NSG 554 - Nurse Practitioners in Primary Care I
Exam 3
Question:
Ulcerative Colitis
Answer:
-Idiopathic inflammatory condition involving the mucosal surface of the colon -Results in diffuse friability and erosions with bleeding -Periods of symptomatic flare-ups and remission -Bloody diarrhea is hallmark ** -Severity based on stool frequency, presence & amount of rectal bleeding, cramps, abdominal pain, fecal urgency, tenesmus and extra intestinal symptoms -PE should focus on volume status (orthostatic BPs + pulse + nutrition status) -Abdominal examination look for tenderness, evidence of peritoneal inflammation; red blood may be present on digital rectal examination
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Question:
Ulcerative colitis: Mild
Answer:
< 4 stools per day < 90 HR Normal hematocrit & albumin, no weight loss, normal temperature < 20 ESR
Question:
Ulcerative colitis: Moderate
Answer:
4-6 stools per day
90-100 HR
30-40% hematocrit 1-10% weight loss 99-100 temperature
20-30 ESR
3-3.5 albumin
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Question:
Ulcerative colitis: Severe
Answer:
>6 mostly bloody stools per day >100 HR < 30% hematocrit > 10% weight loss > 100 temperature > 30 ESR < 3 albumin
Question:
Ulcerative Colitis: Signs and Symptoms - Mild to moderate disease
Answer:
-Fewer than 4-6 bowel movements/day -mild to moderate rectal bleeding -no constitutional symptoms -stools may be formed or loose -Rectal inflammation = fecal urgency & tenesmus -LLQ cramps relieved by defecation -No significant pain or tenderness -Mild anemia and hypoalbuminemia
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Question:
Ulcerative Colitis: Signs and Symptoms - severe
Answer:
-More than 6 bloody bowel movements/day -Severe anemia, hypovolemia, impaired nutrition with hypoalbuminemia -Abdominal pain/tenderness present -"Fulminant colitis" subset of severe disease characterized by rapid worsening symptoms with signs of toxicity
Question:
Diverticulitis
Answer:
-Macroscopic inflammation of a diverticulum that may reflect a spectrum from inflammation alone to micro perforation with localized paracolic inflammation to macroperforation with either abscess or vernalized peritonitis
Question:
Diverticulitis: Signs and Symptoms
Answer:
-Localized inflammation/infection= mild/moderate aching abdominal pain usually LLQ -Constipation or loose stools -Frequent N/V
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