Nurs 623 Maryville University Test 3
Is generally involving the rectosigmoid colon or the entire colon, so just the end of the
GI tract around the rectum.
● It does not involve the small bowel and generally the symptoms of ulcerative colitis
only affect the mucosal surface of the colon.
● It causes friability, erosions, and bleeding, but doesn't go deep into the colon or the
mucosa. – answer Ulcerative colitis
Acute, diarrheal disease. Rapid onset and generally lasts 2 weeks. Can be associated
with n/v. Patient may have diffuse abdominal tenderness. 50% of the time occurs with a
fever. - answer Gastroenteritis
What pathogens can cause gastroenteritis? - answer bacteria or virus: salmonella,
staph aureas, or norovirus
Typical presentation of this is diarrhea alternating with constipation. Abdominal pain
relieved with having a bowel movement. Change in consistency of stool varying over 3
months. - answerIrritable bowel syndrome
When it comes to irritable bowel syndrome what is "2 or more of the following"
requirements? - answerAltered stool frequency
altered stool form such as with mucous
hard or loos
defecation that includes: straining urgency, tenesmus, passage of mucoids, or a varied
degree of bloating or abdominal distention.
What are some differential diagnosis of a patient who presents with diarrhea? -
answerIBS
gastroenteritis
Inflammatory bowel disease
lactase deficiency
Viral versions that are from food transmitted via the fecal oral route from contaminated
food or drinks? - answerHep A and Hep E
Self limiting infection, treated for symptoms only. There is a vaccine: people who travel
should get it. - answerHep A
Hep A education? - answerAvoid the use of oral contraceptives or hormone
replacement to avoid cholestatis
avoid alcohol
Avoid working with food 1 week after onset of infection
,Transferred via sexual activity. Created by semen, vaginal secretions, blood, blood
products, organs. Can also be passed mother to infant. can be acute chronic or self
limiting. - answerHep B
Treatment of Hep B? - answerfirst line: pegylated interferon alpha
Peg-inf-a
Entecavir
Tenofovir disoproxil fumarate
No vaccine in the US
Education for patients with Hep B? - answeravoid hepatotoxic agents: alcohol,
acetomenaphen, statins
use safe sex
Transmitted most commonly from sharing needles or blood transfusions before 1992,
could also be mother to infant, needle stick injuries for healthcare workers like
ourselves, possible, but less commonly, in sexual contact and sharing of personal items
such as razors adn toothbrushes. - answerHepatitis C
The most common cause of liver cancer and liver transplant in the world? - answerHep
C
Treatment for Hep C? - answerHarvoni and Ribavirin: antivirals new
peglyated interferon alpha-2a
liver biopsy to stage disease
Education for Hep C? - answerdo not share razors, toothbrushes, nail clippers, and
cover sores and cuts.
Patient has N/V, fever, chills, no appetite, right lower quadrant pain that started at the
belly button. hard palpiltation or significant pressure on the right lower quadrant in
between the belly button and groin - answerappendicitis
The biggest factor for appendicitis is a posistive what? - answerMcburneys point
Involuntary guarding, Really high white blood cell count, symptoms get worse. Severe
nausea and vomiting. High fevers. Medical emergency? - answerruptured appendicitis
What are the three various maneuvers for diagnosing appendicitis? - answerMcburneys
sign
Rovsings sign
Obturator sign
, Positive finding of the right lower quadrant abdominal pain occurs. Indicated an irritation
to the group of hip flexors in the abdomen, suggest peritoneal irritration. - answerPsoas
sign
How do you perform Psoas sign? - answerwith the patient in a supine position, have the
patient raise right leg against the pressure of the professional's hand resistance. With
the patient on the left side, extend the right leg from the hip.
In a supine position and it's positive if inward rotation of the hip causes right lower
quadrant pain. - answerObturator sign
How do you perform obturator sign? - answerSupine, rotate the right hip through full
range of motion. A positive sign is pain with movement or flexion of the hip.
In supine position, deep palpation of the left lower qaudrant of the abdomen results in
referred pain to the right lower quadrant. - answerRovsing's sign
specifically the area located between the superior iliac crest and umbilicus int eh right
lower quadrant. Tender or pain= possible acute appendicitis. - answerMcburney's point
● May have pain in the epigastrium associated with heartburn, could also be a
combination of belching, coughing, hoarseness, sour taste, and symptoms are usually
worse after eating. Associated with large and/or fatty meals and they're worse when
lying down - answerGERD
● Objective findings—Acidic or sour odor to breath, reflux of sour acid stomach
contents, especially when overeating, thinning tooth enamel due to the hydrochloric
acid, chronic sore red tongue, or chronic coughing. - answerGERD
A chronic cough can always be a sign of what? - answerasthma or GERD
how do we diagnose GERD? - answerHistory
Severity of symptoms
can manifest as asthma, chronic cough, and sore throat
When the diagnosis of GERD is unclear and the patient fails to respond to 4 weeks of
empiric therapy, the most accurate method of diagnosing the disease is by what? -
answerambullatory esophageal pH monitoring
When is an EGD recommended for GERD? - answerHeartburn
dysphasia
bleeding
anemia
weight loss
recurrent vomiting
Is generally involving the rectosigmoid colon or the entire colon, so just the end of the
GI tract around the rectum.
● It does not involve the small bowel and generally the symptoms of ulcerative colitis
only affect the mucosal surface of the colon.
● It causes friability, erosions, and bleeding, but doesn't go deep into the colon or the
mucosa. – answer Ulcerative colitis
Acute, diarrheal disease. Rapid onset and generally lasts 2 weeks. Can be associated
with n/v. Patient may have diffuse abdominal tenderness. 50% of the time occurs with a
fever. - answer Gastroenteritis
What pathogens can cause gastroenteritis? - answer bacteria or virus: salmonella,
staph aureas, or norovirus
Typical presentation of this is diarrhea alternating with constipation. Abdominal pain
relieved with having a bowel movement. Change in consistency of stool varying over 3
months. - answerIrritable bowel syndrome
When it comes to irritable bowel syndrome what is "2 or more of the following"
requirements? - answerAltered stool frequency
altered stool form such as with mucous
hard or loos
defecation that includes: straining urgency, tenesmus, passage of mucoids, or a varied
degree of bloating or abdominal distention.
What are some differential diagnosis of a patient who presents with diarrhea? -
answerIBS
gastroenteritis
Inflammatory bowel disease
lactase deficiency
Viral versions that are from food transmitted via the fecal oral route from contaminated
food or drinks? - answerHep A and Hep E
Self limiting infection, treated for symptoms only. There is a vaccine: people who travel
should get it. - answerHep A
Hep A education? - answerAvoid the use of oral contraceptives or hormone
replacement to avoid cholestatis
avoid alcohol
Avoid working with food 1 week after onset of infection
,Transferred via sexual activity. Created by semen, vaginal secretions, blood, blood
products, organs. Can also be passed mother to infant. can be acute chronic or self
limiting. - answerHep B
Treatment of Hep B? - answerfirst line: pegylated interferon alpha
Peg-inf-a
Entecavir
Tenofovir disoproxil fumarate
No vaccine in the US
Education for patients with Hep B? - answeravoid hepatotoxic agents: alcohol,
acetomenaphen, statins
use safe sex
Transmitted most commonly from sharing needles or blood transfusions before 1992,
could also be mother to infant, needle stick injuries for healthcare workers like
ourselves, possible, but less commonly, in sexual contact and sharing of personal items
such as razors adn toothbrushes. - answerHepatitis C
The most common cause of liver cancer and liver transplant in the world? - answerHep
C
Treatment for Hep C? - answerHarvoni and Ribavirin: antivirals new
peglyated interferon alpha-2a
liver biopsy to stage disease
Education for Hep C? - answerdo not share razors, toothbrushes, nail clippers, and
cover sores and cuts.
Patient has N/V, fever, chills, no appetite, right lower quadrant pain that started at the
belly button. hard palpiltation or significant pressure on the right lower quadrant in
between the belly button and groin - answerappendicitis
The biggest factor for appendicitis is a posistive what? - answerMcburneys point
Involuntary guarding, Really high white blood cell count, symptoms get worse. Severe
nausea and vomiting. High fevers. Medical emergency? - answerruptured appendicitis
What are the three various maneuvers for diagnosing appendicitis? - answerMcburneys
sign
Rovsings sign
Obturator sign
, Positive finding of the right lower quadrant abdominal pain occurs. Indicated an irritation
to the group of hip flexors in the abdomen, suggest peritoneal irritration. - answerPsoas
sign
How do you perform Psoas sign? - answerwith the patient in a supine position, have the
patient raise right leg against the pressure of the professional's hand resistance. With
the patient on the left side, extend the right leg from the hip.
In a supine position and it's positive if inward rotation of the hip causes right lower
quadrant pain. - answerObturator sign
How do you perform obturator sign? - answerSupine, rotate the right hip through full
range of motion. A positive sign is pain with movement or flexion of the hip.
In supine position, deep palpation of the left lower qaudrant of the abdomen results in
referred pain to the right lower quadrant. - answerRovsing's sign
specifically the area located between the superior iliac crest and umbilicus int eh right
lower quadrant. Tender or pain= possible acute appendicitis. - answerMcburney's point
● May have pain in the epigastrium associated with heartburn, could also be a
combination of belching, coughing, hoarseness, sour taste, and symptoms are usually
worse after eating. Associated with large and/or fatty meals and they're worse when
lying down - answerGERD
● Objective findings—Acidic or sour odor to breath, reflux of sour acid stomach
contents, especially when overeating, thinning tooth enamel due to the hydrochloric
acid, chronic sore red tongue, or chronic coughing. - answerGERD
A chronic cough can always be a sign of what? - answerasthma or GERD
how do we diagnose GERD? - answerHistory
Severity of symptoms
can manifest as asthma, chronic cough, and sore throat
When the diagnosis of GERD is unclear and the patient fails to respond to 4 weeks of
empiric therapy, the most accurate method of diagnosing the disease is by what? -
answerambullatory esophageal pH monitoring
When is an EGD recommended for GERD? - answerHeartburn
dysphasia
bleeding
anemia
weight loss
recurrent vomiting
