Exam 10: Gastrointestinal Surgery

Sandra Roberts has arrived for her outpatient screening colonoscopy.She has all of her required paperwork and admits to a successful bowel prep.She is assessed by the perioperative nurse to be in good health and is listed as ASA class I.Sandra has no allergies and her vital signs are within normal range.She changes into the patient 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 :

A patient whose neck has been slashed and has a severed lower trachea may also have injury to the:

The general risks associated with gastrointestinal surgery parallel those risks associated with most abdominal procedures.Select a complication that is the most typical risk associated with surgery of the large bowel.

Select the statement that best reflects the functional components of the gastrointestinal (GI)tract.

Ann Contreras has consulted a noted colorectal surgeon after experiencing episodes of rectal bleeding over the last 2 weeks.She 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 she 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 Ann's procedure?

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

An abdominal perineal resection,or APR,for a patient at high risk for colon cancer without anal/rectal involvement (e.g.,familial adenopolyposis [FAP])can be accomplished through an open laparotomy or laparoscopic-assisted ileoanal pull-through approach,per surgeon preference and appropriate patient selection.Which of these statements about approaches for APR is correct?

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

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.

Carly Shelmire is a 5-year-old girl with a history of weight loss and stomach upset and pain after eating;she is also small for her age.Her pediatrician suspects celiac disease.Carly 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 Carly's scheduled procedure?

Ramona Guerne has been admitted through the emergency department for severe abdominal pain,distended abdomen,and fever.The surgery service has been consulted and has scheduled her for exploratory surgery.Ramona has undergone two abdominal surgeries in the past for "female problems" and states that she has a tendency to form keloids.A small bowel obstruction is suspected.Postoperative ileus is a common complication of open abdominal surgery.Select the procedure that is least likely to promote postoperative ileus formation in this patient.

Michael Mason 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 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.What procedure is Michael prepared to undergo,based on his symptoms and the surgical preparation?

Specific positioning considerations for bariatric patients require particular attention to protecting these patients from inherent risks related to their size and weight.Of considerable concern is the risk of injury to staff.Protective measures to protect both patient and staff include those below.Which measure reflects the most safety protection for both patient and staff?

Single-incision laparoscopic surgery (SILS)and natural orifice endoscopic transluminal surgery (NOTES)are minimal access surgery (MIS)approaches and share many indications,implications,and instrument platforms.The benefits and drawbacks essentially parallel each other;however,there are several unique differences that set each apart and define their application.What is the one question that needs to be answered to determine if SILS should be considered in lieu of NOTES?

Sharon Close 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 surgical approach.What procedure might her surgeon consider in lieu of a Nissen?

Exposure of intra-abdominal anatomy is crucial to safe surgery and employs varied instruments,applications of highly technical energy sources,patient manipulations,light,and imaging.What is unique to the laparoscopic approach that promotes exposure?

Select the statement that most correctly matches a risk factor for adhesions with an appropriate preventive strategy.

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

Triangulation 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?