NURSADN6 EXAM #2 STUDY GUIDE
WITH WELL DETAILED ANSWERS
What 7uis 7ua 7u*Bowel 7uPerforation* 7uand 7uwhat 7uare 7uthe 7usigns/symptoms 7uof 7uit?
7u- 7uANS--Spillage 7uof 7ugastric 7uor 7uduodenal 7ucontents 7uinto 7uperitoneal 7ucavity. 7u
S/S: 7uSudden, 7usevere 7uupper 7uabdominal 7upain 7u(may 7ube 7ureferred 7uto 7uthe
7ushoulder), 7uvomiting, 7uTender 7urigid, 7uboard-like 7uabdomen, 7ushallow/grunting
7urespirations 7uand 7usigns 7uof 7ushock
What 7uis 7uthe 7uintervention 7ufor 7ua 7u*bowel 7uperforation*? 7u- 7uANS--Immediate
7usurgery
What 7uis 7uan 7u*ileostomy*? 7u- 7uANS--A 7usurgical 7uoperation 7uin 7uwhich 7ua 7upiece
7uof 7uthe 7uileum 7uis 7udiverted 7uto 7uan 7uartificial 7uopening 7uin 7uthe 7uabdominal 7uwall.
For 7ua 7upatient 7uwith 7uan 7u*ileostomy*, 7uwhat 7umight 7uthe 7ustool 7ulook 7ulike? 7u-
7uANS--Liquid 7ufecal 7udrainage; 7uconstant 7uand 7ucannot 7ube 7uregulated; 7uminimal
7uodor 7ubecause 7ufewer 7ubacteria 7uare 7upresent
Indications 7ufor 7uan 7u*Ileostomy* 7u- 7uANS--Toxic 7uMegacolon 7ufrom 7uInflammatory
7uBowel 7uDisease
What 7uare 7usome 7uimportant 7u*ileostomy* 7ucomplications? 7u- 7uANS--High 7urisk 7ufor
7ubowel 7uobstruction 7u(Instruct 7upt 7uto 7uchew 7ufood 7uthoroughly 7uand 7udrink 7ulots 7uof
7uwater)
and 7uthe 7upotential 7urisk 7ufor 7uvitamin 7uB12 7udeficiency 7u(Administer 7usupplements
7uas 7uneeded)
What 7uis 7u*peptic 7uulcer 7udisease* 7u(PUD)? 7u- 7uANS--A 7ubreak 7uor 7uulceration 7uin
7uthe 7uprotective 7umucosal 7ulining 7uof 7uthe 7ulower 7uesophagus, 7ustomach, 7upylorus
7uor 7uduodenum 7uassociated 7uwith 7uthe 7uinfection 7uof 7uH. 7upylori
A 7upatient 7upresents 7uto 7uthe 7uclinic 7uwith 7u*dull 7ugnawing 7upain 7uor 7uburning 7uin
7uthe 7umid 7uepigastrium*, 7uheartburn 7uand
vomiting. 7uWhat 7udoes 7uthe 7unurse 7ususpect 7uthis 7upatient 7uto 7ube 7udiagnosed
7uwith? 7u- 7uANS--Peptic 7uUlcer 7uDisease
One 7uof 7uthe 7ugoals 7uin 7umanaging 7uPeptic 7uUlcer 7udisease 7uis 7uto 7ureduce 7uthe
7uacidity 7uwithin 7uthe 7ustomach, 7uthis 7ucan 7ube 7uachieved 7uwith 7uthe 7uuse 7uof 7uPPIs
7uor 7u*Proton 7uPump 7uInhibitors*. 7uTo 7uremember 7uthese 7umedications, 7uwhat 7uis
7uthe 7u*suffix* 7uassociated 7uwith 7uthem?
,A. 7u-prazole 7u(Ex. 7uPantoprazole)
B. 7u- 7udine 7u(Ex. 7uFamotidine)
C. 7u-ate 7u(Ex. 7uSucralfate) 7u
D. 7u-cid 7u(Ex. 7uPepcid) 7u- 7uANS--A. 7u-prazole 7u(Ex. 7uPantoprazole)
*Rationale:* 7uFamotidine 7uis 7uan 7uH2 7uBlocker, 7uSucralfate 7uis 7ua 7usurface 7uagent
7uand 7uPepcid 7uis 7uan 7uantacid. 7uThough 7uthey 7umay 7uall 7ube 7uused 7uin 7uthe
7umanagement 7uof 7uGERD 7uand 7uPUD, 7uonly 7uPanto*prazole* 7uis 7ua 7uPPI.
How 7udo 7uPPIs 7uwork? 7u- 7uANS--They 7ublock 7uthe 7uproton 7upump 7uin 7uour
7ustomach 7uand 7udecrease 7uthe 7uconcentration 7uof 7uHCl; 7uIrreversible 7uinhibit 7uthe
7uH+/K+ 7uATPase 7uin 7ustomach 7uparietal 7ucells.
H 7upylori 7uis 7uassociated 7u70-90% 7uof 7uPeptic 7uUlcer 7ucases. 7uHow 7udoes 7uH.
7upylori 7ucause 7uulcers? 7u- 7uANS--The 7ubacteria 7ubreaks 7udown 7uthe
7ugastroduodenal 7umucosal 7ubarrier 7uand 7ustimulates 7ugastric 7uacid 7usecretion
7uburrow 7uthrough 7ubarrier, 7urelease 7uammonium 7uand 7uliquefy 7uthe 7ubarrier 7uwhich
7ustimulates 7uHCl 7usecretion
*H. 7upylori* 7utreatment 7ucan 7uinclude 7uwhat? 7u- 7uANS--PPI 7u+ 7u2 7uof 7uthe 7ufollowing
7uantibiotics
--Clarithromycin
--Metronidazole
--Amoxicillin
One 7uweek 7utreatment: 7u90% 7ucure 7urate
Two 7uweeks 7uof 7uPPI 7u+ 7u1 7uantibiotic 7u(typically 7uclarithromycin): 7u10-20% 7ulower
7ucure 7urate
MHD 7unotes:
--Tetracycline 7ucan 7ube 7u1 7uof 7uthe 7u2 7uantibiotics
--Bismuth 7usalts, 7udoxycycline, 7uand 7umetronidazole 7ufor 7u14 7udays 7uis 7ucheap 7uand
7ueffective
What 7uis 7u*Crohn's 7udisease*? 7u- 7uANS--A 7uchronic 7uinflammatory 7ubowel 7udisease
7u(IBD) 7uthat 7uaffects 7uthe 7ulining 7uof 7uthe 7udigestive 7utract 7u(anywhere 7ufrom
7umouth 7uto 7uanus) 7uwhich 7ucan 7ulead 7uto 7uabdominal 7upain, 7usevere 7udiarrhea,
7ufatigue, 7uweight 7uloss 7uand 7umalnutrition
What 7uare 7uthe 7usigns 7uand 7usymptoms 7uof 7u*Crohn's 7uDisease*? 7u- 7uANS--First
7usign 7uwill 7ube 7uabd 7upain 7uunrelieved 7uby 7udefecation 7ufollowed 7uby: 7u
-diarrhea, 7u
-weight 7uloss
-constant 7ufluid 7uloss
, -low-grade 7ufever
-fatigue
-tenderness 7uin 7uRLQ
List 7usome 7u*complications* 7uof 7uCrohn's: 7u- 7uANS---Intestinal 7uobstruction
-Perianal 7udisease
-Electrolyte 7uimbalances
-Malnutrition
-Fistula 7u& 7uabscess 7uformation
A 7upatient 7uis 7ubeing 7uprovided 7ueducation 7ufor 7unutritional 7uconsumption 7uwith 7ua
7udiagnosis 7uof 7u*Crohn's 7udisease*. 7uHow 7ushould 7uthe 7unurse 7uinstruct 7uthe
7upatient 7uon 7uhow 7uto 7ualter 7utheir 7udiet? 7u- 7uANS--Limit 7udairy, 7ulow-fat 7ufoods,
7ulimit 7ufiber, 7ueat 7usmall-frequent 7umeals, 7uincrease 7ufluids, 7unutritional
7usupplements 7u(vitamins 7uand 7uiron)
What 7uis 7u*Ulcerative 7uColitis*? 7u- 7uANS--Recurrent 7uulcerative 7uand 7uinflammatory
7ubowel 7udisease 7uof 7uthe 7umucosal 7uand 7usubmucosal 7ulayers 7uof 7uthe 7ucolon 7uand
7urectum 7u(which 7ustarts 7udistally 7uat 7uthe 7urectum 7uand 7uprogresses 7uproximally)
7uOnset 7ucould 7ube 7ugradual 7uor 7uabrupt.
Out 7uof 7uthe 7ufollowing 7upopulations, 7uwho 7uis 7umore 7uhigh 7urisk 7ufor 7ua 7udiagnosis
7uof 7u*Ulcerative 7uColitis*? 7u(Select 7uall 7uthat 7uapply)
7u- 7uCaucasians
- 7uAsian
- 7uHispanic
- 7uAfrican 7uAmerican
- 7uMen 7u
- 7uWomen
- 7uJewish 7u- 7uANS--- 7uCaucasians
- 7uWomen
- 7uJewish
What 7uare 7uthe 7usigns 7uand 7usymptoms 7uof 7u*Ulcerative 7uColitis*? 7u- 7uANS--
Diarrhea 7u(6+ 7uliquid 7ustools/day), 7upassage 7uof 7umucus, 7upus 7uor 7ublood,
LLQ 7uabdominal 7upain, 7uintermittent
tenesmus 7u(straining 7uwith 7uBM), 7urectal
bleeding 7u(mild 7uor 7usevere), 7uPallor, 7uanemia 7uand 7ufatigue, 7uhypocalcemia
*Extra 7uInformation:* 7uHemoglobin/Hematocrit 7u(H&H) 7u- 7uANS--Red 7ublood 7ucell
7umeasurements 7uto 7uevaluate 7uanemia
In 7u*Ulcerative 7uColitis*, 7uH&H 7ulevels 7umay 7ube 7u*high 7uor 7ulow*? 7u- 7uANS--High
WITH WELL DETAILED ANSWERS
What 7uis 7ua 7u*Bowel 7uPerforation* 7uand 7uwhat 7uare 7uthe 7usigns/symptoms 7uof 7uit?
7u- 7uANS--Spillage 7uof 7ugastric 7uor 7uduodenal 7ucontents 7uinto 7uperitoneal 7ucavity. 7u
S/S: 7uSudden, 7usevere 7uupper 7uabdominal 7upain 7u(may 7ube 7ureferred 7uto 7uthe
7ushoulder), 7uvomiting, 7uTender 7urigid, 7uboard-like 7uabdomen, 7ushallow/grunting
7urespirations 7uand 7usigns 7uof 7ushock
What 7uis 7uthe 7uintervention 7ufor 7ua 7u*bowel 7uperforation*? 7u- 7uANS--Immediate
7usurgery
What 7uis 7uan 7u*ileostomy*? 7u- 7uANS--A 7usurgical 7uoperation 7uin 7uwhich 7ua 7upiece
7uof 7uthe 7uileum 7uis 7udiverted 7uto 7uan 7uartificial 7uopening 7uin 7uthe 7uabdominal 7uwall.
For 7ua 7upatient 7uwith 7uan 7u*ileostomy*, 7uwhat 7umight 7uthe 7ustool 7ulook 7ulike? 7u-
7uANS--Liquid 7ufecal 7udrainage; 7uconstant 7uand 7ucannot 7ube 7uregulated; 7uminimal
7uodor 7ubecause 7ufewer 7ubacteria 7uare 7upresent
Indications 7ufor 7uan 7u*Ileostomy* 7u- 7uANS--Toxic 7uMegacolon 7ufrom 7uInflammatory
7uBowel 7uDisease
What 7uare 7usome 7uimportant 7u*ileostomy* 7ucomplications? 7u- 7uANS--High 7urisk 7ufor
7ubowel 7uobstruction 7u(Instruct 7upt 7uto 7uchew 7ufood 7uthoroughly 7uand 7udrink 7ulots 7uof
7uwater)
and 7uthe 7upotential 7urisk 7ufor 7uvitamin 7uB12 7udeficiency 7u(Administer 7usupplements
7uas 7uneeded)
What 7uis 7u*peptic 7uulcer 7udisease* 7u(PUD)? 7u- 7uANS--A 7ubreak 7uor 7uulceration 7uin
7uthe 7uprotective 7umucosal 7ulining 7uof 7uthe 7ulower 7uesophagus, 7ustomach, 7upylorus
7uor 7uduodenum 7uassociated 7uwith 7uthe 7uinfection 7uof 7uH. 7upylori
A 7upatient 7upresents 7uto 7uthe 7uclinic 7uwith 7u*dull 7ugnawing 7upain 7uor 7uburning 7uin
7uthe 7umid 7uepigastrium*, 7uheartburn 7uand
vomiting. 7uWhat 7udoes 7uthe 7unurse 7ususpect 7uthis 7upatient 7uto 7ube 7udiagnosed
7uwith? 7u- 7uANS--Peptic 7uUlcer 7uDisease
One 7uof 7uthe 7ugoals 7uin 7umanaging 7uPeptic 7uUlcer 7udisease 7uis 7uto 7ureduce 7uthe
7uacidity 7uwithin 7uthe 7ustomach, 7uthis 7ucan 7ube 7uachieved 7uwith 7uthe 7uuse 7uof 7uPPIs
7uor 7u*Proton 7uPump 7uInhibitors*. 7uTo 7uremember 7uthese 7umedications, 7uwhat 7uis
7uthe 7u*suffix* 7uassociated 7uwith 7uthem?
,A. 7u-prazole 7u(Ex. 7uPantoprazole)
B. 7u- 7udine 7u(Ex. 7uFamotidine)
C. 7u-ate 7u(Ex. 7uSucralfate) 7u
D. 7u-cid 7u(Ex. 7uPepcid) 7u- 7uANS--A. 7u-prazole 7u(Ex. 7uPantoprazole)
*Rationale:* 7uFamotidine 7uis 7uan 7uH2 7uBlocker, 7uSucralfate 7uis 7ua 7usurface 7uagent
7uand 7uPepcid 7uis 7uan 7uantacid. 7uThough 7uthey 7umay 7uall 7ube 7uused 7uin 7uthe
7umanagement 7uof 7uGERD 7uand 7uPUD, 7uonly 7uPanto*prazole* 7uis 7ua 7uPPI.
How 7udo 7uPPIs 7uwork? 7u- 7uANS--They 7ublock 7uthe 7uproton 7upump 7uin 7uour
7ustomach 7uand 7udecrease 7uthe 7uconcentration 7uof 7uHCl; 7uIrreversible 7uinhibit 7uthe
7uH+/K+ 7uATPase 7uin 7ustomach 7uparietal 7ucells.
H 7upylori 7uis 7uassociated 7u70-90% 7uof 7uPeptic 7uUlcer 7ucases. 7uHow 7udoes 7uH.
7upylori 7ucause 7uulcers? 7u- 7uANS--The 7ubacteria 7ubreaks 7udown 7uthe
7ugastroduodenal 7umucosal 7ubarrier 7uand 7ustimulates 7ugastric 7uacid 7usecretion
7uburrow 7uthrough 7ubarrier, 7urelease 7uammonium 7uand 7uliquefy 7uthe 7ubarrier 7uwhich
7ustimulates 7uHCl 7usecretion
*H. 7upylori* 7utreatment 7ucan 7uinclude 7uwhat? 7u- 7uANS--PPI 7u+ 7u2 7uof 7uthe 7ufollowing
7uantibiotics
--Clarithromycin
--Metronidazole
--Amoxicillin
One 7uweek 7utreatment: 7u90% 7ucure 7urate
Two 7uweeks 7uof 7uPPI 7u+ 7u1 7uantibiotic 7u(typically 7uclarithromycin): 7u10-20% 7ulower
7ucure 7urate
MHD 7unotes:
--Tetracycline 7ucan 7ube 7u1 7uof 7uthe 7u2 7uantibiotics
--Bismuth 7usalts, 7udoxycycline, 7uand 7umetronidazole 7ufor 7u14 7udays 7uis 7ucheap 7uand
7ueffective
What 7uis 7u*Crohn's 7udisease*? 7u- 7uANS--A 7uchronic 7uinflammatory 7ubowel 7udisease
7u(IBD) 7uthat 7uaffects 7uthe 7ulining 7uof 7uthe 7udigestive 7utract 7u(anywhere 7ufrom
7umouth 7uto 7uanus) 7uwhich 7ucan 7ulead 7uto 7uabdominal 7upain, 7usevere 7udiarrhea,
7ufatigue, 7uweight 7uloss 7uand 7umalnutrition
What 7uare 7uthe 7usigns 7uand 7usymptoms 7uof 7u*Crohn's 7uDisease*? 7u- 7uANS--First
7usign 7uwill 7ube 7uabd 7upain 7uunrelieved 7uby 7udefecation 7ufollowed 7uby: 7u
-diarrhea, 7u
-weight 7uloss
-constant 7ufluid 7uloss
, -low-grade 7ufever
-fatigue
-tenderness 7uin 7uRLQ
List 7usome 7u*complications* 7uof 7uCrohn's: 7u- 7uANS---Intestinal 7uobstruction
-Perianal 7udisease
-Electrolyte 7uimbalances
-Malnutrition
-Fistula 7u& 7uabscess 7uformation
A 7upatient 7uis 7ubeing 7uprovided 7ueducation 7ufor 7unutritional 7uconsumption 7uwith 7ua
7udiagnosis 7uof 7u*Crohn's 7udisease*. 7uHow 7ushould 7uthe 7unurse 7uinstruct 7uthe
7upatient 7uon 7uhow 7uto 7ualter 7utheir 7udiet? 7u- 7uANS--Limit 7udairy, 7ulow-fat 7ufoods,
7ulimit 7ufiber, 7ueat 7usmall-frequent 7umeals, 7uincrease 7ufluids, 7unutritional
7usupplements 7u(vitamins 7uand 7uiron)
What 7uis 7u*Ulcerative 7uColitis*? 7u- 7uANS--Recurrent 7uulcerative 7uand 7uinflammatory
7ubowel 7udisease 7uof 7uthe 7umucosal 7uand 7usubmucosal 7ulayers 7uof 7uthe 7ucolon 7uand
7urectum 7u(which 7ustarts 7udistally 7uat 7uthe 7urectum 7uand 7uprogresses 7uproximally)
7uOnset 7ucould 7ube 7ugradual 7uor 7uabrupt.
Out 7uof 7uthe 7ufollowing 7upopulations, 7uwho 7uis 7umore 7uhigh 7urisk 7ufor 7ua 7udiagnosis
7uof 7u*Ulcerative 7uColitis*? 7u(Select 7uall 7uthat 7uapply)
7u- 7uCaucasians
- 7uAsian
- 7uHispanic
- 7uAfrican 7uAmerican
- 7uMen 7u
- 7uWomen
- 7uJewish 7u- 7uANS--- 7uCaucasians
- 7uWomen
- 7uJewish
What 7uare 7uthe 7usigns 7uand 7usymptoms 7uof 7u*Ulcerative 7uColitis*? 7u- 7uANS--
Diarrhea 7u(6+ 7uliquid 7ustools/day), 7upassage 7uof 7umucus, 7upus 7uor 7ublood,
LLQ 7uabdominal 7upain, 7uintermittent
tenesmus 7u(straining 7uwith 7uBM), 7urectal
bleeding 7u(mild 7uor 7usevere), 7uPallor, 7uanemia 7uand 7ufatigue, 7uhypocalcemia
*Extra 7uInformation:* 7uHemoglobin/Hematocrit 7u(H&H) 7u- 7uANS--Red 7ublood 7ucell
7umeasurements 7uto 7uevaluate 7uanemia
In 7u*Ulcerative 7uColitis*, 7uH&H 7ulevels 7umay 7ube 7u*high 7uor 7ulow*? 7u- 7uANS--High
