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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid
Gastroesophageal Reflux Disease (GERD) Assessment
- Pathophysiology
- Relaxed Lower Esophageal Sphincter
- Signs and Symptoms
- Dyspepsia (Indigestion)
- Belching
- Nighttime Coughing
- Dysphagia
- Epigastric Pain
- Regurgitation
- Heartburn (Pyrosis)
- Globus
2 mins
Abdomen Assessment
- Inspect the Abdomen
- 4 Quadrants
- Contour, Shape, Symmetry
- Umbilicus
- Auscultate
- Bowel Stethoscope
- Vascular Sounds
- Percussion
- Percuss 4 Quadrants
- Tympany or Dullness
- Palpate
- Light Palpation
- Deep Palpation
- Rebound Tenderness
5 mins
Types of Hernias
- Hiatal
- Gastroesophageal Reflux Disease (GERD)
- Inguinal
- Men
- Femoral
- Women
- Incisional
- Umbilical
- Consideration
- Strangulation
1 min
Hernia Interventions
- Reduce Intra Abdominal Pressure
- Avoid Straining and Lifting
- Open Mouth Sneezing
- Excision
- Herniorrhaphy
- Hernioplasty
- Consideration
- Scrotal Support
1 min
Patient Position Overview
- Position Techniques
- Trochanter Roll
- Trapeze Bar
- Ankle-Foot Orthotic (AFO) Devices
- Positions
- Fowlers Position
- Supine Position
- Trendelenburg
- Side-Lying Position
- Prone Position
- Sims' Position
- Nursing Considerations
- Reposition q2 Hours/Prevent Skin Breakdown
- Confirm Body Alignment
2 mins
Peptic Ulcer Disease Assessment
- Mechanism/Cause
- Helicobacter Pylori
- NSAIDs
- Increased Stomach Acid
- Assessment
- Abdominal Pain
- Heartburn (Pyrosis)
- Melena
- Weight Changes
- GI Distress
- Considerations
- Most Commonly in Duodenum
- Duodenal: Pain Relieved by Eating
- Gastric: Pain Caused by Eating
2 mins
Peptic Ulcer Disease Interventions
- Combination Drug Therapy
- Two Antibiotics
- Proton Pump Inhibitor (PPI)
- Decrease Acid Secretion
- Avoid NSAIDs
- Diet and Lifestyle Changes
1 min
Helicobacter Pylori
- Characteristics
- Gram-Negative
- Bacilli
- Curved
- Polar Flagellum
- Catalase-Positive
- Oxidase-Positive
- Disease
- Gastric and Duodenal Ulcers
- Ammonia
- Neutral Environment
- Gastric Adenocarcinoma
- MALT lymphoma
- Diagnosis
- Serology IgG antibody
- Stool Antigen
- Urease Positive Breath Test
- Biopsy
- Treatment
- 2 ABX and PPI
2 mins
Helicobacter pylori Associations
- Gastritis
- Peptic Ulcer Disease
- Stomach Cancer
50 secs
Cimetidine and Famotidine (H2 Receptor Blockers)
- -tidine Suffix
- Mechanism
- H2 Receptor Blocker
- Indications
- Suppress Gastric Acid Secretion
- Side Effects (All)
- Pneumonia
- Side Effects - Cimetidine
- Anti-androgen Effects
- CNS Changes
2 mins
Sucralfate (Carafate)
- Mechanism
- Creates Protective Barrier
- Indications
- GI Ulcers
- Side Effects
- Constipation
- Considerations
- Require Acidic Environment
- Give on Empty Stomach
- Oral Suspension Available
- May Decrease Absorption of Other Meds
2 mins
Proton Pump Inhibitors (PPIs)
- "-prazole" Suffix
- Indications
- Zollinger-Ellison Syndrome
- Gastritis
- Peptic Ulcer
- Gastroesophageal Reflux Disease (GERD)
- Mechanism
- Inhibit H+/K+/ATPase
- Side Effects
- Hip fracture
- Pneumonia
2 mins
Omeprazole (Prilosec)
- "-prazole" Suffix
- Indications
- Zollinger-Ellison Syndrome
- Gastritis
- Peptic Ulcer
- Gastroesophageal Reflux Disease (GERD)
- Mechanism
- Proton Pump Inhibitor (PPI)
- Inhibit H+/K+/ATPase
- Side Effects
- Hip Fracture
- Pneumonia
2 mins
Irritable Bowel Syndrome (IBS) Assessment
- Abdominal Pain
- Relieved by Defecation
- Alternating Diarrhea and Constipation
- Fatigue
- Excessive Flatulence
- Sensation of Incomplete Evacuation
- Considerations
- Stressors
- Food Intolerances
- More Common in Women
- Rule Out Other Disorders
2 mins
Irritable Bowel Syndrome (IBS) Interventions
- Interventions
- Identify Triggers
- Increase Fiber Intake
- Probiotics
- Anticholinergics
- Tricyclic Antidepressants (TCAs)
- Loperamide
- Linaclotide
- Medications for Women
- Tegaserod (Zelnorm)
- Lubiprostone (Amitiza)
- Alosetron (Lotronex)
2 mins
Crohn's Disease Assessment
- Diarrhea
- 5-6 per day
- Cramping Abdominal Pain
- Fever
- Weight Loss
- Malabsorption
- Anemia
- Complications
- Obstruction
- Fistulas
2 mins
Ulcerative Colitis Assessment
- Assessment
- Cramping Abdominal Pain
- Tenesmus
- Bloody Diarrhea
- Up to 10-20 / Day
- Fever
- Complications
- Hemorrhage
1 min
Opioids Overview
- Indications
- Pain
- Weaning
- Cough
- Diarrhea
- Mechanism of Action
- Agonists at Mu (μ), Kappa (Κ), and Delta (δ) Receptors
- Decrease Synaptic Transmission
- Side Effects
- Respiratory Depression
- Addiction
- Miosis
- Constipation
2 mins
Diverticulosis and Diverticulitis Assessment
- Diverticulosis
- Outpouching
- Diverticulitis
- Inflamed Diverticula
- Assessment
- Abdominal Pain
- Abdominal Distention
- Flatulence
- Fever
- Rectal Bleeding
- Alternating Constipation and Diarrhea
- Considerations
- Peritonitis
2 mins
Diverticulosis and Diverticulitis Interventions
- Interventions
- High Fiber Diet
- Reduce Intra-abdominal Pressure
- Stool Softeners
- Exercise
- Anticholinergics
- Considerations
- Antibiotics
- Bowel Resection
2 mins
Diet Progression
- Types of Diets
- Clear Liquid
- Full Liquid
- Pureed
- Mechanical Soft
- Low Residue (Fiber)
- High Fiber
- Regular
1 min
Therapeutic Diets
- Common Therapeutic Diets
- High Fiber
- Low Residue (Fiber)
- Low Sodium
- Low Cholesterol
- Diabetic
- Renal
- Dysphagia
- Nursing Considerations
- Diet Education
2 mins
Intestinal Obstruction
- Partial/Early Obstruction
- Severe Abdominal Pain
- Vomiting
- High Pitched Bowel Sounds
- Abdominal Distention
- Increased Peristalsis
- Total/Neurogenic Obstruction
- Absent Bowel Sounds
- Paralytic Ileus
1 min
Types of Intestinal Obstruction
- Mechanical
- Adhesions
- Hernia
- Volvulus
- Intussusception
- Tumor
- Non-Mechanical
- Mesenteric Artery Occlusion
- Spinal Injury
- Paralytic Ileus
2 mins
Intussusception
- Pathophysiology
- Telescoping of Bowel Segments
- Lead Point
- Assessment
- Episodic Abdominal Pain
- Diarrhea
- Sausage-Shaped Mass
- Red Currant Jelly Stools
- Diagnosis
- Ultrasound/CT
- Target Sign
- Considerations
- More Common in Children
- Rotavirus Vaccine Contraindicated
- Management
- Air or Hydrostatic Enema
- Surgical Reduction
3 mins
Colorectal Cancer Assessment
- 3rd Most Common Cancer
- Assessment
- Change in Bowel Habits
- Bowel Obstruction
- Rectal Bleeding
- Anemia
- Weight Loss
- Ascites
- Considerations
- Colonoscopy
- FOBT and FIT
2 mins
Colorectal Cancer Interventions
- Interventions
- Surgical Colon Resection
- Radiation
- Chemotherapy
- Considerations
- Bowel Cleansing
- Screening
- Colostomy
- Dietary Consult
- Body Image
3 mins
Ileostomy Care
- Antibiotics
- Monitor Skin Breakdown
- Drains Continuously
- Fluid and Electrolyte Imbalance
- Low Fiber Diet
2 mins
Preoperative Care
- Preop Education
- Surgical Procedure
- NPO
- Turn, Cough, Deep Breathe, Incentive Spirometer
- Lower Extremity Exercises
- Compression Stockings or SCD's
- Pain Management
- Safety
- Informed Consent
- Physical Preparation
- Preop Checklist
- Handoff to Surgery
- Universal Precautions
2 mins
Colostomy Care
- Wash with Warm Water
- Cut 1/8 inch Around Stoma
- Decreases Skin Irritation
- Empty When 1/3 to 1/2 Full
- Change 3-7 Days
- Considerations
- Avoid Odor Causing Foods
- Irrigate at Same Time
2 mins
Cirrhosis Assessment
- Mechanism
- Degeneration and Destruction of Liver Cells
- Signs and Symptoms
- Jaundice
- Fatigue
- Palmar Erythema
- Spider Angiomas
- Hepatosplenomegaly
- Edema
- Gynecomastia
- Change in LOC
2 mins
Cirrhosis Interventions
- Interventions
- Maintain Nutrition
- Paracentesis
- Esophageal and Gastric Varices
- Drug Therapy
- Endoscopic Band Ligation or Sclerotherapy
- Balloon Tamponade
- Transjugular Intrahepatic Portosystemic Shunt (TIPS)
- Hepatic Encephalopathy
- Lactulose
- Antibiotics
2 mins
Complications of Cirrhosis
- Portal Hypertension
- Ascites
- Esophageal Varices
- Coagulation Defects
- Portal-Systemic Encephalopathy
- Hepatorenal Syndrome
1 min
Hyperbilirubinemia
- Cause/Mechanism
- Increased Unconjugated Bilirubin
- Assessment
- Jaundice
- Kernicterus
- Interventions
- Early Feedings
- Heme Oxygenase Inhibitors
- Phototherapy
- Protect Eyes
- Monitor for Dehydration
- Considerations
- Monitor Bilirubin Levels
3 mins
Bleeding Precautions
- Things to Avoid
- Hard Foods
- Aspirin Products
- Blowing Nose Forcefully
- Straining During BMs
- Enemas or Rectal Suppositories
- Pads and Monitor Menstruation
- Guidelines to Follow
- Soft-bristled Toothbrush
- Electric Razor
- Limit Needle Sticks
- Smaller Needle Size
3 mins
Osmotic Laxatives
- Mechanism of Action
- Increases Osmotic Load
- Indications
- Hepatic Encephalopathy
- Constipation
- Drugs
- Magnesium Hydroxide
- Magnesium Citrate
- Polyethylene Glycol
- Sorbitol
- Lactulose
- Side Effects
- Diarrhea
- Dehydration
- Considerations
- Misused in Bulimia Nervosa
2 mins
Hepatitis A
- Characteristics
- Picornavirus
- 4 Week Incubation Period
- Fecal-oral
- Day Care Centers
- Travel to Developing Countries
- Signs and Symptoms
- Usually Asymptomatic
- Acute Disease
- Jaundice
- Fever
- Vomiting
2 mins
Hepatitis A (HAV) Assessment
- Transmission
- Fecal-Oral
- Ingestion of Contaminated Food or Water
- Incubation
- 4 Weeks
- Assessment
- Fever
- General Malaise
- Hepatomegaly
- Considerations
- Self-Limiting
- Proper Hand Washing
2 mins
Hepatitis B (HBV) Assessment
- Transmission
- Bodily Fluids
- Blood Transmission
- People Who Use IV Drugs
- Incubation
- Variable 1-6 Months
- Assessment
- Fever
- Nausea and Vomiting
- Hepatomegaly
- Chronic Disease
- Cirrhosis
- Hepatocellular Carcinoma
- Considerations
- Vaccination
2 mins
Hepatitis B Virus Disease
- Can turn chronic
- < 10% of adults become chronic carriers
- 90% of newborns become chronic carriers
- Cirrhosis
- Hepatocellular carcinoma
- Membranous Glomerulonephritis
- Polyarteritis nodosa
- Serum sickness like syndrome
2 mins
Hepatitis B Virus Characteristics
- Hepadnavirus
- Enveloped
- Circular
- Partially Double-stranded DNA
- Has Reverse Transcriptase
- IV Drug Use
- Sex
- Maternal Fetal Routes
- 3 Month Incubation Period
2 mins
Hepatitis C
- Characteristics
- Enveloped
- RNA Virus
- Flavivirus
- Icosahedral
- SS positive Linear
- Clinical Features
- Most Cases are Due to IV Drug Use
- Turns to Chronic Hepatitis in Over 70% of Cases
- Cirrhosis
- Hepatocellular Carcinoma
- Most Common Indication for Liver Transplantation
- Associated With Type I MPGN
- Porphyria Cutanea Tarda
2 mins
Hepatitis C (HCV) Assessment
- Transmission
- Blood Transmission
- High Risk Sex (rare)
- IV Drug Users
- Incubation
- 7 Weeks
- Chronic Disease
- Cirrhosis
- Considerations
- Barrier Protection
2 mins
Acute Pancreatitis Causes
- "GET SMASHHED" Mnemonic
- Gallstones
- (Ethanol) Alcohol
- Trauma
- Steroids
- Mumps
- Autoimmune
- Scorpion Sting
- Hypercalcemia
- Hypertriglyceridemia > 1000
- ERCP
- Drugs
1 min
Acute Pancreatitis Assessment
- Mechanism
- Heavy Alcohol Use and Gallstones
- Signs and Symptoms
- Abdominal Pain
- Nausea/Vomiting/Anorexia
- Abdominal Rigidity/Guarding
- Decreased or Absent Bowel Sounds
- Hypotension and Tachycardia
- Jaundice
- Increased White Blood Cells
2 mins
Acute Pancreatitis Interventions
- NPO with NG Tube to Suction
- Pain Management
- Albumin
- Lactated Ringers Solution
- Proton Pump Inhibitor (PPI)
- Antibiotics
- Surgery
- Nutrition
2 mins
Cholecystitis Causes
- Gallbladder Inflammation
- 6 Fs
- Female
- Fair (Caucasian)
- Fat (Obese)
- Fertile (Pregnant)
- Forty (Advanced Age Over 40)
- Flatulence
2 mins
Cholecystitis Assessment
- RUQ Pain
- Referred Shoulder Pain
- Clay Colored Stools
- Jaundice
- Nausea and Vomiting
- Dyspepsia (Indigestion)
- Fever
- Considerations
- Increased WBCs
- Fatty or Spicy Foods
- Ultrasound
2 mins
Cholecystitis Interventions
- Supportive Therapy
- Antibiotics
- Low Fat Diet
- NG Tube
- Analgesics
- Lithotripsy
- Cholecystectomy
- T Tube
2 mins
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