CCRN GI Questions and Correct Answers |
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Upon your assessment of your patient, who has pancreatitis, you find the following values:
temp 37.1C, BP 98/64, HR 110, RR 28, SpO2 88% on 2L NC.
Her labs are WBC 19,000, Hgb 8.9, HCT 39%, Na 144, K 3.1, Ca 7.7, and glucose 224.
Your remaining assessment reveals LLL crackles of the lungs and her abdomen w/ Cullen's
sign. Besides pancreatitis, what else do you think your patient may have?
a) SIRS, hemorrhagic pancreatitis, MODs and needing fluids
b) hemorrhagic shock, stress hyperglycemia, hypoxemia, and needing blood
c) dehydration, ARDS, stress hyperglycemia, and needs intubation
d) hypovolemic shock, diabetes, severe sepsis, and needing antibiotics
✓ -:- a) SIRS, hemorrhagic pancreatitis, MODS and needing fluids
--Your patient has SIRS bc of the increased RR, HR, and WBC. Due to the Cullen's sign,
your patient most likely has hemorrhagic pancreatitis, w/signs of MODS by the low SpO2
and the low BP. Fluids are needed r/t the massive fluid shifts in acute pancreatitis
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--This pt does not have diabetes and does not need antibiotics. However, is at a high risk of
ARDS but does not have bilateral infiltrates or refractory hypoxemia
A new patient just arrived to the hospital s/p acute abdominal trauma. The patient is now
experiencing Kehr's sign. Which of the following may be the cause of Kehr's sign?
a) diaphragmatic irritation
b) liver contusion
c) ruptured kidney
d) ruptured bladder
✓ -:- a) diaphragmatic irritation
--Trauma that causes splenic rupture also causes diaphragmatic irritation and subsequent
referred pain to the left shoulder (Kehr's sign). The other choices do not cause Kehr's sign.
Your coworker goes on break and asks you to "look out" for her patients. Her pt then calls
you to the room w/a complaint of "something doesn't feel right in my abdomen". After
auscultating the pt's bowel sounds, which of the following is present in an early mechanical
bowel obstruction?
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a) normal bowel sounds
b) hypoactive bowel sounds
c) hyperactive bowel sounds
d) absent bowel sounds
✓ -:- c) hyperactive bowel sounds
--In early bowel obstruction, the bowel sounds become hyperactive. In a late bowel
obstruction, bowel sounds become hypoactive or absent.
You are assisting on the admission of a new patient into the ICU for a diagnosis of bleeding
esophageal varies and hypovolemic shock. Which of the following closely resembles
compensation for the hypovolemic shock?
a) vasodilation
b) capillary fluid shift into the interstitial space
c) decrease in renin secretion
d) increase in re-absorption of sodium and water
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