COMPLEX MED SURG EXAM ( QUESTIONS
WITH ANSWERS ) A+ RATED
what is portal hypertension - ANSWER restriction of blood flow through the portal vein
what can portal hypertension lead to? - ANSWER - ascites
- splenomegaly
- GI-esophageal varices and bleeding
- jaundice
- signs of hepatic failure
what is esophageal varices? - ANSWER a complication of portal hypertension. causes the vessels in the
esophagus to become dilated and bleed, and the rupturing can be forceful enough for one to bleed out
what is splenomegaly? - ANSWER enlargement of the spleen
what is ascites? - ANSWER accumulation of fluid in the peritoneal cavity
signs and symptoms of portal hypertension? - ANSWER GI bleeding as evidenced by vomiting of blood,
or black, tarry stools or bloody stools; ascites; decreased platelets. decreased WBC, fluid retention, pain
treatment for portal hypertension? - ANSWER TIPS, octreotide, balloon tamponade, paracentesis,
albumin, fluid restriction
what is the TIPS procedure? - ANSWER connects the portal and hepatic vein
,what is a balloon tamponade? - ANSWER balloon that inflates in esophagus to stop bleeding in
esophageal varices, applies pressure
what is a paracentesis? - ANSWER removal of fluid from the peritoneal cavity (ascites)
what does albumin do? - ANSWER regulates osmotic pressure
what does octreodide to? - ANSWER treats high levels of the growth hormone caused by acromegaly
signs and symptoms of decreased clotting factors - ANSWER bleeding, ecchymosis (bruising caused by
blood leaking from broken blood vessels into the tissues of skin or mucous membranes), bruising
treatment for decreased clotting factors - ANSWER RBC, platelets, folic acid, vitamin br, thiamine
hepatic encephalopathy symptoms - ANSWER increased ammonia levels, hyperreflexia, confusion,
lethargy, seizures, coma
treatment for hepatic encephalopathy - ANSWER low protein diet, lactulose
what does lactulose do? - ANSWER decrease intestinal ammonia absorption in pts with liver disease and
hepatic encephalopathy. pulls the ammonia into poop so it can be excreted
hormonal imbalances signs and symptoms - ANSWER spider angioma, gynemastia, testicular atrophy,
palmar erythema
what is palmar erythema? - ANSWER where palms turn red
what happens during cirrhosis of the liver? - ANSWER liver becomes hardened and shrinks
diabetic ketoacidosis pathophysiology - ANSWER -absolute absence of insulin, which results in the cells
starving, and blood glucose levels to sky rocket
, -the fats that the liver produces are broken down into keytones which are used as energy for the body
when glucose production is low/absent. the keytones are highly acidic, making it so a bunch of fats/acids
are floating around the body making the body acidic, pH low
DKA signs and symptoms - ANSWER polyuria, polydipsia, polyphagia, weight loss, vomiting, abdominal
pain, ketone breath odor, dehydration, weakness, Kussmaul respirations, altered mental state, shock,
coma, high number in anion gap
what would a high anion gap number mean? - ANSWER that the pH is lower, more acidic
risk factors for DKA - ANSWER surgery, trauma, illness, omitted insulin, stress, undiagnosed type 1
diabetes
DKA treatment - ANSWER -give dextrose IV when blood sugar levels are 200-250
-give insulin, but not too much so we avoid hypokalemia. nurse must check potassium levels before
administering insulin
-fluid replacement
-npo diet
-frequent blood sugar checks on an insulin drip
functions of kidneys - ANSWER removes metabolic waste from the blood; forms urine, regulates fluid
and electrolyte balance, helps reduce RBC's with erythropoesis
how much cardiac output do kidneys receive? - ANSWER 20-25%
what does the MAP need to be for adequate perfusion? - ANSWER equal to or above 60-75
what will the kidneys do in the event of reduced cardiac output? - ANSWER hold on to salt and water
what is a normal amount of urine output? - ANSWER 1- 1.5 L
WITH ANSWERS ) A+ RATED
what is portal hypertension - ANSWER restriction of blood flow through the portal vein
what can portal hypertension lead to? - ANSWER - ascites
- splenomegaly
- GI-esophageal varices and bleeding
- jaundice
- signs of hepatic failure
what is esophageal varices? - ANSWER a complication of portal hypertension. causes the vessels in the
esophagus to become dilated and bleed, and the rupturing can be forceful enough for one to bleed out
what is splenomegaly? - ANSWER enlargement of the spleen
what is ascites? - ANSWER accumulation of fluid in the peritoneal cavity
signs and symptoms of portal hypertension? - ANSWER GI bleeding as evidenced by vomiting of blood,
or black, tarry stools or bloody stools; ascites; decreased platelets. decreased WBC, fluid retention, pain
treatment for portal hypertension? - ANSWER TIPS, octreotide, balloon tamponade, paracentesis,
albumin, fluid restriction
what is the TIPS procedure? - ANSWER connects the portal and hepatic vein
,what is a balloon tamponade? - ANSWER balloon that inflates in esophagus to stop bleeding in
esophageal varices, applies pressure
what is a paracentesis? - ANSWER removal of fluid from the peritoneal cavity (ascites)
what does albumin do? - ANSWER regulates osmotic pressure
what does octreodide to? - ANSWER treats high levels of the growth hormone caused by acromegaly
signs and symptoms of decreased clotting factors - ANSWER bleeding, ecchymosis (bruising caused by
blood leaking from broken blood vessels into the tissues of skin or mucous membranes), bruising
treatment for decreased clotting factors - ANSWER RBC, platelets, folic acid, vitamin br, thiamine
hepatic encephalopathy symptoms - ANSWER increased ammonia levels, hyperreflexia, confusion,
lethargy, seizures, coma
treatment for hepatic encephalopathy - ANSWER low protein diet, lactulose
what does lactulose do? - ANSWER decrease intestinal ammonia absorption in pts with liver disease and
hepatic encephalopathy. pulls the ammonia into poop so it can be excreted
hormonal imbalances signs and symptoms - ANSWER spider angioma, gynemastia, testicular atrophy,
palmar erythema
what is palmar erythema? - ANSWER where palms turn red
what happens during cirrhosis of the liver? - ANSWER liver becomes hardened and shrinks
diabetic ketoacidosis pathophysiology - ANSWER -absolute absence of insulin, which results in the cells
starving, and blood glucose levels to sky rocket
, -the fats that the liver produces are broken down into keytones which are used as energy for the body
when glucose production is low/absent. the keytones are highly acidic, making it so a bunch of fats/acids
are floating around the body making the body acidic, pH low
DKA signs and symptoms - ANSWER polyuria, polydipsia, polyphagia, weight loss, vomiting, abdominal
pain, ketone breath odor, dehydration, weakness, Kussmaul respirations, altered mental state, shock,
coma, high number in anion gap
what would a high anion gap number mean? - ANSWER that the pH is lower, more acidic
risk factors for DKA - ANSWER surgery, trauma, illness, omitted insulin, stress, undiagnosed type 1
diabetes
DKA treatment - ANSWER -give dextrose IV when blood sugar levels are 200-250
-give insulin, but not too much so we avoid hypokalemia. nurse must check potassium levels before
administering insulin
-fluid replacement
-npo diet
-frequent blood sugar checks on an insulin drip
functions of kidneys - ANSWER removes metabolic waste from the blood; forms urine, regulates fluid
and electrolyte balance, helps reduce RBC's with erythropoesis
how much cardiac output do kidneys receive? - ANSWER 20-25%
what does the MAP need to be for adequate perfusion? - ANSWER equal to or above 60-75
what will the kidneys do in the event of reduced cardiac output? - ANSWER hold on to salt and water
what is a normal amount of urine output? - ANSWER 1- 1.5 L
