Adult health Nursing-I solved past paper -2015

Q1) a) define Folic acid deficiency anaemia

Folate​-​deficiency anaemia​is the lack of ​folic acid​in the blood. ​Folic acid​is a B vitamin that helps your body make red blood cells. If you don’t have enough red blood cells, you have ​anaemia​. Red blood cells carry oxygen to all parts of your body.

  1. b) write down the dietary sources of Folic acid

Good sources include:

  1. broccoli
  2. brussels sprouts
  3. leafy green vegetables, such as cabbage, kale, spring greens and spinach
  4. peas
  5. chickpeas and kidney beans
  6. liver (but avoid this during pregnancy)
  7. breakfast cereals fortified with folic acid
  8. Okra
  9. Beets
  10. Orange juice
  1. write down the importance of Folic acid in human body
    1. Helps your body form red blood cells and DNA
    2. Promotes normal growth and development
    3. May play a role in prevention of certain cancers
    4. Reduces your risk for heart attack and stroke
    5. Can Prevent some Birth Defects


Q2) a) define renal failure

Renal failure is defined as a significant loss of renal function in both kidneys to the point where less than 10 to 20% of normal GFR remains.

  1. b) difference between acute and chronic renal failure
Acute renal failure Chronic renal failure
1) Onset – over days to weeks Onset 1) Onset – over weeks to months
2) Reversibility – Invariably reversible 2) Usually Irreversible
3) Cause – Pre-renal or post-renal 3) Mostly Renal.
4) Urinary volume – Oliguria & Anuria. 4) Polyuria & Nocturia.
5) Renal failure casts – Absent 5) Renal Failure casts – Present.
6) Specific Gravity – High. 6) Specific Gravity – Low & fixed.
7) Past history of renal disease – Absent 7) Present
8) Dialysis – Required for short period 8) Required repeatedly.
9) Renal transplantation – Not required 9) Required.

Q3) a) define leukemia

Definition It is a group of malignant disorder, affecting the blood and blood –forming tissue of the bone marrow lymph system and spleen.

  1. b) discuss the sign symptoms and diagnosis of Leukemia

Common leukemia signs and symptoms include:

  1. Fever or chills.
  2. Persistent fatigue, weakness.
  3. Frequent or severe infections.
  4. Losing weight without trying.
  5. Swollen lymph nodes enlarged liver or spleen.
  6. Easy bleeding or bruising.
  7. Recurrent nosebleeds.
  1. Tiny red spots in your skin (petechiae)

Diagnosis Of Leukemia

  1. History and physical examination
  2. Clinical features
  3. Blood Examination (work up)
  4. Peripheral blood examination
  5. Chest X ray
  6. Bone marrow studies: BM biopsy, imprint and aspiration.
  7. Flow cytometry
  8. Cytological differentiation and immunophenotyping: FISH, RTPCR, chromosome analysis

Q4) a) define ovarian cyst

ovarian cyst

An ovarian cyst is a semi-solid or fluid-filled sac within the ovary.

  1. b) discuss the causes and management of ovarian cyst

Cause Ovarian Cysts

  1. Polycystic ovary syndrome (PCOS) is a condition that causes lots of small, harmless cysts to develop on your ovaries. The cysts are small egg follicles that do not grow to ovulation and are the result of altered hormone levels.

Medical Management

  1. Watchful waiting (observation):​ An ultrasound scan will be carried out about a month or so later to check it, and to see whether it has gone.
  2. Hormonal birth control pills: prevent the development of new cysts in those who frequently get them.
  3. Analgesic (Pain relievers):​such as nonsteroidal ant-inflammatory drugs, opioids analgesic.

Surgical Management

  1. Laparoscopy (keyhole surgery)
  2. Laparotomy


Q5) a) define Fluid volume excess

Fluid overload or volume overload (hypervolemia) is a medical condition where there is too much fluid in the blood. Excess fluid, primarily salt and water, builds up throughout the body resulting in weight gain.

  1. enlist the clinical manifestation and nursing management of fluid volume excess

Signs of fluid overload may include:

  1. Rapid weight gain.
  2. Noticeable swelling (oedema) in your arms, legs and face.
  3. Swelling in your abdomen.
  4. Cramping, headache, and stomach bloating.
  5. Shortness of breath.
  6. High blood pressure.
  7. Heart problems, including congestive heart failure.

Nursing Management of Fluid Volume Excess

  1. I&O and daily weights; assess lung sounds, oedema, other symptoms; monitor responses to medications- diuretics
  2. Promote adherence to fluid restrictions, patient teaching related to sodium and fluid restrictions
  3. Monitor, avoid sources of excessive sodium, including medications
  4. Promote rest
  5. Semi-Fowler’s position for orthopnoea
  6. Skin care, positioning/turning

Q6) a) define colorectal cancer

Colorectal cancer​is cancer that occurs in the colon or rectum. Sometimes it is called colon cancer

  1. b) discuss the risk factors and nursing management of colorectal cancer

Risk factors

  1. Genetics
  2. Family history
  3. Obesity
  4. Race
  5. Irritable bowel syndrome
  6. Type 2 diabetes

Nursing Management of Colorectal Cancer

1.Prevention is primary issue

2.Client teaching

3.Diet: decrease amount of fat, refined sugar, red meat; increase amount of fiber; diet high in fruits and vegetables, whole grains, legumes

4.Screening recommendations

5.Seek medical attention for bleeding and warning signs of cancer

6.Risk may be lowered by aspirin or NSAID use

Q7) write a short note on the following

1) CT scan

A computerized tomography (CT) scan combines a series of X-ray images taken from different angles around your body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside your body. CT scan images provide more-detailed information than plain X-rays do.

2) upper and lower GI endoscopies

Endoscopy is a procedure in which the gastrointestinal (GI) tract is viewed through a fiber-optic camera known as an endoscope, inserted either through the mouth (upper) to scan the oesophagus, stomach, and small intestines, or through the anus (lower) to examine the large intestine, colon and rectum.

3) ultrasound

Ultrasound is sound that travels through soft tissue and fluids, but it bounces back, or echoes, off denser surfaces. This is how it creates an image. The term “ultrasound” refers to sound with a frequency that humans cannot hear. For diagnostic uses, the ultrasound is usually between 2 and 18 megahertz (MHz).

4) barium studies

Barium studies are specialized X-ray examinations of the gastrointestinal (GI) tract such as the oesophagus, stomach, small and large intestines using a solution containing barium.

5)Biopsy (liver)

A liver biopsy is a procedure to remove a small piece of liver tissue, so it can be examined under a microscope for signs of damage or disease.