Exam 4: NR 324/ NR324 (NEW 2026/ 2027 Update) Adult Health I Guide | Q&A| Grade A| 100% Correct (Verified Solutions) -Chamberlain

Exam 4: NR 324/ NR324 (NEW 2026/ 2027 Update) Adult Health I Guide | Q&A| Grade A| 100% Correct (Verified Solutions) -Chamberlain Q. Obesity is associated with many chronic diseases such as ANSWER cancer, diabetes, and cardiovascular disease Q. The plan for a patient who is obese with GERD is to ANSWER Lose weight Q. Complications of TPN ANSWER fluid imbalance, electrolyte imbalance, infection of central line insertion site, and hyperglycemia Q. The plan of care for a patient on TPN is to include the following ANSWER ▪ Make sure to use an infusion pump ▪ Monitor daily weights ▪ Monitor lab values ▪ Provide oral care Q. Discharge education for a patient going home with TPN can include: ANSWER Refrigerated when not in use. If they are running low on TPN, infuse D10 (10% Dextrose in Water) to prevent hypoglycemia Maintain infusion rate when behind schedule Q. The best indicator for improved nutritional status is ANSWER prealbumin Q. common characteristics of GERD ANSWER Abdominal pain that occurs 1 hour after eating ▪ Can occur with a hiatal hernia ▪ Can cause erosion and inflammation of the esophagus Q. The best action to take when caring for a patient with GERD is to ANSWER elevate the head of the bed when sleeping Q. Gastric ulcer ANSWER •rapid weight loss • pain will get worse when patient eats • blood in vomit • heartburn Q. A patient with a gastric ulcer is at risk of developing ANSWER peritonitis Q. Duodenal ulcer ANSWER pain relief once they eat, Pain will occur at night Q. Normal platelet count ANSWER 150,000-400,000 Q. Normal hemoglobin levels ANSWER 12-18 g/dL Q. Normal Hematocrit levels ANSWER 38-54% Q. Normal RBC count ANSWER 4-6 million Q. Normal WBC count ANSWER 4,500-10,000 Q. Normal MCV levels ANSWER 80-98 Q. lifespan of platelets ANSWER 9 days Q. lifespan of RBC ANSWER 120 days Q. lifespan of WBC ANSWER 20 days Q. erythrocytopenia ANSWER a deficiency of red blood cells Q. erythrocytosis ANSWER too many red blood cells Q. leukocytopenia ANSWER deficiency of white blood cells Q. leukocytosis ANSWER too many white blood cells Q. thrombocytopenia ANSWER not enough platelets Q. thrombocytosis ANSWER too many platelets Q. assessments that show improvement of anemia ANSWER -increased red blood cell count on complete blood count -improved oxygen saturation -increased blood pressure -decreased pulse -improved fatigue Q. assessments that show improvement of Leukocytopenia ANSWER -absence of signs or symptoms of infection -increased white blood cell count Q. assessments that show improvement of Leukocytosis ANSWER -decreased fever -decreased white blood cell count -stable blood pressure Q. assessments that show improvement of Thrombocytopenia ANSWER -absence of signs or symptoms of infection -increased platelet count Q. assessments that show improvement of Thrombocytosis ANSWER -absence of signs or symptoms of thromboembolism -decreased platelet count Q. What lab does the nurse anticipate being prescribed to evaluate the needs of a client with a hematologic alteration? ANSWER Complete Blood Count Q. Which are laboratory markers for anemia? Select all that apply. ANSWER Hematocrit Hemoglobin RBC Q. Causes of anemia ANSWER Iron deficiency Vitamin deficiency Chronic diseases Bone marrow diseases Hemolytic anemia Sickle cell anemia Q. s/s of anemia ANSWER pale skin cool skin temp fatigue and dizziness shortness of breath chest discomfort tachycardia Q. Microcytic anemia ANSWER MCV less than 80 -Small red blood cells are produced and lack oxygen-carrying capacity due to iron deficiency anemia or thalassemia Normocytic anemia MCV 80-100 -Red blood cells are lost or destroyed due to blood loss or kidney failure Macrocytic anemia MCV greater than 100 -Large red blood cells are produced and lack oxygen-carrying capacity due to folate or vitamin B deficiency iron deficiency anemia most common caused by a diet low in iron rich foods, gastric bypass surgery, pregnancy, or pica Pica eating cornstarch, chalk, dirt, clay, ice s/s of iron deficiency anemia fatigue dizziness dyspnea tachycardia pallor Treatments for iron deficiency anemia dietary sources rich in iron (meat, fish, poultry) ferrous sulfate Iron dextran (IV or IM) caution with ferrous sulfate dark or black stools are normal take on an empty stomach 1hr before other meds eat citrus, juices avoid dairy products assessment findings for iron and folate deficiency anemia Low red blood cells, hemoglobin, and hematocrit levels Shortness of breath Abnormal skin assessment aplastic anemia bone marrow cannot make enough new blood cells for your body to work normally -at a greater risk for infection treatment of aplastic anemia bone marrow transplant blood transfusion Thalassemia an inherited blood disorder caused when the body doesn't make enough hemoglobin medication for Anemia caused by renal insufficiency epoetin alfa medication for Symptomatic thalassemia Packed red blood cell transfusion Most common cause of neutropenia chemotherapy and immunosuppresssion therapy S/S of neutropenia fever skin abscess recurrent sinusitis or otitis cough, dyspnea neutropenic precautions Patients immune system is compromised private room positive pressure Must wear mask, gown, and gloves no fresh fruit, veggies, or flowers pernicious anemia body doesn't make enough blood cells due to lack of B12 -lack of intrinsic factor in the GI tract s/s of pernicious anemia glossitis (inflamed red smooth tongue) extreme weakness jaundice medication for pernicious anemia B12 injection (IM or IV) sickle cell anemia lifespan of blood cells are less than 3 weeks curved shaped blood cells s/s of sickle cell anemia unilateral weakness swelling of the feet and hands (dactylitis) hypotension rapidly enlarging spleen assessment findings for sickle cell anemia Low red blood cells, hemoglobin, and hematocrit levels Sickle cells Shortness of breath Joint pain Abnormal skin assessment Hypertension medication for Sickle cell anemia hydration (IV fluids) bed rest PCA pump oxygen therapy function if the gastrointestinal system provides essential nutrients to support body function through digestion, allows for elimination of waste through deflection alimentary canal oral cavity pharynx esophagus stomach small intestine rectum anal canal Acessory organs of the digestive system salivarly glands liver gallbladder pancreas the peritoneum is serious membrane that holds the digestive organs in place within the abdominal cavity small intestine parts duodenum jejunum, ileum mouth parts palate uvula teeth tongue large intestine parts transverse ascending cecum descending sigmoid colon rectum throat parts pharynx vocal cords esophagus salivary glands part parotid submandibular sublingual component of the oral cavity -buccal Mucosa -lip -tongue -hard palate -soft palate -teeth -salivary glands function or oral cavity chemical and mechanical mechanical digestion grinding of food into smaller pieces through mastication chemical digestion Salivary amylase begins digestion of carbohydrates EGD esophagogastroduodenoscopy EGD test -moderate sedation -visualized: esophagus, stomach, duodenum prep: NPO 6-8 hours before procedure sigmoidoscopy -visualizes: anus, rectum, sigmoid colon -no anesthesia -prep: bowel cleanser, clear liquid diet, NPO after midnight colonoscopy -moderate sedations -visualizes: anus, rectum, sigmoid colon, descending colon, transverse, and ascending -prep: bowel cleanser, clear liquid diet, NPO after midnight GI series is used to identify GI abnormalities likes ulcer, tumors, and obstructions during a GI series patients drink barium and xrays are taken as barium moves though the GI tract prep for GI series is NPO, no smoking or chewing gum during the eight hours prior patietn teaching for gi series increase fluid to flush out barium and stool may be white for several days AST levels 0 to 35 AST is high when their is liver damage ALT levels 4-36 amylase levels 60-120 lipase levels 0-160 bilirubin levels 0.3-1.0 mg/dL Ammonia levels 10-80 albumin levels 3.5-5 total protien levels 6.4 to 8.3 ALT is high in liver damage or inflammation amylase is high in pancreatitises and perforated ulcers lipase is high in acute pancreatitis and perforated ulcer biliruibn levels count the livers ability to excretes ammonia is high when their is liver cirrhosis Albumin levels can indicate malnutrition diverticulitis is inflammation of the diverticula patho of diverticulitis high intraluminal pressure causes diverticula to form in weka spots in the GI wall. undigested foos and bacteria accumulate in the diverticula leading to inflammation risk factors for diverticulitis low fiber diet genetic obesity smoking alcohol NSAIDs corticosteroid s/s of diverticulitis LLQ pain boating fever nausea vomiting labs affected with diverticulitis increased WBC and ESR Decreased Hgb/HCT with bleeding how to diagnosis diverticulitis barium enema colonoscopy CT lower GI series treatment for diverticulitis antibiotic and analgesics diverticulosis is considered normal and in many cases doesn't cause symptoms foods to eat when you have diverticulitis -lots of liquids -cooked veggie and fruit -low fiber diet foods not to eat with diverticulitis processed sugars excess carbs fat red meat crohns disease is a chronic inflammatory disease that can involve the entire GI tract and all layers of the bowel wall. Characterized by period of remission and exacerbation patho a crohns disease genetic, immune, and environmental factors cause inflammation, which leads to the developments of patchy ulcerations and granuloma in the GI tract risk factors of crohns autoimmune disease genetics smoking NSAID signs and symptoms of crohns diarrhea steatorrhea RLQ pain weight loss anemia fever fatigue crohns labs decrease: hct, hgb, albumin increase: ESR, CRP, WBC diagnosiss of crohns colonoscopy EGD CT/MRI treatemtn for crohns meds surgery ulcerative colitis is a chronic inflammatory disease of the colon, characterized by period of remission and exacerbation patho of ulcerative colitis abnormal immune response causes inflammation in the mucosal layer of the colon which leads to continuous ulcerations risk factors of ulcerative colitis autoimmune disease genetics stress s/s of ulcerative colitis -diarrhea with blood or pus -abdominal pain -fecal urgency -weakness -weight loss -fever -anemia -dehydration labs for ulcerative colitis increase WBC, CRP, and ESR decreased: Hgb, Hct, albumin, potassium and magnesium difference between crohns and ulcerative colitis crohn: al of colon ulcerative colitis only sigmoid colon an intestinal obstruction is the complete or partial blockage of the intestine that can be potentially life threatening patho of intestinal obstruction mechanical: bowel blocked chemical: neuromuscular disorder cause decreased peristalsis risk factors for intestinal obstructions abdominal surgery -tumor -hernia -fecal impACTION -electrolyte imbalance s/s of abdominal obstruction abd pain abd distention constipation absent bowel sounds abdominal hernia is when a section of the intestine protrude through a weakness in the abdominal muscle wall risk factors for herna obesity pregnancy lifting heaving objects s/s of hernia lumo severe pain decreased bowels hiatal hernia is a protrusion of the stomach through the diaphragm into the chest cavity patho of hiatal hernia weakening of the diaphragm that allows the fundus of the stomach to protrude through the esophageal hiatus s/s of hiatal hernia heart burn dysphagia chest pain IBS is a intestinal disorder that causes abdominal pain and changes in the bowel movements risk factors for IBS stress mental health bacteria overgrwoth food sensitivies s/s of ibs pain bloating diarrhea constipation peptic ulcer is a sore in the stomach lining patho of peptic ulcer protective superficial muscosa in the GI becomes damages exposing inner epithelium to gastric secretions s/s of peptic ulcer epigastric pain nausea vomiting bloating hematemesis melena gastric ulcer pain 15-30 min after meal worse in dat duodenal ulcer pain 2/3 hours after meal, worse at night better with eating signs of stomach ulcer indigestion weight loss burning always hungry nausea vomiting burping trouble sleeping bloating lack of appetite dark tarry stol antacids gastritis inflammation of the gastric mucous rish factors for gastritis h pylori long term NSAID smoking stress heavy alcohol radiation B12 def s/s of gastrities heartburn nausea vomiting bloating lack of appetite anemia GERD is when gastric contents back flow into the esophagus, causing pain and mucosal damage risk fators for GERD obesity smoking alcohol hitalin hernia old age s/s of GERD indigestion regurgitation throat irritation bitter taste burning in esohag. chronic cough with GERD dont eat spicy citrus caffeine cig smok do woth GERD small portiom 2 hrs b4 bed eat healthy weight elevate HOB Which health problems are associated with metabolic syndrome high blood glucose hypertension Metabolic syndrome is not a disease but a group of factors placing a client at risk for -cardiac disease -hypertension -cerebral vascular accidents (CVA) -diabetes mellitus type 2. Cultural preferences are important factors to consider when conducting a nutritional assessment 18.5 BMI underweight 18.5-24.9 BMI normal 25-29.9 BMI overweight 30-39.9 BMI obese 40 BMI extreme obesity surgical management of obesity bariatric surgery gastric sleeve roux-en-y bypass bariatric surgery surgical reduction of gastric capacity to treat morbid obesity gastric sleeve removal of part of the stomach Roux-en-Y gastric bypass Small pouch created from stomach Part of small intestine bypassed Restriction and malabsorption What factors increase a client's risk of developing malnutrition? -excessive dieting -current infection -dysphagia -depression -dailysis What is the purpose of elevating a client's head of the bed prior to administering enteral nutrition? to reduce the risk of the client aspirating