MedSurg Quiz2

Question 1

Ulcerative Colitis

Answer 1

Ulcers in colon r/t chronic inflammatio

Question 2

UC cause? R/t Stress?

Answer 2

Not known.
Expected genetic/immunologic

However, stress -> mast -> eicosanoid, serotonins, IL6 which are r/t colon ulcers

Question 3

UC Severity Levels S/S (4x3)

Answer 3

Mild < 4/day ±blood Øsymptomatic/normal labs
Mod > 4/day ± blood Mild ab.pain/nausea ↑CR/ESR
Sev > 6/day +blood Fever, tachycardia, abpain ↑CR/ESR
Fulminant >10 +blood, may req. transfusion, colonic distention on Xray

Question 4

UC Dx (4)

Answer 4

Hx
Physical
CBC, SED, CRP, CMP (albumin levels)
Stool study
Endoscopy (colonoscopy/flexible sigmoidoscopy)

Question 5

UC Tx?

Answer 5

Ømedication

ONLY treat S/S and surgery

Question 6

UC Heads Ups (8)

Answer 6

Inflammatory ▲ in bowel
Deficient Fluid
Imba. Nutrition
Pain
Skin integrity
Coping
Social Isolation
ØBody Image

Question 7

UC Priorities (3)

Answer 7

↓ Diarrhea/Incontinence, pain, GI bleeding

Question 8

UC Education (7)

Answer 8

Hydrate
Ø High fiber stuck things (nuts, seeds, popcorn)
Smaller meals
Nutrient dense foods
Ø fatty foods
Stress mngmnt
Skin maintenance

Question 9

Braden Scale.
Max score? Lower/Higher meaning?
4 criteria?

Answer 9

Max 23 points
Lower = higher risk!
> 16 = low risk
15 - 16 = mild
12 - 14 = moderate
< 11 = severe

Question 10

Braden Assessments (6)

Answer 10

Sensory
Moisture
Activity
Mobility
Nutrition
Friction/Shear

Question 11

Braden: Sensory Perception (4)

Answer 11

1 = Øresponse
2 = responds w/ pain/moaning
3 = responds to verbal commands
4 = OK

Question 12

Braden: Moisture (4)

Answer 12

1 = moist constantly
2 = often, linen ▲/shift
3 = occasionally, extra linen
4 = OK

Question 13

Braden: Activity (4)

Answer 13

1 = bedfast
2 = chairfast
3 = walks occasionally
4 = OK

Question 14

Braden: Mobility (4)

Answer 14

1 = immobile
2 = very limited
3 = slightly limited
4 = OK

Question 15

Braden: Nutrition (4)

Answer 15

1 = poor
2 = probably inadequate
3 = adequate
4 = OK

Question 16

Braden: Friction/Shear

Answer 16

1 = problem
2 = potential problem
3 = OK

Question 17

Pressure Ulcers WHY? (2)

Answer 17

pressure & no O2

Question 18

Pressure Ulcers Stages and description (5)

Answer 18

1 = intact
2 = skin loss
3 = full loss
4 = loss w/ bone, tendon, muscle
5 (Unstagable) = eschar/slough

Question 19

Pressure ulcers fx on pt/hospital

Answer 19

pain/fees

Question 20

Newer forms of pressure ulcer tx (5)

Answer 20

Direct electrical stimulation
Pulsed Radio freq.
Silver/Honey dressings
Hyperbaric O2
Biofilms

Question 21

UC Medications

Answer 21

Aminosalicylates: Balsalazide, Melsalamine, Sulfasalaline
Coritocsteroids: Predisone
Immunomodulators: Azthiopinr,e 6-meraptopurine (6-MP)
Biologics: Remicade, Humira, Simponi, Entyvio