Cumulative Final- Adult Health 2

What are key characteristics of Crohn's disease?

Skip lesions, fistulas, affects any part of GI tract, causes inflammation through all layers. Encourage small frequent meals and increase fluids.

What are key characteristics of ulcerative colitis?

Affects colon and rectum, continuous inflammation, risk for toxic megacolon, bleeding, shock, and hypotension.

How does gastric ulcer pain differ from duodenal ulcer pain?

Gastric ulcer pain occurs immediately after eating and worsens with food.

How does duodenal ulcer pain differ from gastric ulcer pain?

Duodenal ulcer pain occurs 2-3 hours after eating and improves with food.

What precautions are used for tuberculosis (TB)?

Airborne precautions. Sputum culture is the gold standard diagnostic test.

What is the purpose of no water with meals after bariatric surgery?

Prevents dumping syndrome by slowing gastric emptying and preventing rapid movement of food into intestines.

Which hepatitis viruses require another virus to replicate?

Hepatitis B and Hepatitis D require each other.

How are Hepatitis A and E transmitted?

Fecal-oral route, commonly contaminated food or water.

How are Hepatitis B and C transmitted?

Blood exposure, needles, body fluids, and sexual transmission.

What symptoms may older adults show with pneumonia?

Confusion, weakness, fatigue, and decreased functional status instead of typical symptoms.

What diagnostic test is used for pulmonary embolism (PE)?

CT pulmonary angiography with IV contrast.

What liver enzymes increase with cirrhosis?

ALT and AST may be elevated due to liver injury.

What are signs and symptoms of pancreatitis?

Left upper quadrant pain, Cullen's sign, Grey Turner's sign, oily stools, low calcium, elevated amylase/lipase.

What are pancreatitis risk factors?

Gallstones and heavy alcohol use.

What teaching is important for GERD?

Decrease trigger foods, smoking cessation, proton pump inhibitor (PPI), possible EGD evaluation.

What is the first intervention for small bowel obstruction (SBO)?

IV fluids are priority to treat fluid loss and dehydration.

What foods trigger gallbladder pain?

Fatty or greasy foods.

What is the path of an NG tube?

Nose → ear → xiphoid process.

What is treatment for peptic ulcer disease (PUD)?

Antibiotics for H. pylori and proton pump inhibitor (PPI).

Why is total parenteral nutrition (TPN) used?

Provides nutrition while allowing bowel rest.

What does bubbling in a chest tube system indicate?

A leak in the system. Continuous bubbling in the water seal chamber indicates an air leak.

What does hematemesis indicate?

Vomiting blood, which may indicate bleeding esophageal varices.

What foods should be avoided with irritable bowel disease/IBD symptoms?

Avoid trigger foods; high-fat foods like pancakes and syrup may worsen symptoms.

How often should an ostomy appliance be changed?

Do not change daily because frequent removal irritates the skin; change only as needed.

What cirrhosis symptom requires immediate attention?

Coughing up blood (hemoptysis) or respiratory changes require immediate evaluation.

What precautions are used for hepatitis from IV drug use?

Standard precautions.

Where is the most common location for peptic ulcer formation?

Duodenum.

What causes Hepatitis A?

Contaminated food or water.

What diet is recommended after new ileostomy surgery?

Low residue/low fiber diet while healing.

What position helps after cholecystectomy?

Sims position may promote comfort and drainage.

What does elevated amylase indicate?

Possible pancreatitis.

What findings indicate ineffective airway clearance?

Wheezes and crackles.

What does a pH of 7.21 indicate?

Acidosis.

What do crackles at lung bases indicate?

Pulmonary edema or fluid accumulation.

What is flail chest?

Paradoxical chest movement where part of the chest moves opposite during breathing.

What test confirms pulmonary embolism?

CT pulmonary angiography with IV contrast.

What foods must be avoided with celiac disease?

Gluten-containing foods: wheat, rye, and barley.

What are precautions for TB?

Airborne precautions.

What is the best way to promote airway clearance in pneumonia?

Increase fluids, coughing/deep breathing, and mobilization if appropriate.

What are signs of hyperthyroidism?

Anorexia, weight loss, heat intolerance, tachycardia, anxiety, hyperactivity, and increased bowel movements.

What electrolyte abnormalities occur with Addison's disease?

Hyponatremia (low sodium) and hyperkalemia (high potassium).

What are signs of diabetes insipidus (DI)?

High urine output (>200 mL/hr), very dilute urine, urine specific gravity

How do you know DDAVP is working for diabetes insipidus?

Urine output decreases and urine specific gravity increases (ex: 1.020).

What are the lab findings in SIADH?

Low sodium (hyponatremia), concentrated urine, increased urine specific gravity.

What happens to BUN and creatinine with kidney infection/pyelonephritis?

May increase if kidney function is impaired.

What indicates an intra-renal kidney injury?

Elevated creatinine, decreased urine output, and kidney damage from causes such as toxins or prolonged ischemia.

What are signs of chronic kidney disease (CKD)?

Anemia, fluid overload, hyperkalemia, decreased erythropoietin production.

What foods are appropriate for a low potassium diet?

Grilled chicken, white rice, and green beans are lower potassium choices.

What medication treats hyperthyroidism?

Methimazole.

Why does end-stage kidney disease cause anemia?

The kidneys produce less erythropoietin, causing decreased red blood cell production.

What medication may be given for CKD with edema/crackles?

Diuretics may be prescribed to reduce fluid overload (monitor kidney function and electrolytes).

What should kidney stone patients avoid?

Excess calcium intake unless specifically instructed otherwise.

What should be available after thyroidectomy?

Emergency tracheostomy tray due to airway risk.

What are symptoms of SIADH?

Hyponatremia, confusion, headache, seizures, decreased urine output, concentrated urine.

What are symptoms of DI?

Polyuria, polydipsia, dehydration, low urine specific gravity.

What electrolyte imbalance occurs with Addison's disease?

Hyperkalemia.

What does Cushing syndrome look like?

Excess cortisol causing moon face, buffalo hump, central obesity, thin skin, bruising, and disturbed body image.

Why do corticosteroids increase infection risk?

They suppress the immune system.

What is myxedema coma?

A severe hypothyroidism emergency causing decreased LOC, hypothermia, bradycardia, and respiratory depression.

What happens if a patient skips thyroid medication?

Hypothyroidism symptoms return and severe cases can lead to myxedema coma.

What are signs of thyroid storm?

High fever, tachycardia, hypertension, agitation, vomiting, diarrhea, and altered mental status.

What finding is associated with Graves disease?

Bulging eyes (exophthalmos).

What should you monitor after thyroidectomy?

Signs of hypocalcemia: numbness, tingling, muscle cramps, and tetany.

What is the major complication of peritoneal dialysis?

Peritonitis (infection of the peritoneum).

What should be assessed in an AV fistula?

Thrill and bruit to confirm patency.

What ECG finding indicates hyperkalemia?

Peaked T waves.

Why are seizure precautions used for SIADH?

Severe hyponatremia can cause seizures.

What is a common sign of bladder cancer?

Hematuria (blood in urine).

What causes acromegaly?

Excess growth hormone, usually from a pituitary tumor.

What ECG wave represents ventricular repolarization?

Ventricular repolarization is represented by the T wave.

A patient is in atrial fibrillation and is hemodynamically stable. What is the priority nursing action?

Continue to monitor the patient and manage according to provider orders.

What medication is the first-line treatment for stable supraventricular tachycardia (SVT)?

Adenosine.

Which side of heart failure commonly causes pulmonary edema?

Left-sided heart failure.

Why should a patient with a myocardial infarction be placed on continuous cardiac monitoring?

To detect life-threatening dysrhythmias and monitor for cardiac complications.

What serious complications can uncontrolled hypertension lead to?

Stroke and heart disease.

What are the characteristics of peripheral artery disease (PAD)?

Intermittent claudication, diminished or absent pulses, cool extremities, shiny skin, hair loss, delayed capillary refill, pain with activity relieved by rest.

What are the characteristics of chronic venous insufficiency?

Edema, brown discoloration, varicose veins, warm skin, venous ulcers near the ankles, aching pain relieved by elevation.

A patient presents with a suspected myocardial infarction. What interventions help prevent further cardiac muscle damage?

Nitroglycerin, oxygen (if indicated), and bed rest to reduce myocardial oxygen demand.

A patient with PAD has a difficult-to-palpate pedal pulse. What should the nurse do?

Use a Doppler ultrasound to assess the pulse.

Gangrene is commonly associated with which vascular disorder?

Peripheral artery disease (PAD).

What is the priority goal when caring for a patient with atrial fibrillation?

Prevent thrombus formation and stroke with anticoagulation.

What does an implantable cardioverter-defibrillator (ICD) do?

Detects and treats life-threatening ventricular dysrhythmias such as ventricular tachycardia and ventricular fibrillation.

Which meal is appropriate for a patient on a low-sodium diet?

Broiled chicken with white rice.

What are the modifiable risk factors for coronary artery disease (CAD)?

Smoking, physical inactivity, unhealthy diet, obesity.

What is intermittent claudication?

Leg pain during walking or exercise that is relieved by rest.

Which lab value is most commonly elevated in heart failure?

B-type natriuretic peptide (BNP).

What vision changes may indicate digoxin toxicity?

Blurred vision, yellow or green halos, and color vision changes.

A patient develops chest pain while mowing the lawn that goes away with rest. What condition does this describe?

Stable angina pectoris.

What medication is administered for symptomatic bradycardia?

Atropine.

Which cardiac rhythms are shockable?

Ventricular fibrillation (V-fib) and pulseless ventricular tachycardia (V-tach).

Should lidocaine be used to treat bradycardia or heart block?

No. Atropine is the medication used for symptomatic bradycardia.

What ECG pattern is characteristic of atrial flutter?

Sawtooth flutter waves.

Which lifestyle factors should the nurse address in a patient with atherosclerosis and heart failure?

Smoking, poor diet, and alcohol use.

What assessment findings are classic for pulmonary edema?

Pink frothy sputum, severe dyspnea, crackles, and hypoxia.

When is synchronized cardioversion used?

For unstable patients with a pulse experiencing tachydysrhythmias such as atrial fibrillation, atrial flutter, SVT, or unstable ventricular tachycardia.

When is defibrillation used?

For pulseless ventricular tachycardia and ventricular fibrillation.