NR 576 Final Exam Review Latest Update -

NR 576 Final Exam Review Latest Update - 50 Questions with 100% Verified Correct Answers Guaranteed A+ Verified by Professor

• Describe how to perform a

Tinnel test - CORRECT ANSWER: Purpose: Assess for compression neuropathy

Procedure: Percuss the median nerve at the wrist. If the patient complains of tingling in the digits (POSITIVE TINEL SIGN), compression at the site of percussion is likely.

• Discuss common characteristics (objective findings) of patients with lumbar spinal

stenosis - CORRECT ANSWER: - Muscle weakness

• Impaired proprioception
• Diminished reflexes
• Sensory changes (numbness/tingling)
• Bowel or bladder symptoms
• Sphincter tone decreased
• Don't confuse w/ prostate problems in older men

Acute appendicitis - CORRECT ANSWER: Inflammation of the vermiform appendix; due to obstruction or infection Most common surgical emergency of the abdomen Hollow tube - most common cause is obstruction of appendix Fecaltih - hard lump of fecal matter Undigested seeds Pinworm infections 1 / 3

Lymphoid follicle growth/lymphoid hyperplasia Symptoms

• Symptoms

Nausea/vomiting RLQ pain Guarding

Acute appendicitis diagnostics - CORRECT ANSWER: Diagnosis is made clinically and based on history and physical Elevated WBC Mild Fever, 99-100 RLQ pain/McBurneys point CT abd may help rule out other diagnostic possibilities ABD ultrasound helps to visualize the inflamed appendix

Acute appendicitis treatment - CORRECT ANSWER: • Appendectomy

• Antibiotic • Drain abscesses • Can be removed prophylactically

Acute cholecystitis - CORRECT ANSWER: Inflammation of gallbladder (GB)

Usually due to gallstone in cystic duct

• Cystic duct - leaves gall bladder & connects to common bile duct

Symptoms Patient will have mid-epigastric pain Because GB is still squeezing, increasing pressure w/ nowhere for bile to go Can lead to nausea/vomting Stone can get more stuck w/ more squeezing 2 / 3

Bile starts to irritate mucosa Mucosa starts to produce mucous and inflamm enzymes Leads to inflammation, distention, pressure build up Bacterial growth (E. coli, enterococci, bacteroides fragilis, colstriduim) As GB "balloons", pain shifts to RUQ, R scapula/shoulder Bacteria invades in & through GB wall, into peritoneum, causing peritonitis Rebound tenderness Murphy's Sign = Put pressure on right side under ribs. This will hold GB in place. Have patient take a deep breath. The diaphragm will push on the GB & a painful response = Cholecystitis Immune response Neutrophilic leukocytosis Fever

Acute cholecystitis diagnostics - CORRECT ANSWER: US confirmed

Detects stones Sonographic murphy sign Tenderness when sonogram is over gallbladder GB wall thickening Sludge Distention of GB or common bile duct Cholescintigraphy (HIDA scan) Radiolabeled marker used to visualize the biliary system Acute cholecys - ducts are blocked, GB can't be seen Endoscopic Retrograde Cholangiopancreatography (ERCP) Endoscope down to pancreas Dye injected & viewed via fluoro Magnetic Resonance Cholangiopancreatography (MRCP)

• / 3