FINAL EXAM - NURS LATEST
3366
A patient comes into the ER hematemesis. It is found that they are
an alcoholic and they are complaining about very bad stomach
pains. What is a possible conclusion?
peptic ulcer disease
- chronic inflammation that causes the breakdown of the intestinal lining
A patient comes in with severe lower abdominal pain. The doctor
orders a colostomy and they find many areas throughout the
intestine that are patchy and inflamed. What might the diagnosis be
and what complications could be associated?
Crohn's
- autoimmune disease
- ilium and cecum has transmural patches of inflammation
- could also have some systemic inflammation
- could have obstructions, fistulas, or perforations
A patient comes in with stomach pain and severe dehydration. A
colonoscopy is performed and they find inflamed membranes in the
rectal and sigmoid colon. What might their diagnosis be and why
are they experiencing those symptoms?
ulcerative colitis
- autoimmune disease affecting large intestines
- inflammation is not transmural
- dehydrated due to less absorption of water from large intestine
What is diverticular disease?
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PAGE
1
, FINAL EXAM - NURS LATEST
3366
- outpouching of muscular layer into the lumen
- can become inflamed and infected
What signs and symptoms would indicate an upper GI bleed?
- esophagus, stomach, duodenum
- occult bleeding (small amount of blood in vomit)
- frank bleeding (blood is easily visible)
- coffee-grounds: blood is partially digested, then thrown up
- may have melena: black tarry stool due to digestion of blood
What signs and symptoms would be associated with a lower GI
bleed?
- jejunum, ilium, or colon
- blood in stool
- NOT digested blood
A patient comes in with a yellow tint to their eye and skin. Their
labs show high indirect bilirubin but normal direct bilirubin.
Explain what is happening and why?
- prehepatic jaundice
- indirect bilirubin is produced in the spleen due to the breakdown of
RBCs.
- the liver is fine due to normal lab levels
- probable issue with the spleen, where RBCs are being broken down too
much
END OF
PAGE
2
, FINAL EXAM - NURS LATEST
3366
- could be erythroblastosis fetalis, where the mom is Rh- and the second
baby is Rh+
A patient comes in with a yellow tint in their eyes and skin. Their
labs come back with high direct bilirubin, but normal indirect.
Explain what is happening and why.
- posthepatic jaundice
- the liver converts indirect bilirubin to direct bilirubin
- it then leaves the liver as waste or as bile then as waste
- if there are high direct bilirubin levels in the blood, then there must be
a blockage preventing bile from entering the small intestine
- possible gall stones or tumor
A patient comes in with a yellow tint in their eyes and skin. Their
labs come back with low direct bilirubin, but high indirect. Explain
what is happening and why.
- hepatic jaundice
- RBCs are being broken down at a normal rate, but the bilirubin is not
being conjugated
- possible due to liver failure (cirrhosis)
A forty year old female patient comes in complaining of upper right
abdominal pain that radiates into her right shoulder. What may be
her diagnosis and what could potential complications be?
cholelithiasis
- gallstones
END OF
PAGE
3
3366
A patient comes into the ER hematemesis. It is found that they are
an alcoholic and they are complaining about very bad stomach
pains. What is a possible conclusion?
peptic ulcer disease
- chronic inflammation that causes the breakdown of the intestinal lining
A patient comes in with severe lower abdominal pain. The doctor
orders a colostomy and they find many areas throughout the
intestine that are patchy and inflamed. What might the diagnosis be
and what complications could be associated?
Crohn's
- autoimmune disease
- ilium and cecum has transmural patches of inflammation
- could also have some systemic inflammation
- could have obstructions, fistulas, or perforations
A patient comes in with stomach pain and severe dehydration. A
colonoscopy is performed and they find inflamed membranes in the
rectal and sigmoid colon. What might their diagnosis be and why
are they experiencing those symptoms?
ulcerative colitis
- autoimmune disease affecting large intestines
- inflammation is not transmural
- dehydrated due to less absorption of water from large intestine
What is diverticular disease?
END OF
PAGE
1
, FINAL EXAM - NURS LATEST
3366
- outpouching of muscular layer into the lumen
- can become inflamed and infected
What signs and symptoms would indicate an upper GI bleed?
- esophagus, stomach, duodenum
- occult bleeding (small amount of blood in vomit)
- frank bleeding (blood is easily visible)
- coffee-grounds: blood is partially digested, then thrown up
- may have melena: black tarry stool due to digestion of blood
What signs and symptoms would be associated with a lower GI
bleed?
- jejunum, ilium, or colon
- blood in stool
- NOT digested blood
A patient comes in with a yellow tint to their eye and skin. Their
labs show high indirect bilirubin but normal direct bilirubin.
Explain what is happening and why?
- prehepatic jaundice
- indirect bilirubin is produced in the spleen due to the breakdown of
RBCs.
- the liver is fine due to normal lab levels
- probable issue with the spleen, where RBCs are being broken down too
much
END OF
PAGE
2
, FINAL EXAM - NURS LATEST
3366
- could be erythroblastosis fetalis, where the mom is Rh- and the second
baby is Rh+
A patient comes in with a yellow tint in their eyes and skin. Their
labs come back with high direct bilirubin, but normal indirect.
Explain what is happening and why.
- posthepatic jaundice
- the liver converts indirect bilirubin to direct bilirubin
- it then leaves the liver as waste or as bile then as waste
- if there are high direct bilirubin levels in the blood, then there must be
a blockage preventing bile from entering the small intestine
- possible gall stones or tumor
A patient comes in with a yellow tint in their eyes and skin. Their
labs come back with low direct bilirubin, but high indirect. Explain
what is happening and why.
- hepatic jaundice
- RBCs are being broken down at a normal rate, but the bilirubin is not
being conjugated
- possible due to liver failure (cirrhosis)
A forty year old female patient comes in complaining of upper right
abdominal pain that radiates into her right shoulder. What may be
her diagnosis and what could potential complications be?
cholelithiasis
- gallstones
END OF
PAGE
3
