Gastrointestinal Quiz Flashcards
Select the correct statement about gastric mucosa:
a.) Stress ulcerations or stress-related erosive syndrome occurs in less than 5% of patients.
b.) Abnormalities are slow to develop.
c.) Disruption of gastric mucosa resistance with increased acid production & decreased mucosal blood flow occurs in critical illness.
d.) No prophylaxis is indicated as the gastric mucosa will easily regenerate cell healing.
c.) Disruption of gastric mucosa resistance with increased acid production & decreased mucosal blood flow occurs in critical illness.
- Stress ulcers occur in 1-30% of patients
- Prophylactic measures such as cytoprotective agents, H2 antagonsists, & PPIs are often used.
- Abnormalities develop rapidly within hours of admission & range from superficial mucosal erosion to deep ulcers.
Your patient with long standing cirrhosis & alcoholism has developed esophageal varicies. Which of the following statements is true?
a.) Patients with superficial varicies of the legs are more likely to develop esophageal varicies.
b.) Control of bleeding can only be accomplished with a Sengstaken Blackmore tube.
c.) A TIPPS procedure creates a channel between the systemic & protal venous system to redirect portal blood & reduce portal hypertension.
d.) The portal hypertension is confined to pressure with the esophageal vessels.
c.) A TIPPS procedure creates a channel between the systemic & protal venous system to redirect portal blood & reduce portal hypertension.
Clinical manifestations of class 1 hemorrhage (< 15% blood loss) include which of the following?
a.) Pulse rate > 100 beats per minute
b.) Capillary refill > 3 seconds
c.) Urine outut low 25-30 cc/hr
d.) Orthostatic hypotension & apprehension
d.) Orthostatic hypotension & apprehension
True or false: two of the most common causes of pancreatitis are biliary disease such as gallstones and alcoholism.
True
Laboratory values for a patient with pancreatitis include which of the following?
a.) Hypercalcemia
b.) Hyperglycemia
c.) Low triglycerides
d.) Low serum amylase
e.) All of the above
b.) Hyperglycemia
What are potential complications of acute pancreatitis?
a.) Hypoxemia & ARDS
b.) Hypotension
c.) Acute tubular necrosis
d.) All of the above
d.) All of the above
Nursing care of the patient with pancreatitis includes:
a.) Minimizing pancreatic stimulation to inhibit autodigestion process
b.) Encourage oral feeding to support nutritional state of patient
c.) Nasogastric suction
d.) All of the above
a.) Minimizing pancreatic stimulation to inhibit autodigestion process
Match the term with the correct description:
TERM:
a.) Jaundice
b.) Hematochezia
c.) Melena
DESCRIPTION:
1.) Passage of bright red bloody stools from the rectum
2.) Black tarry stool which is stool altered by the gut flora
3.) Abnormally high accumulation of bilirubin in the blood
1-b.) Passage of bright red bloody stools from the rectum = hematochezia
2-c.) Black tarry stool which is stool altered by the gut flora = melena
3-a.) Abnormally high accumulation of bilirubin in the blood = jaundice
True or false: The patient’s hemoglboin & hematocrit is a reliable indicator of the severity or rapidity of blood loss.
FALSE
What do appropriate nursing measures for the patient with GI bleeding include?
a.) Prepare for urgent fiberoptic endoscopy as the examination has a 90-95% accuracy rate.
b.) Hemodynamically stabilize the patient with two large bore IV’s & fluid resuscitation.
c.) Monitor coagulation studies carefully including PT, aPTT, INR, & platelets especially if the patient has cirrhosis or multiple transfusions have been given.
d.) Prepare for endotracheal intubation if the patient is at risk for aspiration or to facilitate gastric lavage.
e.) All of the above
e.) All of the above
Which of the following statements regarding fulminant hepatic failure (FHF) is true?
a.) Disease ususally occurs in patients with long standing liver failure
b.) Syndrome is characterized by development of acute liver failure over 1-3 months
c.) Results in impaired bilirubin conjugation, decreased production of clotting factors, depressed glucose synthesis, & decreased lactate clearance.
d.) All of the above
c.) Results in impaired bilirubin conjugation, decreased production of clotting factors, depressed glucose synthesis, & decreased lactate clearance
- Patients with fulminant hepatic failure (FHF) will develop jaundice, coagulopathies, hypoglycemia, & metabolic acidosis
To assess your patient for presence of encephalopathy you request him to extend his arms & dorsiflex his hands. If the patient’s hands flap, then what is this motion referred to as?
a.) Anisicoria
b.) Asterixis
c.) Homan’s sign
d.) Ranson’s criteria
b.) Asterixis
Select ALL of the correct medical interventions for fulminant hepatic failure (HFH).
a.) Neomycin reduces bacterial flora of colon which aids in decreasing ammonia formation by the colon & decreases bacterial action on protein in the feces.
b.) Side effects of Neomycin include liver toxicity.
c.) Lactulose creates an acidic environment that decreases bacterial growth.
d.) Lactulose traps ammonia & has a laxative effect that promotes expulsion.
a.) Neomycin reduces bacterial flora of the colon which aids in decreasing ammonia formation by the colon & decreases bacterial action on protein in the feces.
c.) Lactulose creates an acidic environment that decreases bacterial growth.
d.) Lactulose traps ammonia & has a laxative effect that promotes expulsion.
Which of the following is an indicator that hepatic failure is severe?
a.) Albumin > 3.5
b.) Mild confusion & slurred speech
c.) INR < 3
d.) Bilirubin > 3
d.) Bilirubin > 3
Average total bilirubin = 0.2-1.3 mg/dL
Your patient has been in the critical care unit for several weeks with acute respiratory failure. The stools become black & tarry & the Hemoglobin drops. What do you suspect?
a.) Ulcerative colitis
b.) Stress ulcer
c.) Pancreatitis
d.) All of the above
b.) Stress ulcer
