Peptic Ulcer Disease
A patient comes into the ED stating that they have pain typically at night a couple hours after eating dinner. The patient is then diagnosed with an ulcer. Where is the ulcer most likely located?
Duodenum
A patient with suspected cholecystitis has pain with palpation on inspiration in the RUQ. What is this called?
Murphys sign
Lipase breaks down what?
Fats
What are the manifestations of calculi?
PAIN, nausea and vomiting, flank pain, bloody or cloudy urine, inability to urinate or feeling the urge to urinate often
What patient education can be given about antibiotic therapy regarding the prevention of acute post infectious glomerulonephritis?
Complete the entire course of antibiotics
A patient presents with a low H & H on their CBC. What common complication of peptic ulcers is most likely happening?
Hemorrhage
What labs/enzymes will be abnormal with an obstruction in the common bile duct below the pancreatic duct?
Elevated amylase & lipase, elevated bilirubin & LFTs
What is the most common cause of pancreatitis?
Alcoholism
Spinach, nuts, wheat, bran
A decreased GFR causes an increase in what electrolyte?
K
Name the risk factors associated with Peptic Ulcer Disease.
SMOKING, chronic use of NSAIDS, low socioeconomic status, unsanitary living conditions, chronic H. pylori infection, advanced age
What is the most common diagnostic test for gallbladder obstruction?
Ultrasound
What medication can be given with meals to enhance digestion of starches and fats?
Creon- pancreatic enzyme replacement
What medication is often given to prevent further lithiasis and to decrease uric acid levels?
Allopurinol
Name some assessment priorities for nephritis patients.
History of infection, urine output, edema & swelling, assess labs, daily weights, BP monitoring
A 26 year old woman is prescribed a PPI and a prostaglandin analogue. What should be checked prior to administration of the prostaglandin analogue, misoprostol?
Possible pregnancy.
You are the nurse caring for a postoperative t-tube placement patient. They are 3 days post op and you check the drainage output and record the measurement as 300 mL. What should be done next and why?
Notify the provider. Output should be less than 200 mL 2 to 3 days after surgery.
What causes a positive Turner and Cullen sign?
Internal bleeding from pancreatic necrosis and vascular damage
What is a disadvantage to having lithotripsy?
Although the stones have been broken up into smaller pieces, they must still be passed
A patient diagnosed with acute post infectious glomerulonephritis is prescribed cyclosporine. What is most likely a part of their treatment plan?
Infection prevention- screen visitors, perform good hand hygiene, avoid invasive procedures, screen for upper respiratory infections
Explain patient education regarding PPIs & Sucralfate.
PPIs- Take in the morning before eating. Do not stop medication abruptly.
Sucralfate- Take 30 minutes to 1 hour before a meal.
What diet should gallbladder disease patients adhere to? What vitamins should they take?
Low-fat, high protein diet
They should consume fat soluble vitamins- A, D, E, K
The nurse provides care for a client who is diagnosed with acute pancreatitis and notes a positive Chvostek sign while obtaining vital signs. Which laboratory value is most likely responsible for this abnormality?
a. Amylase 300 U/L
b. Calcium 6 mg/dL
c. Potassium 5 mEq/L
d. Sodium 135 mEq/L
B
Which intervention is most important for the nurse to implement for the client diagnosed with rule-out renal calculi?
a. Assess the client's neurological status every two (2) hours.
b. Strain all urine and send any sediment to the laboratory.
c. Monitor the client's creatinine and BUN levels.
d. Take a 24-hour dietary recall during the client interview
B
Explain HAD STREP
H- Hypertension (watch for)
A- ASO+ step
D- Decreased GFR or urine output
S- Swelling
T- Tea colored urine
R- Recent strep infection
E- Elevated BUN
P- Proteinuria (mild)