NR511 Midterm Study Guide Worksheet
Disease Risk Subjective Finding Objective Findings Diagnostics Treatment Education
GI DISORDERS
Appendicitis -Most common -Dx made clinically, -May have HTN\tachy -Labs are not -Surgical; preoperative -F\U with surgeon
between 10-30yrs; but based primarily on proportional to diagnostic and care, NPO, correction of -Ambulation after
can occur at any age; H&P exam pain\symptoms nonspecific fluid\electrolyte surgery
rare in infants and older - Classic presentation -When lying flat, may -Women should have imbalances -Adv diet when
adults includes acute onset of flex R knee to relieve urine human -Avoid narcotics bowel sounds
-men more at risk mild to severe colicky, tension in abd muscle chorionic -Atb with 3rd gen return
- Diets low in fiber, high epigastric, or -Pain with palpation in gonadotrophin to r\o cephalosporin; Ex: -Return to hosp
in fat, refined sugars, & periumbilical pain abd, diffuse in early ectopic pregnancy ampicillin, gentamycin, with s\s of infection
other carbs at increased - Pain is vague at first stages. Localized to - +Rovsing’s Sign- flagyl -Avoid heavy lifting
risk. then localizes within RLQ later deep palpation & for at least 2 wks
- Obstruction of 24hrs to RLQ -Positive for rebound release in LLQ causes
appendix is cause of - Pain exacerbated by pain; ask pt to cough rebound pain in RLQ
majority of appendicitis walking\coughing to localize pain - +Psoas Sign- lift R
- contributing factors: - Men may feel location leg against gentle
Intra-abdominal radiated pain in testes -Sudden cessation of pressure causes pain
tumors, positive family - Abd muscle rigidity, pain means - +Obturator Sign-
hx N\V, anorexia perforation and is ER flex R hip & knee and
- Recent roundworm - Mildly elevated temp slowly rotate
infection or viral GI 99-100F common internally causes pain
infection - If RLQ accompanied - +McBurney’s Sign-
by shaking chills, pain with pressure
perforation should be applied to point
suspected between umbilicus &
- Older adults may ilium
present with - x-ray\CT helpful
weakness, anorexia, when paired with
abd distention, mild positive H&P findings
pain leading to delayed
dx and increased
morbidity.
Celiac disease ** Mostly diagnosed in Many asymptomatic. Muscle wasting Serologic testing for lifelong adherence to a teaching related to
(autoimmune adulthood. May complain of (anemia), reduces anti-tTG IgA antibody strict gluten-free diet. gluten free diet.
disorder caused by an diarrhea, gas, subcutaneous fat, Some people with
immunologic A family member with dyspepsia, wt loss. ataxia, & peripheral Total IgA (2% of pts Referral to a dietician to celiac disease have
response to gluten) celiac disease or Atypical symptoms: neuropathy (vitamin have IgA deficiency help. vitamin or nutrient
dermatitis fatigue, B12 deficiencies) and will falsely test deficiencies that do
herpetiformis bone or joint pain, osteoporosis or negative) Some pts may need not cause them to
arthritis, osteopenia (bone treatment with feel ill, such as
Type 1 diabetes osteoporosis, or loss) duodenal biopsies immunomodulating anemia due to iron
, NR511 Midterm Study Guide Worksheet
osteopenia (bone loss) hypothyroidism agents. deficiency or bone
Down syndrome or liver and biliary tract Test for nutritional loss due to vitamin
Turner syndrome disorders Pts with dermatitis deficiencies D deficiency.
(transaminitis, fatty herpetiformis found associated with However, these
Autoimmune thyroid liver, primary to have signs of celiac malabsorption of C.D. deficiencies can
disease sclerosing cholangitis, disease on intestinal (hemoglobin, iron, cause problems
depression or anxiety biopsy. folate, vit B12, over the long term.
Microscopic colitis peripheral neuropathy Calcium, and Vitamin Untreated
(lymphocytic or seizures or migraines D.) celiac/developing
collagenous colitis) missed menstrual certain types of
periods gastrointestinal
Addison's disease infertility or recurrent cancer. This risk can
miscarriage be reduced by
canker sores inside the eating a gluten-free
mouth diet.
dermatitis
herpetiformis (itchy
skin rash)
Cholelithiasis is the formation of Patient complaint of Right side involuntary Mild elevation of a. Initial management-- Nonsurgical
gallstones and is found indigestion, nausea, guarding of WBC up to 15, 000 begins with definitive intervention: weight
in 90% of patients with vomiting (after abdominal muscles, Abdominal Xray: diagnosis. When loss, avoidance of
cholecystitis. consuming meal high Positive Murphy's Quick, noninvasive, asymptomatic (normally fatty foods to
--Risk factors--2 types of in fat), and pain in RUG sign, possible palpable reliable, and cost- an incidental finding while decrease attacks,
stones (cholesterol and or epigastrium that gallbladder, Low effective means of exploring another alternative birth
pigmented) may radiate to the grade fever between identifying the problem) require no control for persons
a. Cholesterol (most middle of the back, 99-101 degrees. presence of further treatment except taking oral
common form): female, infrascapular area or Possible jaundice cholelithiasis. teaching s/sx of contraceptives,
obesity, pregnancy, right shoulder. from common bile "gallbladder attack". menopausal women
increased age, drug- duct edema and Nonsurgical candidate can taking estrogen
induced (oral diminished bowel be treated with dissolution informed about
contraceptives and sounds. therapy or lithotripsy. alternative sources
clofibrates: cholesterol Acute includes hydration of phytoestrogens
lowering agent), cystic (IV fluids), antibiotics, (soy products).
fibrosis, rapid weight analgesics, GI rest.
loss, spinal cord injury, b. Treatment of choice for
Ileal disease with Acute cholecystitis is early
extensive resection, surgical intervention after
Diabetes mellitus, sickle stabilization. Poor surgical
cell anemia. risk may benefit from
b. Pigmented: hemolytic cholecystectomy
diseases, increasing age, operatively or
hyperalimentation percutaneously.
Disease Risk Subjective Finding Objective Findings Diagnostics Treatment Education
GI DISORDERS
Appendicitis -Most common -Dx made clinically, -May have HTN\tachy -Labs are not -Surgical; preoperative -F\U with surgeon
between 10-30yrs; but based primarily on proportional to diagnostic and care, NPO, correction of -Ambulation after
can occur at any age; H&P exam pain\symptoms nonspecific fluid\electrolyte surgery
rare in infants and older - Classic presentation -When lying flat, may -Women should have imbalances -Adv diet when
adults includes acute onset of flex R knee to relieve urine human -Avoid narcotics bowel sounds
-men more at risk mild to severe colicky, tension in abd muscle chorionic -Atb with 3rd gen return
- Diets low in fiber, high epigastric, or -Pain with palpation in gonadotrophin to r\o cephalosporin; Ex: -Return to hosp
in fat, refined sugars, & periumbilical pain abd, diffuse in early ectopic pregnancy ampicillin, gentamycin, with s\s of infection
other carbs at increased - Pain is vague at first stages. Localized to - +Rovsing’s Sign- flagyl -Avoid heavy lifting
risk. then localizes within RLQ later deep palpation & for at least 2 wks
- Obstruction of 24hrs to RLQ -Positive for rebound release in LLQ causes
appendix is cause of - Pain exacerbated by pain; ask pt to cough rebound pain in RLQ
majority of appendicitis walking\coughing to localize pain - +Psoas Sign- lift R
- contributing factors: - Men may feel location leg against gentle
Intra-abdominal radiated pain in testes -Sudden cessation of pressure causes pain
tumors, positive family - Abd muscle rigidity, pain means - +Obturator Sign-
hx N\V, anorexia perforation and is ER flex R hip & knee and
- Recent roundworm - Mildly elevated temp slowly rotate
infection or viral GI 99-100F common internally causes pain
infection - If RLQ accompanied - +McBurney’s Sign-
by shaking chills, pain with pressure
perforation should be applied to point
suspected between umbilicus &
- Older adults may ilium
present with - x-ray\CT helpful
weakness, anorexia, when paired with
abd distention, mild positive H&P findings
pain leading to delayed
dx and increased
morbidity.
Celiac disease ** Mostly diagnosed in Many asymptomatic. Muscle wasting Serologic testing for lifelong adherence to a teaching related to
(autoimmune adulthood. May complain of (anemia), reduces anti-tTG IgA antibody strict gluten-free diet. gluten free diet.
disorder caused by an diarrhea, gas, subcutaneous fat, Some people with
immunologic A family member with dyspepsia, wt loss. ataxia, & peripheral Total IgA (2% of pts Referral to a dietician to celiac disease have
response to gluten) celiac disease or Atypical symptoms: neuropathy (vitamin have IgA deficiency help. vitamin or nutrient
dermatitis fatigue, B12 deficiencies) and will falsely test deficiencies that do
herpetiformis bone or joint pain, osteoporosis or negative) Some pts may need not cause them to
arthritis, osteopenia (bone treatment with feel ill, such as
Type 1 diabetes osteoporosis, or loss) duodenal biopsies immunomodulating anemia due to iron
, NR511 Midterm Study Guide Worksheet
osteopenia (bone loss) hypothyroidism agents. deficiency or bone
Down syndrome or liver and biliary tract Test for nutritional loss due to vitamin
Turner syndrome disorders Pts with dermatitis deficiencies D deficiency.
(transaminitis, fatty herpetiformis found associated with However, these
Autoimmune thyroid liver, primary to have signs of celiac malabsorption of C.D. deficiencies can
disease sclerosing cholangitis, disease on intestinal (hemoglobin, iron, cause problems
depression or anxiety biopsy. folate, vit B12, over the long term.
Microscopic colitis peripheral neuropathy Calcium, and Vitamin Untreated
(lymphocytic or seizures or migraines D.) celiac/developing
collagenous colitis) missed menstrual certain types of
periods gastrointestinal
Addison's disease infertility or recurrent cancer. This risk can
miscarriage be reduced by
canker sores inside the eating a gluten-free
mouth diet.
dermatitis
herpetiformis (itchy
skin rash)
Cholelithiasis is the formation of Patient complaint of Right side involuntary Mild elevation of a. Initial management-- Nonsurgical
gallstones and is found indigestion, nausea, guarding of WBC up to 15, 000 begins with definitive intervention: weight
in 90% of patients with vomiting (after abdominal muscles, Abdominal Xray: diagnosis. When loss, avoidance of
cholecystitis. consuming meal high Positive Murphy's Quick, noninvasive, asymptomatic (normally fatty foods to
--Risk factors--2 types of in fat), and pain in RUG sign, possible palpable reliable, and cost- an incidental finding while decrease attacks,
stones (cholesterol and or epigastrium that gallbladder, Low effective means of exploring another alternative birth
pigmented) may radiate to the grade fever between identifying the problem) require no control for persons
a. Cholesterol (most middle of the back, 99-101 degrees. presence of further treatment except taking oral
common form): female, infrascapular area or Possible jaundice cholelithiasis. teaching s/sx of contraceptives,
obesity, pregnancy, right shoulder. from common bile "gallbladder attack". menopausal women
increased age, drug- duct edema and Nonsurgical candidate can taking estrogen
induced (oral diminished bowel be treated with dissolution informed about
contraceptives and sounds. therapy or lithotripsy. alternative sources
clofibrates: cholesterol Acute includes hydration of phytoestrogens
lowering agent), cystic (IV fluids), antibiotics, (soy products).
fibrosis, rapid weight analgesics, GI rest.
loss, spinal cord injury, b. Treatment of choice for
Ileal disease with Acute cholecystitis is early
extensive resection, surgical intervention after
Diabetes mellitus, sickle stabilization. Poor surgical
cell anemia. risk may benefit from
b. Pigmented: hemolytic cholecystectomy
diseases, increasing age, operatively or
hyperalimentation percutaneously.
