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NURS 5463 Test 5 Questions And 100% Correct Answers 100% Pass

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  • November 3, 2024
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  • NURS 5463
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NURS 5463 Test 5 Questions And 100% Correct
Answers 100% Pass


Symptoms of retroperitoneal hemorrhage - Cullen's - periumbilical bruising; Grey
Turner'sbruising in flank area



In a pt > 40 yrs with acute pancreatitis - Consider pancreatic tumor



Pancreatitis DX -Must have 2/3 Characteristic abdominal pain, biochemical evidence of
pancreatitis with lipase or amylase elevation > 3 times upper limit of normal; And/or
Radiological evidence of pancreatitis on crosssectional imaging



Lab Diagnosis of Pancreatitis - Answer Lipase 99% Sensitive & Specific



Imaging Diagnosis of Pancreatitis - Answer MRI/MRCP: dedicated MR that evaluated the
biliary tract, detects necrosis



Management of Pancreatitis - Answer IV fluids=250-500 ml per hour within 12-24 hrs



Hydration goal in Pancreatitis - Answer decrease the BUN which is elevated with volume
depletion; NPO (if pt is having N/V),



Early feeding in Pancreatitis - Answer help protect the gut - mucosal barrier and reduce
bacterial translocation



Pancreatitis Diet Reccs - Answer low-fat solid diet ; nasojejunal



Pancreatitis Analgesia - Answer (opioids Dilaudid, Morphine)

,Gallstone pancreatitis - Answer urgent ERCP recommended



Hypertriglyceridemia-induced acute pancreatitis TX - Answer Insulin gtt rate of 0.1 to
0.3 Units/Kg/Hr, (activate Lipoprotein Lipase which help decrease the Trg) Insulin gtt
can be stopped once Trg < 500



Hypertriglyceridemia PO TX - Answer Apherisis when available, Fibrates (Gemfibrozil
600 mg BID)



Necrotising pancreatic infection-Consider pts with pancreatic or extrapancreatic
necrosis who deteriorate or fail to improve after 7-10 days of hospitalization.



ABX in Infected Necrosis- Carbapenems, Quinolones & Metronidazole may be useful in
delaying or totally avoiding intervention such as IR drainage



Complication of Infected Necrosis- ARDS, abdominal compartment syndrome, DIC,
Hypocalcemia, hyperglycemia, Fluid collections, Acute fluid collection; Pancreatic
pseudocyst



Ulcerative Colitis S/S - Answer Watery diarrhea, Bloody diarrhea, Frequent small BM



Crohn's Disease S/S - Answer No gross bleeding, Fistulas, Malnutrition, Severe oral
aphthous ulcers (Cancker Sores), Dysphagia/odynophagia, Fatigue, fevers



Differences between Crohn's and UC - Answer Cronhn's has fistulas whereas UC does
not



Ulcerative Colitis Mild - Answer < 4 stool per day with or without blood. Normal SED rate.
Mild cramping, tenesmus, even period of constipation.

,U C Moderate disease-Answer > 4 per day, mild anemia. Abdominal pain, low grade
temp, SED rate > 30 mm/hr



U C Severe disease-Answer > 6 per day. Severe cramping. + systemic symptoms > 37.5,
HR > 90, anemia, elevated SED rate 30.



Ulcerative Colitis Complications-Answer Fulminant colitis /Toxic Megacolon (colonic
diameter > 6cm or cecal diameter > 9cm), 10 stools per day or more



UC Perforation consequence of - Answer toxic megacolon.



Ulcerative Colitis Extra intestinal S/S - Answer Inflammation



UC labs and imaging - Answer Raised SED rate > 30 mm/hr, CRP can show severity of
the inflammation, Low albumin,



UC Imaging - Answer Double contrast barium enema may be normal in mild UC, CT scan
or MRI can show thickening of bowel wall



UC Colonoscopy findings - Answer Mucosa can have a petechiae, exudates, edema,
erosions, touch friability, and spontaneous bleeding.



Mild to Moderate UC stool - Answer C diff, WBC, O/P ~ Shigella, Salmonella, Yersinia



UC TX - Answer Topical 5-Aminosalicylic acid (5 ASA) suppositories/enema, Mesalamine
(Sulfasalazine), 6-MP & Azathiaprine if not responding to steroids, Infliximab refractory
to steroids



2 systems for Crohn's Disease - Answer Chrone's DX Activity Index CDAI < 150 &
Harvery-Bradshaw Index HBI < 4

, Asymptomatic remission - Answer CDAI < 150



Mild to Moderate CDAI 150-220 - Answer dehydration, toxicity abdominal pain, masses,
weight loss



Moderate to Severe CDAI 220-450 - Answer :fever, weight loss, abdominal pain, NV,
anemia



Severe-fulminant disease CDAI > 450 has symptoms - Answer continue despite steroids
or biologic (Infliximab, Adalimumab, Certolizumab)



Labs-CD Ans CBC ck for anemia, BMP, Elevated SED rate, CRP, Iron studies, B12



CD Primary dx- Ans Colonoscopy: cobblestone appearance



Before starting On Immunosuppressive therapy (biologics) must checks- Ans Viral labs



CD TX- Ans Sulfasalazine is effective; Oral Mesalamine should not be used in active
flare, Oral Steroids effective & used short-term



CD TX to spare steroid use- Ans Azathioprine & 6-Mercaptopurine



CD TX for steroid dependent pts Answer Methotraxate



Severe treatment of CD Answer Anti-TF agents = Infliximab, Adalimumab, Certolizumab
Pegol which are resistant to steroids



Severe/Fulminant CD Answer IV Corticosteroids, anti-TNF agents Infliximab,
Adalimumab, Certolizumab Pegol

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