NUR 915 Module 4 Test With
Complete Solution
What are some signs/symptoms of appendicitis? - ANSWER -sudden onset
-colicky, achy pain
-migrates from umbilicus to RLQ
-worse with movement/coughing
-N/V, low grade fever
-(+) Psoas, Obturator, or Rovsing's sign
How is appendicitis diagnosed? - ANSWER -abd CT with contrast (best)
-MRI (if pregnant or allergies to contrast)
-abd US
-CBC with differential
What signs/symptoms are unique to children with appendicitis? - ANSWER
-more gradual onset
-more generalized belly pain
-anorexia and diarrhea
How is appendicitis treated? - ANSWER -surgical appendectomy (first)
-antibiotics
,What are the antibiotics of choice for appendicitis? - ANSWER Adults:
1st - cefoxitin or cefotetan 2 g IV
2nd - clindamycin 900 mg IV
Children:
1st - cefoxitin or cefotetan 40 mg/kg IV
2nd - cefazolin 30 mg/kg + metronidazole 15 mg/kg
3rd - clindamycin 10 mg/kg IV
What are some signs/symptoms of diverticulitis? - ANSWER -achy pain and
tenderness
-acute and constant
-LLQ
-sometimes palpable mass
-fever, N/V/D/C
-considered mild if able to tolerate oral intake + no s/s of peritonitis
How is diverticulitis diagnosed? - ANSWER -by H/P findings
-abd CT with contrast (best)
-abd US (if pregnant or allergies to contrast)
-abd XR
-CBC with differential (high WBCs), BMP, ESR, CRP
-UA
, How is diverticulitis treated? - ANSWER Mild:
-clear liquids for 2-3 days
-high fiber diet
If septic/immunocompromised:
1st - Augmentin 875/125 2x/day for 7-10 days
2nd - Bactrim 160/800 mg Q12 + Metronidazole 500 mg Q6-8 for 7-10 days
3rd - Cipro 500 mg 2x/day + Metronidazole 500 mg Q6-8 hrs for 7-10 days
*Colonoscopy 6-8 weeks AFTER acute episode
When should you refer a patient with diverticulitis? - ANSWER -if
unimproved after 3 days of mild management
-abscess
-generalized peritonitis or sepsis
-recurrent attacks
-chronic GI complications
When should you admit a patient with diverticulitis? - ANSWER -increasing
pain/fever
-inability to tolerate oral fluids
-immunocompromised
-significant comorbid illness
-abscess >3-4 cm
Complete Solution
What are some signs/symptoms of appendicitis? - ANSWER -sudden onset
-colicky, achy pain
-migrates from umbilicus to RLQ
-worse with movement/coughing
-N/V, low grade fever
-(+) Psoas, Obturator, or Rovsing's sign
How is appendicitis diagnosed? - ANSWER -abd CT with contrast (best)
-MRI (if pregnant or allergies to contrast)
-abd US
-CBC with differential
What signs/symptoms are unique to children with appendicitis? - ANSWER
-more gradual onset
-more generalized belly pain
-anorexia and diarrhea
How is appendicitis treated? - ANSWER -surgical appendectomy (first)
-antibiotics
,What are the antibiotics of choice for appendicitis? - ANSWER Adults:
1st - cefoxitin or cefotetan 2 g IV
2nd - clindamycin 900 mg IV
Children:
1st - cefoxitin or cefotetan 40 mg/kg IV
2nd - cefazolin 30 mg/kg + metronidazole 15 mg/kg
3rd - clindamycin 10 mg/kg IV
What are some signs/symptoms of diverticulitis? - ANSWER -achy pain and
tenderness
-acute and constant
-LLQ
-sometimes palpable mass
-fever, N/V/D/C
-considered mild if able to tolerate oral intake + no s/s of peritonitis
How is diverticulitis diagnosed? - ANSWER -by H/P findings
-abd CT with contrast (best)
-abd US (if pregnant or allergies to contrast)
-abd XR
-CBC with differential (high WBCs), BMP, ESR, CRP
-UA
, How is diverticulitis treated? - ANSWER Mild:
-clear liquids for 2-3 days
-high fiber diet
If septic/immunocompromised:
1st - Augmentin 875/125 2x/day for 7-10 days
2nd - Bactrim 160/800 mg Q12 + Metronidazole 500 mg Q6-8 for 7-10 days
3rd - Cipro 500 mg 2x/day + Metronidazole 500 mg Q6-8 hrs for 7-10 days
*Colonoscopy 6-8 weeks AFTER acute episode
When should you refer a patient with diverticulitis? - ANSWER -if
unimproved after 3 days of mild management
-abscess
-generalized peritonitis or sepsis
-recurrent attacks
-chronic GI complications
When should you admit a patient with diverticulitis? - ANSWER -increasing
pain/fever
-inability to tolerate oral fluids
-immunocompromised
-significant comorbid illness
-abscess >3-4 cm
