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Chamberlain NR 511 Midterm Questions and Answers 100% CORRECT
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Chamberlain NR 511 Midterm
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Chamberlain NR 511 MidtermWhat are common causes of N/V associated with gastritis? - answer Alcohol, NSAIDs,
ASA, ABX, and illicit substances
What is the most common cause of nausea and vomiting? - answer Acute
Gastroenteritis (AGE)
What are some manifestations of AGE? - answer Nausea, vomiting, and diarrhea, fever,
abdominal pain. May also include fatigue, malaise, anorexia, tenesmus and
borborygmus.
How is the severity of AGE gauged? - answer Dehydration secondary to profuse watery
diarrhea, fever greater than 101ºF (38.3ºC), vomiting, or dysentery.
What are important parts of a patient's history when AGE is suspected? - answer
Travel, dining locations, ABX history..
What happens to the pH of the stomach when antacids are taken and how does this
affect bacteria? - answer High pH can make it easier for bacteria to survive and cause
and infection.
How does motility of the GI tract affect bacteria colonization? - answerSmall bowel
stasis as a result of obstruction, diverticulitis, or blind loop syndrome frequently develop
an overgrowth of bacteria within the stagnant segment.
Which immunoglobulin may protect the GI tract against invading organisms? -
answerIgA...may also help protect against a future attack by the same pathogen.
Onset of N/V begin within 6 hours after exposure. Is this bacterial or viral? -
answerBacterial: time frame suggests food poisoning resulting from the ingestion of a
preformed toxin such as that of Bacillus cereus.
What two indications are highly suggestive of viral AGE? - answerIncubation periods
greater than 14 hours and the initial symptom of vomiting.
If a patient presents with AGE and reports bloody stools, what can be understood about
the reason for blood in the stool/ - answerMucosal damage and inflammatory process
secondary to invasive pathogens.
What do frothy stools and flatus suggest? - answerMalabsorption problem.
,Patients with prolonged AGE illness who are malnourished may present with edema.
What is the reason? - answerHypoalbuminemia
T or F: Chronic diarrhea usually has a noninfectious etiology. - answerTrue
T or F: Acute diarrhea usually is caused by infectious agents or toxins - answerTrue
What is the most common viral pathogen causing AGE in adults? - answerNorovirus
What is the most common viral pathogen causing AGE in pediatrics? -
answerRotavirus. This has been greatly reduced since the introduction of the rotavirus
vaccine.
T or F: Stool studies are indicated in the absence of bloody diarrhea or systemic
disease - answerFalse
T or F: A CBC will help distinguish between viral and bacterial AGE - answerFalse
When are stool studies warranted? - answerSevere or prolonged diarrhea, a fever >
38.5ºC, bloody stools or stools that test positive for leukocytes or occult blood.
What are common pathogens involved in Traveler's Diarrhea? - answerShigella,
Campylobacter, and E. coli.
What should the clinician do if the patient develops diarrhea after initiation of completion
of antibiotic therapy? - answerTest for C. diff.
What are some DDx of AGE, particularly in patients with persistent or chronic diarrhea
and severe abdominal pain? - answerIBS, IBD, ischemic bowel disease, partial bowel
obstruction, small bowel diverticulosis.
What are some red flag symptoms that may indicate the need for hospitalization? -
answerHypovolemia, dehydration, abnormal electrolytes, decreased renal function,
bloody stool/rectal bleeding, weight loss, severe abdominal pain, prolonged symptoms
greater than 1 week, pregnancy, advanced age, history of hospitalization or antibiotic
use in the last 3-6 months.
What is the usual course of treatment for AGE? - answerOnly supportive treatment is
initiated since AGE is usually self-limiting and resolves within 1 week after onset of
symptoms.
How such patients with evidence of dehydration be treated initially? - answerFluid
repletion and nutrition. Sports drinks aren't as effective as specific electrolyte
replenishing drinks.
, At what point should a patient be referred to the hospital for dehydration? - answerSigns
of hypovolemia such as hypotension, tachycardia, pallor, and poor skin turgor.
T of F: Empiric antimicrobial therapy is recommended for patients with severe diarrhea
suspected form traveling. - answerTrue. Bactrim, Ciprofloxacin, Norfloxacin, Floxacin.
T or F: Antibiotic prophylaxis for patients traveling to high-risk areas is appropriate. -
answerTrue
How effective is antibiotic prophylaxis for patients traveling to high-risk areas? -
answer90% effective
What does antibiotic prophylaxis treatment consist of? - answerBactrim, Ciprofloxacin,
Norfloxacin, or Floxacin given once daily until 2 days after returning home.
What is an appropriate symptomatic treatment for patients < 65 years or age with
moderate to severe diarrhea? - answerTwo-day course of Loperamide (Imodium)
What is an appropriate symptomatic treatment for patients < 65 years or age with
significant vomiting? - answerTwo-day course of Zofran or Phenergan.
What is the best way to prevent AGE? - answerHand washing.
T or F: Kids can attend daycare with infectious diarrhea as long as they're separated
from other children. - answerFalse! Not until the diarrhea has stopped.
If pain is present in the right lower quadrant, what might be the etiology related to bowel
disorders? - answerIBD, IBS, Infectious Colitis, and Constipation
If pain is present in the left lower quadrant, what might be the etiology related to bowel
disorders? - answerDiverticulitis, IBS, IBD, Constipation, and Infectious Colitis.
If pain is present in the left upper quadrant, what might be the etiology related to bowel
disorders? - answerStomach ulcers, pancreatitis, and gastritis.
If pain is present in the right upper quadrant, what might be the etiology related to bowel
disorders? - answerGall bladder, hepatitis, and pancreatitis.
T or F: IBS is a disorder of bowel function in the absence of an atomic abnormality. -
answerTrue
What are common symptoms of IBS? - answerChanges in bowel habits such as
diarrhea (IBS-D), constipation (IBS-C), abdominal pain, bloating, rectal urgency with
diarrhea.
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