Final Exam Nr574 Questions With Correct Verified Answers | 100% Pass (A+ Certified)

FINAL EXAM NR574 QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. What are common trauma-related risk factors for Rhabdomyolysis Correct Answer Trauma, muscle compression, or ischemia 2. What are examples of trauma-related causes of Rhabdomyolysis Correct Answer Compartment syndrome, crush injuries, lightning strike, near-drowning, significant burns, blunt force trauma, high-voltage electrical injuries, prolonged immobilization following a fall 3. What heat-related conditions can lead to Rhabdomyolysis Correct Answer Heatstroke, malignant hyperthermia, and neuroleptic malignant syndrome 4. What infections can directly attack muscle and cause Rhabdomyolysis Correct Answer - Epstein-Barr virus (EBV), cytomegalovirus (CMV), adenovirus, human immunodeficiency virus (HIV), coxsackievirus, influenza A/B, herpes simplex virus (HSV), Varicella-zoster virus (VZV), E. Coli, C. perfringens, Legionella, Rickettsia, Group B beta-hemolytic streptococci, S. pneumoniae, S. pyogenes 5. What metabolic factors can contribute to Rhabdomyolysis Correct Answer Electrolyte imbalances (hypocalcemia, hypophosphatemia, hypokalemia, hypo-and hypernatremia), hypothyroidism, hyperglycemic hyperosmolar nonketotic syndrome 6. Rhabdomylosis risk factors Correct Answer Genetic factors Phosphofructokinase deficiency, myoadenylate deaminase deficiency phosphoglycerate kinase deficiency, mitochondrial respiratory chain enzyme deficiencies, sickle cell trait, etc. Medications that may cause direct myotoxicity HMG-CoA reductase inhibitors, cyclosporin, corticosteroids, zidovudine, colchicine, itraconazole Toxins which may cause indirect myotoxicity CNS depressants, alcohol, heroin, cocaine, ethanol, ketamine, barbiturates, amphetamines, caffeine, neuromuscular blocking agents, ecstasy, carbon monoxide, snake, or spider venom, etc. Exertional activity Marathons, high-intensity interval training, intense repetitive physical activity especially in untrained people, activities causing dehydration or performed in hot or humid conditions Nutritional supplements which contain substances that may induce muscle injuryEphedra, creatine, or large doses of caffeine 7. Clinical presentation of Rhabdo (subjective) Correct Answer Classic clinical findings characteristic of rhabdomyolysis includes dark urine, muscle pain, and muscle weakness. However, myoglobin is rapidly excreted and metabolized to bilirubin (half-life 2-3 hours) so visible changes in the urine may no longer be observable by the time the client seeks care. 8. Physical exam finidings of Rhabdo Correct Answer Physical exam findings in clients with rhabdomyolysis may also include: muscle tenderness soft tissue swelling bruising skin changes consistent with pressure necrosis muscle weakness confusion, delirium, agitation anuria 9. How do you diagnose Rhabdo Correct Answer dark urine, acute neuromuscluar illness without other symptoms PLUS acute elevation in serum creatinine kinase (typically 5x the upper limit of normal) 10. what is the most reliable lab for Rhabdo Correct Answer CK it will be markely elevated 1000 normal level is 45-260 11. Ck levels in rhabdo Correct Answer it begins to rise within 2-12 hours , peaks around 24-72 hrs following the injury. then the levels decline 3-5 days of muscle injury cessation. SERUM CK 5,000 results in AKI 12. what test assesses the extent of injury to the muscles Correct Answer MRI 13. Complications for RHabdo Correct Answer Compartment syndrome is suspected in when CK levels continue to rise or fail to decline following the inciting event. compartment pressures should be measured. 14. TX of Rhabdo Correct Answer Fluids at least 400ml/hr to prevent AKI to maintain a UOP of at least 200ml/hr in patients who CK levels are greater than 15,000 6L of IVF is required 15. what electrolyte imbalance are rhabdo patients at risk for Correct Answer Hypocalcemia - - not clinically signifant unless in a dysrhythmia Hyperkalemia - - Dextrose, sodium bicarb, sodium polystyrene sulfonate , sometimes HD Hyperurecemia & Hyperphosphate usually dont require tx 16. Tx of rhabdo (2) Correct Answer monitor for DIC, renal failure, seizure, ekg changes, hyperkalemia 17. acute Intestinal obstruction risk factors Correct Answer Adhesions from previous abdominal surgery Internal or external hernias Foreign bodies Feces Congenital issues (atresia, stenosis, cyst formation, intestinal duplication, and malrotation) Trauma (hematoma formation) Inflammation (inflammatory bowel disease, diverticulitis, radiation, and tuberculosis) Neoplasms including carcinomatosis, colon cancer, primary small bowel cancer, and extraintestinal malignancies such as ovarian cancer Endometriosis Volvulus Ischemic injury Intussusception Intraperitoneal abscess 18. How will the patient present in acute intestinal obstruction Correct Answer The most common presenting symptoms of acute intestinal obstruction include: colicky abdominal pain (cramping periumbilical pain initially; later becomes constant and diffuse) abdominal pain often more severe with distal obstruction vomiting (more significant with proximal obstruction) abdominal bloating obstipation History should include essential elements such as previous abdominal or pelvic surgeries, comorbid conditions such as inflammatory bowel disease or malignancy. 19. Key physical exam / clinical findings in acute intestinal obstruction Correct Answer Clients presenting with acute intestinal obstruction can often be critically ill. Key physical exam findings may include: Fever (systemic inflammation or strangulation) High-pitched, tinkling, bowel sounds (may be hypoactive or absent with complete obstruction) Abdominal distention (more significant with distal obstruction due to the greater volume of intraluminal fluid accumulation) Mild abdominal tenderness but no peritoneal findings