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Mary's Tests - Spring 2016 > ADULT EXAM 2 > Flashcards

ADULT EXAM 2 Flashcards

1
Q

Which hernia has a symptom of heartburn?

A

Sliding

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2
Q

Two types of Hernias:

A

Sliding and Paraesophageal

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3
Q

Sliding hernias occur when..

A

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

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

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4
Q

Complications of hernias:

A

hemorrhage, obstruction and strangulation

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5
Q

What diagnostic test would you do for Hernias?

A

barium swallow, xray, CT

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6
Q

most common reason for PUD

A

h. pylori

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7
Q

Diagnostics for PUD:

A

endoscopy to confirm ulcer

CBC

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8
Q

Medical Management for PUD: Dietary modifications:

A

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

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9
Q

Complications of PUD

A

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

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10
Q

Bariatric surgery dietary restriction

A

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

Can have 600-800 calories a day.

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11
Q

Dumping syndrome:

A

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

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12
Q

S/S of dumping syndrom

A

fullness, weakness, cramping, diaphoresis, diarrhea.

can occur 10 to 90 minutes after eating.

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13
Q

Dietary guidelines for bariatric patients

A

smaller more frequent meals–1cup

low carb intake

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

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14
Q

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

A

PUD (duodenal)

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15
Q

Meds for PUD

A

PPI, bismuth salts, antibiotics

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16
Q

H2 and PPIs are used to treat ulcers not associated with

A

H pylori

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17
Q

how many meals should a person with PUD eat

A

3 meals a day

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18
Q

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

A

B12 and iron

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19
Q

Bariatric surgery patients should drink water

A

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

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20
Q

bariatric patients should be positioned in..

A

low fowlers

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21
Q

lab findings of someone with appendicitis

A

elevated WBC, neutrophils

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22
Q

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

A

could be ectopic pregnancy

should also rule out UTI

23
Q

What diagnostic test is number one in determining appendicitis

A

X RAY

CT SCAN-when diagnosis is uncertain

24
Q

complication of appendicitis is..

A

peritonitis, abscess and portal pyleophlebitis

25
Q

someone with appendicitis position the patient..

A

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

26
Q

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

A

5-7 days

27
Q

patients after appendix surgery should avoid heavy lifting for..

A

2-4weeks

lift no more than 10lbs (gallon on milk)

28
Q

LLQ pain is prevalent in..

A

diverticulitis

29
Q

complications of diverticulitis

A

peritonitis or abcsess and septicemia

30
Q

what is contraindicated in patients with diverticulosis

A

barium enema

31
Q

what is contraindicated with patients with diverticulitis

A

colonoscopy

32
Q

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

A

ESR and WBC

33
Q

dietary management for patients with diverticulitis

A

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

34
Q

what pharmacological interventions can you give to someone with diverticulitis

A

broad spectrum antibiotics, antispasmotics, bulk forming laxatives

35
Q

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

A

diverticulitis

36
Q

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

A

severe case of diverticulitis

37
Q

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

A

crohns disease

38
Q

This shows a string sign..

A

Crohns disease

39
Q

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

A

Crohns disease

40
Q

Complications of people with crohns

A

intestinal obstruction and perianal disease

41
Q

patient complains of LLQ pain and an inclination to defecate

A

Ulcerative colitis

42
Q

patient has pus and mucous in their stool

A

ulcerative colitis

43
Q

Patients with ulcerative colitis may have hypo or hypercalcemia

A

hypo

44
Q

major complication of ulcerative colitis

A

Toxic mega Colon

45
Q

Which ostomy do we see most often with perforated diverticulitis

A

Sigmoid

46
Q

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

A

ileostomy

47
Q

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

A

4-5 days

48
Q

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

A

acute pancreatitis with peritonitis

49
Q

cullen sign

A

bruising around umbillicus

50
Q

grey-turners sign

A

bruising around the flank

51
Q

amylase and lipase levels are increased in

A

acute pancreatitis

52
Q

pancreatitis nutritional status

A

npo or send home on low fat high protein diet for 4-6 weeks

check blood sugars every45-6 hours

53
Q

how many carbs should diabetic have..

A

45-60

54
Q

give how much insulin for every 15 gram of carbs

A

1 unit

Mary's Tests - Spring 2016 (10 decks)

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