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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    Description

    Test your knowledge on the common findings and complications associated with cirrhosis and cholecystitis. This quiz covers topics such as laboratory findings, nutritional recommendations, and specific medical terms related to these conditions. Perfect for medical students and healthcare professionals.

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