NUR 430 Exam 3 questions with correct answers
A+ passed
1. Acute GI This is also known as stress ulcer or hemorrhagic
Bleed- ing
from gastritis This has the same pathophysiology as
Peptic Ulcer
and Stress- peptic ulcer disease.
Relat- ed
Mucosal Dis- But gastric mucosal resistance disruption is caused by increased acid
ease production and decreased mucosal blood flow that results in ischemia
and degeneration of the mucosal lining, while peptic ulcers are caused
by increased gastric acid production and h. pylori and/or NSAIDs
At Risk
Patients
Burns
Severe
trauma
Major
2. Acute GI surgery
Hemor- Shock
rhage/Esoph Acute neurologic disease
a-
gogastric These are due to hepatic cirrhosis and portal hypertension
Varices
Rupture and hemorrhage occur in 30% of patients and has a high
3. What are mortality.
the 4
classes of GI
bleeding? 4 classes
<15% HR N, UO ok, BP orthostatic
15-30% HR > 100, UO 25-30/hr, BP down
supine 30-40% HR 120+, UO 5-15/hr, BP
hypotensive.
1/
67
,NUR 430 Exam 3 questions with correct answers
A+ passed
>40% HR 140+, UO
minimal, profound
hypotension
Ditterent GI bleeding:
Hematemesis (upper GI)
Hema
toche
zia
(brigh
t red
stools
) from
lower
GI
bleedi
ng
Mela
na
(dige
sted
blood
)
Losing whole blood thus
Hgb and Hct may not
decrease for many hours
Endoscopy
2/
67
,NUR 430 Exam 3 questions with correct answers
A+ passed
4. What is the Stabilization
med- ical
-Give crystalloids, blood, and blood products, need several IV sites
management
-Perhaps, intubate to prevent
of GI
aspiration Insert gastric tube for
bleeding?
saline lavages
Control bleeding
-Endoscopic thermal therapy (PU)
-Endoscopic injection therapy (PU)
-Intraarterial vasopressin (PU & SRMD)
-Gelfoam pledgets, steel coils, etc. (PU)
-Endoscopy treatments for PU
-Balloon blood
-Gastrectomy tamponade
TIPS (shunting, vagotomy, or pyloroplasty) for
EV Patients at risk goals
-Identify at risk patients early
-Reduce gastric aciditiy
-Support the gastric mucosal defense mechanisms
Management of at Risk Patients
-Give prophylatic agents: Need to know how each of these classes of
drugs work and why used.
-antacids
-histamine 2 blockers
-cytoprotective agents such as Carafate
-proton-pump inhibitors
-Vasopressin (pitressin)
Medical Goals of Patients with GI Bleeding
3/
67
, NUR 430 Exam 3 questions with correct answers
A+ passed
-Provide fluid resuscitation
to achieve hemodynamic
stability
4/
67
A+ passed
1. Acute GI This is also known as stress ulcer or hemorrhagic
Bleed- ing
from gastritis This has the same pathophysiology as
Peptic Ulcer
and Stress- peptic ulcer disease.
Relat- ed
Mucosal Dis- But gastric mucosal resistance disruption is caused by increased acid
ease production and decreased mucosal blood flow that results in ischemia
and degeneration of the mucosal lining, while peptic ulcers are caused
by increased gastric acid production and h. pylori and/or NSAIDs
At Risk
Patients
Burns
Severe
trauma
Major
2. Acute GI surgery
Hemor- Shock
rhage/Esoph Acute neurologic disease
a-
gogastric These are due to hepatic cirrhosis and portal hypertension
Varices
Rupture and hemorrhage occur in 30% of patients and has a high
3. What are mortality.
the 4
classes of GI
bleeding? 4 classes
<15% HR N, UO ok, BP orthostatic
15-30% HR > 100, UO 25-30/hr, BP down
supine 30-40% HR 120+, UO 5-15/hr, BP
hypotensive.
1/
67
,NUR 430 Exam 3 questions with correct answers
A+ passed
>40% HR 140+, UO
minimal, profound
hypotension
Ditterent GI bleeding:
Hematemesis (upper GI)
Hema
toche
zia
(brigh
t red
stools
) from
lower
GI
bleedi
ng
Mela
na
(dige
sted
blood
)
Losing whole blood thus
Hgb and Hct may not
decrease for many hours
Endoscopy
2/
67
,NUR 430 Exam 3 questions with correct answers
A+ passed
4. What is the Stabilization
med- ical
-Give crystalloids, blood, and blood products, need several IV sites
management
-Perhaps, intubate to prevent
of GI
aspiration Insert gastric tube for
bleeding?
saline lavages
Control bleeding
-Endoscopic thermal therapy (PU)
-Endoscopic injection therapy (PU)
-Intraarterial vasopressin (PU & SRMD)
-Gelfoam pledgets, steel coils, etc. (PU)
-Endoscopy treatments for PU
-Balloon blood
-Gastrectomy tamponade
TIPS (shunting, vagotomy, or pyloroplasty) for
EV Patients at risk goals
-Identify at risk patients early
-Reduce gastric aciditiy
-Support the gastric mucosal defense mechanisms
Management of at Risk Patients
-Give prophylatic agents: Need to know how each of these classes of
drugs work and why used.
-antacids
-histamine 2 blockers
-cytoprotective agents such as Carafate
-proton-pump inhibitors
-Vasopressin (pitressin)
Medical Goals of Patients with GI Bleeding
3/
67
, NUR 430 Exam 3 questions with correct answers
A+ passed
-Provide fluid resuscitation
to achieve hemodynamic
stability
4/
67
