Abnormal Dx
Upon auscultation of the abdomen for someone with a partial bowel obstruction you would hear....
A. Hypoactive bowel sounds
B. Hyperactive bowel sounds
c. No bowel sounds
B. Hyperactive bowel sounds
True or False:
Large bowel obstructions are more common than small bowel obstructions.
False
Rationale: Large bowel obstructions only make up 25% of intestinal obstructions. p.1408
Select all that apply:
Which of the following are symptoms of a bowel obstruction?
A. Cramping of abdomen
B. Dull ache in groin area
C. Sharp pain in abdomen
D. hyperactive peristalsis
A. Cramping of abdomen (peristalsis attempting to move stuff along)
C. Sharp pain in abdomen (leading into perforation)
D. hyperactive peristalsis (early stages of obstruction)
p.1408
Which of the following are methods of treating a bowel obstruction?
A. Cholecystectomy
B. Vagotomy
C. Colectomy
D. Appendectomy
C. Colectomy
p. 1409
What tools will be used to Dx of a bowel obstruction? Select all that apply.
A. X-ray
B. EGD
C. CT
D. MRI
A. X-ray
C. CT
D. MRI
What is the meaning of the term intussusception?
A. The process of the body absorbing from food
B. The production of RBCs in the bone marrow
C. Strangulation of the bowel
D. A condition where part of the intestine folds into another part of the intestine
D. A condition where part of the intestine folds into another part of the intestine
This is a medical emergency. p. 1408
Which of the following are a complication of a bowel obstruction? (select all)
A. Cardiac Arrest
B. Strangulation
C. Perforation
D. Gout
B. Strangulation
C. Perforation
p. 1408
How often do we provide oral care for someone with an NGT?
A. Every 1 hour
B. Every 2 hours
C. Every 3 hours
D. Every 4 hours
D. At least every 4 hours
(mouth gets dry, they're NPO, lips crack)
p.1409
What would an X-ray show for someone who has experienced a perforation from a SBO?
A. Large amounts of water
B. Free-air
C. Protruding bowel
D. Excessive gas distal to the obstruction with SBO
B. Free-air (when perforation happens air escapes into the peritoneal cavity)
D is wrong because you'd see as PROXIMAL to the SBO
p. 1409
What does it mean for a large bowel obstruction to have a neurogenic blockage?
A. A blockage that occurs due to a mechanical blockage
B. A complete blockage due to strictures
C. Barium impaction
D. An obstruction that occurs mainly after manipulation of bowel during surgery
D. An obstruction that occurs mainly after manipulation of bowel during surgery
(or in cases of peritoneal irritation or intestinal ischemia)
p. 1408
Intestinal perforation could result in which of the following? Select all that apply.
A. Hypovolemic shock
B. Hyperkalemia
C. Vascular collapse
D. Septic shock
A. Hypovolemic shock
C. Vascular collapse
D. Septic shock
Treatment for SBO would include which of the following? Select all that apply.
A. Pain management
B. Antibiotics
C. Antihypertensive
D. Fluid and electrolyte replacement
A. Pain management
B. Antibiotics
D. Fluid and electrolyte replacement
True or False
A CT scan with contrast is the gold standard for diagnosing the cause and severity of a bowel obstruction.
True
Which of the following best describes the pathophysiology of a mechanical bowel obstruction?
A. Increased peristalsis causing bowel distension
B. Decreased blood flow leading to ischemia and bowel necrosis
C. Impaired motility due to a dysfunction of the enteric nervous system
D. Inflammation of the bowel wall causing a narrowing of the lumen
B. Decreased blood flow leading to ischemia and bowel necrosis
Not A. because increased peristalsis doesn't cause the obstruction its an attempt to move contents. Not C. because dysfunction of the enteric NS would be a non-mechanical obstruction. Not D. because while, for example, Crohn's can cause bowel obstruction its not the description of the patho behind it.
Which of the following is the most likely physical finding in a patient with a strangulated bowel obstruction?
A. Mild, diffuse abdominal tenderness
B. Localized rebound tenderness and guarding
C. Increased bowel sounds with gurgling
D. Decreased heart rate and blood pressure
B. Localized rebound tenderness and guarding
A strangulated bowel obstruction occurs when the blood supply to the obstructed part of the bowel is compromised, leading to ischemia and potential bowel necrosis. This condition typically causes localized rebound tenderness (pain upon release of pressure) and guarding (tensing of the abdominal muscles to protect the painful area), which suggests peritoneal irritation and the risk of perforation.
What is an anastomosis?
A. A type of tumor that grows in the intestines
B. A technique for removing a part of the intestine during surgery
C. A medication used to treat infections of the GI tract
D. A surgical connection between two structures
D. A surgical connection between two structures
(Removing part of the intestine is RESECTIONING, and reconnecting after re-sectioning is anastomosis)