Certified Gastroenterology RN Intra-Procedure Complication Management 4

Question 1

During PEG tube placement, the patient's abdomen becomes rigid and the transillumination point is lost. What should the team suspect?

Accepted Answer

Malposition with possible injury to an interposed organ or peritoneal leakage

Answer

Loss of transillumination and a rigid abdomen suggest the tract is misplaced or another organ, such as the colon, is interposed.

Question 2

A patient becomes hypotensive (BP 78/40) during colonoscopy after moderate sedation. After stopping scope advancement, what is the nurse's first intervention?

Accepted Answer

Open IV fluids and place the patient flat while assessing responsiveness

Answer

Sedation-related hypotension is first managed with positioning and a fluid bolus while assessing the patient.

Question 3

Cautery is about to be used during polypectomy, but the nurse learns the patient had an inadequate bowel prep. Why is this a safety concern?

Accepted Answer

Residual colonic gases from poor prep can ignite during electrocautery

Answer

Combustible hydrogen and methane concentrations in a poorly prepped colon create an explosion risk with cautery.

Question 4

During ERCP, the patient develops severe epigastric pain radiating to the back before leaving the procedure room. Which lab values should the nurse anticipate the provider ordering to evaluate the most common ERCP complication?

Accepted Answer

Serum amylase and lipase

Answer

Post-ERCP pancreatitis is the most common ERCP complication and is assessed with amylase and lipase.

Question 5

A patient with an implanted cardiac defibrillator (ICD) requires snare cautery during colonoscopy. What intra-procedure precaution is most appropriate?

Accepted Answer

Follow the pre-arranged plan for magnet use or device reprogramming and monitor cardiac rhythm continuously

Answer

Electrocautery can cause an ICD to misinterpret interference as an arrhythmia, so device management and continuous monitoring are required.

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Intra-Procedure Complication Management 4