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NSG 6310 Exam 1_Cedarville University_Latest 2023_Score A+
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NSG 6310 Exam 1_Cedarville University_Latest 2023_Score A+
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· any identified infection or disease should be treated - 1% hydrocortisone can be usedinitially but no longer than 2 weeks due to skin atrophy; if nocturnal itching is a problem
then antipruritic properties such as hydroxyzine can help with sleep and break the itch-
Pharmacologic treatment of pruritis ani scratch cycle; usually gone in 4-6 weeks; can use witch hazel as an anti-pruritic; barrier
creams with zinc oxide can help protect the skin from moisture while promoting
healing; if NO response to these therapies then intradermal methylene blue injections
have relieved the disorder for some patients
CBC with differential, LFTs, serum pancreatic enzymes, serum electrolyte values, BUN
Labs needed for RUQ abdominal pain
and creatinine, blood cultures
· UA
· hCGs (pregnancy test) - if woman of childbearing age
· Electrocardiography
Diagnostics for RUQ abdominal pain · Ultrasound
· Biliary scintigraphy (HIDA scan)
· Endoscopic retrograde cholangiopancreatography
· CT scan with contrast
· Osmotic laxatives like PEG are first line treatment for constipation, compared to
stimulant laxatives, because there is more research showing efficacy of PEG
more effective than lactulose
Advice for patients using polyethylene
PEG should be used cautiously in patients with diabetes
glycol for constipation
PEG should be used judiciously in patients with a history of congestive heart failure or
renal insufficiency to avoid fluid and electrolyte abnormalities
avoid laxatives unless necessary and especially during pregnancy
· CBC w/ diff, c-reactive protein, UA, BUN, and Cr(before computed tomography scan
Labs for diverticulitis
in older adults or in patients with renal insufficiency)
· Colonoscopy (4-6 weeks after the acute episode has resolved)
Diagnostics for diverticulitis
· CT scan, MRI, Water-soluble contrast enema, Angiography (if the patient is bleeding),
Endoscopy, Flexible sigmoidoscopy
· Videofluoroscopy (VFS) or MBS is gold standard
Diagnostic testing for dysphagia · CT or MRI
· Fiberoptic endoscopic examination of swallow (FEES)
Related to diffuse superficial lesions in the gastric mucosa that are usually associated
with H. pylori.
Risk factors for gastritis
Major physiologic stressors including burns, sepsis, trauma, and long-distance running,
chronic NSAID use, and alcohol use.
, · CBC and PLTs for possible presence of anemia
· CRP and ESR
· Electrolytes
Labs for IBD · LFTs
· Glucose, BUN, Cr
· Vit D, B12, and folate levels
· Serogenetic markers
· Stool test
· CT or MRI
· Small bowel series
Diagnostic testing for IBD
· Flexible sigmoidoscopy
· Endoscopy
· Mucosal Biopsy
· Symptoms frequently occur after eating or alcohol consumption
· Abdominal pain must be present.
· Pain is described as:
· Non-radiating, intermittent, and crampy
Classic symptoms of IBS · Pain can be anywhere but is usually located in the left lower abdominal quadrant.
· May be associated with diarrhea, constipation, or a pattern of alternating diarrhea and
constipation
Mucus may be present in the stool; complaints of abdominal distension, bloating,
nausea, lethargy, and backache are common and most likely reflect increased
sensitivity to normal amounts of intestinal gas rather than an actual increase in gas
o Serum amylase and lipase (obtained once only) are the most common lab tests used
to diagnose acute pancreatitis. Rising 6 to 12 hours after the onset of symptoms, serum
amylase levels usually return to normal within 3 to 5 days in uncomplicated cases (not
always seen in alcoholic cases).
o CHEM-12 (electrolytes, BUN, Cr, hepatic function panel)
Labs for pancreatitis
o Fasting triglycerides
o CBC
o Hcg (pregnancy test)
o Urine toxicology screening and serum ethanol level
, · KUB
· Abdominal x-ray
· Chest x-ray
· Abdominal US
· MRI/MRCP
Diagnostic testing for pancreatitis
· Endoscopic US
· CT if no improvement after 72 hrs
· Apache II Scoring and Ranson's Criteria
· Electrocardiogram
· Endoscopic retrograde cholangiopancreatography (only used as a therapeutic
modality)
o CBC w/ diff - r/o anemia
Labs for PU o H. pylori testing (serum)
o Serum chemistries - assess liver function and Ca levels
· Endoscopy with biopsy is the standard criterion
Diagnostics for PUD · Barium radiography (as indicated)
· Additional testing - H. pylori testing (breath, fecal)
Helpful to exclude incomplete emptying and can be obtained through either pelvic
ultrasound or catheterization
Interpretation of PVR test
A PVR of less than 50mL is normal whereas residuals of more than 100mL are
considered abnormal and require further evaluation
· Below 4 ng/mL is considered normal but tumor may still be present
PSA values · 4 -10ng/mL may be seen in early prostate cancer and other benign conditions
· Above 10 ng/mL suggests prostate cancer
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