NUR 511 Exam 2 Questions With Correct
Answers
Ulcerative |Colitis |- |CORRECT |ANSWER✔✔-Autoimmune, |young |adults, |flu |like |symptoms. |
First |intervention |is |NPO, |IV |fluids, |then |NSAIDs |(sulfasalazine |and |mesalamine), |
corticosteroids, |antimicrobials |(Flagyl), |DMARDs |(Imuran, |6-MP, |cyclosporine), |antidiarrheals |
(Lomotil). |No |anticholinergics, |can |mask |toxic |megacolon.
Sigmoid |colon |and |rectum
F |and |E |imbalances.
Toxic |megacolon.
Bloody |mucoid |diarrhea.
Left |lower |abdominal |pain.
Preforation.
No |milk |or |highly |spiced |foods.
Crohn's |disease |- |CORRECT |ANSWER✔✔-Autoimmune, |young |adults, |flu |like |symptoms. |
First |intervention |is |NPO, |IV |fluids, |then |NSAIDs |(sulfasalazine |and |mesalamine), |
corticosteroids, |antimicrobials |(Flagyl), |DMARDs |(Imuran, |6-MP, |cyclosporine), |antidiarrheals |
(Lomotil).
Terminal |ilium |and |ascending |colon, |but |can |occur |anywhere. |Primarily |affects |small |intestine. |
Skip |leison |pattern, |cobblestone |appearance.
Fistulas. |Malabsorption. |Colicky. |Right |lower |quadrant |pain. |Malnutrition. |Pernicious |anemia.
Crohn's |disease |(IBS) |- |CORRECT |ANSWER✔✔-•Transmural |disease |occurring |mostly |in |
terminal |ileum |& |ascending |colon, |but |can |occur |anywhere |in |GI |tract |(oral |to |anus)
•Patchy |pattern |of |involvement; |has |"skip |lesion |pattern" |(cobble-stone |appearance)
,•Greater |risk |of: |small |bowel/ |colon |cancer, |obstruction, |fistulas, |strictures, |leakage |with |
abscesses, |perforation/peritonitis, |malabsorption, |cholelithiasis, |B12 |deficiency
Crohns
5-6 |x's |higher |risk |of |small |bowel |Ca |than |general; |highest |risk |if |extensive |involvement |& |
disease |>10 |years
may |have |malabsorption |of |proteins, |fats, |carbs, |water, |wide |variety |of |vitamins |(B12, |folic |
acid, |vit |D, |etc.), |& |possibly |minerals |b/c |most |nutrient |absorption |occurs |in |the |ileum |& |
jejunum.
•Bile |salts |& |cobalamin |exclusively |absorbed |in |terminal |ileum
•Water |& |lytes |cannot |be |absorbed |thru |inflamed |mucosa, |therefore, |diarrhea |w/ |large |F |& |E |
losses
Ulcerative |Colitis |(IBS) |- |CORRECT |ANSWER✔✔-•Affects |mucosa |& |submucosa |of |mostly |
sigmoid |colon |& |rectum
•Occurs |in |continuous |pattern, |progressing |distally |to |proximally
•Greater |risk |of |diarrhea |and |F |& |E |(fluid |and |electrolyte) |losses
•Greater |risk |of: |colorectal |cancer, |toxic |megacolon, |fulminant |colitis, |perforation, |massive |
hemorrhage, |pseudopolyps
ulcerative |colitis |(UC) |manifestation |- |CORRECT |ANSWER✔✔-•Bloody/mucoid |diarrhea
•Mild, |moderate, |severe
•Fecal |urgency, |tenesmus
•Abdominal |pain
•Mild |left |lower |abdominal |cramping |associated |with |diarrhea |to |severe |constant |pain |(may |
indicate |perforation)
•Frequently |relieved |by |defecation
,•Other: |weight |loss |& |fever |only |if |severe |disease, |F |& |E |imbalances, |fatigue
Crohn's |disease |(IBS) |manifestations |- |CORRECT |ANSWER✔✔-•Diarrhea:
•Continuous |or |episodic; |limited |blood
•Abdominal |pain:
•Colicky, |crampy
•Tenderness |in |RLQ |or |periumbilical |- |degree |of |pain |increases |as |disease |progresses
•Pain |may |be |relieved |with |defecation
•Other: |weight |loss/ |malnutrition, |vitamin |deficiencies, |palpable |RLQ |mass, |fever, |fatigue
IBS |manifestations |- |CORRECT |ANSWER✔✔-Both |can |be |mild |to |severe; |exacerbations |are |
unpredictable
Crohn's |- |if |intestine |involved |= |weight |loss |from |malabsorption
•Nutritional |problems |> |concern |with |Crohn's |(especially |if |involves |terminal |ileus) |b/c |bile |
salts |& |B12 |exclusively |absorbed |here, |therefore, |higher |risk |for |fat |malabsorption |& |anemia
Early |Crohn's |= |similar |to |IBS
Ulcerative |colitis
Mild |= |1-4 |semi-formed |bloody |stools
Moderate |= |4-10 |stools/day; |increased |bleeding, |systemic |symptoms |(fever, |malaise, |anorexia)
Severe |= |10-20 |stools/day; |stool |bloody |w/ |mucus, |fever, |weight |loss |(>10% |body |weight), |
anemia, |tachycardia, |dehydration, |fecal |urgency
, Tenesmus |- |spasmodic |contraction |of |anal |or |bladder |sphincter |with |pain |and |persistent |desire
|to |empty |the |bowel |or |bladder, |with |involuntary |ineffectual |straining |efforts.
IBS |testing |- |CORRECT |ANSWER✔✔-•Sigmoidoscopy, |colonoscopy, |capsule |endoscopy
•Rectal |and |colon |biopsies
•Barium |enema |(double |contrast)/small |bowel |series
•Stool: |FOBT, |mucus, |C |& |S
•CBC, |CRP, |ESR, |WBC
•Serum |electrolytes, |vitamins/minerals, |and |albumin
•Liver |function |tests
•Abdominal |x-rays/ultrasound/CT |scan/MRI
Ba |enema |(bowel |prep); |double |- |after |barium |removed, |use |air |to |look |for |detecting |mucosal |
abnormalities |in |UC; |not |done |during |acute |episodes |d/t |danger |of |perforation
Biopsies |cannot |be |obtained |with |capsule |endo |or |Ba |enema
C |& |S |- |to |check |for |treatable |bacterial |infection
CBC |low |H |& |H |(do |check |for |anemia) |- |iron |deficiency |from |blood |loss, |B12 |from |ileum |
malabsorption
WBC |- |toxic |megacolon |or |perforation
Elevated |ESR |= |chronic |inflammation; |CRP |- |used |to |dx |bacterial |infection |& |inflammatory |
disorders |(RBC |has |tendency |to |stack |up)
CRP |used |to |dx |bacterial |infection |& |inflammatory |disorders
Answers
Ulcerative |Colitis |- |CORRECT |ANSWER✔✔-Autoimmune, |young |adults, |flu |like |symptoms. |
First |intervention |is |NPO, |IV |fluids, |then |NSAIDs |(sulfasalazine |and |mesalamine), |
corticosteroids, |antimicrobials |(Flagyl), |DMARDs |(Imuran, |6-MP, |cyclosporine), |antidiarrheals |
(Lomotil). |No |anticholinergics, |can |mask |toxic |megacolon.
Sigmoid |colon |and |rectum
F |and |E |imbalances.
Toxic |megacolon.
Bloody |mucoid |diarrhea.
Left |lower |abdominal |pain.
Preforation.
No |milk |or |highly |spiced |foods.
Crohn's |disease |- |CORRECT |ANSWER✔✔-Autoimmune, |young |adults, |flu |like |symptoms. |
First |intervention |is |NPO, |IV |fluids, |then |NSAIDs |(sulfasalazine |and |mesalamine), |
corticosteroids, |antimicrobials |(Flagyl), |DMARDs |(Imuran, |6-MP, |cyclosporine), |antidiarrheals |
(Lomotil).
Terminal |ilium |and |ascending |colon, |but |can |occur |anywhere. |Primarily |affects |small |intestine. |
Skip |leison |pattern, |cobblestone |appearance.
Fistulas. |Malabsorption. |Colicky. |Right |lower |quadrant |pain. |Malnutrition. |Pernicious |anemia.
Crohn's |disease |(IBS) |- |CORRECT |ANSWER✔✔-•Transmural |disease |occurring |mostly |in |
terminal |ileum |& |ascending |colon, |but |can |occur |anywhere |in |GI |tract |(oral |to |anus)
•Patchy |pattern |of |involvement; |has |"skip |lesion |pattern" |(cobble-stone |appearance)
,•Greater |risk |of: |small |bowel/ |colon |cancer, |obstruction, |fistulas, |strictures, |leakage |with |
abscesses, |perforation/peritonitis, |malabsorption, |cholelithiasis, |B12 |deficiency
Crohns
5-6 |x's |higher |risk |of |small |bowel |Ca |than |general; |highest |risk |if |extensive |involvement |& |
disease |>10 |years
may |have |malabsorption |of |proteins, |fats, |carbs, |water, |wide |variety |of |vitamins |(B12, |folic |
acid, |vit |D, |etc.), |& |possibly |minerals |b/c |most |nutrient |absorption |occurs |in |the |ileum |& |
jejunum.
•Bile |salts |& |cobalamin |exclusively |absorbed |in |terminal |ileum
•Water |& |lytes |cannot |be |absorbed |thru |inflamed |mucosa, |therefore, |diarrhea |w/ |large |F |& |E |
losses
Ulcerative |Colitis |(IBS) |- |CORRECT |ANSWER✔✔-•Affects |mucosa |& |submucosa |of |mostly |
sigmoid |colon |& |rectum
•Occurs |in |continuous |pattern, |progressing |distally |to |proximally
•Greater |risk |of |diarrhea |and |F |& |E |(fluid |and |electrolyte) |losses
•Greater |risk |of: |colorectal |cancer, |toxic |megacolon, |fulminant |colitis, |perforation, |massive |
hemorrhage, |pseudopolyps
ulcerative |colitis |(UC) |manifestation |- |CORRECT |ANSWER✔✔-•Bloody/mucoid |diarrhea
•Mild, |moderate, |severe
•Fecal |urgency, |tenesmus
•Abdominal |pain
•Mild |left |lower |abdominal |cramping |associated |with |diarrhea |to |severe |constant |pain |(may |
indicate |perforation)
•Frequently |relieved |by |defecation
,•Other: |weight |loss |& |fever |only |if |severe |disease, |F |& |E |imbalances, |fatigue
Crohn's |disease |(IBS) |manifestations |- |CORRECT |ANSWER✔✔-•Diarrhea:
•Continuous |or |episodic; |limited |blood
•Abdominal |pain:
•Colicky, |crampy
•Tenderness |in |RLQ |or |periumbilical |- |degree |of |pain |increases |as |disease |progresses
•Pain |may |be |relieved |with |defecation
•Other: |weight |loss/ |malnutrition, |vitamin |deficiencies, |palpable |RLQ |mass, |fever, |fatigue
IBS |manifestations |- |CORRECT |ANSWER✔✔-Both |can |be |mild |to |severe; |exacerbations |are |
unpredictable
Crohn's |- |if |intestine |involved |= |weight |loss |from |malabsorption
•Nutritional |problems |> |concern |with |Crohn's |(especially |if |involves |terminal |ileus) |b/c |bile |
salts |& |B12 |exclusively |absorbed |here, |therefore, |higher |risk |for |fat |malabsorption |& |anemia
Early |Crohn's |= |similar |to |IBS
Ulcerative |colitis
Mild |= |1-4 |semi-formed |bloody |stools
Moderate |= |4-10 |stools/day; |increased |bleeding, |systemic |symptoms |(fever, |malaise, |anorexia)
Severe |= |10-20 |stools/day; |stool |bloody |w/ |mucus, |fever, |weight |loss |(>10% |body |weight), |
anemia, |tachycardia, |dehydration, |fecal |urgency
, Tenesmus |- |spasmodic |contraction |of |anal |or |bladder |sphincter |with |pain |and |persistent |desire
|to |empty |the |bowel |or |bladder, |with |involuntary |ineffectual |straining |efforts.
IBS |testing |- |CORRECT |ANSWER✔✔-•Sigmoidoscopy, |colonoscopy, |capsule |endoscopy
•Rectal |and |colon |biopsies
•Barium |enema |(double |contrast)/small |bowel |series
•Stool: |FOBT, |mucus, |C |& |S
•CBC, |CRP, |ESR, |WBC
•Serum |electrolytes, |vitamins/minerals, |and |albumin
•Liver |function |tests
•Abdominal |x-rays/ultrasound/CT |scan/MRI
Ba |enema |(bowel |prep); |double |- |after |barium |removed, |use |air |to |look |for |detecting |mucosal |
abnormalities |in |UC; |not |done |during |acute |episodes |d/t |danger |of |perforation
Biopsies |cannot |be |obtained |with |capsule |endo |or |Ba |enema
C |& |S |- |to |check |for |treatable |bacterial |infection
CBC |low |H |& |H |(do |check |for |anemia) |- |iron |deficiency |from |blood |loss, |B12 |from |ileum |
malabsorption
WBC |- |toxic |megacolon |or |perforation
Elevated |ESR |= |chronic |inflammation; |CRP |- |used |to |dx |bacterial |infection |& |inflammatory |
disorders |(RBC |has |tendency |to |stack |up)
CRP |used |to |dx |bacterial |infection |& |inflammatory |disorders
