Exam 2: NR341 / NR 341 (Latest
Update ) Complex Adult
Health | Questions & Verified
Answers | 100% Correct | Grade A -
Chamberlain
Question:
first-line management for gastrointestinal bleeding. If this therapy fails,
surgical intervention is necessary.
Answer:
Endoscopic stasis of a bleeding vessel
Question:
reliable indicator of blood loss in the early stage of bleeding
Answer:
hematocrit
,Question:
Emergency Management of Gastrointestinal Bleeding
Answer:
Isotonic fluids are needed for volume replacement. Whole blood, packed red
blood cells, and fresh frozen plasma may also be used in massive
hemorrhages. Supplemental oxygen may be needed to maintain adequate
ventilation.
Endoscopic stasis of a bleeding vessel is the first-line management for
gastrointestinal bleeding. If this therapy fails, surgical intervention is
necessary.
During the acute phase of bleeding, proton pump inhibitors (PPI) can be used
to decrease bleeding, decrease hydrochloric acid (HCl) secretion, and
neutralize the HCl that is present. PPIs reduce acid secretion, which is
necessary to prevent altered platelet function and clot stabilization. Later,
antacids may be given to neutralize the pH of stomach contents.
Question:
The BUN is elevated in significant gastrointestinal (GI) hemorrhage
Answer:
because blood proteins are broken down by bacteria in the gut. With
controlled bleeding, the BUN will decrease.
,Question:
Esophageal Varices
Answer:
Esophageal varices are distended, engorged veins that are susceptible to
hemorrhage. They occur from cirrhosis of the liver and portal hypertension
due to chronic alcoholism. To reduce the pressure, the body creates collateral
circulation. Rupture can cause life-threatening bleeding. Treatment focuses
on reducing portal pressures.
Medications to reduce portal pressures include:
vasopressin
octreotide acetate
beta-blockers
nitrates
Treatment options:
Endoscopic ligation or banding involves the suctioning of a vein into the
chamber of the endoscope, which is then tied up with a small band. The vein
then loses its blood supply and, over time, thrombosis and fibrosis occur.
Sclerosis involves injecting an agent into the vein that causes thrombosis and
hemostasis.
Balloon tamponade uses an inflated balloon to put pressure on the varices to
stop esophageal blood flow.
If these treatments do not work, surgical intervention is necessary. A shunt
may be placed to divert blood flow and reduce portal pressures.
, Question:
Addisonian crisis or adrenal crisis
Answer:
this problem is caused by a sudden sharp decrease in adrenocortical
hormones (glucocorticoids and mineralocorticoids). If not treated quickly,
the prognosis is poor.
Addisonian crisis is triggered by:
stress (infection, surgery, emotional/ psychological)
sudden withdrawal of corticosteroid hormone therapy
adrenal surgery
sudden pituitary gland destruction
Clinical manifestations:
hypotension
tachycardia
dehydration
fever
weakness
confusion
hypoglycemia.
Life-threatening electrolyte imbalances result in hyponatremia and
hyperkalemia. Gastrointestinal symptoms occur as well, including vomiting,
diarrhea, and abdominal pain.
Severe hypotension and dehydration lead to shock and, ultimately, circulatory
collapse.
Update ) Complex Adult
Health | Questions & Verified
Answers | 100% Correct | Grade A -
Chamberlain
Question:
first-line management for gastrointestinal bleeding. If this therapy fails,
surgical intervention is necessary.
Answer:
Endoscopic stasis of a bleeding vessel
Question:
reliable indicator of blood loss in the early stage of bleeding
Answer:
hematocrit
,Question:
Emergency Management of Gastrointestinal Bleeding
Answer:
Isotonic fluids are needed for volume replacement. Whole blood, packed red
blood cells, and fresh frozen plasma may also be used in massive
hemorrhages. Supplemental oxygen may be needed to maintain adequate
ventilation.
Endoscopic stasis of a bleeding vessel is the first-line management for
gastrointestinal bleeding. If this therapy fails, surgical intervention is
necessary.
During the acute phase of bleeding, proton pump inhibitors (PPI) can be used
to decrease bleeding, decrease hydrochloric acid (HCl) secretion, and
neutralize the HCl that is present. PPIs reduce acid secretion, which is
necessary to prevent altered platelet function and clot stabilization. Later,
antacids may be given to neutralize the pH of stomach contents.
Question:
The BUN is elevated in significant gastrointestinal (GI) hemorrhage
Answer:
because blood proteins are broken down by bacteria in the gut. With
controlled bleeding, the BUN will decrease.
,Question:
Esophageal Varices
Answer:
Esophageal varices are distended, engorged veins that are susceptible to
hemorrhage. They occur from cirrhosis of the liver and portal hypertension
due to chronic alcoholism. To reduce the pressure, the body creates collateral
circulation. Rupture can cause life-threatening bleeding. Treatment focuses
on reducing portal pressures.
Medications to reduce portal pressures include:
vasopressin
octreotide acetate
beta-blockers
nitrates
Treatment options:
Endoscopic ligation or banding involves the suctioning of a vein into the
chamber of the endoscope, which is then tied up with a small band. The vein
then loses its blood supply and, over time, thrombosis and fibrosis occur.
Sclerosis involves injecting an agent into the vein that causes thrombosis and
hemostasis.
Balloon tamponade uses an inflated balloon to put pressure on the varices to
stop esophageal blood flow.
If these treatments do not work, surgical intervention is necessary. A shunt
may be placed to divert blood flow and reduce portal pressures.
, Question:
Addisonian crisis or adrenal crisis
Answer:
this problem is caused by a sudden sharp decrease in adrenocortical
hormones (glucocorticoids and mineralocorticoids). If not treated quickly,
the prognosis is poor.
Addisonian crisis is triggered by:
stress (infection, surgery, emotional/ psychological)
sudden withdrawal of corticosteroid hormone therapy
adrenal surgery
sudden pituitary gland destruction
Clinical manifestations:
hypotension
tachycardia
dehydration
fever
weakness
confusion
hypoglycemia.
Life-threatening electrolyte imbalances result in hyponatremia and
hyperkalemia. Gastrointestinal symptoms occur as well, including vomiting,
diarrhea, and abdominal pain.
Severe hypotension and dehydration lead to shock and, ultimately, circulatory
collapse.
