GI part 2

Question 1

S&S of GI disease

Answer 1

N&V
anorexia
cachexia
constipation
dysphagia
achlasia
heartburn/indigestion

Question 2

N&V complications

Answer 2

• dehydration
• fluid & electrolyte imbalance
• pulmonary aspiration of vomitus
• mucosal tear at gastroesophageal jxn
• rupture of esophagus
• malnutrition

Question 3

anorexia

Answer 3

diminished appetite

can result in heart disease, renal disease, hypokalemia, hypotension, OH

Question 4

cachexia

Answer 4

loss of muscle mass and body weight - CA
hypermetabolic, high sympathetic drive 
high pro degradation
involuntary wt loss
malnutrition

Question 5

constipation causes

Answer 5

dehydration
inactivity
acute/chronic disease 
lesions or structure abnormalities
defecatory disorders

Question 6

dysphagia

Answer 6

difficulty swallowing

Question 7

achlasia

Answer 7

failure of smooth mm fibers to relax

lower esophageal spincter failures to relax/open when needed

Question 8

heartburn/indigestion

Answer 8

burning sensation in esophagus

Question 9

types of abdominal pain

Answer 9

mechanical
inflammatory
referred
ischemic

Question 10

mechanical abdominal pain

Answer 10

stretching of wall or hollow organ or capsule of solid organ

Question 11

inflammatory abdominal pain

Answer 11

occurs by release of histamines

stimulates sensory nerves

Question 12

ischemic abdominal pain

Answer 12

metabolites are released in the area of the ischemia resulting the generation of pain

Question 13

S&S of bleeds

Answer 13

hematemesis
hematochezia
melena

Question 14

hematenesis

Answer 14

vomiting of blood
red: injury in esophageal
coffee grinds: coagulated blood, injury in stomach

Question 15

hematochezia

Answer 15

blood in stool
injury in lower colon or rectum
can lead to hemorrhoids

Question 16

melena

Answer 16

passing of dark, tarry stool

caused by bleeding from any intestinal site

Question 17

implications for PTs on GI disease

Answer 17

body fluid loss - diarrhea, vomiting
electrolyte imbalance
hypovolemia –> OH, tachycardia, pallor

Question 18

what is most commonly seen in older adults

Answer 18

constipation
incontinence 
diverticular disease
decreased taste bud fxn
decreased salivary secretions
loss of smooth muscle tone = slow gastric emptying

Question 19

diseases of esophagus

Answer 19

dysphagia
pain
bleeding
hiatal hernia

Question 20

hiatal hernia

Answer 20

upper portion of stomach protrudes into the chest cavity through an opening of diaphragm

Question 21

symptoms of hiatal hernia

Answer 21

GERD

Question 22

what should pts avoid with hiatal hernia

Answer 22

avoid valsalva maneuver in supine position, coughing, vomiting, straining or sudden physical exertion

Question 23

GERD

Answer 23

• inflammation of esophagus secondary to retrograde flow to gastric juices
• painful
• LES not working

Question 24

PT implication with GERD

Answer 24

• dont treat directly after a meal = heartburn
• avoid supine position
• nocturnal reflex = sleep on L side with pillow
• avoid vigorous activity
• elevate head of bed

Question 25

gastritis

Answer 25

- inflammation of protective lining of stomach mucosa - can be acute or chronic - not a stomach ulcer

Question 26

symptoms of gastritis

Answer 26

- epigastric pain - loss of appetite - heart burn - asymptomatic or symptoms associated with eating - hematemesis

Question 27

PT implications for gastritis

Answer 27

- know which pts are on stomach injuring drugs - know how much they are taking - be alert for symptoms

Question 28

PT implications with ulcers

Answer 28

- monitor symptoms - monitor NSAID use - pay attention to older aging adults - signs of bleeding = SP < 100, HR > 100, or a >10 drop in DP with position change

Question 29

diarrhea & dysentery

Answer 29

increase in stool mass, fq. of fluidity

Question 30

PT implication for diarrhea & dysentery

Answer 30

excess loss of water = dehydration

Question 31

colorectal carcinomas

Answer 31

asymptomatic for years

Question 32

what test, if done properly, stop the continuation of a growing colorectal tumor

Answer 32

colonoscopy

Question 33

PT implications for colorectal tumors

Answer 33

- hx of corticosteroid treatment - impaired posture - removal of lymph nodes - metastasis to prostate, lungs, liver

Question 34

peritonitis

Answer 34

- inflammation of the serous membrane lining walls of the abdominal cavity - high mortality rate - painful

Question 35

peritonitis creates what

Answer 35

severe systemic effects --> respiratory problems leading to fluid and electrolyte imbalance