Final Exam: NR341 / NR 341 (Latest Update
) Complex Adult Health |
Questions & Answers | Grade A | 100%
Correct. Chamberlain
1. Where does an Upper GI bleed occur: Above the ligament of Treitz
(esophagus, stomach, duodenum)
2. Where does a lower GI bleed occur?: Below the ligament of Treitz
(jejunum, ileum, colon, rectum)
3. Causes of upper GI bleed: -peptic ulcers
-esophageal varices
-gastritis
-Mallory-weiss tear
-NSAID use
-Portal hypertension (Cirrhosis)
4. causes of lower GI bleed: -diverticulosis
-hemorrhoids
,-inflammatory bowel disease
-colon cancer
-infection (C-diff)
-polyups
5. what diagnostic testing is need for an UPPER GI bleed: Endoscopy
6. what diagnostic test is used for w LOWER GI bleed?: colonoscopy
7. what labs do you draw for a GI bleed: -“ Hemoglobin and hematocrit
-‘ BUN (with upper GI bleed due to protein breakdown)
-Coagulation panel (PT/INR, aPTT)
-Liver enzymes (ALT, AST) if liver-related
-Occult blood test (guaiac test)
-ABGs: May show metabolic acidosis if in shock
8. Signs and Symptoms of an UPPER GI bleed: -hypovolemia (low BP,
elevated HR, low Urine output, dizzy, pallor)
-fatigue, weakness, confusion
-hematemesis ( vomiting blood, bright red of coffee ground like)
melena (black tarry stools)
,9. signs and symptoms of a LOWER GI bleed: -hypovolemia (low BP,
elevated
HR, low Urine output, dizzy, pallor)
-fatigue, weakness, confusion
-hematochezia (bright red or marron blood in stool)
10. Emergency assessment for GI bleed: vital signs (hypotension,
tachycardia low SpO2)
urine output <30 mL/hr and low perfusion
skin (cool,
clammy) Neuro
(Restless,
confused)
Abd (distended, tenderness, hypoactive or absent bowel sounds)
11. Priority treatment for GI bleed: -Airway, breathing, circulation
-O2 (nasal cannula or nn rebreather if unstable
-fluids( NS or LR bolus)
-establish 2 large bore IV's
, -Blood products or platelets or FFP
-(proton pump inhibitors (pantoprazole)
-Octreotide) (for variceal bleeds
-Vasopressin and nitroglycerin (for varices)
12. If Gi bleed is uncontrolled what is needed?: SURGERY
13. what is pantoprazole used for ?: Reduce stomach acid & prevent
rebleed
14. what is octreotide used for ?: low portal pressure in variceal bleed
15. what is Vasopressin and nitro used for ?: Constrict bleeding vessels
16. what is lactulose used for?: low ammonia buildup from GI bleeding
17. CLINICAL JUDGEMENT TIPS FOR GI BLEED: -Prioritize ABC:
airway/breathing always come first
-Rapid blood loss ’ think hypovolemic shock
-Elderly patients may have subtle signs
-NG tube: if bright red blood returns, bleeding is active
-Monitor for signs of rebleeding post-procedure
) Complex Adult Health |
Questions & Answers | Grade A | 100%
Correct. Chamberlain
1. Where does an Upper GI bleed occur: Above the ligament of Treitz
(esophagus, stomach, duodenum)
2. Where does a lower GI bleed occur?: Below the ligament of Treitz
(jejunum, ileum, colon, rectum)
3. Causes of upper GI bleed: -peptic ulcers
-esophageal varices
-gastritis
-Mallory-weiss tear
-NSAID use
-Portal hypertension (Cirrhosis)
4. causes of lower GI bleed: -diverticulosis
-hemorrhoids
,-inflammatory bowel disease
-colon cancer
-infection (C-diff)
-polyups
5. what diagnostic testing is need for an UPPER GI bleed: Endoscopy
6. what diagnostic test is used for w LOWER GI bleed?: colonoscopy
7. what labs do you draw for a GI bleed: -“ Hemoglobin and hematocrit
-‘ BUN (with upper GI bleed due to protein breakdown)
-Coagulation panel (PT/INR, aPTT)
-Liver enzymes (ALT, AST) if liver-related
-Occult blood test (guaiac test)
-ABGs: May show metabolic acidosis if in shock
8. Signs and Symptoms of an UPPER GI bleed: -hypovolemia (low BP,
elevated HR, low Urine output, dizzy, pallor)
-fatigue, weakness, confusion
-hematemesis ( vomiting blood, bright red of coffee ground like)
melena (black tarry stools)
,9. signs and symptoms of a LOWER GI bleed: -hypovolemia (low BP,
elevated
HR, low Urine output, dizzy, pallor)
-fatigue, weakness, confusion
-hematochezia (bright red or marron blood in stool)
10. Emergency assessment for GI bleed: vital signs (hypotension,
tachycardia low SpO2)
urine output <30 mL/hr and low perfusion
skin (cool,
clammy) Neuro
(Restless,
confused)
Abd (distended, tenderness, hypoactive or absent bowel sounds)
11. Priority treatment for GI bleed: -Airway, breathing, circulation
-O2 (nasal cannula or nn rebreather if unstable
-fluids( NS or LR bolus)
-establish 2 large bore IV's
, -Blood products or platelets or FFP
-(proton pump inhibitors (pantoprazole)
-Octreotide) (for variceal bleeds
-Vasopressin and nitroglycerin (for varices)
12. If Gi bleed is uncontrolled what is needed?: SURGERY
13. what is pantoprazole used for ?: Reduce stomach acid & prevent
rebleed
14. what is octreotide used for ?: low portal pressure in variceal bleed
15. what is Vasopressin and nitro used for ?: Constrict bleeding vessels
16. what is lactulose used for?: low ammonia buildup from GI bleeding
17. CLINICAL JUDGEMENT TIPS FOR GI BLEED: -Prioritize ABC:
airway/breathing always come first
-Rapid blood loss ’ think hypovolemic shock
-Elderly patients may have subtle signs
-NG tube: if bright red blood returns, bleeding is active
-Monitor for signs of rebleeding post-procedure
