CMN 568 - Unit 4 Questions And Answers 100%Solved Rated A+

CMN 568 - Unit 4 Questions And
Answers 100%Solved Rated A+
Acute onset of severe pain and vomiting suggests what? - correct answer...✔✔+
Peritoneal irritation
+ Acute gastric or intestinal obstruction
+ Pancreaticobiliary disease

(McPhee p 588)

Persistent vomiting suggests what? - correct answer...✔✔+ Pregnancy
+ Gastric outlet obstruction
+ Gastroparesis
+ Intestinal dysmotility
+ Psychogenic disorders
+ CNS or systemic disorders

(McPhee p 589)

Vomiting in the morning suggests what? - correct answer...✔✔+ Pregnancy
+ Uremia
+ ETOH intake
+ ↑ ICP

Vomiting after meals suggests what? - correct answer...✔✔+ Bulimia
+ Peptic ulcer disease
+ Other psychogenic causes

(McPhee p 589, Shimp p 373)

Vomiting of undigested food 1-2 hours after a meal suggests what? - correct answer...✔
✔+ Gastroparesis
+ Small bowel obstruction
+ Gastric outlet obstruction

NOTE: Sucussion splash often heard on auscultation

(McPhee p 589, Shimp p 373)

4 causes of nausea and vomiting - correct answer...✔✔1) Visceral afferent stimulation
(seratonin receptors)



AGRADESOLUTIONS

,2) Vestibular disorders (fibers ↑ in histamine and muscarinic receptors)
3) CNS disorders
4) Irritation of chemoreceptor trigger zone

(McPhee Table 15.1)

Ways to stimulate the chemoreceptor trigger zone and cause vomiting - correct
answer...✔✔1) Chemo
2) Medications and drugs
3) Radiation therapy
4) Systemic disorders

CNS disorders that can cause vomiting - correct answer...✔✔1) Migraine
2) ↑ ICP
3) Infections (e.g. meningitis, encephalitis)
4) Psychogenic

Vestibular disorders that can cause vomiting - correct answer...✔✔Labyrinthitis,
Meniere syndrome, motion sickness

Define RETCHING - correct answer...✔✔Strong, spasmodic, involuntary effort to vomit
without bringing up emesis.

(McPhee and Shimp)

Define REGURGITATION - correct answer...✔✔Effortless return of gas or small
amounts of food from stomach (McPhee and Shimp)

Common causes of vomiting in infants - correct answer...✔✔1) Any acute illness (esp
gastroenteritis)
2) Hypertrophic pyloric stenosis (2 - 8 weeks of life, may feel an "olive" in epigastric
area after feeding)
3) Intussisception (6 - 18 months of life, sausage-shaped mass and "currant jelly"
stools)
4) Regurgitation ("spitting up") -- usually normal and usually resolves by 6 - 12 months.

(Shimp)

Medications associated with N/V - correct answer...✔✔+ Antidepressants
--SSRIs
--venlafaxine

+ Cardiac meds
--antiarrhythmics
--anti-HTN meds (diuretics, beta blockers, CCBs)
-- ↓ CHO meds (statins, gemfibrozil, niacin)


AGRADESOLUTIONS

, -- Digoxin

+ Chemotherapy agents

+ GI meds
--sulfasalazine (for tx of UC)
--azathioprine (tx of Crohns or UC)

+ Meds to treat infectious diseases
-- Acyclovir
-- Anti-fungals
-- ABX
-- UTI meds
-- TB meds

+ Pain meds
-- Anti-gout meds
-- Aspirin
-- NSAIDs
-- Opioids

+ Others
-- Lithium
-- Metformin
-- BC pills
-- Quinidine

(Shimp Table 46-2)

OLD CART - correct answer...✔✔*O*nset -- When did it start
*L*ocation -- Can you pinpoint it? Does it radiate?
*D*uration -- How long have you had it?

*C*haracter-- Is it sharp, dull, throbbing, burning, crampy, colicky?
*A*ggravating factors -- What makes it worse?
*R*elieving factors -- What makes it better?
*T*iming -- Is the pain constant or intermittent? Does it occur at a certain time of day?

Antiemetic medications - correct answer...✔✔1) Seratonin-receptor antagonists
(McPhee/Shimp)
- Ondansetron (and other -setrons)
2) Corticosteroids (McPhee)
- Dexamethasone and methylprednisolone (used to enhance action of seratonin-
receptor antagonists used for post-operative and chemo-related n/v)
3) Dopamine receptor antagonists -- SEDATING but good for post-op gastroparesis or
nausea


AGRADESOLUTIONS