Chamberlain NR 511 Midterm Exam Questions with 100% Correct Answers

What are common causes of N/V associated with gastritis? Correct Answer Alcohol, NSAIDs, ASA, ABX, and illicit substances What is the most common cause of nausea and vomiting? Correct Answer Acute Gastroenteritis (AGE) What are some manifestations of AGE? Correct Answer Nausea, vomiting, and diarrhea, fever, abdominal pain. May also include fatigue, malaise, anorexia, tenesmus and borborygmus. How is the severity of AGE gauged? Correct Answer Dehydration secondary to profuse watery diarrhea, fever greater than 101ºF (38.3ºC), vomiting, or dysentery. What are important parts of a patient's history when AGE is suspected? Correct Answer Travel, dining locations, ABX history.. What happens to the pH of the stomach when antacids are taken and how does this affect bacteria? Correct Answer High pH can make it easier for bacteria to survive and cause and infection. How does motility of the GI tract affect bacteria colonization? Correct Answer Small bowel stasis as a result of obstruction, diverticulitis, or blind loop syndrome frequently develop an overgrowth of bacteria within the stagnant segment. Which immunoglobulin may protect the GI tract against invading organisms? Correct Answer IgA...may also help protect against a future attack by the same pathogen. Onset of N/V begin within 6 hours after exposure. Is this bacterial or viral? Correct Answer Bacterial: time frame suggests food poisoning resulting from the ingestion of a preformed toxin such as that of Bacillus cereus. What two indications are highly suggestive of viral AGE? Correct Answer Incubation periods greater than 14 hours and the initial symptom of vomiting. If a patient presents with AGE and reports bloody stools, what can be understood about the reason for blood in the stool/ Correct Answer Mucosal damage and inflammatory process secondary to invasive pathogens. What do frothy stools and flatus suggest? Correct Answer Malabsorption problem. Patients with prolonged AGE illness who are malnourished may present with edema. What is the reason? Correct Answer Hypoalbuminemia T or F: Chronic diarrhea usually has a noninfectious etiology. Correct Answer True T or F: Acute diarrhea usually is caused by infectious agents or toxins Correct Answer True What is the most common viral pathogen causing AGE in adults? Correct Answer Norovirus What is the most common viral pathogen causing AGE in pediatrics? Correct Answer Rotavirus. This has been greatly reduced since the introduction of the rotavirus vaccine. T or F: Stool studies are indicated in the absence of bloody diarrhea or systemic disease Correct Answer False T or F: A CBC will help distinguish between viral and bacterial AGE Correct Answer False When are stool studies warranted? Correct Answer Severe or prolonged diarrhea, a fever 38.5ºC, bloody stools or stools that test positive for leukocytes or occult blood. What are common pathogens involved in Traveler's Diarrhea? Correct Answer Shigella, Campylobacter, and E. coli. What should the clinician do if the patient develops diarrhea after initiation of completion of antibiotic therapy? Correct Answer Test for C. diff. What are some DDx of AGE, particularly in patients with persistent or chronic diarrhea and severe abdominal pain? Correct Answer IBS, IBD, ischemic bowel disease, partial bowel obstruction, small bowel diverticulosis. What are some red flag symptoms that may indicate the need for hospitalization? Correct Answer Hypovolemia, dehydration, abnormal electrolytes, decreased renal function, bloody stool/rectal bleeding, weight loss, severe abdominal pain, prolonged symptoms greater than 1 week, pregnancy, advanced age, history of hospitalization or antibiotic use in the last 3-6 months. What is the usual course of treatment for AGE? Correct Answer Only supportive treatment is initiated since AGE is usually self-limiting and resolves within 1 week after onset of symptoms. How such patients with evidence of dehydration be treated initially? Correct Answer Fluid repletion and nutrition. Sports drinks aren't as effective as specific electrolyte replenishing drinks.