* Spinal anesthesia is the most common method used in

appendectomy. Using thismethod, Only the area affected is

anesthetized preventing systemic side effects of anesthetics like
dizziness, hypotension and RR depression.93. Post op care for
appendectomy include the following except [1]A. Early
ambulation
B. Diet as tolerated after fully conscious
C. Nasogastric tube connect to suctionD. Deep breathing and leg
exercise* Client's peristalsis will return in 48 to 72 hours post-
op therefore, Fluid and food arewitheld until the bowel sounds
returns. Remember that ALL PROCUDURES
requiringGENERAL and SPINAL anesthesia above the nerves
that supply the intestines will causetemporary paralysis of the
bowel. Specially when the bowels are traumatized during
the procedure, it may take longer for the intestinal peristalsis to
resume.94. Peritonitis may occur in ruptured appendix and may
cause serious problems whichare [2]1. Hypovolemia, electrolyte
imbalance2. Elevated temperature, weakness and diaphoresis3.
Nausea and vomiting, rigidity of the abdominal wall4. Pallor
and eventually shock A. 1 and 2B. 2 and 3C. 1,2,3
D. All of the above
* Peritonitis will cause all of the above symptoms. The
peritoneum has a natural tendencyto GUARD and
become RIGID as to limit the infective exudate exchange inside
theabdominal cavity. Hypovolemia and F&E imbalance are
caused by severe nausea andvomiting in patients with peritonitis
because of acute pain. As inflammation and infectionspreads,
fever and chills will become more apparent causing elevation in
temperature,weakness and sweating. If peritonitis is left
untreated, Client will become severelyhypotensive leading to
shock and death.95. If after surgery the patient’s abdomen
becomes distended and no bowel soundsappreciated, what
would be the most suspected complication? [1]A.
Intussusception
B. Paralytic Ileus
C. HemorrhageD. Ruptured colon* Paralytic Ileus is a
mechanical bowel obstruction where in, the patients intestine
fails toregain its motility. It is usually caused by surgery
and anesthesia. Intusussusception,Appendicitis and Peritonitis
also causes paralytic ileus.
96. NGT was connected to suction. In caring for the patient with
NGT, the nurse must [2]
A. Irrigate the tube with saline as ordered
B. Use sterile technique in irrigating the tubeC. advance the tube
every hour to avoid kinksD. Offer some ice chips to wet lips*
NGT after appendectomy is used not to deliver nutrients but to
decompress the GI tract because of the absence of peristalsis
after appendectomy. The stomach and intestines arenot sterile,
Clean technique is sufficient during irrigation. NGT is placed
and notanymore advanced as long as it already reach the
stomach. Naso enteric tubes are the onethat are advanced
periodically until obstruction is reached in the intestine. The
client stillneeds assessment and confirmation of the return of
peristalsis before anything is given per orem. Irrigations are
done to prevent obstruction in the tube.97. When do you think
the NGT tube be removed? [1]A. When patient requests for itB.
Abdomen is soft and patient asks for water
C. Abdomen is soft and flatus has been expelled
D. B and C only* When flatus is expelled, it means that
peristalsis has returned and theres is no need for continuing the
NGT.Situation: Amanda is suffering from chronic
arteriosclerosis Brain syndrome she fellwhile getting out of the
bed one morning and was brought to the hospital, and she
wasdiagnosed to have cerebrovascular thrombosis thus
transferred to a nursing home.98. What do you call a STROKE
that manifests a bizarre behavior? [4]A. Inorganic StrokeB.
Inorganic PsychosesC. Organic Stroke
D. Organic Psychoses
* Organic psychoses is a broad and collective term used for
psychoses and schizophreniathat has an organic cause. [ Due to
Creutzfeldt jakob disease, huntington, hydrocephalus,increase
ICP, dementia, stroke etc. ] Manifesting signs and symptoms
like hallucination,delustions, illusion, ideas of reference etc. that
is similar to schizophrenia and psychosesin absence of organic
causes.99. The main difference between chronic and organic
brain syndrome is that the former [2]A. Occurs suddenly and
reversibleB. Is progressive and reversible
C. tends to be progressive and irreversible
D. Occurs suddenly and irreversible
* Chronic brain syndrome tends to be progressive and
irreversible. Organic brainsyndrome is acute and irreversible
or reversible depending on the causative factor.100. Which
behavior results from organic psychoses? [4]A. Memory deficit
B. DisorientationC. Impaired JudgementD. Inappropriate
affect
* B, C and D are all behaviors that results from organic
psychoses. The questions seemsto ask EXCEPTION which is
A. MEMORY DEFICIT
. Organic psychoses is the sameas the usual psychoses except
that the causative factor of organic psychoses is evidentlycaused
by a disease process of the brain or affecting the brain. Example
are patients whosuffer stroke suddenly experience hallucinations
and delusions. Organic psychoses issimply a psychoses that has
an IDENTIFIED CAUSE. Knowing this will lead you
tounderstand that psychoses is manifested by B,C, and D but
NOT MEMORY DEFICIT.