N138 Midterm 2 Questions with 100% Correct Answers.
Hirschsprung disease: patho, s/s, - Correct Answer absent ganglion cells >. decreased
motility, loss of rectosphincteric reflux (unable to relax to evacuate stool)
s/s: failure to pass meconium in first 24-48hr of birth, abd distention, constipation, foul
ribbon like stools, bilious vomiting
Hirschsprung Disease: diagnosis - Correct Answer Rectal biopsy (shows no ganglion
cells), contrast enema
GERD: manifestations, feeding manuevers, surgerical tx - Correct Answer excessive
crying, arching, asthma, choking, vomiting, poor weight gain, hoarseness
thicken with thickener or rice cereal + enlarged nipple opening
nissen fundoplication: for recurrent aspiration pneumonia, apnea, severe esophagitis,
FTT, those who failed tx
Hypertrophic Pyloric Stenosis: patho, manifestations, tx - Correct Answer pylorus thickens
>>stenotic>> unable to get contents of gut into duodenum projectile nonbilious vomiting,
gastric peristalsis may be visible, poor feeding &wt gain, dehydration, metabolic alkalosis
surgery (Pyloromyotomy), F/E
Intusseception: patho - Correct Answer intestine slides into adjacent part of the intestine>>
cuts off blood supply>> ischemia>> sloughs off, mucous production
Intussception: s/s - Correct Answer jelly like stools, colicky abdominal pain, crying, drawing
up knees to chest, bilious vomiting, sausage like mass in RUQ
Intussecption: tx - Correct Answer gas enema, NG decompression, antibx, surgical
resection ( ischemic, peritonitis, bowel perforation, or failed enema)
,Acute Appendicitis: patho, causes - Correct Answer obstruction>>
blockage>>compression of BV>> ischemia>> ulceration of endothelial lining and bacterial
invasion
causes: fecal, swollen lymphoid tissue, pinworms
Acute Appendicitis: s/s (whats the first sign) - Correct Answer 1st sign: periumbilical pain
rebound tenderness
RLQ pain (McBurney Point), N/V/D/C, Fever, Anorexia
Acute appendicitis: complication - Correct Answer Perforation w/in 48hr
Acute Appendicitis: tx - Correct Answer appendectomy
Acute Appendicitis: nursing considerations - Correct Answer be aware of danger of admin
of laxatives/enemas (during severe abdominal pain)>> stimulate bowel motility and
increase the risk of perforation
soft palpation
low intermittent gas decompression
Short Bowel Syndrome: patho - Correct Answer · Group of problems related to poor
absorption of nutrients. Cannot absorb enough water, vitamins, minerals, protein, fat,
calories, and other nutrients from food.
Short Bowel Syndrome: s/s - Correct Answer diarrhea, dehydration, foul smelling stool,
electrolyte imbalance, wt loss, ,malnourishment, FTT
Short Bowel Syndrome: complication - Correct Answer Necrotizing Enterocolitis:
increased abdominal girth , blood tinged stool, absent BS>> Surgery
Fulminant(rapid onset) sepsis: central line/TPN
PN Cholestasis (bile flow to liver slows/stops)
, Bowel Atrophy: increas. permeability of bacteria
Hepatic Dysfunction
Short Bowel Syndrome: nsg care - Correct Answer TPN>> ENteral Feed>> Oral Feed
Infection prevention: central line
Ostomy care
Diet: high fat, low carb for bacterial overgrowth and infection
Decrease secretory losses: H2 blockers, PPI
Biliary Atresia: patho, s/s - Correct Answer Atresia leads to plugging, inflammation, fibrosis
of bile canaliculi --> no drainage of bile, backs up, damages hepatocytes
jaundice, white/gray stool, hepatomegaly, bruising, dark urine. pruritis
Biliary Atresia: nsg care/meds, tx - Correct Answer Nutritional Support: give fat soluble
vitamins (ADEK)
Phenobarbitol: stimulate bile flow
Ursodeoxycholic acid: decrease cholestasis and pruritis
Surgery, Liver transplant
obstipation - Correct Answer extremely long intervals between defecation
Encopresis - Correct Answer constipation with fecal soiling( fecal incontinence)
pooping anywhere other than the toilet
Acute Gastroenteritis :nsg care - Correct Answer NO antidiarrheal or antiemetics,
Dehydration:>> F/E
Hirschsprung disease: patho, s/s, - Correct Answer absent ganglion cells >. decreased
motility, loss of rectosphincteric reflux (unable to relax to evacuate stool)
s/s: failure to pass meconium in first 24-48hr of birth, abd distention, constipation, foul
ribbon like stools, bilious vomiting
Hirschsprung Disease: diagnosis - Correct Answer Rectal biopsy (shows no ganglion
cells), contrast enema
GERD: manifestations, feeding manuevers, surgerical tx - Correct Answer excessive
crying, arching, asthma, choking, vomiting, poor weight gain, hoarseness
thicken with thickener or rice cereal + enlarged nipple opening
nissen fundoplication: for recurrent aspiration pneumonia, apnea, severe esophagitis,
FTT, those who failed tx
Hypertrophic Pyloric Stenosis: patho, manifestations, tx - Correct Answer pylorus thickens
>>stenotic>> unable to get contents of gut into duodenum projectile nonbilious vomiting,
gastric peristalsis may be visible, poor feeding &wt gain, dehydration, metabolic alkalosis
surgery (Pyloromyotomy), F/E
Intusseception: patho - Correct Answer intestine slides into adjacent part of the intestine>>
cuts off blood supply>> ischemia>> sloughs off, mucous production
Intussception: s/s - Correct Answer jelly like stools, colicky abdominal pain, crying, drawing
up knees to chest, bilious vomiting, sausage like mass in RUQ
Intussecption: tx - Correct Answer gas enema, NG decompression, antibx, surgical
resection ( ischemic, peritonitis, bowel perforation, or failed enema)
,Acute Appendicitis: patho, causes - Correct Answer obstruction>>
blockage>>compression of BV>> ischemia>> ulceration of endothelial lining and bacterial
invasion
causes: fecal, swollen lymphoid tissue, pinworms
Acute Appendicitis: s/s (whats the first sign) - Correct Answer 1st sign: periumbilical pain
rebound tenderness
RLQ pain (McBurney Point), N/V/D/C, Fever, Anorexia
Acute appendicitis: complication - Correct Answer Perforation w/in 48hr
Acute Appendicitis: tx - Correct Answer appendectomy
Acute Appendicitis: nursing considerations - Correct Answer be aware of danger of admin
of laxatives/enemas (during severe abdominal pain)>> stimulate bowel motility and
increase the risk of perforation
soft palpation
low intermittent gas decompression
Short Bowel Syndrome: patho - Correct Answer · Group of problems related to poor
absorption of nutrients. Cannot absorb enough water, vitamins, minerals, protein, fat,
calories, and other nutrients from food.
Short Bowel Syndrome: s/s - Correct Answer diarrhea, dehydration, foul smelling stool,
electrolyte imbalance, wt loss, ,malnourishment, FTT
Short Bowel Syndrome: complication - Correct Answer Necrotizing Enterocolitis:
increased abdominal girth , blood tinged stool, absent BS>> Surgery
Fulminant(rapid onset) sepsis: central line/TPN
PN Cholestasis (bile flow to liver slows/stops)
, Bowel Atrophy: increas. permeability of bacteria
Hepatic Dysfunction
Short Bowel Syndrome: nsg care - Correct Answer TPN>> ENteral Feed>> Oral Feed
Infection prevention: central line
Ostomy care
Diet: high fat, low carb for bacterial overgrowth and infection
Decrease secretory losses: H2 blockers, PPI
Biliary Atresia: patho, s/s - Correct Answer Atresia leads to plugging, inflammation, fibrosis
of bile canaliculi --> no drainage of bile, backs up, damages hepatocytes
jaundice, white/gray stool, hepatomegaly, bruising, dark urine. pruritis
Biliary Atresia: nsg care/meds, tx - Correct Answer Nutritional Support: give fat soluble
vitamins (ADEK)
Phenobarbitol: stimulate bile flow
Ursodeoxycholic acid: decrease cholestasis and pruritis
Surgery, Liver transplant
obstipation - Correct Answer extremely long intervals between defecation
Encopresis - Correct Answer constipation with fecal soiling( fecal incontinence)
pooping anywhere other than the toilet
Acute Gastroenteritis :nsg care - Correct Answer NO antidiarrheal or antiemetics,
Dehydration:>> F/E
