Packet 12 - GI System (2)

Question 1

Inadequate amounts of digestive secretions (r/t inflammation/injury, autoimmune conditions).

a. ) GERD b.) Appendicitis
c. ) Peritonitis d.) Acute Pancreatitis
e. ) Gastritis / Ulcers f.) Malabsorption
g. ) Peptic Ulcer Disease h.) Ulcerative Colitis
i. ) Crohn Disease / Regional Enteritis

Answer 1

f.) Malabsorption / Malnutrition

Inadequate amounts of digestive secretions (r/t inflammation/injury, autoimmune conditions).

Question 2

Obstruction or twisting of appendix. The appendix becomes enflamed, and can become gangrenous / necrotic. The appendix can burst, causing bacteria to leak out.

a. ) GERD b.) Appendicitis
c. ) Peritonitis d.) Acute Pancreatitis
e. ) Gastritis / Ulcers f.) Malabsorption
g. ) Peptic Ulcer Disease h.) Ulcerative Colitis
i. ) Crohn Disease / Regional Enteritis

Answer 2

b.) Appendicitis

Obstruction or twisting of appendix.

The appendix becomes enflamed, and can become gangrenous / necrotic.

The appendix can burst, causing bacteria to leak out.

Question 3

Inflammation of intestines that primarily affects the colon and rectum (large intestine), and also usually affects the mucosal layer of the GI wall. Has an ulcerative inflammatory process (mucosal inflammation → abscess → ulceration). Has continuous lesions. (type of IBD)

a. ) GERD b.) Appendicitis
c. ) Peritonitis d.) Acute Pancreatitis
e. ) Gastritis / Ulcers f.) Malabsorption
g. ) Peptic Ulcer Disease h.) Ulcerative Colitis
i. ) Crohn Disease / Regional Enteritis

Answer 3

h.) Ulcerative Colitis

Type of inflammatory bowel disease (IBD)

inflammation of intestines, characterized by remissions and exacerbations of diarrhea, fecal urgency, and weight loss.

• Affects primarily colon and rectum (large intestine).
• Usually affects mucosal layer of GI wall.
• Pathophysiology: ulcerative inflammatory process
  
  • ​Mucosal inflammation → abscess → ulceration.
  • Continuous lesions.

Assessment Findings:

• Diarrhea
• Bleeding / mucous in diarrhea
• Abdominal pain / cramping

P/C Factors:

• Cause unknown: possibly autoimmune problem.
• Possible heriditary predisposition.
• Possible psychogenic factors.

Interventions:

1. Anti-inflammatory drugs.
   
   • No NSAIDs
2. immunosuppressants / corticosteroids.
3. Surgical treatment.
4. Ostomy bag (ileostomy.
5. Nutritional support.

Question 4

Weak / incompetent esophageal sphincter.

a. ) GERD b.) Appendicitis
c. ) Peritonitis d.) Acute Pancreatitis
e. ) Gastritis / Ulcers f.) Malabsorption
g. ) Peptic Ulcer Disease h.) Ulcerative Colitis
i. ) Crohn Disease / Regional Enteritis

Answer 4

a.) GERD

Weak / incompetent esophageal sphincter.

Heartburn → Acid Reflux

If chronic:

• inflammation
• tissue damage
• scar tissue
• dysphagia (trouble swallowing)
• metaplasia
• displasia

Question 5

Bacterial invasion or chemical irritation of peritoneum (r/t perforatior or trauma of abdominal organs). Severe pain that is aggrivated by movement. Patient is laying still, trying not to move. Patient takes shallow breaths because deep breathing causes movement that aggrivates the pain. Tensing of abdominal muscles to prevent movement. When palpating, you feel board-like rigidity. Also when palpating, the patient will feel pain when you lift up (rebound tenderness).

a. ) GERD b.) Appendicitis
c. ) Peritonitis d.) Acute Pancreatitis
e. ) Gastritis / Ulcers f.) Malabsorption
g. ) Peptic Ulcer Disease h.) Ulcerative Colitis
i. ) Crohn Disease / Regional Enteritis

Answer 5

c.) Peritonitis

Bacterial invasion or chemical irritation/inflammation of peritoneum (r/t perforatior or trauma of abdominal organs).

Severe pain that is aggrivated by movement.

Patient is laying still, trying not to move.

Patient takes shallow breaths because deep breathing causes movement that aggrivates the pain.

Tensing of abdominal muscles to prevent movement.

When palpating, you feel board-like rigidity.

Also when palpating, the patient will feel pain when you lift up (rebound tenderness).

Question 6

Inflammation of intestines that primarily affects the small and/or large intestine, and also usually affects all layers of the GI wall. Has a granulomatous inflammatory process (inflammation → edema and granulomas in submucosa, surrounded by fissures / linear ulcers (“cobblestone appearnace”). Has skip lesions and possibly fistulas. (type of IBD)

a. ) GERD b.) Appendicitis
c. ) Peritonitis d.) Acute Pancreatitis
e. ) Gastritis / Ulcers f.) Malabsorption
g. ) Peptic Ulcer Disease h.) Ulcerative Colitis
i. ) Crohn Disease / Regional Enteritis

Answer 6

i. ) Crohn Disease / Regional Enteritis
* Type of inflammatory bowel disease (IBD)*

inflammation of intestines, characterized by remissions and exacerbations of diarrhea, fecal urgency, and weight loss.

• Affects small and/or large intestine
  
  • ​small is more common
• Can involve all layers of GI wall
  
  • submucosal layer is most affected
• Pathophysiology: granulomatous inflammatory process
  
  • inflammation → edema and granulomas in submucosa, surrouned by fissures / linear ulcers (“cobblestone” appearance)
  • “Skip lesions”
  • Possible fistulas

Assessment Findings:

• Diarrhea (fluid / e^- imbalances)
• Cramping / colicky pain (right lower quadrant)
• Inflammation
• Abdominal abscess
• Fistula (passageway that connects)

P/C Factors:

• Cause unknown: possibly autoimmune problem.
• Possible heriditary predisposition.
• Possible psychogenic factors.

Interventions:

1. Anti-inflammatory drugs.
   
   • No NSAIDs
2. immunosuppressants / corticosteroids.
3. Surgical treatment.
4. Ostomy bag (ileostomy.
5. Nutritional support.

Question 7

Breaking of “mucosal barrier.” Inflammation of gastric mucosa. Acids/peptin irritate lining causing inflammation.

a. ) GERD b.) Appendicitis
c. ) Peritonitis d.) Acute Pancreatitis
e. ) Gastritis / Ulcers f.) Malabsorption
g. ) Peptic Ulcer Disease h.) Ulcerative Colitis
i. ) Crohn Disease / Regional Enteritis

Answer 7

e.) Gastritis / Ulcers

Breaking of “mucosal barrier.”

Inflammation of gastric mucosa.

Question 8

Leakage/activation of pancreatic enzymes in pancreas caused by biliary tract disease (reflux, obstruction r/t to gallstones) or alcohol abuse (stimulates pancreatic secretion and edema/partial obstruction of ducts).

a. ) GERD b.) Appendicitis
c. ) Peritonitis d.) Acute Pancreatitis
e. ) Gastritis / Ulcers f.) Malabsorption
g. ) Peptic Ulcer Disease h.) Ulcerative Colitis
i. ) Crohn Disease / Regional Enteritis

Answer 8

d.) Acute Pancreatitis

Leakage/activation of pancreatic enzymes in pancreas caused by:

1. biliary tract disease (reflux, obstruction r/t to gallstones) or
2. alcohol abuse (stimulates pancreatic secretion and edema/partial obstruction of ducts)

Question 9

Ulcerative disorder in areas of GI tract exposed to acid-pepsin secretions (stomach and duodenum). P/C factors include H. pylori (can colonize epithelial cells of stomach and disrupt barrier) & NSAIDS (direct mucosal injury causes a decrease in GI prostaglandins, which then causes decreased blood flow, and decreased bicarp and mucus production.

a. ) GERD b.) Appendicitis
c. ) Peritonitis d.) Acute Pancreatitis
e. ) Gastritis / Ulcers f.) Malabsorption
g. ) Peptic Ulcer Disease h.) Ulcerative Colitis
i. ) Crohn Disease / Regional Enteritis

Answer 9

g.) Peptic Ulcer Disease (PUD) - Gastric & Duodenal Ulcers

Ulcerative disorder in areas of GI tract exposed to acid-pepsin secretions (stomach and duodenum).

Assessment Findings:

• Epigastric pain
• Occurs @ night (when stomach is empty)
• in between meals (when stomach is empty)
• Bleeding (anemia)
• Perforation → penetrate all 3 walls → peritonitis
• Obstruction

P/C factors:

• H. pylori (can colonize epithelial cells of stomach and disrupt barrier)
• NSAIDS (direct mucosal injury causes a decrease in GI prostaglandins, which then causes decreased blood flow, and decreased bicarp and mucus production.

Interventions:

1. If H. pylori → antibiotics
2. Meds that decrease acidity (med is in paste form)
3. Avoid things that will trigger ulcers (NSAIDs, smoking, avoid alcohol)