Mesenteric ischemia in the acute care setting : The Nurse Practitioner

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Mesenteric ischemia in the acute care setting

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The Nurse Practitioner 48(6):p 25-26, June 2023. | DOI: 10.1097/01.NPR.0000000000000066
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INSTRUCTIONS Mesenteric ischemia in the acute care setting


  • Read the article. The test for this CE activity is to be taken online at Tests can no longer be mailed or faxed.
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This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.5 contact hours Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states.

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Mesenteric ischemia in the acute care setting

Learning Outcomes: Seventy-five percent of participants will be able to demonstrate competency in clinical reasoning for care of patients with mesenteric ischemia in the acute care setting by achieving a posttest score of 70% or greater.

Learning Objectives: After reading the article and completing the posttest, the participant will be able to:

  1. Explain the pathophysiology of mesenteric ischemia and the differentiation between acute and chronic types.
  2. Describe clinical presentations and diagnostic testing for mesenteric ischemia.
  3. Summarize treatment strategies and required surgical referrals for different types of mesenteric ischemia based on findings from computed tomography angiogram (CTA) imaging.


  1. Which of the following vessels provides most of the blood supply to the small intestine?
    1. celiac artery
    2. inferior mesenteric artery
    3. superior mesenteric artery
  2. Chronic mesenteric ischemia is most often associated with
    1. atherosclerotic disease.
    2. malignancy.
    3. vasculitis.
  3. In patients younger than 50 years of age with a history of medical conditions or use of medications that increase the risk of thrombosis, the type of mesenteric ischemia seen most often is
    1. mesenteric arterial embolism.
    2. mesenteric arterial thrombosis.
    3. mesenteric venous thrombosis.
  4. Nonocclusive mesenteric ischemia (NOMI) occurs due to hypoperfusion from
    1. decreased arterial vascular resistance.
    2. vasoconstriction of the mesenteric arteries.
    3. vasoconstriction of the right renal artery.
  5. Which patient's clinical presentation is most suspicious for NOMI?
    1. 24-year-old patient with acute abdominal pain and vomiting
    2. 40-year-old patient with present bowel sounds and mild generalized abdominal discomfort
    3. 78-year-old patient with abdominal distension and shock of unknown etiology
  6. The gold standard for diagnosing mesenteric ischemia is
    1. abdominal ultrasound.
    2. plain abdominal radiograph.
    3. CTA of the abdomen and pelvis.
  7. A study by Calame et al. (2020) found that NOMI is more frequently associated with findings of
    1. pneumatosis intestinalis on computed tomography.
    2. less mesenteric fat stranding on computed tomography.
    3. occlusive acute mesenteric ischemia.
  8. For a patient with a clinical presentation of acute mesenteric ischemia, it is best to limit or avoid
    1. broad-spectrum antibiotics.
    2. vasopressors.
    3. unfractionated heparin.
  9. A male patient underwent CTA imaging that confirmed a diagnosis of mesenteric ischemia without peritonitis. He will not need a consult for vascular surgery because the CTA imaging results indicated a cause of
    1. arterial embolism.
    2. arterial thrombosis.
    3. mesenteric venous thrombosis.
  10. After CTA imaging, a female patient is diagnosed with NOMI with clinical signs of peritonitis. The NP consults general surgery to evaluate the patient for an emergency laparoscopy. Surgery for this situation is typically
    1. due to the need to resect necrotic bowel.
    2. associated with a very low mortality risk.
    3. associated with a morbidity and adverse event risk of 2%.
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