Modules 1,2, & 3: GI Parts I & II, Endocrinology

Common clinical manifestations of Grave's disease include:

Exophthalmos, heat intolerance, menstrual changes, palpitations, low thyroid stimulating hormone, increased thyroid hormones

A patient reports experiencing hyperglycemia in the morning after having a low blood glucose reading overnight. The nurse educates the patient that this is a result of:

Somogyi effect

Rationale: Hypoglycemia during the night leads to rebound hyperglycemia in the morning due to the stimulation of counterregulatory hormones such as epinephrine, GH, cortisol, glucagon.

Luis, a 55-year old male patient, is a type two diabetic patient. He reports experiencing diarrhea and increased flatulence since starting his new diabetic medication, acarbose (Precose). The nurse understands that is caused by:

Delayed absorption of dietary carbohydrates due to inhibition of alpha-glucosidase

Rationale: Alpha-glucosidase inhibitors delay absorption of dietary carbohydrates by inhibiting alpha-glucosidase. Common adverse effects include flatulence and diarrhea.

Ulcerative colitis and Chron's disease can be differentiated by their:

location and depth of inflammation within the intestinal mucosa

Clinical manifestations associated with thyrotoxic crisis include:

Hyperthermia, tachycardia, arrhythmias, heart failure, restlessness, agitation, psychosis, nausea, vomiting, and diarrhea

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How would the nurse assess for its presence?

A. Dorsiflex the client's foot

B. Measure the abdominal girth

C. Ask the client to extend the arms

D. Instruct the client to lean forward

C

Rationale: Asterixis is a flapping tremor of the hands commonly referred to as a "liver flap" and is a classic sign of hepatic encephalopathy.

Diarrhea is a common clinical manifestation of inflammatory bowel disorders such as Crohn's disease and ulcerative colitis. An anti-diarrheal agent such as ___________, may be used to help alleviate this symptom associated with these disorders.

loperamide (Imodium)

A 36 year-old female is admitted to the medical-surgical unit after undergoing an abdominal CT that revealed a liver mass concerning for malignancy. The patient has a history of colorectal cancer. The nurse knows that this liver mass is likely a:

Metastasis from the patient's colorectal cancer

Rationale: Primary liver cancer is rare before 40 years of age and is most common after 60 years of age. Cancer in the liver is usually caused by metastatic spread from a primary site elsewhere in the body.

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply.

A. Maintain NPO (nothing by mouth) status

B. Give small, frequent high-calorie feedings

C. Maintain the client in a supine and flat position

D. Give hydromorphone intravenously as prescribed for pain

A & D

Clinical manifestations of peritonitis include:

Abdominal pain that increases with movement, rigid board-like abdomen, fever, leukocytosis, tachycardia, hypotension, and paralytic ileus

Risk factors for cholelithiasis include:

Female, childbearing age, pregnancy, overweight/obesity, advanced age (>40y/o)

Test-taking strategy: Think of the 4 F's. Female, fertile, fat, and forty

A 62 year-old male patient with a history of chronic alcohol use presents to the emergency department with altered mental status, lethargy, and slow speech. The providers order blood work for further evaluation of the patient's symptoms. The nurse can expect that the blood work will include which lab?

Serum ammonia

Rationale: Hepatic encephalopathy is caused by a buildup of ammonia due to the body's inability to covert it to urea.

This class of oral diabetic medications works by stimulating the release of insulin from beta cells of the pancreas:

Meglitinides

Risks factors for GERD include:

Increased stress, increasing age, obesity, drugs that relax the LES, alcohol consumption, acidic foods, eating larger meals, tight fitting clothing, laying down/reclining after meals

Irritable bowel syndrome is a non-inflammatory bowel disorder which is characterized by:

recurrent abdominal pain, altered bowel habits, abdominal bloating, pain relieved with defecation, and nausea