Medical Surgical Nursing Review Questions Part 2

Rebound tenderness Rebound tenderness is a clinical sign that a doctor may detect in physical examination of a patient's abdomen. Cullen's sign is superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity. Grey Turner's sign refers to bruising of the flanks.

Alcohol The condition is most often caused by alcoholism and alcohol abuse (70% of cases in the U.S.). Genetics may be a factor in some cases. Sometimes the cause is not known, however.

Insulin is naturally secreted by Beta cells in the pancreas. Since the pancreas is defective, there is a substantial need for therapeutic doses of insulin. Diuretics serve as lowering retention which has something to do with the kidneys’ function. Steriods are for inflammatory cases, while potassium are commonly used for cases with dehydration.

Hyperlipidemia Elevated serum amylase and lipase levels, in combination with severe abdominal pain, often trigger the initial diagnosis of acute pancreatitis.

Peptic ulcers A peptic ulcer, also known as , PUD or peptic ulcer disease,[1] is an ulcer (defined as mucosal erosions equal to or greater than 0.5 cm) of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. Hemorrhagic cystitis or Haemorrhagic cystitis is diffuse inflammation of the bladder leading to dysuria, hematuria, and hemorrhage. Mallory-Weiss syndrome or gastro-esophageal laceration syndrome refers to bleeding from tears (a Mallory-Weiss tear) in the mucosa at the junction of the stomach and esophagus, usually caused by severe retching, coughing, or vomiting. Gastroesophageal varices are extremely dilated sub-mucosal veins in the lower esophagus.

Increased insulin secretion Pancreatitis is inflammation of the pancreas. The pancreas is a gland located behind the stomach. It releases the hormones insulin and glucagon, as well as digestive enzymes that help you digest and absorb food.

TIPS (transjugular intrahepatic portosystemic shunt) it is used to treat portal hypertension (which is often due to scarring of the liver (liver cirrhosis)) which frequently leads to intestinal bleeding (esophageal varices) or the buildup of fluid within the abdomen (ascites).

Abdominal pain The pancreas is an organ located behind the stomach that produces chemicals called enzymes, as well as the hormones insulin and glucagon. Most of the time, the enzymes are only active after they reach the small intestine, where they are needed to digest food. Abdominal pain is the most presenting symptom of acute pancreatitis.

H. Pylori is associated with Peptic ulcers Helicobacter pylori (English pronunciation: /ˌhɛlɨkɵˈbæktər pɪˈlɔraɪ/) is a Gram-negative, microaerophilic bacterium that can inhabit various areas of the stomach, particularly the antrum.

Cirrhosis is most commonly caused by alcoholism, hepatitis B and C, and fatty liver disease, but has many other possible causes. Some cases are idiopathic, i.e., of unknown cause.

Vasopressin is a peptide hormone that controls the reabsorption of molecules in the tubules of the kidneys by affecting the tissue's permeability. It also increases peripheral vascular resistance, which in turn increases arterial blood pressure.

“It blocks secretion of gastric acid.” Proton pump inhibitors (PPIs) are a group of drugs whose main action is a pronounced and long-lasting reduction of gastric acid production.

Lansoprazole s a proton-pump inhibitor (PPI) which prevents the stomach from producing gastric acid. Mylanta an antacid is any substance, generally an acid or acidic salt, which neutralizes stomach acidity. Ranitidine is a histamine H2-receptor antagonist that inhibits stomach acid production. Sucralfate is an oral gastrointestinal medication primarily indicated for the treatment of active duodenal ulcers.

Class I Hemorrhage involves up to 15% of blood volume. There is typically no change in vital signs and fluid resuscitation is not usually necessary.

Lipase Lipase is a protein (enzyme) released by the pancreas into the small intestines. It triggers the breakdown of fat into fatty acids. Amylase is an enzyme that helps digest carbohydrates. It is produced mainly in the pancreas and the glands that make saliva. When the pancreas is diseased or inflamed, amylase releases into the blood.

Class II Hemorrhage involves 15-30% of total blood volume. A patient is often tachycardic (rapid heart beat) with a narrowing of the difference between the systolic and diastolic blood pressures. The body attempts to compensate with peripheral vasoconstriction. Skin may start to look pale and be cool to the touch. The patient may exhibit slight changes in behavior.

Sclerotherapy is a procedure used to treat blood vessels or blood vessel malformations (vascular malformations) and also those of the lymphatic system. Electrocoagulation, also known as Radio Frequency Diathermy or Short Wave Electrolysis, is a technique used for medical treatment and wastewater treatment. Laser medicine is the use of various types of lasers in medical diagnosis, treatment, or therapy. Rubber band ligation is an outpatient treatment for second-degree internal hemorrhoids.

Glucose Glucose is the primary source of energy for the body's cells, and blood lipids (in the form of fats and oils) are primarily a compact energy store. Glucose is transported from the intestines or liver to body cells via the bloodstream, and is made available for cell absorption via the hormone insulin, produced by the body primarily in the pancreas.

Monitor the patient for possible complications such as adverse effects from sedation, cardiac arrhythmias, respiratory depression and bleeding. It is impossible for the patient to have increased bowel sounds since the patient lies supine for hours.

Pantoprazole is used for short-term treatment of erosion and ulceration of the esophagus caused by gastroesophageal reflux disease.

Respiratory rate >24 with hypoventilation Class III Hemorrhage involves loss of 30-40% of circulating blood volume. The patient's blood pressure drops, the heart rate increases, peripheral hypoperfusion (shock), such as capillary refill worsens, and the mental status worsens. Fluid resuscitation with crystalloid and blood transfusion are usually necessary.

Intravenous line The patient is inhibited to eat or under NPO in order to prevent undue damage to the gastrointestinal disorders. Likewise intravenous line makes it easier for medications to be absorbed.

Antacids Concurrent administration with any other drug may inhibit absorption of that drug in particular, don’t give within two hours of orally administered digoxin (Lanoxin), tetracyclines, indomethiacin (Indocin) or iron salts.

A reasonable indication for a CT scan at admission (but not necessarily a CT with IV contrast) is to distinguish acute pancreatitis from another serious intra-abdominal condition, such as a perforated ulcer.

“It blocks secretion of gastric acid.” The H2 receptor antagonists are a class of drugs used to block the action of histamine on parietal cells in the stomach, decreasing the production of acid by these cells.