Exam 2: NR341 NR 341 Latest

Exam 2: NR341 / NR 341 (Latest

Update 2025 / 2026) 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

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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.

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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.

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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.

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