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NURSADN6 Exam #2 Study Guide : Questions With Complete Solutions
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NURSADN6 Exam #2 Study Guide : Questions With Complete Solutions
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NURSADN6 Exam #2 Study Guide : Questions WithComplete Solutions
GI/GU, renal system and fluid & electrolytes
What is a *Bowel Perforation* and what are the signs/symptoms of it?
Right Ans - Spillage of gastric or duodenal contents into peritoneal cavity.
S/S: Sudden, severe upper abdominal pain (may be referred to the shoulder),
vomiting, Tender rigid, board-like abdomen, shallow/grunting respirations
and signs of shock
What is the intervention for a *bowel perforation*? Right Ans - Immediate
surgery
What is an *ileostomy*? Right Ans - A surgical operation in which a piece of
the ileum is diverted to an artificial opening in the abdominal wall.
For a patient with an *ileostomy*, what might the stool look like? Right Ans
- Liquid fecal drainage; constant and cannot be regulated; minimal odor
because fewer bacteria are present
Indications for an *Ileostomy* Right Ans - Toxic Megacolon from
Inflammatory Bowel Disease
What are some important *ileostomy* complications? Right Ans - High risk
for bowel obstruction (Instruct pt to chew food thoroughly and drink lots of
water)
and the potential risk for vitamin B12 deficiency (Administer supplements as
needed)
What is *peptic ulcer disease* (PUD)? Right Ans - A break or ulceration in
the protective mucosal lining of the lower esophagus, stomach, pylorus or
duodenum associated with the infection of H. pylori
A patient presents to the clinic with *dull gnawing pain or burning in the mid
epigastrium*, heartburn and
,vomiting. What does the nurse suspect this patient to be diagnosed with?
Right Ans - Peptic Ulcer Disease
One of the goals in managing Peptic Ulcer disease is to reduce the acidity
within the stomach, this can be achieved with the use of PPIs or *Proton Pump
Inhibitors*. To remember these medications, what is the *suffix* associated
with them?
A. -prazole (Ex. Pantoprazole)
B. - dine (Ex. Famotidine)
C. -ate (Ex. Sucralfate)
D. -cid (Ex. Pepcid) Right Ans - A. -prazole (Ex. Pantoprazole)
*Rationale:* Famotidine is an H2 Blocker, Sucralfate is a surface agent and
Pepcid is an antacid. Though they may all be used in the management of GERD
and PUD, only Panto*prazole* is a PPI.
How do PPIs work? Right Ans - They block the proton pump in our
stomach and decrease the concentration of HCl; Irreversible inhibit the H+/K+
ATPase in stomach parietal cells.
H pylori is associated 70-90% of Peptic Ulcer cases. How does H. pylori cause
ulcers? Right Ans - The bacteria breaks down the gastroduodenal mucosal
barrier and stimulates gastric acid secretion burrow through barrier, release
ammonium and liquefy the barrier which stimulates HCl secretion
*H. pylori* treatment can include what? Right Ans - PPI + 2 of the following
antibiotics
--Clarithromycin
--Metronidazole
--Amoxicillin
One week treatment: 90% cure rate
Two weeks of PPI + 1 antibiotic (typically clarithromycin): 10-20% lower cure
rate
MHD notes:
--Tetracycline can be 1 of the 2 antibiotics
, --Bismuth salts, doxycycline, and metronidazole for 14 days is cheap and
effective
What is *Crohn's disease*? Right Ans - A chronic inflammatory bowel
disease (IBD) that affects the lining of the digestive tract (anywhere from
mouth to anus) which can lead to abdominal pain, severe diarrhea, fatigue,
weight loss and malnutrition
What are the signs and symptoms of *Crohn's Disease*? Right Ans - First
sign will be abd pain unrelieved by defecation followed by:
-diarrhea,
-weight loss
-constant fluid loss
-low-grade fever
-fatigue
-tenderness in RLQ
List some *complications* of Crohn's: Right Ans - -Intestinal obstruction
-Perianal disease
-Electrolyte imbalances
-Malnutrition
-Fistula & abscess formation
A patient is being provided education for nutritional consumption with a
diagnosis of *Crohn's disease*. How should the nurse instruct the patient on
how to alter their diet? Right Ans - Limit dairy, low-fat foods, limit fiber, eat
small-frequent meals, increase fluids, nutritional supplements (vitamins and
iron)
What is *Ulcerative Colitis*? Right Ans - Recurrent ulcerative and
inflammatory bowel disease of the mucosal and submucosal layers of the
colon and rectum (which starts distally at the rectum and progresses
proximally) Onset could be gradual or abrupt.
Out of the following populations, who is more high risk for a diagnosis of
*Ulcerative Colitis*? (Select all that apply)
- Caucasians
- Asian
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