Alimentary Tract Diseases Flashcards
regurgitation vs vomiting?
regurgitation = expulsion of undigested food/liquid from oesophagus
- often shortly after eating and is a passive process
vomiting = expulsion of stomach and/or upper intestine contents
- active process involving contraction of abdominal muscles
causes, tests and treatment for regurgitation?
causes
- megaoesophagus - no muscle tone pushing food down and hard to swallow
- oesphageal FB, stricture or neoplasia
- infection/disease
- persistent right aortic arch
- myopathy/neuropathy
diagnostics
- bloods - rule out infectious disease and check organ function
- plain and barium swallow radiographs - better imaging
- endoscopy - investigate FBs/masses and take biopsies
nursing care
- medications/post-op care
- monitor hydration, vitals and weight
- observe regurgitation and record
- observe for signs of aspirational pneumonia
- small volumes of concentrated foods - eg recovery diet
- postural feeding - gravity assist
causes, tests and treatment for vomiting?
primary causes
- reaction to food/change in diet
- GI infection
- gastric ulceration/neoplasia/FB/ischaemia
secondary causes
- motion sickness
- renal/pancreas/liver disease
- causes of sepsis - eg pyometra
- pain and/or stress
diagnostics
- physical examination and clinical history
- test bloods, vomit and faeces
- ultrasound and barium swallow radiographs
- gastroscopy/ex-lap/biopsies
nursing care
- isolate and barrier nurse - until rule out infection
- monitor weight, hydration and vomit
- replace fluids and electrolytes
- diet modification - sometimes starvation
- medications - eg anti-emetics and analgesia
- clean and comfort
what is GDV?
signs, causes and diagnostics?
Gastric dilatation-volvulus
stomach dilation due to increased gas causes torsion/rotation
- so blocking entry and exit passages of stomach
- often in deep chested breeds - eg GSD
signs
- regurgitation
- traying to vomit but failing
- bloated and lethargic
- pain +++ and salivation/stress
caused often from eating and then playing/exercises soon after
diagnostics
- radiographs and ultrasound
the pathogenesis of GDV?
as the stomach rotates the distal oesophagus and intestine become twisted preventing ingesta leaving the stomach in either direction
the stomach will continue to distend putting pressure on the hepatic portal vein and distal vena cava which decreases venous return
this leads to hypovolemic shock as blood is not returned to the heart and is not available to be re-oxygenated and delivered to the tissues
blood supply to the heart is affected resulting in arrhythmias such as ventricular premature contractions
the stomach wall will also become damaged leading to toxins leaking into the blood stream
the twisting may also affect the spleen nearby causing splenic torsion and potential hemorrhage into the abdomen
treatment and nursing care for GDV?
immediate decompression
- stomach tube or percutaneous torcarisation
agressive shock fluid therapy
intravenous ABs
monitor arrythmias
corrective surgery - gastroplexy
- corrects and prevents twisting but doesnt stop dilation
post-op
- starve for 12 hours
- slowly introduce fluid diets - bland and easily digestible
- monitor and manage shock
- monitor vitals - arrhythmias and electrolytes
types of diarrhoea?
signs, effects and causes?
acute
- mild = appear bright and alert
- severe = depressed, dull and dehydrated
chronic
- causes inadequate nutrition over prolonged period of time
- so weight loss and loss of condition
both can originate from the small and/or large intestine
result in loss of fluids and electrolytes
- dehydration, electrolyte imbalance and metabolic acidosis
causes
- diet change
- bacteria/virus
- FB
- medications
what is intussusception?
signs, diagnostics, nursing care?
hypermotility of the gut (often due to diarrhoea) causing telescoping of a segment of intestine inside itself
- can compromise mesentery causing decrease blood supply to and reduced drainage of the gut
- causing rupture and bacteria build up
signs
- abdominal pain and discomfort
- can vary depending on how long ago and level of obstruction
diagnostics
- sometime palpable on exam
- ultrasound will show
nursing care
- post-op care after resection of damaged tissue
- slowly introduce fluid diets - bland and easily digestible
- monitor and manage vitals
what is gut stasis?
causes, signs and nursing care?
long-stemmed fibre from grasses and hay is broken down in caecum
- this produces volatile fatty acids and microrganisms
- this encourages gut motility
a disturbance in this causes hypomotility - gut stasis
- alters ceacal fermentation, pH and substrate production
- alters microflora population so harmful bacteria growth
- leads to hepatic lipidosis - fatty liver syndrome
causes for disturbance
- insufficient fibre in diet or sudden diet change
- stress - eg environmenral changes
- dental disease - malocclusion/molar elongation
- metabolic disease - renal/liver
- pain
- medications
signs
- depressed/lethargic
- eating less/nothing
- hunched
- may bloat
- smaller, harder, darker faecal matter
nursing care
- stress reduction - warmth/dark/quiet
- pain relief/medications
- monitor vitals
- fluid replacement
- nutritional support
- client educations
what is pancreatitis?
causes, signs, diagnostics and nursing care?
inflammation of the pancreas from self-digestion by digestive enzymes
- pancreas releases digestive enzymes
- released too soon causing digestion of the pancreas
- can be acute or chronic
exact cause unknown but predispositions include
- obesity
- high fat diet - eg table scraps
- drug therapies - eg steroids
- hypotension
clinical signs
- V+/D+ and dehydration
- weight loss and anorexia
- abdominal pain
- lethargic
- shock and collapse
diagnostics
- ultrasound to see any swelling/inflammation or blood around panc.
- bloods - check lipase/amylase and snap-test
nursing care - acute
- monitor vitals
- Nil Per Mouth until vomiting stops - avoid sight and smell of food otherwise encourages digestive enzyme production
- IVFT and electrolytes
- analgesia and anti-emetics
- slowly reintroduce low fat diet
nursing care - chronic
- palliative care as prone
- long-term dietary management - small but frequent and low-fat
- enzyme supplement with food
- monitor feacal output and weight
- client education
what is hepatic disease?
signs, diagnostics and nursing care?
disease of the liver
examples:
- hepatitis - inflammation of the liver - infection/toxins/trauma
- cirrhosis - scarring of liver causing long-term damage
signs
- will not appear until 70%+ of liver is damaged
- non-specific = D+/weight loss/anorexia/polydipsia/polyurea
- anterior abdominal pain and ascites
- jaundice
- dark urine due to increased bilirubin from RBC breakdown
- bleeding disorders from clotting factor deficiency
diagnostics
- bloods - albumin/globulin/ALT/ALKP/bile acid stim/coags
- radiography - see size/inflammation
- ultrasound - FNA and biopsy
nursing care
- IVFT
- meds - eg ABs and anti-inflammatories
- lactulose - helps bind ammonia which aids liver function
- specialist diets to reduce strain
