surgeon for care.He is currently in the ambulatory surgical center operating room (OR)bed positioned in the jackknife position.The perioperative nurse has gently but firmly taped his buttocks laterally to the rails of the OR bed to promote exposure to the surgical site.Which procedure is the patient prepared to undergo based on his symptoms and the surgical preparation?

The stomach receives ingested food from the esophagus to begin the digestive process.In anticipation of receiving ingested material,the stomach prepares for its role in digestion by:

A 72-year-old male is scheduled for a total colectomy with ileostomy in the morning.The wound ostomy care nurse (WOCN)has consulted the patient to initiate his ostomy teaching,answer his questions,and mark the site on his abdomen that would be the ideal placement for the ileostomy.An appropriate nursing diagnosis for the patient at this time would be:

A 12-year-old girl with a history of weight loss and stomach upset and pain after eating is also small for her age.Her pediatrician suspects celiac disease.The patient has arrived at the pediatric endoscopy unit for a procedure that is less invasive and will also have the benefit of spending the next few hours in the mall across from the hospital with her mom until the procedure is over.What is her scheduled procedure?