Cirrhosis and Cholecystitis Quiz

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Questions and Answers

Which of the following is a common finding in the early stages of cirrhosis?

  • Shrunken and hard liver
  • Ascites and jaundice
  • Esophageal varices
  • Enlarged and firm liver (correct)

A patient with cirrhosis is exhibiting a coarse hand tremor. What is the medical term for this finding?

  • Asterixis (correct)
  • Pruritus
  • Petechiae
  • Ecchymoses

A patient with cirrhosis develops esophageal varices. What is the underlying cause of this complication?

  • Portal hypertension (correct)
  • Biliary obstruction
  • Hepatorenal syndrome
  • Vitamin deficiency

Which laboratory finding is consistent with the decreased liver function and impaired albumin production in cirrhosis?

<p>Decreased serum albumin (C)</p> Signup and view all the answers

A patient experiencing chronic cholecystitis without calculi, who is athletic and thin, is LEAST likely to exhibit which of the following?

<p>Weight gain (C)</p> Signup and view all the answers

Which of the following is NOT considered a risk factor for cholecystitis?

<p>High fiber diet (B)</p> Signup and view all the answers

A patient with cirrhosis develops an enlarged spleen. What specific term describes this condition?

<p>Splenomegaly (C)</p> Signup and view all the answers

What nutritional modification is generally recommended for a patient with cirrhosis?

<p>Low-sodium, high-carb, high-protein, moderate-fat diet (B)</p> Signup and view all the answers

A patient reports upper abdominal pain that radiates to the right shoulder. Which assessment finding is MOST specific to cholecystitis?

<p>Rebound tenderness (D)</p> Signup and view all the answers

A patient with cirrhosis is having difficulty absorbing fat-soluble vitamins. Which of the following is most likely impaired?

<p>Biliary Function (C)</p> Signup and view all the answers

Which lab value is LEAST likely to be elevated in a patient with cholecystitis?

<p>Serum creatinine (B)</p> Signup and view all the answers

Which diagnostic test is typically the initial choice for evaluating a patient with suspected cholecystitis?

<p>Ultrasound of the right upper quadrant (A)</p> Signup and view all the answers

Which nursing assessment finding would be of particular concern in a patient with esophageal varices?

<p>Hematemesis (A)</p> Signup and view all the answers

Increased levels of what substance in the blood is a major contributor to the cognitive changes in hepatic encephalopathy?

<p>Ammonia (C)</p> Signup and view all the answers

A patient with cholecystitis is experiencing moderate, biliary pain. What medication is MOST appropriate?

<p>Ketorolac (A)</p> Signup and view all the answers

Which nursing intervention should be avoided for a patient diagnosed with cholecystitis?

<p>Consuming large quantities of high-fat foods (C)</p> Signup and view all the answers

Which of the following is a medication class frequently used in the management of ascites, but requires monitoring of electrolyte levels?

<p>Diuretics (D)</p> Signup and view all the answers

Which medication is used for the long-term management of dissolving gallstones?

<p>Ursodiol (A)</p> Signup and view all the answers

A patient considering Extracorporeal Shock Wave Lithotripsy (ESWL) for symptomatic gallstones should be excluded if they have which of the following condition?

<p>Pacemaker (D)</p> Signup and view all the answers

What is a common late-stage or chronic manifestation of cholecystitis?

<p>Dark urine (A)</p> Signup and view all the answers

Diverticula most commonly develop in which part of the digestive system?

<p>The sigmoid colon (B)</p> Signup and view all the answers

Which of the following dietary factors is most closely associated with the development of diverticula?

<p>Low-fiber diet (D)</p> Signup and view all the answers

Which diagnostic test is considered most definitive for diagnosing diverticulitis?

<p>Colonoscopy (D)</p> Signup and view all the answers

A patient with acute diverticulitis is experiencing severe abdominal pain. Which of the following medications should be specifically avoided?

<p>Laxatives (D)</p> Signup and view all the answers

Which symptom is most indicative of a peptic ulcer hemorrhage?

<p>Bright red or coffee-ground vomit (A)</p> Signup and view all the answers

Which of these assessment findings would be MOST indicative of peritonitis in a patient with diverticulitis?

<p>Profound rebound tenderness and hypotension (A)</p> Signup and view all the answers

What is a common cause of pyloric obstruction in peptic ulcer disease?

<p>Blockage in the pylorus due to scarring, edema and/or inflammation (D)</p> Signup and view all the answers

Following an acute episode of diverticulitis, what is the recommended dietary approach when symptoms subside?

<p>Gradual increase in fiber intake (B)</p> Signup and view all the answers

A patient with a peptic ulcer is experiencing sudden, sharp abdominal pain and a rigid abdomen. Which complication is most likely?

<p>Perforation (D)</p> Signup and view all the answers

Which of the following activities should be avoided by a patient with diverticulitis during an inflammatory episode?

<p>Lifting heavy objects (B)</p> Signup and view all the answers

What is the most serious complication associated with peptic ulcer disease?

<p>Hemorrhage (A)</p> Signup and view all the answers

Which of the following is a potential complication of diverticulitis, caused by perforation of the bowel into an adjacent organ?

<p>Fistula formation (B)</p> Signup and view all the answers

Which of the following is a symptom of perforation in peptic ulcer disease?

<p>Sudden, sharp pain in the epigastric region (C)</p> Signup and view all the answers

What is a common laboratory finding in a patient with diverticulitis?

<p>Increased white blood cell count (A)</p> Signup and view all the answers

What type of surgical treatment is indicated for severe or recurrent diverticulitis?

<p>Colon resection with colostomy (A)</p> Signup and view all the answers

What is a common risk factor for peptic ulcer disease?

<p>History of chronic NSAID use (C)</p> Signup and view all the answers

What symptom is a common indicator of pyloric obstruction?

<p>Vomiting (C)</p> Signup and view all the answers

Which symptom is characteristic of peptic ulcer hemorrhage, particularly in older adults?

<p>Acute confusion (B)</p> Signup and view all the answers

Which surgical procedure is classified as 'urgent'?

<p>Hysterectomy for uterine fibroids (B)</p> Signup and view all the answers

Which procedure is considered an 'emergency'?

<p>Control of internal bleeding after a gunshot wound (B)</p> Signup and view all the answers

A liver biopsy to confirm hepatitis is classified as what type of surgery by purpose?

<p>Diagnostic (B)</p> Signup and view all the answers

Which of these is an example of an ablative procedure?

<p>Removal of gangrenous toes (D)</p> Signup and view all the answers

Restoring the appearance of malnourised tissues is classified as what type of surgery by purpose?

<p>Reconstructive/restorative (C)</p> Signup and view all the answers

Which type of anesthesia involves the patient being in a drug-induced coma?

<p>General anesthesia (C)</p> Signup and view all the answers

A patient who is awake and maintains their own airway, but is drowsy and may have amnesia, is likely under which type of anesthesia?

<p>Moderate sedation (A)</p> Signup and view all the answers

Which type of anesthesia blocks pain impulses without loss of consciousness?

<p>Regional anesthesia (B)</p> Signup and view all the answers

An injection of anesthetic into the venous circulation of an extremity for surgery is known as what?

<p>Bier block (C)</p> Signup and view all the answers

A patient undergoing a mastectomy is most likely going to have which kind of anesthesia and surgery by risk?

<p>Major surgery with general anesthesia (C)</p> Signup and view all the answers

Which assessment finding is most indicative of potential fluid volume deficit in a patient with a peptic ulcer?

<p>Orthostatic hypotension (A)</p> Signup and view all the answers

A patient is scheduled for an esophagogastroduodenoscopy (EGD). What is the primary purpose of this procedure in the context of peptic ulcer disease?

<p>To visualize ulcers and obtain biopsy samples (D)</p> Signup and view all the answers

Which of the following surgical intervention involves removing the lower portion of the stomach and attaching the remainder to the jejunum?

<p>Gastrojejunostomy (B)</p> Signup and view all the answers

What is the primary goal of a vagotomy in the treatment of peptic ulcer disease?

<p>To reduce gastric acid production (A)</p> Signup and view all the answers

A patient is prescribed magnesium hydroxide with aluminum hydroxide for peptic ulcer disease. What is a critical piece of patient education regarding the timing of this medication?

<p>Take 2 hrs after meals &amp; at bedtime (C)</p> Signup and view all the answers

A patient is taking aluminum hydroxide for peptic ulcer disease. Which potential side effect should the nurse monitor?

<p>Constipation (A)</p> Signup and view all the answers

A patient is prescribed sucralfate for peptic ulcer disease. Which instruction should be given to the patient regarding medication administration?

<p>Take sucralfate 1 hr before meals &amp; at bedtime (D)</p> Signup and view all the answers

Which medication is contraindicated for use in patients with kidney problems?

<p>Magnesium hydroxide with aluminum hydroxide (D)</p> Signup and view all the answers

What is a priority nursing action when administering pantoprazole (Protonix) intravenously (IV)?

<p>Administer via a pump with a filter and a separate line (B)</p> Signup and view all the answers

A patient is using bismuth subsalicylate (Pepto-Bismol). What should the patient be educated to avoid during this medication therapy?

<p>Aspirin (B)</p> Signup and view all the answers

Which of the following is a primary focus of patient education for clients with peptic ulcer disease?

<p>Keeping a food journal to track trigger foods (D)</p> Signup and view all the answers

A patient is taking omeprazole (Prilosec) for PUD. What should a nurse monitor for given the known side effects of this medication?

<p>Osteoporosis (B)</p> Signup and view all the answers

A patient, who is of childbearing age, is prescribed misoprostol. What education point should the patient receive regarding this medication?

<p>Pregnancy precautions should be taken while on this medication (B)</p> Signup and view all the answers

Which diagnostic test is considered the most common for peptic ulcer disease, allowing for visualization and biopsy?

<p>Esophagogastroduodenoscopy (EGD) (C)</p> Signup and view all the answers

A patient with peptic ulcer disease has been prescribed an H2 antagonist. When should the patient take this medication?

<p>Single dose at bedtime (C)</p> Signup and view all the answers

Flashcards

Cholecystitis

Inflammation of the gallbladder, often with bile obstruction.

Symptoms of Cholecystitis

Includes upper abdominal pain, jaundice, clay-colored stools, and nausea.

Risk Factors for Cholecystitis

Factors include obesity, ethnicity, pregnancy, and family history.

High White Blood Cell Count

Indicates infection or inflammation (>10,000 cells/mm3).

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Ultrasound of URQ

Best initial test for diagnosing gallbladder issues.

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Nausea and Vomiting Treatment

Use antiemetics and IV hydration to manage symptoms.

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Steatorrhea

Fatty stools often observed in chronic cholecystitis.

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Ursodiol and Chenodiol

Medications used for long-term management of gallstones.

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Extracorporeal Shock Wave Lithotripsy

Non-invasive treatment using shock waves to break up stones.

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Risk Factors: Low Fat Diet

A long-term low-fat diet can increase cholecystitis risk.

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Hemorrhage

A serious complication of peptic ulcers presenting with internal bleeding.

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Perforation

Occurs when an ulcer erodes through the stomach or duodenal wall, spilling contents into the cavity.

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Pyloric Obstruction

Blockage in the pylorus that leads to gastric stasis and dilation due to scarring or inflammation.

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Intractable Disease

Recurrence or worsening of peptic ulcer symptoms despite treatment.

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Hematemesis

Vomiting of blood, indicative of gastrointestinal bleeding.

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Melena

Dark, tarry stools indicating bleeding in the upper gastrointestinal tract.

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Symptoms of Hemorrhage

Signs include hypotension, tachycardia, and confusion, especially in older adults.

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Symptoms of Perforation

Include sudden sharp pain and a rigid abdomen indicating peritonitis.

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Cirrhosis

Chronic liver disease causing scarring and impaired function.

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Types of Cirrhosis

Different causes of cirrhosis including postnecrotic, alcoholic, and biliary.

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Jaundice

Yellowing of skin and eyes due to bilirubin buildup.

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Portal Hypertension

Increased pressure in the portal vein due to liver scarring.

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Ascites

Fluid accumulation in the abdominal cavity due to cirrhosis.

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Esophageal Varices

Swollen veins in the esophagus due to portal hypertension.

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Hepatic Encephalopathy

Cognitive impairment due to liver failure, progresses through stages.

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Splenomegaly

Enlargement of the spleen due to backed-up blood from the liver.

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Vitamin Deficiency

Lack of essential vitamins due to poor liver function, especially fat-soluble ones.

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Nursing Interventions for Cirrhosis

Care strategies include monitoring weights, diet adjustments, and managing symptoms.

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Urgent procedure

A procedure performed within 24 hours of diagnosis to prevent complications.

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Emergency procedure

A procedure performed ASAP to save life or organ function, high mortality risk.

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Minor surgery

Low-risk surgery, minimal anesthesia, often outpatient.

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Major surgery

Moderate to high-risk surgery requiring anesthesia and usually inpatient.

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Diagnostic procedure

Surgery to establish or confirm a diagnosis.

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Ablative surgery

Procedure that removes diseased body parts.

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Reconstructive surgery

Restores function or appearance to damaged tissues.

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Palliative surgery

Improves comfort and decreases symptoms without curing illness.

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General anesthesia

Drug-induced unconsciousness with risks, may need airway support.

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Regional anesthesia

Blocks pain in specific areas while patient remains conscious.

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Diverticula

Pouches formed in the intestinal wall, often in the sigmoid colon.

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Causes of Diverticula

Advanced age and low-fiber diets lead to weak intestinal walls.

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Symptoms of Diverticulitis

Includes abdominal pain, bloating, fever, and blood in stool.

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WBC Count in Diverticulitis

High WBC count (>10,000 cells/mm3) indicates inflammation or infection.

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Nursing Interventions

Include avoiding laxatives, providing analgesics, and checking for bleeding.

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Complications of Diverticulitis

Can lead to peritonitis, bowel abscess, or uncontrolled bleeding.

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Types of Peptic Ulcers

Include duodenal, gastric, and stress ulcers, each with specific locations.

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Stress Ulcer

Usually occurs in the stomach body, often due to stress.

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Antibiotic Use in Diverticulitis

Antibiotics are given to treat infection and reduce inflammation.

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Diet Management

After symptoms subside, gradually increase fiber to 25-35g/day to prevent recurrence.

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H.pylori infection

An infection caused by Helicobacter pylori bacteria, linked to peptic ulcers.

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Dyspepsia

Discomfort in the upper abdomen, includes heartburn, bloating, and nausea.

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Epigastric tenderness

Pain or discomfort in the upper middle region of the abdomen.

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Urea breath test

A non-invasive test to detect H.pylori using a breath sample.

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Esophagogastroduodenoscopy (EGD)

A diagnostic test that visualizes the esophagus, stomach, and duodenum.

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Gastrectomy

Surgical procedure to remove part or all of the stomach.

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Antacid function

Drugs that neutralize stomach acid and alleviate heartburn.

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Proton Pump Inhibitors (PPIs)

Medications that reduce gastric acid secretion by blocking enzymes.

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Mucosal Barrier Fortifiers

Medications that protect the stomach's lining from acid damage.

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Antimicrobials for H.pylori

Drugs used to eradicate the H.pylori bacteria in peptic ulcer disease.

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Lifestyle factors for ulcers

Factors like alcohol, smoking, stress, and caffeine that influence ulcer risk.

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Patient education for ulcers

Advice given to manage and prevent ulcer symptoms effectively.

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Vagotomy

A surgical procedure that involves cutting the vagus nerve to decrease acid production.

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Side effects of antacids

Potential adverse effects from antacid use such as diarrhea or constipation.

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Food diary importance

Tracking food intake to identify and avoid ulcer-triggering foods.

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Study Notes

General Study Notes

  • This document is a collection of study notes, organized by topic, for a Health Concepts II course.
  • It contains information on various health conditions, treatments, and nursing care procedures.
  • The document covers topics such as hepatitis, cirrhosis, cholecystitis, diverticulitis, and peptic ulcer disease, among many others, including nursing care procedures.
  • The notes outline detailed information surrounding each condition, including pathophysiology, assessment cues, diagnostic tests, and nursing interventions.
  • The notes include details on risks factors, treatment options, and preventative measures for different medical conditions.
  • The document also includes a comprehensive overview of perioperative nursing care.
  • It contains detailed information about various types of skills, including nasogastric intubation, IV therapy, and indwelling catheter insertion, as well as descriptions of diseases.

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