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NRSG 421 GI Exam Questions And Correct Answers
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NRSG 421 GI Exam Questions And Correct AnswersWhat are the categories for acute abdominal pain? - ANSWER - Inflammatory (bacterial
or chemical cause)
- Mechanical (ileus or obstruction)
- Neoplastic (tumour obstructing nerves or vessels)
- Vascular (clot or atherosclerosis
- Congenital
- Traumatic
Acute pancreatitis can be divided into three categories. What are these categories? -
ANSWER - Mild acute pancreatitis
- Moderately severe acute pancreatitis
- Severe acute pancreatitis
Mild Acute Pancreatitis -ANSWER No organ failure, and no local or systemic
complications
Moderately Severe Acute Pancreatitis - ANSWER Defined as transient organ failure-no
more than 48 hours-and/or local or systemic complications in the absence of persistent
organ failure
Severe Acute Pancreatitis - ANSWER Evidence of one or more persistent organ failures
Some causes for acute pancreatitis? -ANSWER - Gall stones*
- Alcohol
- Infection (mumps, coxsackie B)
- Pancreatic tumours
,- Drugs (azathioprine, thiazide, valproic acid)
- Trauma
- Idiopathic (tropical pancreatitis, CF)
What are the two most common causes for chronic pancreatitis? -ANSWER- Alcoholism
- Idiopathic
What are some signs and symptoms of pancreatitis? -ANSWER- Acute onset of steady,
severe epigastric abdominal pain which may be upper right quadrant. Pain may vary
with cause. Pain partially relieved by leaning back or bending forward
Nausea and vomiting Dyspnea due to diaphragmatic inflammation, 2° to pancreatitis
Foul smelling, foamy, grey coloured stools Back pain What are some clinical findings
indicative of pancreatitis? - ANSWER - Upper epigastric abdominal pain on palpation
Abdominal distention and hypoactive bowel sounds from ileus caused by inflammation
May have jaundice Severe pancreatitis can present with fever, tachypnea, hypoxemia
and hypotension Cullen's sign Grey turner sign
What is Cullen's sign? - ANS Bruising around umbilicus
What is Grey Turner's sign? - ANS Bruising of the flanks
How is pancreatitis diagnosed? - ANS Diagnosis is made if 2 of the following 3 criteria
are met:
- Abdominal pain strongly suggestive of pancreatitis
- Amylase and/or lipase levels at least three times higher than normal
- Characteristic findings of pancreatic inflammation on either transabdominal CT or
ultrasound
Why are NG suction and NPO status used as medical management for pancreatitis? -
ANSWER These interventions suppress/reduce pancreatic enzyme secretions. It allows
the pancreas to rest with this decrease in stimulation.
Why might antibiotics be used to medically manage pancreatitis? - ANSWER Abx
therapy can help with early phase of infection because of inflammation and necrotic
, pancreatic tissue is a good medium for bacteria growth.
What are some surgical interventions that can be done to treat pancreatitis? -ANSWER-
Surgical drainage of retained necrotic fluid
- In case the acute pancreatitis is due to gallstones then urgent ERCP and endoscopic
sphincterotomy is performed along with laparoscopic cholecystectomy in order to
decrease the risk of recurrence.
What medicines can be administered to manage acute pancreatitis? -ANSWER-
Mophine: relief of pain
- Nitroglycerin: smooth muscle relaxation, pain relief
- Antispasmodics: inhibit vagal stimulation and pancreatic outflow
- Carbonic anhydrase inhibitor: decreases amount of pancreatic secretions and
concentration of bicarbonate
- Antacids: neutralize gastric pH
- H2 receptor antagonist: inhibits secretion of HCl which, in turn, reduces pancreatic
activity
What pharmacologic agents are used in the treatment of chronic pancreatitis? ANSWER
Pancrelipase
Insulin
HCl
What are key points for patient teaching with pancrelipase? - ANSWER - Will need to
take medication for life
-Check for pork allergy related
Take medication before, during or immediately after meals
Do not crush microspheres within capsules
Do not change brands without discussing with your doctor
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