NUR 2063 / NUR2063: ESSENTIALS OF PATHOPHYSIOLOGY EXAM 2 (LATEST 2024 / 2025) RASMUSSE, Exams of Nursing

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NUR 2063 / NUR2063: ESSENTIALS OF

PATHOPHYSIOLOGY EXAM 2 (LATEST 2024 /

2025) RASMUSSEN COLLEGE

What are the functions of the kidneys? Regulation of blood pressure; regulating blood osmolarity; removal of toxins; blood filtration; activate vitamin D What are the clinical manifestations of benign prostatic hypertrophy? dribbling; difficulty initiating urine stream; hesitancy; urinary retention, decreased stream What substance controls the reabsorption of water from the collecting ducts? ADH- Anti Diuretic Hormone What is type 2 diabetes characterized as? peripheral tissue insulin resistance What are the clinical manifestations of Graves' disease? Exophthalmos (bulging eyes), goiter, enlarge thyroid, heat intolerance, anxiety- hyperthyroidism What processes occur during fasting? glucogenesis; glycogenesis What type of tissue is accessed to promote energy production in type 1 diabetes? adipose/ fat What are the clinical manifestations of hypothyroidism? myxedema, fatigue, cold sensitivity, constipation, weight gain What are the clinical manifestations of hyperthyroidism? Goiter, fatigue, weight loss, infertility, memory loss, hair loss, muscle pain What are the clinical manifestation of hyper para thyroidism? fatigue, body aches, bone pain, depression, headaches, memory loss What are the clinical manifestations of hypo para thyroidism? numbness, tetany, parathesis, muscle spasms What are the clinical manifestations of ketoacidosis? fruity breath, drowsiness, nausea, thirst, confusion, lethargy, vomiting

What mechanisms control hormone release and regulation? negative feedback loop What hormones are released by the anterior pituitary gland? Growth Hormone, prolactin, follicle stimulating hormone, thyroid stimulating hormone, LH, ACTH and endorphins What is diabetes insipidus? a disorder caused by inadequate amounts of ADH which causes excessive water loss clinical manifestations of diabetes insipidus polyuria, nocturia, continuous thirst, and polydipsia clinical manifestations of Cushings syndrome? Excessive secretion of cortisol causes redistribution of fat, "moon face", "buffalo" hump on the back and pendulous abdomen. - Facial skin is flushed (high blood pressure), skin covering abdomen develops stretch marks - • ndividual bruises easily and wound healing is poor - Approximately 1/2 develop mental status changes from irritability to severe psychiatric disturbance - Females may experience changes due to increased androgen levels clinical manifestations of secondary hypothyroidism Weakness. - Fatigue. - Cold intolerance. - Constipation. - Weight gain. - Depression. - Joint or muscle pain. - Brittle fingernails. clinical manifestations of primary hypothyroidism fatigue. - lethargy.

• sensitivity to cold.

• depression. - muscle weakness. clinical manifestations of primary aldosteronism hypertension and hypokalemia clinical manifestations of secondary aldosteronism High blood pressure. - Low level of potassium in the blood. - Feeling tired all the time. - Headache. - Muscle weakness. - Numbness. What is myxedema? severe hypothyroidism; non pitting edema What are the causes of hypothyroidism? Hashimoto's disease: most common when the immune system attacks the thyroid cells
• after surgical or radioactive treatment for hyperthyroidism
• head or neck radiation for cancer
• iodine deficiency What are the three p's in diabetes? polydipsia, polyuria, polyphagia What is the difference between primary and secondary endocrine disorders? Primary endocrine disease inhibits the action of downstream glands, malfunction of the hormone producing gland; Secondary endocrine disease is indicative of a problem with the pituitary gland. What is the cause of Cushing syndrome? Excessive corticosteroids What is acute gastritis? Transient inflammation of the gastric mucosa What is chronic gastritis? Chronic mucosal inflammatory changes leading to atrophy and intestinal metaplasia. This is mostly due to H. Pylori, but in some cases it can be autoimmune. What causes gastritis?

Acute - circulatory disturbances (shock) and exposure to exogenous irritants (drugs [aspirin], alcohol, chemicals, lactose intolerance) Chronic

• cause is unknown is probably mediated by immunologic mechanism or related to infection with H. pylori What is amenorrhea? - absence of menstruation What is metrorrhagia? - bleeding between periods What is dysmenorrhea?
• painful periods Costal vertebral angle (CVA) angle formed by the 12th rib and the vertebral column on the posterior thorax, overlying the kidney; percuss for kidney tenderness What causes flank pain? kidney stones When is enuresis abnormal? after age 5 People with polycystic kidney disease should do what? increase fluid intake, measure blood pressure regularly What is polyuria? frequent urination Female Mutilation risks for uti, trouble urinating What hormone causes bleeding during menopause? estrogen Where does exchange occur in the kidneys? As the filtered fluid moves along the tubule, the blood vessel reabsorbs almost all of the water, along with minerals and nutrients your body needs. The tubule helps remove excess acid from the blood. The remaining fluid and wastes in the tubule become urine. What increases the risk for bladder cancer? smoking What is the kidney filtration path? Bowmans capsule>proximal tubule>loop of henle>distal tubule What causes increase in glumerial filtration? increase capillary hydrostatic pressure What is cystitis?

inflammation of the urinary bladder; UTI, painful burning, itching, What is a hydrocele? Fluid collection within the tunica vaginalis What are the symptoms of prositis? pain, fever, trouble urinating, trouble with urine retention What is renal colic? kidney stone related pain What is the bacteria associated with syphilis? anaerobic spirochetes What are complications of syphilis? vascular problems, cardiovascular, aortic stenosis, inflamed aorta, aorta necrosis, brain aneurysm, blindness, numbness, tingly, loopyness What end periods? anorexia, menopause, pregnancy, hypothyroidism, adenomas and carcinomas When is RAS activated? low BP Treatment for herpes Acyclovir, sitz bath, dry heat symptoms of post streptococcal glomerulonephritis dark urine What causes acromegaly? excessive GH during adulthood Primary hypothyroidism levels low T4, high TSH Secondary hypothyroidism levels low T3, T4 and TSH What is gigantism? hypersecretion of GH in children What is diabetes insipidus? a disorder caused by inadequate amounts of ADH which causes excessive water loss What is SIADH? syndrome of inappropriate antidiuretic hormone; too much sodium secretion What is the tumor of the adrenal gland? Pheochromocytoma Acromegaly/Gigantism

coarse facial features, deepening of voice, increased ring or shoe size Graves disease unexplained weight loss, goiter, bulging eyes Myexdema coma is associated with hyperthyroidism false Patient with dysmenorrhea assess pain in pelvic area and upper thighs What is the sign of acute prostatitis? tender prostate CVA is pain is another description for flank pain? True A client has flank pain of 6 on a scale from 0-10. This flank pain is likely because of what reason? possible pyelonephritis, with inflammation and stretching of renal caps Which is indicative of secondary hypothyroidism? Low TSH and LOW T3/T What is indicative of primary hypothyroidism? High TSH and Low T3/T What are the two stress hormones that increase glucose production in the liver? Corticosteroids

• catecholamines A client presents with right lower abdominal pain and occasional diarrhea. This is likely? Appendicitis A female arrives at the clinic complaining of bleeding between menstrual periods. The nurse identifies this as? Metrorrhagia A good explanation for myxedema in thyroid deficiency is? Lack of thyroid hormone contributes to non- pitting edema An example of a genetic defect in young children with cystitis is? Vesicoureteral reflux Diabetes insipidus is caused from?

too little ADH production Helicobacter pylori (H.pylori) is often a cause of? peptic ulcer disease In response to a respiratory infection and a high fever, the kidney tubules maintain a normal ph of body fluids by? secreting acids and reabsorbing bicarbonate ions Metabolic acidosis develops with bilateral kidney disease for what reason? tubule exchanges are impaired The client has gallstones obstructing the cystic duct. What would the nurse anticipate in the assessment of the client? severe upper right quadrant pain The glomerular filtration will increase by which of the following? increase hydrostatic pressure in the glomerular capillaries Cardinal signs of pheochromocytoma? hypertension The nurse expects which of the following in an assessment of a client with ketoacidosis? deep fast respirations and lethargy The nurse is aware that cushings syndrome is caused by which of the following? hypercortisolism What causes Hirschsprung Disease? inadequate innervation of the colon What would the nurse expect to assess in a client with Addisons disease? severe fatigue, muscle joint pain, nausea, vomiting, abdominal pain, darkening areas of the skin Which of the following results from obstruction of the left ureter by a renal calculus? severe renal colic What are the clinical manifestations of appendicitis? right lower abdominal pain, nausea and occasionally diarrhea What is the cause of pseudomembranous colitis?

overgrowth of Clostridioides difficile (C difficile) bacteria; overexposure to antibiotics What is the nonpharmacologic treatment for pseudocolitis? fecal transplant, colectomy, antibiotics What is the cause of Helicobacter pylori (H. pylori)? bacteria spread from person to person; bacteria penetrates the stomach mucous lining and generates substances to neutralize stomach acids What are the clinical manifestations of gastric carcinoma? No early signs; later signs are anorexia weight loss and GI bleeding What causes gastroenteritis due to Salmonella? Raw or under cooked chicken or eggs What are complications of a perforated gallbladder? Sepsis infection What causes jaundice? Increased serum bilirubin over 2.5 mg/dL What disease is associated with jaundice? Cirrhosis of the liver; hepatitis What is dysphasia? difficulty swallowing What is occult blood? Blood that is not visible to the naked eye What should patients with newly diagnosed pancreatitis avoid? Alcohol What causes greenish- yellow emesis? Bile What is the most frequent location of peptic ulcers? proximal duodenum What types of hepatitis increase the risk of hepatocellular carcinoma? Hep B and C What are the clinical manifestations of chronic gastritis? inflammation of the stomach lining and anorexia from not eating What types of things put a patient at risk for developing acute gastritis? lactose intolerance, regular use of pain relievers, stress, excessive alcohol use What are the clinical manifestations of acute gastritis?

GI distress, bloat, , nausea, vomiting, anorexia from not eating, postprandial discomfort What is the cause of hiatal hernia? Increased intra-abdominal pressure, such as ascites, pregnancy, obesity, chronic straining or coughing What is the cause of a rigid abdomen in peritonitis? inflamed peritoneum What is cryptorchidism? undescended testes What are complications of cryptorchidism? infertility and cancer What are the clinical manifestations of acute prostatitis? dysuria, frequency, urgency, painful prostate What is a complication of removing too much fluid during dialysis? hemodialysis, low BP What would you monitor while removing fluid during dialysis? BP What are the clinical manifestations of pyelonephritis? CVA tenderness, fever, chills, N/V, anorexia which increases fever induced dehydration Individuals with HPV are at risk for developing what disease? Cervical cancer What is enuresis? bed wetting What is stress incontinence? Leakage with increased abdominal pressure, effort, exertion, sneezing, or coughing What is micturition? urination What is overflow incontinence? Leakage due to inability of the bladder to empty itself correctly (thus causing bladder to fill up to max capacity) caused by a urethral blockage What is a genetic defect in young children with cystitis?

vesicoureteral reflux; back flow of urine from the bladder to the ureter and renal pelvis How do kidney tubules maintain a normal pH in response to fever and respiratory infection? secrete acid and reabsorb bicards Why does metabolic acidosis occur? excessive production of fixed acids;

• DKA
• lactic acidosis
• low flow states
• loss of buffers, like loss of bicarb from GIT or
• inability of kidney to eliminate acids; ie. renal failure What is the serum marker ordered when screening fro prostate cancer? PSA- Prostate specific antigen What are complications of hydronephrosis? ischemia and necrosis; swelling and build-up of fluid in the kidney; back flow, swelling pressure What is the cause of increased glomerular filtration rate? increase in the glomerular capillary hydrostatic pressure What is the most common cause of pyelonephritis? E. coli; ascending UTI What are the risk factors for developing chronic renal failure? too much Nsaids, chronic kidney disease; diabetes type 1; hypertension What are the three stages of AKI presentation?
• Prodromal
• Oliguric
• post-oliguric Causes of chronic kidney disease
• Outcome of progressive and irrevocable loss of functional nephrons.
• Due to kidney not recovering
• Can lead up to end-stage renal disease (ESRD) which requires dialysis

Risk Factors of chronic kidney disease

• Diabetes
• Hypertension
• Recurrent pyelonephritis
• Polycystic kidney disease
• History of exposure to toxins
• Age over 65
• Ethnicity (African American male higher risk) complications of chronic kidney disease
• hypertension and cardiovascular disease
• uremic syndrome
• metabolic acidosis
• electrolyte imbalances
• bone and mineral disorders

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malnutrition anemia

• pain
• depression Hypertension and cardiovascular disease
• (increased blood volume) Hypervolemia, escalated atherosclerotic process Uremic Syndrome
• Can't get rid of normal metabolic waste Retention of metabolic wastes, impaired healing, pruritusm dermatitis, and uremic frost (itching & discomfort) . Metabolic acidosis
• Retention of acidic waste products, hyperkalemia Electrolyte Imbalances
• Retained potassium (hyperkalemia), phosphorus, and magnesium Bone and mineral disorders Elevated phosphorus and PTH causes altered bone/mineral metabolism. Kidneys are unable to reabsorb calcium (body steals calcium from parts of the body) Malnutrition
• Decreased intake, depression, and dietary limitations (Decreased salt, protein and potassium) Anemia
• Lack of erythropoietin (produces new RBC), uremia shortens RBCs life Pain
• Many reasons; disease itself, treatment, comorbidities Depression
• Comorbid conditions; disease itself; disruption of social interactions and relationships Urge Incontinence
• Sudden need to void with an involuntary leakage of urine If it happens at night (nocturia) it is called overactive bladder Stress Incontinence

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Small amounts of urine are voided involuntarily when there is an increase in intraabdominal pressure. (More common in women following childbirth; Can occur with coughing, sneezing and lifting heavy objects) Neurogenic bladder From a disruption of nervous communication that controls micturition. Seen in individuals with stroke, Parkinson's, MS, and spinal cord injuries. Functional Incontinence

• Secondary to physical or environmental limitations such as not getting to the toilet in time. Mixed Incontinence
• A combination of both stress and urge incontinence More common in elderly women Overflow Incontinence
• When the bladder becomes full and overflows (Due to something physically blocking; NOT from holding urine) Cystitis (UTI)
• Inflammation of the bladder lining due to E. coli from infections, chemical irritants or stones. General S/S of Cystitis (UTI)
• frequency, urgency, dysuria, suprapubic pain, and cloudy urine S/S of Cystitis (UTI) in Children
• fever, irritability, poor feeding, vomiting, and diarrhea. S/S of Cystitis (UTI) in older adults - delirium and new onset incontince. . Patient teachings to prevent cystitis
• Urinate before and after sexual intercourse
• Wipe front to back
• Take antibiotics as prescribed

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Increase fluid intake Do not resist urge to urinate What can happen if cystitis does not resolve?

• It can lead up to kidney infections. . Benign Prostatic Hyperplasia (BPH)
• Enlargement of prostate gland S/S of Benign Prostatic Hyperplasia (BPH)
• Decreased stream, Hesitancy (difficulty initiating stream), and infection caused by retention. Hydrocele
• Fluid collection progressively surrounding the testicle or spermatic cord causing swelling by evening. Testicular Torsion (Primarily in prepubertal males)
• Twisting of the spermatic cord with compromised vascular supply and ischemia, followed by infarction.
• Can cut off blood supply & lead up to necrosis and ischemia Endometriosis
• Endometrial tissue outside the lining of the uterine cavity, abnormal tissue implant (endometrioma) S/S of Endometriosis
• Dysmenorrhea (painful menses), pain w/ intercourse, pain w/ defecation, & pain begins 5 to 7 days before menses and lasts for 2 to 3 days. Uterine Prolapse
• Prolapse (sinking) of the uterus from its normal position into the vagina S/S of Uterine Prolapse
• Depends on the severity of prolapse, discomfort in walking/sitting, difficulty urinating, vaginal discomfort, and bleeding. S/S of Pelvic Inflammatory Disease (PID)
• Abdominal tenderness, pelvic pain, purulent (thick and mucus) vaginal discharge and fever. which organisms/viruses contribute to pelvic inflammatory disease (PID)?

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Neisseria gonorrhoeae and chlamydia trachomatis which organisms/viruses contribute to cervical cancer?

• Human Papillomavirus (HPV) which organisms/viruses contribute to UTIs?
• E. coli which organisms/viruses contribute to syphilis?
• Treponema pallidum which organisms/viruses contribute to herpes?
• HSV- 2 Incubation phase (syphilis)
• 10 to 90 days Primary phase (syphilis) begins with formation of chancre
• Painless, ulcerative lesion at original portal of entry
• Female- may go unnoticed
• Men- chancre on genitalia
• Resolves spontaneously within 3 to 6 weeks Secondary Stage(syphilis)
• Low-grade fever, sore throat, & mucosal or cutaneous rash Latent phase(syphilis)
• No symptoms present, contagious, can last 40 years, & two thirds remain asymptomatic. Late phase(syphilis)
• Final, destructive phase of disease; cardiovascular and CNS at risk for damage, blindness and paresis. What organ systems is most affected by syphilis?
• vascular system What are the five stages of syphilis?
• Incubation, primary, secondary, latency and Late Pregnancy Induced Hypertension (PIH) 0.5% To 8% pregnancies Rapid rise in arterial blood pressure associated with the loss of large amounts of protein in the urine (proteinuria)

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• Pre-eclampsia- HBP during pregnancy . S/S of Pregnancy Induced Hypertension (PIH)
• Edema, renal failure, liver malfunction, extreme hypertension, arterial spasm in kidneys, brain, and liver, and decreased renal flow and GFR. Hyperemesis Gravidarum
• Excessive vomiting during pregnancy - 0.3% to 2% pregnancies . S/S of Hyperemesis Gravidarum
• Severe vomiting, electrolyte imbalances (loss of potassium) and hepatic/renal damage which can lead up to death if not corrected. What is the concern with chlamydial infection during labor/delivery?
• The mother can infect the infant during labor/delivery. Dwarfism
• decreased GH secretion that results in a short stature and delayed puberty; cells are not effective
• May be due to congenital, tumors, radiation or trauma to head. S/S of dwarfism
• Growth below third percentile, irregular setting of permanent teeth, thin hair, poor nail growth, delayed puberty, and decreased muscle mass. Gigantism
• Occurs in childhood before the skeletal epiphyses closes (before bones fuse: length growth).
• May grow to 8ft if left untreated Acromegaly
• Occurs in adults after skeletal epiphyses close (after bone fuses; width growth) - Only portions of the body are affected. Diabetes Insipidus Due to decrease or lack of ADH production
• Low ADH, Low water in body HIGH UO, Polyuria

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• High sodium (hyponatremia)
• High H&H and serum osmolality (increased concentration of solutes in blood) from dehydration S/S of Diabetes Insipidus
• Dizziness, disorientation, nausea, rapid heart rate (due to hypovolemia), and headaches Risk of Diabetes Insipidus
• Hypovolemic shock Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) Body produces too much ADH
• High ADH, water intoxication
• LOW UO, oliguria
• Low sodium (dilutional) S/S of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) - edema, weight gain, and hyponatremia (can lead up to cerebral edema due to the cells swelling from hyponatremia) What is Antidiuretic Hormone (ADH)?
• Also known as somatostatin; regulates water balance in body and keeps water in body (water retention). What is What is Antidiuretic Hormone (ADH) also known as?
• Somatostatin What electrolyte is most affected by disorders of ADH production?
• Sodium Review the differences between hypothyroidism and hyperthyroidism.
• The difference between Hyperthyroidism and Hypothyroidism is that hypothyroidism is due to an autoimmune issue while hyperthyroidism is due to autoantibodies binding and stimulating TSH receptors. Hyperthyroidism Abnormally elevated calcium levels in blood due to excess PTH.
• Most commonly caused by graves' disease (autoantibodies bind and stimulate TSH

receptors).

• Thyromegaly (enlargement of thyroid), exophthalmos (bulging of eyes), lid lag, vision changes, and photophobia. Thyromegaly
• enlargement of thyroid exophthalmos
• bulging of eyes S/S of Hyperthyroidism Insomnia, restlessness, tremor, palpitations, heat intolerance, diaphoresis, diarrhea, and amenorrhea (scant menses). . Hypothyroidism
• most commonly caused by autoimmune thyroiditis
• Iodine deficiency (needed for T3/T4 formation) S/S of Hypothyroidism
• Lethargy, cold intolerance, bradycardia, weight gain, dry skin, constipation, difficulties with concentration/memory, loss of hair, and menstrual irregularities. What labs can be drawn to determine if an individual is suffering from a thyroid disorder?
• T3, T4, and TSH hormone What is parathyroid hormone (PTH)?
• Increases calcium levels in blood Which electrolyte is primarily affected by PTH disorders?
• Calcium What's another name for Cushing's syndrome?
• hypercortisolism Cushing's syndrome (hypercortisolism)
• caused by excessive glucocorticoids and a pituitary tumor or tumor of the adrenal cortex S/S of Cushing's syndrome
• Hyperglycemia, loss of muscle and bone, excess water and salt retention, weight gain, hypertension, edema, swollen moon face (rounding of face) and redistribution of fat to the abdomen and the posterior neck (buffalo hump) What is another name for Addison's disease?

• adrenocortical insufficiency . Addison's disease (adrenocortical insufficiency)
• due to not enough steroid being produced; adrenocortical insufficiency, decreased glucocorticoid levels (usually decreases cortisol); due to autoimmune condition or removal of adrenal glands; sudden withdrawal from corticosteroid therapy S/S of Addison's disease (adrenocortical insufficiency)
• Weight loss, weakness, hyperpigmentation (bronzing) of skin, hypoglycemia, and hyperkalemia. Type I diabetes mellitus
• Diagnosed in young children/adolescents
• Autoimmune disorder- beta cells in pancreas destroyed
• Unable to produce insulin Type II diabetes mellitus Most common form of DM
• Cells become resistant to insulin, decrease insulin receptors on target cells (unable to bind to target cells.) - Overtime insulin production by pancreas decreases signs and symptoms of hypoglycemia
• Dizziness, Sweating, Hunger, Irritability or moodiness, Anxiety or nervousness, and Headache Hyperglycemia
• High levels of sugar/glucose in blood; hot & dry sugar high Hyperglycemia S/S
• Dry mouth, increased thirst, blurred vision, frequent urination, weakness, and headache Hypoglycemia
• Low levels of sugar/glucose in blood; cold & clammy=candy Hypoglycemia S/S
• Sleepiness, sweating, pallor, irritability, and hunger signs and symptoms of hyperglycemia

• hypertension, cardiovascular disease, stroke, retinopathy (loss of vision), diabetic neuropathy (losing sensation in nerves), and nephropathy (kidney damage) What are the three Ps?
• Polyuria - increased urination
• Polydipsia - increased thirst
• Polyphagia - increased hunger Polyuria
• increased urination . Polydipsia
• increased thirst . Polyphagia
• increased hunger Diabetic ketoacidosis Occurs in Type I DM; continued insulin deficiency leads to lipolysis of body.
• Metabolism of fats leads to free fatty acids (FFA)
• FFAs are transformed into ketones, leading to ketoacidosis. S/S of Diabetic ketoacidosis
• Deep, labored respirations (Kussmaul respirations) due to the body trying to get rid of extra CO2, acetone (fruity) breath odor, polyuria, polydipsia, polyphagia, dehydration, and hypovolemia. Why does Diabetic ketoacidosis occur?
• due to the FFAs transforming into ketones Which person is most prone to develop nephrolithiasis? One with A. dehydration B. an exercise routine C. hypotension D. a nephroblastoma A patient develops kidney dysfunction from hemorrhage. Which type of kidney injury will be documented on the chart? A. Prerenal kidney injury B. Postrenal kidney injury

C. Intrinsic kidney injury D. Intrarenal kidney injury A patient has acute tubular necrosis and is in the oliguric phase. Which laboratory finding is of greatest concern to the nurse? A. Hyponatremia B. Hyperkalemia C. Hypernatremia D. Hypokalemia An 83-year-old patient is confused, anxious, lethargic, and has no appetite. Which of the following conditions may be responsible? A. Bladder cancer B. Cystitis C. Nocturnal enuresis D. Ureterolithiasis-Cystitis Which of the following laboratory results are consistent with diabetes insipidus? A. Decreased serum osmolality, increased urine osmolality B. Hypernatremia and low serum levels of ADH C. Elevated serum calcium, decreased serum phosphorus D. High serum GH levels A patient has a low cortisol level from autoimmune destruction of the adrenal gland. Which diagnosis will the nurse observe documented on the chart? A. SIADH B. Diabetes insipidus C. Cushing syndrome D. Addison disease A patient with type 1 diabetes mellitus is pale, has tremors, and is diaphoretic. What does the nurse suspect the patient is experiencing? A. Hypoglycemia B. Hyperglycemia C. Nonketotic Hyperglycemic Hyperosmolar Syndrome (NHHS) D. Diabetic ketoacidosis

Esophageal cancer is a complication of which of the following GI conditions? A. peptic ulcer disease B. GERD C. ulcerative colitis D. Crohn's disease Colectomy and fecal transplant are treatments for which of the following conditions? A. ulcerative colitis B. Intussusception C. gallstones D. pseudomembranous colitis (C DIFF) two thirds of all pancreatitis cases are due to gallstones TRUE OR FALSE

• FALSE; It's due to alcohol Proteinuria is a classic symptom of which group of disorders? A. gastritis B. pituitary disorders C. glomerulopathies D. diabetes Which of the following is NOT a symptom in individuals w/ acute glomerulonephritis following β hemolytic strep infection? A. coffee-colored urine B. decreased urine output C. increased GFR D. edema Causes of postrenal kidney injury include all of the following EXCEPT A. stone obstructing a ureter B. enlarged prostate C. bladder tumor D. hypotension . All of the following are causes of intrinsic/intrarenal failure EXCEPT

A. hypovolemia B. methamphetamine C. contrast dye D. prolonged postrenal failure Pain that begins 5 to 7 days before the peak of menses may be due to which of the following? A. pelvic inflammatory disease B. endometriosis C. Hyperemesis gravidarum D. syphilis Symptoms of this disorder include copious amounts of dilute urine, hypovolemia and hypernatremia (serum) A. SIADH B. Diabetes mellitus C. diabetes insipidus D. Cushings syndrome Type I diabetes is typically the result of insulin resistance and decreased presence of insulin receptors on cells TRUE OR FALSE - FALSE; It's due to an autoimmune disorder; commonly hashimotos Common signs and symptoms of gastrointestinal disorders as a whole

• Pain
• Nausea
• Vomiting
• Diarrhea
• Constipation . Gastritis
• Inflammation of the stomach lining Causes of Gastritis

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Precipitated by ingestion of irritating substances (Ex. alcohol and aspirin, NSAIDs, viral, bacteria, & autoimmune) GERD

• Backflow of gastric contents into esophagus through lower esophageal sphincter (LES) (Due to a problem with sphincter) Causes To GERD increases abdominal pressure, fatty foods, caffeine, large amounts of alcohol, cigarette smoking, & pregnancy What are complications of GERD if left untreated?
• it can cause cellular changes leading up to esophageal cancer (Barrett esophagus) and the individual can develop pulmonary symptoms (cough, asthma, and laryngitis: from reflux in breathing passages) peptic ulcer disease S/S
• Epigastric burning pains, gastric ulcers, duodenal ulcer and GI bleeding. What is the role of H. pylori in peptic ulcer disease?
• The role of Pylori is that it promotes both gastric and duodenal ulcer formation. It thrives in acidic conditions causing slow rates of ulcer healing and a high rate of recurrence. pseudomembranous colitis
• A highly contagious acute inflammation and necrosis of large intestine What contributes to pseudomembranous colitis?
• Caused by Clostridium difficile (c.diff is kept in check by other bacteria in our system but due to exposure to antibiotics the other bacteria cannot keep it in check.) pseudomembranous colitis Treatment
• Stop current antibiotic (if possible)
• Oral antibiotics - metronidazole or vancomycin
• Recurrence common
• Fecal transplant - transfer of fecal material from another healthy person to the source patient via enema or gastric tube
• Colectomy - removal of portion of colon (remove disease portion)

Ulcerative Colitis Chronic inflammatory disease of the mucosa of the rectum and colon.

• Associated with increased cancer risk after 7 to 10 years of disease
• Have exacerbations and remissions
• Bloody diarrhea (only difference between ulcerative colitis and crohn's disease)
• Treatment: Corticosteroids (mainstay for acute), Broad spectrum antibiotic, Immunomodulating agents (Azathioprine or Mercaptopurine); used in severe cases Crohn's Disease (regional enteritis or granulomatous colitis) - Chronic inflammation of the colon or terminal ileum. Chron's disease S/S
• Intermittent bouts of fever, diarrhea (with or without blood)
• Treatment: Alleviating and reducing inflammation (NO CURE) Appendicitis
• Inflammation of the vermiform appendix Appendicitis S/S
• Periumbilical pain, RLQ pain "McBurney's point", nausea, vomiting, fever, diarrhea, RLQ tenderness, systemic signs of inflammation. How do we assess for Appendicitis?
• Rebound tenderness between the belly button and hip bone. . Causes of bowel obstructions
• previous abdominal surgery w/ adhesions, congenital abnormalities of bowel (born with), and metastatic carcinoma. Mechanical obstruction
• Something is physically blocking movement of material. Ex. Adhesions (tissue cells fused and stuck), hernia, tumors, impacted feces, volvulus (twisting of intestine), and intussusception (intestines collapse into themselves). Functional Obstruction
• Due to change in movement Ex. Conditions inhibiting peristalsis such as certain medications (anticholinergics; stimulate flight or fight response), opioids and low fiber diets.