NR 511 FINAL EXAM | QUESTIONS AND ANSWERS | VERIFIED AND
WELL DETAILED ANSWERS | ALREADY GRADED A+ | LATEST
UPDATE
Ulcerative Colitis
A disease only of the colon
Inflammatory bowel disease (IBD)
the mucosal surface of the colon is inflamed-most often occurs in the
rectosigmoid areas, must may involve the entire colon
Inflammatory bowel disease (IBD)
Occurs in the rectum and sigmoid colon
Inflammatory bowel disease (IBD)
Results in friability, erosions, and bleeding
Inflammatory bowel disease (IBD)
Characterized by bloody and purulent diarrhea
Inflammatory bowel disease (IBD)
While it is not the first treatment choice, total colectomy is a treatment option
that can completely resolve this problem
Diverticulitis
Patients with diverticulitis may present with bleeding not associated with pain
or discomfort.
Diverticulitis
Is associated with obesity-these patients are at higher risk
Diverticulitis
When the diverticula become inflamed, there are usual signs and symptoms of
infection-fever, chills, and tachycardia, painless bloody stools
Diverticulitis
Patients typically present with localized pain and tenderness in the LLQ of the
abdomen with associated anorexia, nausea and vomiting
,Diverticulitis
CT scan with contrast may sometimes be done to r/o if the gynecologic etiology
(such as ovarian cyst or tumor) as well as bowel pathology such as abdominal
abscess
Diverticulitis
High-fiber diet is best management
Clostridium Difficile
Infection of the large intestine
Clostridium Difficile
Exists in air, water, soil, processed food and human feces
Clostridium Difficile
Causes profuse, watery, mucoid diarrhea
Clostridium difficile (C. diff)
Certain types can be dangerous or life-threatening if not treated
Clostridium Difficile Risk factors
*Working in healthcare facility
*Long duration hospitalization
*Long-term use of antibiotics affects normal GI flora
Long-term use of medications that reduce GI acidity, Consumption of
contaminated food or water *Touching infected soil, objects and surfaces
*Older adult will become dehydrated quickly
Clostridium Difficile
*Patient may be asymptomatic
*Generally profuse, watery, mucoid diarrhea
Clostridium Difficile: Mild to moderate infection
Watery diarrhea three or more times/day for two or more days
Clostridium Difficile: Mild to moderate infection
Mild abdominal cramping and tenderness
Clostridium Difficile Severe infection:
Watery diarrhea (10-15 stools/day)
,Clostridium Difficile Severe infection:
Strong foul odor
Clostridium Difficile Severe infection:
Acute abdomen secondary to toxic megacolon with perforation
Clostridium Difficile Severe infection:
Abdominal distention
Clostridium Difficile Severe infection:
Fever
Clostridium Difficile Severe infection:
Nausea/vomiting/dehydration requiring hospitalization
Clostridium Difficile Severe infection:
Blood or pus in the stools (severe cases)
Clostridium Difficile: Diagnosis
Complete blood count (CBC): elevated WBC count
Clostridium Difficile: Diagnosis
Enzyme-linked immunodeficiency assay (ELISA): identifies toxins that produce
C. diff bacteria
Clostridium Difficile: Diagnosis
Cell cytotoxicity assay: identifies the effects of bacterial toxins on human cells
Clostridium Difficile: Diagnosis
Polymerase chain reaction (PCR): detects bacterial genes
Clostridium Difficile: Diagnosis
Endoscopy: if the patient is unresponsive to treatment; will show
pseudomembranes that suggest c-diff infection
Clostridium Difficile: Treatment
Metronidazole
Clostridium Difficile: Treatment
Probiotics- to restore the healthy growth of normal GI bacteria
, Clostridium Difficile: Treatment
Colectomy in severe cases
Clostridium Difficile: Treatment
Maintain fluids, Clear liquid diet
Clostridium Difficile: Treatment
Eat starchy foods to prevent diarrhea, Avoid caffeine, spicy foods, milk and
greasy foods
Clostridium Difficile: Treatment
May require a GI consult
Gastroesophageal Reflux Disease (GERD)
*Symptoms occur at night with regurgitation; heartburn is classic for GERD
(mild to severe).
*Dysphagia is frequently a prominent symptom of GERD. It is usually
associated with other symptoms, including regurgitation, water brash (reflex
salivation), sour taste in the mouth in the morning, odynophagia, belching,
coughing, hoarseness, or wheezing, usually at night.
Gastroesophageal Reflux Disease (GERD)
If patient has been treated with diet modifications and 6 weeks of omeprazole
without improvement of symptoms, the next step is an endoscopy
Gastroesophageal Reflux Disease (GERD)
a biopsy can be done and sent for H pylori at that time.
Gastroesophageal Reflux Disease (GERD) diet
Patients should be instructed to avoid coffee, alcohol, chocolate, peppermint,
and spicy foods; eat smaller meals; stop smoking; remain upright for 2 hours
after meals; elevate the head of the bed on 6- to 8-in blocks; and refrain from
eating for 3 hours before retiring.
Rotavirus
-Rotavirus is common in children younger than age 3.
-Peak incidence at age 6-24 months.
-Uncommon in adults because most have developed immunity.
Rotavirus
WELL DETAILED ANSWERS | ALREADY GRADED A+ | LATEST
UPDATE
Ulcerative Colitis
A disease only of the colon
Inflammatory bowel disease (IBD)
the mucosal surface of the colon is inflamed-most often occurs in the
rectosigmoid areas, must may involve the entire colon
Inflammatory bowel disease (IBD)
Occurs in the rectum and sigmoid colon
Inflammatory bowel disease (IBD)
Results in friability, erosions, and bleeding
Inflammatory bowel disease (IBD)
Characterized by bloody and purulent diarrhea
Inflammatory bowel disease (IBD)
While it is not the first treatment choice, total colectomy is a treatment option
that can completely resolve this problem
Diverticulitis
Patients with diverticulitis may present with bleeding not associated with pain
or discomfort.
Diverticulitis
Is associated with obesity-these patients are at higher risk
Diverticulitis
When the diverticula become inflamed, there are usual signs and symptoms of
infection-fever, chills, and tachycardia, painless bloody stools
Diverticulitis
Patients typically present with localized pain and tenderness in the LLQ of the
abdomen with associated anorexia, nausea and vomiting
,Diverticulitis
CT scan with contrast may sometimes be done to r/o if the gynecologic etiology
(such as ovarian cyst or tumor) as well as bowel pathology such as abdominal
abscess
Diverticulitis
High-fiber diet is best management
Clostridium Difficile
Infection of the large intestine
Clostridium Difficile
Exists in air, water, soil, processed food and human feces
Clostridium Difficile
Causes profuse, watery, mucoid diarrhea
Clostridium difficile (C. diff)
Certain types can be dangerous or life-threatening if not treated
Clostridium Difficile Risk factors
*Working in healthcare facility
*Long duration hospitalization
*Long-term use of antibiotics affects normal GI flora
Long-term use of medications that reduce GI acidity, Consumption of
contaminated food or water *Touching infected soil, objects and surfaces
*Older adult will become dehydrated quickly
Clostridium Difficile
*Patient may be asymptomatic
*Generally profuse, watery, mucoid diarrhea
Clostridium Difficile: Mild to moderate infection
Watery diarrhea three or more times/day for two or more days
Clostridium Difficile: Mild to moderate infection
Mild abdominal cramping and tenderness
Clostridium Difficile Severe infection:
Watery diarrhea (10-15 stools/day)
,Clostridium Difficile Severe infection:
Strong foul odor
Clostridium Difficile Severe infection:
Acute abdomen secondary to toxic megacolon with perforation
Clostridium Difficile Severe infection:
Abdominal distention
Clostridium Difficile Severe infection:
Fever
Clostridium Difficile Severe infection:
Nausea/vomiting/dehydration requiring hospitalization
Clostridium Difficile Severe infection:
Blood or pus in the stools (severe cases)
Clostridium Difficile: Diagnosis
Complete blood count (CBC): elevated WBC count
Clostridium Difficile: Diagnosis
Enzyme-linked immunodeficiency assay (ELISA): identifies toxins that produce
C. diff bacteria
Clostridium Difficile: Diagnosis
Cell cytotoxicity assay: identifies the effects of bacterial toxins on human cells
Clostridium Difficile: Diagnosis
Polymerase chain reaction (PCR): detects bacterial genes
Clostridium Difficile: Diagnosis
Endoscopy: if the patient is unresponsive to treatment; will show
pseudomembranes that suggest c-diff infection
Clostridium Difficile: Treatment
Metronidazole
Clostridium Difficile: Treatment
Probiotics- to restore the healthy growth of normal GI bacteria
, Clostridium Difficile: Treatment
Colectomy in severe cases
Clostridium Difficile: Treatment
Maintain fluids, Clear liquid diet
Clostridium Difficile: Treatment
Eat starchy foods to prevent diarrhea, Avoid caffeine, spicy foods, milk and
greasy foods
Clostridium Difficile: Treatment
May require a GI consult
Gastroesophageal Reflux Disease (GERD)
*Symptoms occur at night with regurgitation; heartburn is classic for GERD
(mild to severe).
*Dysphagia is frequently a prominent symptom of GERD. It is usually
associated with other symptoms, including regurgitation, water brash (reflex
salivation), sour taste in the mouth in the morning, odynophagia, belching,
coughing, hoarseness, or wheezing, usually at night.
Gastroesophageal Reflux Disease (GERD)
If patient has been treated with diet modifications and 6 weeks of omeprazole
without improvement of symptoms, the next step is an endoscopy
Gastroesophageal Reflux Disease (GERD)
a biopsy can be done and sent for H pylori at that time.
Gastroesophageal Reflux Disease (GERD) diet
Patients should be instructed to avoid coffee, alcohol, chocolate, peppermint,
and spicy foods; eat smaller meals; stop smoking; remain upright for 2 hours
after meals; elevate the head of the bed on 6- to 8-in blocks; and refrain from
eating for 3 hours before retiring.
Rotavirus
-Rotavirus is common in children younger than age 3.
-Peak incidence at age 6-24 months.
-Uncommon in adults because most have developed immunity.
Rotavirus
