NURS 623 EXAM 3 MARYVILLE UNIVERSITY
| QUESTIONS AND CORRECT ANSWERS |
GRADED A+ | VERIFIED ANSWERS |
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GERD is the backward flow of stomach contents into the ------CORRECT
ANSWER---------------esophagus without associated retching or vomiting
What are some lifestyle modifications for GERD? ------CORRECT
ANSWER---------------smoking cessation, avoid tight clothing, diet, exercise,
dont eat 4 hours before bedtime, sleep with HOB elevated
The primary cause of GERD is the inappropriate, spontaneous ------
CORRECT ANSWER---------------transient relaxation of the lower
espophageal sphincter(LES) to an unknown stimulus
Lifestyle modification are the first line treatment for GERD, name some?? --
----CORRECT ANSWER---------------elevating HOB, avoid large, high fat
meals, avoid chocolate, alcohol, peppermint, caffeine, onions garlic, citrus
and tomatoes; avoid lying down 3-4 hours after meal, avoid bedtime
snacks, weightloss
If lifestyle modifications dont work in the treatment of GERD what is the first
"step up" treatment with non erosive reflux? ------CORRECT ANSWER------
---------"tidine" :cimetidine, ranitidine, famotidine, nizatidine; if no
improvement then PPIs are used
,What is the initial therapy for patients with GERD who have erosive
esophagitis or barretts esophagus ------CORRECT ANSWER---------------
PPI's (razole) such as omeprazole once a day 30 minutes before breakfast
(8 week course)
For a patient with GERD and complications such as erosive esophagitis or
barretts esophagus who is unresponsive to treatments what would your
plan of action be ? ------CORRECT ANSWER---------------surgical
intervention: nissen fundoplication
GERD is a lifelong disease and patients should be evaluated on a regular
basis , patients with mild to moderate symptoms should be instructed to
treat how? ------CORRECT ANSWER---------------lifestyle modifications and
antacids or OTC H2-RAs (famotidine) for 4 weeks;
What are the lifestyle modifications for GERD? ------CORRECT ANSWER--
-------------elevate HOB, no eating 3-4 hour before bed and no snacks,
weight reducation, smoking cessation, avoid large meals, tight clothing ,
avoid bending or straining, advise to eat small frequent meals
What are the most common causes of gasteroenteritis? ------CORRECT
ANSWER---------------bacterial, viral and parasitic
A stool culture should be done on any patient who has what symptoms? ----
--CORRECT ANSWER---------------severe diarrhea, fever >101.3, bloody
stools, leukocytes, lactoferrin or occult blood bc there are indications of a
bacterial pathogen
,Any patient who develops diarrhea after initiation or completion of
antibiotics therapy should have a ....... ------CORRECT ANSWER--------------
-tissue culture assay or an ELISA test for possible C-Diff
Viral gastroenteritis should be suspected in any patient with ____ as their
major symptoms ------CORRECT ANSWER---------------vomiting; and in
cases of possible food or water contamination
All patients who present with diarrhea should be treated with ------
CORRECT ANSWER---------------fluid and electrolyte management; patients
who can take oral replacement should be instructed to
drink fluids with a sodium content 45-75 meq (pedialyte or gatorade)
Patients with diarrhea require a diet that includes calories that come from --
----CORRECT ANSWER---------------boiled starches and cereals (potatoes,
rice, pasta wheat and oats), with the addition of salt
Describe the clinical presentation for Gastroesophageal Reflux Disease
(GERD)? ------CORRECT ANSWER---------------heartburn, regurgitation,
water brash (reflex salivation), sour taste in morning, belching, coughing,
and hoarseness. Objective: only sign may be occult blood in stool.
How is GERD diagnosed (when to refer to GI)? ------CORRECT ANSWER--
-------------With symptoms, sometimes with upper endo; refer if failed
treatment of step 2- after 6 weeks of treatment
, Discuss the patient education regarding lifestyle changes for management
of GERD. ------CORRECT ANSWER---------------lifestyle changes including
diet
weight loss, raising the head of their bed 6-8 inches, avoid nicotine
products avoid recumbency or sleeping for 3 to 4 hours after a meal, avoid
bedtime snacks, avoid fatty and late meals, foods such as chocolate,
alcohol, peppermint, caffeine, onions, garlic, citrus, and tomatoes, wearing
loose comfortable clothing, and starting a routine exercise and weight loss
program
Describe medical management of GERD? ------CORRECT ANSWER--------
-------step-up: LIFESTYLE changes, PRN OTC H2ra and antacid; PPI;
referral
Step-down: starts with PPI then step down until Sx under control
46 year old male complains of dysphasia hoarseness and cough he states
he wakes up with a sour taste in his mouth. What is the most likely cause of
the patient symptoms? ------CORRECT ANSWER---------------GERD
Managment of peptic/gastric ulcer ------CORRECT ANSWER---------------
*relieve pain, heal the ulcer, and prevent complications/reoccurrence
*PHARMACOLOGICAL therapy is the foundation of management (H2Ra,
PPI, antacids, antibx w/H-pylori)
Describe the diagnosis criteria IBS ------CORRECT ANSWER---------------3
Criteria:
1. pain relieved by defacation or change in BMs for 3 months
2. BM with patterns of constipation/diarrhea 25% of the time
