NURSING 150- EXAM #1 QUESTIONS
AND ANSWERS
What is the best way to diagnose ulcerative colitis? - Answer-Colonoscopy
- It cannot be done during a flare up
- When a person gets back from a colonoscopy, continue checking S&S for a perforated
bowel
X-ray exam that can detect changes or abnormalities in the large intestine. An enema is
the injection of a liquid into your rectum through a small tube - Answer-Barium enema
- Make sure person passes barium or it can harden inside bowel (Drink a lot of fluid)
- Barium is clay colored ; May take stool a few days to return back to normal after
procedure
Drug #1 for ulcerative colitis:
- GI anti inflammatory drugs that affect the GI
- First line of defense drugs
- A maintenance medication that the person will take long term - Answer-
Aminosalicylates otherwise known as 5-ASA
- Sulfasalazine (Azulfidine)
- Mesalamine (Pentasa, Rowasa, Asacol HD)
Drug #2 for ulcerative colitis:
- A systemic steroid that is used to treat all types of inflammation
- Used for initial flare ups and not long-term use - Answer-Corticosteroids
- Prednisone
- Budesonide
*If patient is on steroids, you have to taper them off for the body to adjust to not being
on them
What is the IV form called for corticosteroids? - Answer-Methylprednisolone (Solu-
Medrol)
*Can cause high blood sugar so you have to check the patients blood sugar
Drug #3 for ulcerative colitis:
- Used to get rid of inflammation
- The patient has to take the medication 3 to 6 months for the pills to work at there full
therapeutic affect - Answer-Immunomodulators
- Azathioprine (Imuran)
- Cyclosporine (Sandimmune)
Drug #4 for ulcerative colitis:
- Trying to alter the immune response - Answer-Biologic therapy
- Infliximab (Remicade)
,- Adalimumab (Humira)
Drug #5 for ulcerative colitis:
- Used to prevent infection/lower intestinal bacteria - Answer-Antibiotics
- Flagyl *Most commonly used for GI
- Cipro
What diet would someone be on with ulcerative colitis? - Answer-NPO/Clear liquid
advance to reg diet as tolerated
*TPN is used for people who are NPO long term
What surgeries can be performed to help treat ulcerative colitis? - Answer-- Total
proctocolectomy with permanent ileostomy (Removal of the colon, rectum, and anus)
- Total colectomy with ileoanal anastamosis (The large intestine is bypassed and the
lower portion of the small intestine is directly attached to the anal canal)
- Total colectomy with continent ileostomy
T or F ; 20-40% of people with ulcerative colitis will have surgery to remove their colon. -
Answer-True!
Cultural considerations for ulcerative colitis: - Answer-- Affects people most commonly
15-30 years old
- People who have it have a 10% more chance of getting colon cancer
What are some complications that can occur with ulcerative colitis? - Answer--
Hemmorhage
- Perforation
- Toxic megacolon
- Colorectal cancer
What is a fistula? - Answer-Tunneling caused by an infection that goes through the
bowel until it can find an exit point
Pathophysiology of Crohn's - Answer-Chronic inflammation that can affect any part of
the GI tract from the mouth to the anus and it affects all layers of the bowel
What is the etiology of Crohn's disease? - Answer-They do not know the exact cause of
crohn's but it is seen to be caused by:
- Genetics
- Immunity
- Viruses
- Environment
What are some cultural considerations and risk factors for crohn's? - Answer-- Effects
Eastern European, Jewish, and African American people the most
Risk factors:
, - Affects people most commonly 15-30 years old
- Smokers are 2 to 4x more times likely to get Crohn's
Clinical manifestations for Crohn's disease:
Pain - where?
Stool - what is it like?
Weight loss - why?
Fatigue
What else? - Answer-Pain: Right lower quadrant (Terminal ileum - distal end of the
small intestine that intersects the large intestine)
Stool: Frequent stools, not watery but not firm
Weight loss: Not absorbing nutrients
*They can eat whatever they want and the person gains no weight
What lab tests would be done to diagnose Crohn's? - Answer-CBC, Electrolytes, ESR,
Albumin, Total protein, Vitamin B12 and B6, Folic acid
If someone has Crohn's, what would CBC levels show? - Answer-- Increased WBC
- RBC steady
- H&H steady because no bleeding in body
What are the 5 tests that can be done to diagnose Crohn's? - Answer-- EGD (Best way
to diagnose Crohn's)
- Upper GI
- Colonoscopy
- Barium enema
- CT Scan/MRI
What do you have to access when a person gets back from an EGD? - Answer-- Check
gag reflex because they put a numbing gel on the back of the throat and you want to
make sure it is going back to normal
- Check for perforation
What type of diet would someone be on with Crohn's? - Answer-High calorie, Low fiber
diet
If a patient goes in for surgery when it comes to Crohn's, what is the doctor typically
doing during surgery? - Answer-The doctor will perform a bowel resection and remove
the area of irritation and then sew the bowel back together
*The patient is most likely to get Crohn's back at the junction site of the bowel that they
put together.
What is your main goal during health education and promotion when it comes to people
that have Crohn's? - Answer-There diet and nutrition and what to properly eat to be
healthy
AND ANSWERS
What is the best way to diagnose ulcerative colitis? - Answer-Colonoscopy
- It cannot be done during a flare up
- When a person gets back from a colonoscopy, continue checking S&S for a perforated
bowel
X-ray exam that can detect changes or abnormalities in the large intestine. An enema is
the injection of a liquid into your rectum through a small tube - Answer-Barium enema
- Make sure person passes barium or it can harden inside bowel (Drink a lot of fluid)
- Barium is clay colored ; May take stool a few days to return back to normal after
procedure
Drug #1 for ulcerative colitis:
- GI anti inflammatory drugs that affect the GI
- First line of defense drugs
- A maintenance medication that the person will take long term - Answer-
Aminosalicylates otherwise known as 5-ASA
- Sulfasalazine (Azulfidine)
- Mesalamine (Pentasa, Rowasa, Asacol HD)
Drug #2 for ulcerative colitis:
- A systemic steroid that is used to treat all types of inflammation
- Used for initial flare ups and not long-term use - Answer-Corticosteroids
- Prednisone
- Budesonide
*If patient is on steroids, you have to taper them off for the body to adjust to not being
on them
What is the IV form called for corticosteroids? - Answer-Methylprednisolone (Solu-
Medrol)
*Can cause high blood sugar so you have to check the patients blood sugar
Drug #3 for ulcerative colitis:
- Used to get rid of inflammation
- The patient has to take the medication 3 to 6 months for the pills to work at there full
therapeutic affect - Answer-Immunomodulators
- Azathioprine (Imuran)
- Cyclosporine (Sandimmune)
Drug #4 for ulcerative colitis:
- Trying to alter the immune response - Answer-Biologic therapy
- Infliximab (Remicade)
,- Adalimumab (Humira)
Drug #5 for ulcerative colitis:
- Used to prevent infection/lower intestinal bacteria - Answer-Antibiotics
- Flagyl *Most commonly used for GI
- Cipro
What diet would someone be on with ulcerative colitis? - Answer-NPO/Clear liquid
advance to reg diet as tolerated
*TPN is used for people who are NPO long term
What surgeries can be performed to help treat ulcerative colitis? - Answer-- Total
proctocolectomy with permanent ileostomy (Removal of the colon, rectum, and anus)
- Total colectomy with ileoanal anastamosis (The large intestine is bypassed and the
lower portion of the small intestine is directly attached to the anal canal)
- Total colectomy with continent ileostomy
T or F ; 20-40% of people with ulcerative colitis will have surgery to remove their colon. -
Answer-True!
Cultural considerations for ulcerative colitis: - Answer-- Affects people most commonly
15-30 years old
- People who have it have a 10% more chance of getting colon cancer
What are some complications that can occur with ulcerative colitis? - Answer--
Hemmorhage
- Perforation
- Toxic megacolon
- Colorectal cancer
What is a fistula? - Answer-Tunneling caused by an infection that goes through the
bowel until it can find an exit point
Pathophysiology of Crohn's - Answer-Chronic inflammation that can affect any part of
the GI tract from the mouth to the anus and it affects all layers of the bowel
What is the etiology of Crohn's disease? - Answer-They do not know the exact cause of
crohn's but it is seen to be caused by:
- Genetics
- Immunity
- Viruses
- Environment
What are some cultural considerations and risk factors for crohn's? - Answer-- Effects
Eastern European, Jewish, and African American people the most
Risk factors:
, - Affects people most commonly 15-30 years old
- Smokers are 2 to 4x more times likely to get Crohn's
Clinical manifestations for Crohn's disease:
Pain - where?
Stool - what is it like?
Weight loss - why?
Fatigue
What else? - Answer-Pain: Right lower quadrant (Terminal ileum - distal end of the
small intestine that intersects the large intestine)
Stool: Frequent stools, not watery but not firm
Weight loss: Not absorbing nutrients
*They can eat whatever they want and the person gains no weight
What lab tests would be done to diagnose Crohn's? - Answer-CBC, Electrolytes, ESR,
Albumin, Total protein, Vitamin B12 and B6, Folic acid
If someone has Crohn's, what would CBC levels show? - Answer-- Increased WBC
- RBC steady
- H&H steady because no bleeding in body
What are the 5 tests that can be done to diagnose Crohn's? - Answer-- EGD (Best way
to diagnose Crohn's)
- Upper GI
- Colonoscopy
- Barium enema
- CT Scan/MRI
What do you have to access when a person gets back from an EGD? - Answer-- Check
gag reflex because they put a numbing gel on the back of the throat and you want to
make sure it is going back to normal
- Check for perforation
What type of diet would someone be on with Crohn's? - Answer-High calorie, Low fiber
diet
If a patient goes in for surgery when it comes to Crohn's, what is the doctor typically
doing during surgery? - Answer-The doctor will perform a bowel resection and remove
the area of irritation and then sew the bowel back together
*The patient is most likely to get Crohn's back at the junction site of the bowel that they
put together.
What is your main goal during health education and promotion when it comes to people
that have Crohn's? - Answer-There diet and nutrition and what to properly eat to be
healthy
