NR 576 FINAL STUDY GUIDE WITH QUESTIONS AND
DETAILED ANSWERS WITH RATIONALES THE
LATEST UPDATED EXAM BANK INCLUDING EXPERT
VERIFIED SOLUTIONS FOR A SURE PASS
Nausea
unpleasant sensation in the stomach, an occur alone or precede vomiting, most
common cause is gastroenteritis
Vomiting
forceful expulsion of gastric contents; it is a reflex response to stimulation of
receptor sites in the mucosa of the upper GI tract, the labyrinthine apparatus in the
inner ear, higher cortical centers in response to emotional stimuli, or the
chemoreceptor trigger zone of the medulla oblongata.
Nausea/Vomiting Treatment
-dimenhydrinate, promethazine, hydroxyzine, meclizine
-prochlorperazine
-metoclopramide
-scopolamine
-ondansetron, granisetron
Diarrhea
increase in the frequency, volume, or fluid content of bowel movements over what
is normal for the individual, most common cause is acute viral gastroenteritis
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Gastroenteritis Risk Factors
Anyone traveling to a developing country, immunocompromised patients, anyone
engaging in anal intercourse, residents of institutions or nursing homes, infants and
children attending day-care centers, and individuals consuming raw shellfish and
seafood
-Shigella, Salmonella, Campylobacter, Cryptosporidium, Bacillus cereus
Gastroenteritis FIndings
-Nausea, vomiting, diarrhea, fever, abdominal pain, cramping., fatigue, malaise,
anorexia, tenesmus, borborygmus (stomach rumbling), rectal burning and
hematochezia
-Dehydration
Gastroenteritis Diagnostics
A stool culture should be done on any patient who has severe diarrhea, a fever of
101.3°F (38.5°C) or higher, the presence of bloody stools, or stools that test
positive for leukocytes, lactoferrin, or occult blood because these findings are
indications of a bacterial pathogen
Gastroenteritis Treatment
-fluid and sodium replacement
-enterocyte renewal
-should not receive antimotility medications: may prolong the duration
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-azithromycin, bismuth subsalicylate
Gastroenteritis Education
-hand washing and safe disposal of waste products
-When traveling consume only safe foods and beverages
GERD Risk Factors
Obesity, hiatal hernia
GERD Findings
Heartburn, regurgitation, water brash (reflex salivation), dysphagia, sour taste in
the mouth in the morning, odynophagia, belching, coughing, hoarseness, or
wheezing, usually at night.
GERD Diagnostics
History and Presentation, EGD
GERD Treatment
PPI's: omeprazole, rabeprazole, pantoprazole, or lansoprazole once a day 30
minutes before breakfast
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GERD Education
lifestyle modifications that include weight loss; elevating the head of the bed 6 to 8
inches and avoidance of meals 2 to 3 hours before bedtime; and avoidance of
certain foods known to trigger reflux (chocolate, alcohol, caffeine, acidic
[tomatoes, citrus] or spicy foods)
Diverticulitis Risk Factors
Low fiber diet, obesity, smoking, genetics, sedentary, aspirin/NSAID use
Diverticulitis Findings
-LLQ pain, worse after eating, sometimes relieved with a bowel movement or
passing flatus, diarrhea or constipation, abdominal distention and tenderness,
bleeding
-firm, fixed mass, rebound tenderness with involuntary guarding and rigidity.
Bowel sounds hypoactive or hyperactive (obstructive process), stool is usually
positive for occult blood
Diverticulitis Diagnostics
computed tomography (CT) scan with oral contrast
Diverticulitis Treatment
-amoxicillin and clavulanate potassium or metronidazole with trimethoprim/
sulfamethoxazole