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MedSurg-Inflammation
MedSurg EX#2
| Question | Answer |
|---|---|
| What are some risk factors related to Peptic Ulcer Disease (PUD)? (refer to BOX 57.1 for more) | H. pylori, NSAIDs, smoking, alcohol, obesity, coffee consumption and genetic factors |
| What noninvasive tests are done to diagnosed PUD? | Blood, breath, biopsy and fecal culture |
| What are priority labs for Peptic Ulcer Disease (PUD)? | CBC and electrolytes (K+ and Mg+) |
| A patient diagnosed with PUD has a WBC count of 40,000/mm, what do you suspect has happened? | Perforation |
| A patient complains of burning epigastric pain that is aggravated when fasting and also states they are awaken during the night due to pain. Which form of PUD do you suspect the patient to have? | Duodenal ulcer (PUD) |
| What is the objective of therapy in patients with NSAID-induced PUD? | Heal the ulcer and remove the offending agent |
| What are some foods someone with PUD should avoid? | spicy foods, alcohol and caffeine |
| What are complications of PUD? | GI bleeding, penetration, perforation and obstruction |
| What would be priority actions for someone with PUD that has a GI bleed? | Large bore IV for rapid IV fluids, blood tr |
| What age group does appendicitis occurs more frequently in? | 10-19 years of age |
| Three main clinical manifestations are? | rebound tenderness, fever and nausea/vomiting |
| The classic area of rebound tenderness that occurs in the later stage of appendicitis, in the right lower quadrant is called? | McBurney's Point |
| The most common diagnostic test performed to confirm appendicitis. | CT scan |
| A patient that has been diagnosed with appendicitis has an abrupt change in pain, change in BP, a spiked fever and a firm, rigid board like abdomen. What do you suspect has happened to the patient? | Perforation |
| What are some ways to provide comfort for someone with appendicitis? | apply ice to the right lower quadrant, elevate HOB to 30 to 45 degrees with knees flexed or side lying with knees flexed, opioids analgesics(post-op) |
| Risk factors for diverticulitis. | older age, lack of fiber in diet, obesity and sedentary lifestyle |
| Clinical manifestations of diverticulitis. | abdomen pain, fever, change in mental status, diarrhea and/or constipation |
| True or False. A patient that has been recently diagnosed with diverticulitis should avoid foods high in fiber. | True. Patients should start with clear liquids to low residue and then advanced slowly as tolerated |
| What are some long term effects of PPIs? | osteoporosis, C-diff., pneumonia |
| What are some clinical manifestations of Irritable Bowel Disease (IBD)? | diarrhea, abdomen pain, malnutrition, anemia and electrolyte imbalance (zinc, K+, Mg+) |
| Priority labs for IBD. | electrolytes and CBC (check for anemia) |
| Abscess | Symptoms include fever, pain, and swelling. Abscesses are often treated with surgery |
| Fistula | Abnormal tunnel between organs |
| What portion of the body does Crohn's Disease affect? | Any portion of GI tract from mouth to anus |
| True or False. Someone with Crohn's is able to absorb nutrients and rarely has any nutritional deficits. | False. Because the intestines are scarred the individual is less likely to absorb any nutrients which leads to nutritional deficit |
| What portion of the body does Ulcerative Colitis affect? | Large intestine and involves only the mucosa and submucosa. The disease spreads uniformly beginning at the rectum and spreading upward toward the cecum |
| Primary goal treatment for IBD. | Rest the bowel and control the inflammation |
| What kind of foods should someone diagnosis with IBD avoid? | milk, gluten, caffeine, cocoa, chocolate, citrus juices, cold or carbonated drinks, nuts, seeds, popcorn, and alcohol |
| Medications used for IBD. (refer to TABLE 58.4 for more in depth reasoning) | Aminosalicylates(common treatment for UC), Immunomodulators (end in "mab"), Steroids(try to use only for short periods), and Antibiotics |
| Diagnostic test used to diagnosis Acute Appendicitis. | CT scan |
| Diagnostic test used to diagnosis diverticulitis. | Abdomen X-ray |
| Diagnostic test used to diagnosis IBD. | Colonoscopy |
| Diagnostic test used to diagnosis PUD. | EGD |
| Complications of IBD. | bleedings, cancer, stricture, fistula(more common with Crohn's), and toxic megacolon(massive dilation of colon; can lead to gangrene & peritonitis) |
| IBD priority nursing actions. | Daily weights, bowel rest during periods of acute exacerbation- TPN, Fluid & electrolyte management/ treatment (IV fluids; K+ if needed), skin care |
| When is surgery reserved for a patient with Crohn's Disease? | patients who have failed medical management and/or who experience complications from the disease (strictures, abscesses, intestinal obstruction, perforation, hemorrhage, or cancer) |
| When is surgery reserved for a patient with Ulcerative Colitis? | patients who have failed medical management or experienced complications may undergo a colectomy and be cured from the disease but not from the extraintestinal manifestations |
Created by:
bolenrocks
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