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NR 509 Final Exam study guide correct verified 100%NR 509 Final Exam study guide correct verified 100% Appendicitis - correct answers-1. McBurney point tenderness 2. Rovsing sign 3. the psoas sign 4. the obturator sign --Appendicitis is twice as likely in the presence of RLQ tenderness, R...

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  • October 3, 2024
  • 25
  • 2024/2025
  • Exam (elaborations)
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  • nr 509 final exam study guide correct verified 100

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NR 509 Final Exam study guide correct
jng jng jng jng jng jng jng




verified 100% jng




Appendicitisjng-jngcorrectjnganswers-1.jngMcBurneyjngpointjngtendernessjng

2.jngRovsingjngsign

3.jngthejngpsoasjngsign

4.jngthejngobturatorjngsign

--
AppendicitisjngisjngtwicejngasjnglikelyjnginjngthejngpresencejngofjngRLQjngtenderness,jngRovsingjngsign,jngandjngthejngpsoasj
ngsign



--
Thejngpainjngofjngappendicitisjngclassicallyjngbeginsjngnearjngthejngumbilicus,jngthenjngmigratesjngtojngthejngRLQ.jngOlder
jngadultsjngarejnglessjnglikelyjngtojngreportjngthisjngpattern.



--LocalizedjngtendernessjnganywherejnginjngthejngRLQ,jngevenjnginjngthejngrightjngflank,jngsuggestsjngappendicitis.

McBurneyjngPointjng-jngcorrectjnganswers-
1.jngMcBurneyjngpointjngliesjng2jnginchesjngfromjngthejnganteriorjngsuperiorjngspinousjngprocessjngofjngiliumjngonjngajngline
jngdrawnjngfromjngthatjngprocessjngtojngthejngumbilicus



2.jngAppendicitisjngisjngthreejngtimesjngmorejnglikelyjngifjngtherejngisjngMcBurneyjngpointjngtenderness.

Rovsingjngsignjng-jngcorrectjnganswers-
PressjngdeeplyjngandjngevenlyjnginjngthejngLLQ.jngThenjngquicklyjngwithdrawjngyourjngfingers.

PainjnginjngthejngRLQjngduringjngleft-sidedjngpressurejngisjngajngpositivejngRovsingjngsign.

PsoasjngSignjng-jngcorrectjnganswers---
Placejngyourjnghandjngjustjngabovejngthejngpatient'sjngrightjngkneejngandjngaskjngthejngpatientjngtojngraisejngthatjngthighjnga
gainstjngyourjnghand.jngAlternatively,jngaskjngthejngpatientjngtojngturnjngontojngthejngleftjngside.jngThenjngextendjngthejngp
atient'sjngrightjnglegjngatjngthejnghip.jngFlexionjngofjngthejnglegjngatjngthejnghipjngmakesjngthejngpsoasjngmusclejngcontract;jng
extensionjngstretchesjngit.

--Increasedjngabdominaljngpainjngonjngeitherjngmaneuverjngisjngajngpositivejngpsoasjngsign,jngsug-
gestingjngirritationjngofjngthejngpsoasjngmusclejngbyjnganjnginflamedjngappendix.

ObturatorjngSignjng-jngcorrectjnganswers---Lessjnghelpful

--
Flexjngthejngpatient'sjngrightjngthighjngatjngthejnghip,jngwithjngthejngkneejngbent,jngandjngrotatejngthejnglegjnginternallyjngatjn
gthejnghip.jngThisjngmaneuverjngstretchesjngthejnginternaljngobturatorjngmuscle.jng

,--
Rightjnghypogastricjngpainjngisjngajngpositivejngobturatorjngsign,jngfromjngirritationjngofjngthejngobturatorjngmusclejngbyjng
anjnginflamedjngappendix.jngThisjngsignjnghasjngveryjnglowjngsensitivity.

AcutejngCholecystitsjng-jngcorrectjnganswers-RUQjngpain

MurphyjngSign

MurphyjngSignjng-jngcorrectjnganswers-
Hookjngyourjngleftjngthumbjngorjngthejngfingersjngofjngyourjngrightjnghandjngunderjngthejngcostaljngmarginjngatjngthejngpointj
ngwherejngthejnglateraljngborderjngofjngthejngrectusjngmusclejngintersectsjngwithjngthejngcostaljngmargin.jngAlternatively,j

ngpalpatejngthejngRUQjngwithjngthejngfingersjngofjngyourjngrightjnghandjngnearjngthejngcostaljngmargin.jngIfjngthejngliverjngisjng

enlarged,jnghookjngyourjngthumbjngorjngfingersjngunderjngthejngliverjngedgejngatjngajngcomparablejngpoint.jngAskjngthejngp
atientjngtojngtakejngajngdeepjngbreath,jngwhichjngforcesjngthejngliverjngandjnggallbladderjngdownjngtowardjngthejngexamin
ingjngfingers.jngWatchjngthejngpatient'sjngbreathingjngandjngnotejngthejngdegreejngofjngtenderness.

--
AjngsharpjngincreasejnginjngtendernessjngwithjnginspiratoryjngeffortjngisjngajngpositivejngMurphyjngsign.jngWhenjngpositiv
e,jngMurphyjngsignjngtriplesjngthejnglikelihoodjngofjngacutejngcholecystitis.

AcutejngPancreatitisjngProcessjng-jngcorrectjnganswers-
Intrapancreaticjngtrypsinogenjngactivationjngtojngtrypsinjngandjngotherjngenzymes,jngresult-
ingjnginjngautodigestionjngandjnginflammationjngofjngthejngpancreas

AcutejngPancreatitisjngLocationjng-jngcorrectjnganswers-
Epigastric,jngmayjngradiatejngstraightjngtojngthejngbackjngorjngotherjngareasjngofjngthejngabdomen;jng20%jngwithjngseverejn
gsequelaejngofjngorganjngfailure



AcutejngPancreatitisjngQualityjng-jngcorrectjnganswers-Usuallyjngsteady

AcutejngPancreatitisTimingjng-jngcorrectjnganswers-Acutejngonset,jngpersistentjngpain

AcutejngPancreatitisjngAggrevatingjngFactorsjng-jngcorrectjnganswers-
Lyingjngsupine;jngdyspneajngifjngpleuraljngeffusionsjngfromjngcapillaryjngleakjngsyn-
drome;jngselectedjngmedications,jnghighjngtriglyceridesjngmayjngexacerbate

AcutejngPancreatitisjngRelievingjngfactorsjng-jngcorrectjnganswers-Leaningjngforwardjngwithjngtrunkjngflexed

AcutejngPancreatitisjngAssociatedjngSymptomsjngandjngSettingjng-jngcorrectjnganswers-
Nausea,jngvomiting,jngabdominaljngdis-
tention,jngfever;jngoftenjngrecurrent;jng80%jngwithjnghistoryjngofjngalcoholjngabusejngorjnggallstones

PepticjngUlcerjngDiseasejngProcessjng-jngcorrectjnganswers-Mucosaljngulcerjnginjngstomachjngorjngduode-
numjng>5jngmm,jngcoveredjngwithjngfibrin,jngex-tendingjngthroughjngthejngmuscularisjngmu-
cosa;jngH.jngpylorijnginfectionjngpresentjnginjng90%jngofjngpepticjngulcers

PepticjngUlcerjngDiseasejngLocationjng-jngcorrectjnganswers-Epigastric,jngmayjngradiatejngstraightjngtojngthejngback

PepticjngUlcerjngDiseasejngQualityjng-jngcorrectjnganswers-
Variable:jngepigastricjnggnawingjngorjngburningjng(dyspepsia);jngmayjngalsojngbejngboring,jngaching,jngorjnghungerlike

, Nojngsymptomsjnginjngupjngtojng20%

PepticjngUlcerjngDiseasejngTimingjng-jngcorrectjnganswers-
Intermittent;jngduodenaljngulcerjngisjngmorejnglikelyjngthanjnggastricjngulcerjngorjngdyspepsiajngtojngcausejngpainjngthatjng
(1)jngwakesjngthejngpatientjngatjngnight,jngandjng(2)jngoccursjngintermittentlyjngoverjngajngfewjngwks,jngdisappearsjngforjng
months,jngthenjngrecurs

PepticjngUlcerjngDiseasejngaggravatingjngfactorsjng-jngcorrectjnganswers-Variable

PepticjngUlcerjngDiseasejngrelievingjngfactorsjng-jngcorrectjnganswers-Foodjngandjngantacidsjngmayjngbringjngre-
liefjng(lessjnglikelyjnginjnggastricjngulcers)

PepticjngUlcerjngDiseasejngassociatedjngsymptomsjngandjngsettingjng-jngcorrectjnganswers-
Nausea,jngvomiting,jngbelching,jngbloating;jngheartburnjng(morejngcommonjnginjngduodenaljngulcer);jngweightjnglossjn
g(morejngcommonjnginjnggastricjngulcer);jngdyspepsiajngisjngmorejngcom-monjnginjngthejngyoungjng(20-

29jngyrs),jnggastricjngulcerjnginjngthosejngoverjng50jngyrs,jngandjngduodenaljngulcerjnginjngthosejng30-60jngyrs

GERDjngProcessjng-jngcorrectjnganswers-
Prolongedjngexposurejngofjngesophagusjngtojnggastricjngacidjngduejngtojngimpairedjngesopha-
gealjngmotilityjngorjngexcessjngrelaxationsjngofjngthejnglowerjngesophagealjngsphincter;jngHelico-
bacterjngpylorijngmayjngbejngpresent

GERDjngLocationjng-jngcorrectjnganswers-Chestjngorjngepigastric

GERDjngQualityjng-jngcorrectjnganswers-Heartburn,jngregurgitation

GERDjngtimingjng-jngcorrectjnganswers-Afterjngmeals,jngespeciallyjngspicyjngfoods

GERDjngaggravatingjngfactorsjng-jngcorrectjnganswers-
Lyingjngdown,jngbendingjngover;jngphysicaljngactivity;jngdiseasesjngsuchjngasjngscleroderma,jnggastroparesis;jngdrugsjng
likejngnicotinejngthatjngrelaxjngthejnglowerjngesophagealjngsphincter

GERDjng:jngrelievingjngfactorsjng-jngcorrectjnganswers-Antacids,jngprotonjngpumpjnginhibi-
tors;jngavoidingjngalcohol,jngsmoking,jngfattyjngmeals,jngchocolate,jngselectedjngdrugsjngsuchjngasjngtheophylline,jngcal
-ciumjngchanneljngblockers

GERDjngassociatedjngsymptomsjngandjngsettingjng-jngcorrectjnganswers-Wheezing,jngchronicjngcough,jngshort-
nessjngofjngbreath,jnghoarseness,jngchokingjngsensation,jngdysphagia,jngregurgitation,jnghalitosis,jngsorejngthroat;jngi
ncreasesjngriskjngofjngBarrettjngesophagusjngandjngesopha-gealjngcancer

Diverticulitisjngprocessjng-jngcorrectjnganswers-Acutejnginflammationjngofjngcolonicjngdiver-
ticula,jngoutpouchingsjng5-10jngmmjnginjngdi-ameter,jngusuallyjnginjngsigmoidjngorjngdescend-ingjngcolon

Diverticulitisjnglocationjng-jngcorrectjnganswers-Leftjnglowerjngquadrant

Diverticulitisjngqualityjng-jngcorrectjnganswers-Mayjngbejngcrampingjngatjngfirst,jngthenjngsteady

Diverticulitisjngtimingjng-jngcorrectjnganswers-Oftenjnggradualjngonset

Diverticulitisjngaggravatingjngfactorsjng-jngcorrectjnganswers---

Diverticulitisjngrelievingjngfactorsjng-jngcorrectjnganswers-Analgesia,jngboweljngrest,jngantibiotics

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