ADULT EXAM 2

Question 1

Which hernia has a symptom of heartburn?

Answer 1

Sliding

Question 2

Two types of Hernias:

Answer 2

Sliding and Paraesophageal

Question 3

Sliding hernias occur when..

Answer 3

the upper stomach and GI junction are displaced upward and slide out of the thorax.

S/S: heartburn, difficulty swallowing, weakness, trauma, tight pants

Question 4

Complications of hernias:

Answer 4

hemorrhage, obstruction and strangulation

Question 5

What diagnostic test would you do for Hernias?

Answer 5

barium swallow, xray, CT

Question 6

most common reason for PUD

Answer 6

h. pylori

Question 7

Diagnostics for PUD:

Answer 7

endoscopy to confirm ulcer

CBC

Question 8

Medical Management for PUD: Dietary modifications:

Answer 8

avoid extreme temp foods, avoid alcohol and caffeine, eat 3 regular meals a day.

Question 9

Complications of PUD

Answer 9

Hemorrage: vomiting bright red or coffee groups, tachycardia, test stools

Question 10

Bariatric surgery dietary restriction

Answer 10

sugar free clear liquids for 48 hours, drink 30 ml every 15 minutes, no Ng tube needed.

Can have 600-800 calories a day.

Question 11

Dumping syndrome:

Answer 11

unpleasant set of vasomotor and GI symptoms. Eat first, drink Later.

Question 12

S/S of dumping syndrom

Answer 12

fullness, weakness, cramping, diaphoresis, diarrhea.

can occur 10 to 90 minutes after eating.

Question 13

Dietary guidelines for bariatric patients

Answer 13

smaller more frequent meals–1cup

low carb intake

eat only foods high in nutrients (peanut butter, fish, beans, cheese, chicken)

Question 14

patient complains of midepigastric pain, dull and gnawing pain, burping (esp when stomach is empty), diarrhea, bleeding, etc.

Answer 14

PUD (duodenal)

Question 15

Meds for PUD

Answer 15

PPI, bismuth salts, antibiotics

Question 16

H2 and PPIs are used to treat ulcers not associated with

Answer 16

H pylori

Question 17

how many meals should a person with PUD eat

Answer 17

3 meals a day

Question 18

It is important for those with bariatric surgery to get what type of injections

Answer 18

B12 and iron

Question 19

Bariatric surgery patients should drink water

Answer 19

30 minutes after or before a meal but never with a meal to prevent dumping syndrome

Question 20

bariatric patients should be positioned in..

Answer 20

low fowlers

Question 21

lab findings of someone with appendicitis

Answer 21

elevated WBC, neutrophils

Question 22

why is it important to do a pregnancy test for someone with suspected appendicitis

Answer 22

could be ectopic pregnancy

should also rule out UTI

Question 23

What diagnostic test is number one in determining appendicitis

Answer 23

X RAY

CT SCAN-when diagnosis is uncertain

Question 24

complication of appendicitis is..

Answer 24

peritonitis, abscess and portal pyleophlebitis

Question 25

someone with appendicitis position the patient..

Answer 25

HIGH FOWLERS--> makes patient comfortable by increasing peristalsis, reduces tension on incision and abdominal organs

Question 26

When should the patient follow up with an appointment after appendix removal

Answer 26

5-7 days

Question 27

patients after appendix surgery should avoid heavy lifting for..

Answer 27

2-4weeks lift no more than 10lbs (gallon on milk)

Question 28

LLQ pain is prevalent in..

Answer 28

diverticulitis

Question 29

complications of diverticulitis

Answer 29

peritonitis or abcsess and septicemia

Question 30

what is contraindicated in patients with diverticulosis

Answer 30

barium enema

Question 31

what is contraindicated with patients with diverticulitis

Answer 31

colonoscopy

Question 32

In lab values, what might be elevated in patients with dierticulitis

Answer 32

ESR and WBC

Question 33

dietary management for patients with diverticulitis

Answer 33

clear liquids initially; rest bowels, high fiber, low fat, decrease pressure and increased stool volume

Question 34

what pharmacological interventions can you give to someone with diverticulitis

Answer 34

broad spectrum antibiotics, antispasmotics, bulk forming laxatives

Question 35

if stool is blood or pusy when it can mean the patient has

Answer 35

diverticulitis

Question 36

If patient has a rigid abdomen, elevated ESP, elevated WBC, increased temp, tachycardia and hypotension the patient may have

Answer 36

severe case of diverticulitis

Question 37

Patient complains of pain in RLQ with diarrhea that is unrelieved by defecation and complains of cramping after eating..

Answer 37

crohns disease

Question 38

This shows a string sign..

Answer 38

Crohns disease

Question 39

Can have an elevated ESR, WBC and albumin will be decreased with H&H decreased as well. Shows bowel wall thickening and/or fistula formation

Answer 39

Crohns disease

Question 40

Complications of people with crohns

Answer 40

intestinal obstruction and perianal disease

Question 41

patient complains of LLQ pain and an inclination to defecate

Answer 41

Ulcerative colitis

Question 42

patient has pus and mucous in their stool

Answer 42

ulcerative colitis

Question 43

Patients with ulcerative colitis may have hypo or hypercalcemia

Answer 43

hypo

Question 44

major complication of ulcerative colitis

Answer 44

Toxic mega Colon

Question 45

Which ostomy do we see most often with perforated diverticulitis

Answer 45

Sigmoid

Question 46

Which ostomy puts out more enzymes since it is closer to the stomach?

Answer 46

ileostomy

Question 47

For a postop ostomy patient, how long should IV fluids be administered for?

Answer 47

4-5 days

Question 48

patient complains of epigastric pain after a heavy meal/ binge drinking and has a rigid or boardlike abdomen

Answer 48

acute pancreatitis with peritonitis

Question 49

cullen sign

Answer 49

bruising around umbillicus

Question 50

grey-turners sign

Answer 50

bruising around the flank

Question 51

amylase and lipase levels are increased in

Answer 51

acute pancreatitis

Question 52

pancreatitis nutritional status

Answer 52

npo or send home on low fat high protein diet for 4-6 weeks check blood sugars every45-6 hours

Question 53

how many carbs should diabetic have..

Answer 53

45-60

Question 54

give how much insulin for every 15 gram of carbs

Answer 54

1 unit