Download NURS 316 Exam 3 Questions and Answers: Gastrointestinal System and more Exams Nursing in PDF only on Docsity!
NURS 316 Exam 3 Questions With
Complete Solutions
Gallbladder function correct answer: stores and concentrates bile, releases into cystic duct cholelithiasis correct answer: gallstones Cholecystitis correct answer: inflammation of the gallbladder choledocholithiasis correct answer: stones in the common bile duct Cholesterol stones correct answer: most common type of gallbladder stones (80%) Black pigment stones correct answer: small hard stones (calcium salts) alcoholic liver dx Brown pigment stones correct answer: calcium salts, cholesterol and protein commonly in bile duct what happens when stones are in the common bile duct? correct answer: cause obstruction backup of bile into the liver backup pf bilirubin and bile salts in the bloodstream
Accumulation of bilirubin in the bloodsteam causes... correct answer: jaundice backup of bile salts into the bloodstream pruritus (itching) abdominal ultrasound can detect... correct answer: the presence of stones thickening of the gallbladder wall distention of the lumen Acholecystogram (HIDAscan) correct answer: assessment of gallbladder function computed tomography (CT) abd ERCP correct answer: gallbladder disorder when other studies are equivocal endoscopic retrogradecholangiopancreatography (ERCP) correct answer: used in both diagnosis and treatment ultrasonography correct answer: remove stone from the bile duct insert a bile duct stent pancratic physiology correct answer: stomach --> enzyme release with hormone sectretin (intestine) -->enzymes from pancreatic dict into common bile duct --> small intestine ampulla digestive emzyme lipase correct answer: breaks down fat
chronic inflammation does not heal, causes permanent damage chronic pancreatitis risk factors correct answer: chronic, heavy alcohol, repeated trauma from acute pancreatitis pancreatic cancer risk factors correct answer: smoking, obesity, diabetes mellitus chronic pancreatitis, consumption of nitrites s/s of pancreatic cancer correct answer: Jaundice, anorexia, nausea & vomiting Pruritus, darkening of urine, clay colored stool Fat malabsorption & Steatorrhea Back pain, epigastric pain Virchow's node (PC) correct answer: enlarged L. supaclavicular lymph node Couvoisier Sign correct answer: elnarged and palpable gallbladder pancratic cancer imaging correct answer: ct scan, ERCP, MRCP pancreatic cancer dx correct answer: often silent till late stages tumors make CA 19-9 carcinoembryonic antigen pancreatic cancer tx correct answer: Whipple procedure gastic parietal cells correct answer: secrets HCL acid and intrinsic factors
gastic goblet cells correct answer: secrets mucous that protects GI tract GERD (gastroesophageal reflux disease) correct answer: weak lower esophageal spincher permits reflex of gastic contents irritation of esophageal mucosa ulceration relfex correct answer: backflow of stomach content into esophagus burning sensation in the chest what is a complication of gerd? correct answer: metaplasia (cells at the gastroesophageal juction = barretts esophagus) Barrett's esophagus correct answer: a condition that occurs when the cells in the epithelial tissue of the esophagus are damaged by chronic acid exposure (can lead to cancer) esophageal varices correct answer: swollen, varicose veins at the lower end of the esophagus what do esophageal varices commonly caused by? correct answer: portal vein hypertension s/s of esophageal varices correct answer: jaundice, n/v, weight loss, dark urine and abd distention
peptic ulcer disease correct answer: gastric ulcers + doudenal ulcer Zollinger-Ellison syndrome correct answer: Gastrin-secreting tumor associated with ulcers Stress ulcers correct answer: upper GI bleed abd pain during examination... correct answer: cardinal signs of acute abdomen s/s pyloric stenosis correct answer: abd pain, dehydration, n/v, weight loss, electrolyte imbalances, projectile vomiting who is at risk? pyloric stenosis correct answer: common among infants, male > female, rare in adults tx pyloric stenosis correct answer: surgical repair peptic ulcer disease (PUD) correct answer: inflammatory erosion in the stomach or duodenal lining ulceration occurs 4x in the duodenum than in the stomach H. pylori (PUD) correct answer: urease -> urea -> CO2 and ammonia -> ammonium s/s PUD correct answer: epigastic and abd pain, nausea risk factors PUD correct answer: H. Pylori, genetics, stress, alcohol, smoking, COPD, NSAIDs, Aspirin
PUD tx correct answer: triple or quadruple drug therapy for 10- 14 days surgical procedure cathartic colon correct answer: anatomical and physiological changes in the colon occurs with chronic use of stimulant laxatives excessive laxative use correct answer: >3 times per week for 1 yr fluid and electrolyte imbalance vitamin and mineral deficiencies s/s chronic use of laxatives correct answer: bloating, a feeling of fullness, abd pain, incomplete fecal evacuation intestinal obstruction (LBO) mechanical correct answer: severe, colicy pain borborymus (rumbling and gurgling sound with intestinal content movement) audible, high-pitched peristalsis, peristaluc rushes awaremess of intestinal movements intestinal obstruction (LBO) non-mecganical correct answer: continuous pain, silent abdomen s,s abd pain, distention, tenderness, rididity and absent bowel sounds peritonitis correct answer: nflammation of the peritoneal membrane due to bacterial infection
melena correct answer: bleeding in the intestines with large volumes of blood hematochezia correct answer: bleeding in the rectum with red blood coating stools large intestine fluid and electrolytes correct answer: water, Na+, K+, Cl- large intestine bacteria/flora correct answer: bacteroides, ecoli, anaerobes, amino acids cartharic colon correct answer: blating, feeling of fullness, incomplete fecal evacuation, redundant colon partial obstuction = correct answer: high-pitched bowel sounds complete obstruction = correct answer: no bowel sounds, no feces in rectum large bowel obstruction dx correct answer: abd x-ray, ct scan, colonoscopy lbo tx correct answer: surgery, bowel resection with colostomy, stent placement irritable bowel syndrome correct answer: a GI disorder characterized by abd pain and altered bowel activity in the absence of specific pathology no specific motility or structural disorders
diverticulosis correct answer: bowel wall has multiple weakened areas that form small outpouchings called diverticula diverticula correct answer: collects intestinal contents diverticulitis correct answer: inflammed diverticula etiologu of diverticular disease correct answer: weakness of the bowel wall increased intrluminal pressure s/s diverticular disease correct answer: episodic pain, LLQ tenderness, constipation, flatulence, occult blood diverticular disease dx correct answer: ct scan, colonoscopy, darium enema diverticulitis tx correct answer: increased fluid and fiber intake rest the colon (NG tube) total parenteral nutrition avoid opioids due to colon spasms temporary colostomy volvulus correct answer: twisting of the large intestine around a point of attachment in the abdomen sigmoid volvulus is the most common s/s volvulus correct answer: bilious vomiting, colicky pain, anorexia, blood and mucus in the stool, abd tenderness, shock possible
obturator sign correct answer: RLQ on internal rotation of right thigh indicative of appendicitis hepatocytes (liver function) correct answer: canaliculi are responsible for conduction of bile to the hepatic duct sinusoids of liver correct answer: produce plasma proteins that enter bloodstream Kupffer cells correct answer: line the sinusoids and protect the body by detoxifying the bloodstream bile salt secretion (liver) correct answer: solubilize ingested fat and fat-soluble vitamins, facilitating their digestion and absorption enterohepatic recycling correct answer: the process whereby drug is eliminated from the liver/biliary tract into the GI tract and then reabsorbed from the GI tract back to the liver excessive RBC hemolysis = correct answer: prehepatic jaundice hepatocellular injury = correct answer: intrahepatic jaundice bile duct onstruction = correct answer: posthepatic jaundice inflammation of liver correct answer: most common cause is a virus ( hepatitis A, B, C, D, E, or mono), drugs or toxic substances, or excessive alcohol use
nonalcoholic fatty liver disease correct answer: describes a range of conditions characterized by an accumulation of fat within the liver that affect people who drink little or no alcohol Hepatitis correct answer: inflammation of the liver systemic infection alcoholic liver disease (alcoholic cirrhosis) correct answer: an acute disorder that causes a distinct syndrome or reversible and transient symptoms; it can resolve if ingestion of alcohol ceases, but long-term effects often remain dx: liver biopsy cirrhosis correct answer: Chronic disease of the liver side effects of liver failure correct answer: spider angiomata skin telangiectasias palmar erythema finger clubbing pruitus often develops becuase of accumulation of bile salts in the bloodstream muscle wasting is caused by protein loss males may develop gynecomastia and impotence loss of axillary and pubic hair biliary cirrhosis correct answer: bile production is dysfunctional prolonged obstruction of the intrahepatic or extrahepatic biliary system causes biliary cirrhosis inflammation of fibrous destruction of intraheptic bile ductules are the tissue evidence of primary biliary cirrhosis (PBC)
