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Gastrointestinal NP

Info & Q: NP EXAM

QuestionAnswer
Which drugs should be avoided in pts with GERD because it will exacerbate their symptoms? CCB - muscle control the sphincter, calcium makes muscles contract thus loosens the LES
What is pyrosis? Heartburn
Mechanism of Action: Antacids Raise pH
How soon and how long do Antacids work? Fastest relief for about 30 minutes
Name some Antacids: 1. Maalox 2. Gaviscon 3. Rolaids 4. Tums
Mechanism of Action: H2 Blockers Decrease acid production
How soon and how long do H2 Blockers work? Relief in 1-2 hours and last about 6-12 hours.
H2 Blockers suffix: tidine
Name some H2 Blockers: 1. Cimetidine (Tagamet) 2. Ranitidine (Zantac) 3. Famotidine (Pepcid) 4. Nizatidine (Axid)
What are the Cadillac drugs for tx GERD: Proton Pump Inhibitors (PPI)
Mechanism of Action: Proton Pump Inhibitor (PPI) reduce gastric secretion; shuts down the proton (H) pump
Proton Pump Inhibitor (PPI) suffix: prazole
How soon and how long do PPIs work? Usually not PRN because take 2-3 days to begin and take for 4-8 weeks
Name some PPIs: 1. lansoprazole (Prevacid) 2. omeprazole (Prilosec) 3. pantoprazole (Protonix) 4. esomeprazole (Nexium) 5. rabeprazole (Aciphex)
Coumadin is a very dirty drug? T or F True
Tagamet is a very dirty drug? T or F True
Pts with recurrent or chronic GERD OR atypical symptoms ie hoarse, sore throat are at increase risk of what? Barret's esophageal
What should we do/order if we suspect Barret's esophageal? Refer/Endoscopy
What is the most common tx for H. pylori? Triple Therapy: 2 Antibiotics and 1 PPI
When pt c/o diarrhea it is very important to get a good and thorough history? T or F TRUE
Diarrhea asso with gastroenteritis usually progresses in this manner: Upper GI - vomiting followed by Lower GI - diarrhea
Stool smear positive for WBCs think 2 things: 1. bacterial infection 2. inflammation
What intervention for a pt c/o diarrhea for 36 hrs and mild dehydration: Oral rehydration with Pedi-lyte
Common symptoms of diverticulitis include? LLQ pain and fever
Describe a positive Murphy's sign: Ask pt to exhale then press RUQ then Pt breathes in. During inspiration abd contents are pushed down as the diaphragm moves down. Pt stops breathing in as the GB is tender & in move down comes in contact with the examiner's fingers; test is pos
McBurney's Point very tender with app
Psoas Test lie down; have pt bring R knee to chest while you push it away thus causing contraction of the psoas muscle and abd pain; APP
Obtruator lie down; external rotate hip stretching obtruator thus abd pain; APP
Jar Test Stand and bounce on heels; pain; APP
AST and ALT measure liver for what? integrity
PT and Albumin measure liver ability for what? to synthesize things
Bilirubin, GGT, Alkaline Phosphatase measure liver for what? excretory function
ALT vs AST: 1. ALT is higher than AST think - liver viral hepatis 2. AST is higher than ALT think - consumption Acetominophen, Statins, Tequilla
Elevated Alkaline Phosphatase think? possible bone or liver disease
Note that Alkaline phosphatase may be elevated in normal situations such as (2: 1. adolescence (rapid bone turnover) 2. pregnancy
What are the 5 types of Hepatitis? A, B, C, D, E
Which types of hepatitis can cause chronic disease? B, C, D
How did you get hepatitis A? Ate something (bad oysters, water, fecal matter)
What is an immunoglobulin? an Antibody
Elevated IgM means? IgM - You Feel Miserable; first to rescue; start producing them; acute infection
Elevated IgG means? IgG - Gone Infection; you have gotten over your illness;
No IgM or IgG means? Never had whatever it is? Vaccinate if available.
How did you get Hepatitis B? Blood and Body fluid
Hepatitis B surface antigen means? Postive means Hep B bug is in you Negative means Hep B bug is gone
Hepatitis B core means Positive core equals you had bug Negative core equals you only had vaccine
Created by: dprest
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