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ABSN NUR 326 > Week 5: GI Problems > Flashcards

Week 5: GI Problems Flashcards

1
Q

What is considered upper GI?

A

esophagus, stomach and beginning of small intestine

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2
Q

What is considered lower GI?

A

small intestine, colon, rectum and anus

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3
Q

What are common upper GI problems?

A

Esophageal = GERD and hiatal hernia
Stomach = gastritis, acute gastroenteritis, and PUD

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4
Q

What is GERD?

A

backflow of gastric acid from the stomach into the esophagus, occurs at the lower esophageal sphincter

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5
Q

Etiology of GERD

A

anything that alters closure strength of the lower esophageal sphincter OR increases abdominal pressure

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6
Q

S/S of GERD

A

heartburn, dyspepsia, regurgitation, chest pain. dysphagia, and pulmonary symptoms

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7
Q

Complications of GERD

A

ulceration, scarring, strictures, and Barrett esophagus (development of abnormal metaplastic tissue)

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8
Q

What is a hiatal hernia?

A

a defect in the diaphragm that allows part of the stomach to pass through the thorax

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9
Q

What the two main types of hiatal hernias?

A
  1. sliding hernia
  2. paraoesophageal hernia
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10
Q

Need to know about sliding hernia

A

usually small and don’t need surgery

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11
Q

What is the patho of a paraoesophageal hernia?

A

part of the stomach pushes through the diaphragm and stays there

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12
Q

Patho for a hiatal hernia?

A

exact cause unknown. Can occur from damage to the diaphragm, or by repeatedly putting too much pressure on the muscle around the stomach (severe coughing, vomiting, straining for a BM)

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13
Q

S/S of a hiatal hernia

A

asymptomatic, belching, dysphagia, chest or epigastric pain

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14
Q

Treatment for hiatal hernia

A

Mostly a conservative treatment of teaching, but surgery may be necessary

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15
Q

What teachings go along with having hiatal hernias?

A

small, frequent meals, avoid lying down after eating, avoid tight clothes, weight control, and antacids to alleviate GERD symptoms

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16
Q

What is acute gastritis?

A

TEMPORARY inflammation of the stomach lining only, lasts 2-10days

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17
Q

Etiology of acute gastritis

A

irritating substance (alcohol), NSAIDs, and infectious agents

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18
Q

What is chronic gatritis?

A

Progressive disorder with inflammation that lasts weeks to years

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19
Q

Complications of chronic gastritis

A

PUD, bleeding, ulcers, anemia, and gastric cancers

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20
Q

What are the 2 main etiologies of chronic gastritis?

A

autoimmune = attacks parietal cells
H. pylori infection

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21
Q

What is H. pylori?

A

Helicobacter pylori bacterium, causing destructive pattern of persistent inflammation

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22
Q

How is H. pylori transmitted?

A

person to person via saliva, fecal or vomit
contaminated food or water

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23
Q

S/S of acute or chronic gastritis

A

sometimes none, anorexia, V/V, postprandial discomfort, intestinal gas, hematemesis, tarry stools, anemia

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24
Q

What is acute gastroenteritis?

A

inflammation of stomach AND small intestine

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25
Etiology of gastroenteritis?
Viral infections = norovirus, rotavirus Bacterial infections= E. col, salmonella, campylobacter Parasitic infection
26
S/S of gastroenteritis
watery diarrhea (sometimes bloody) , abdominal pain, N/V, fever, malaise
27
Complications of gastroenteritis
fluid volume deficits
28
What is peptic ulcer disease (PUD)
ulcerative disorder that effects the esophagus, stomach, and duodenum
29
Etiology of PUD
H. pylori, injury causing substances (NSAIDs, ASA, and alcohol), smoking, family hx, and stress (increased stress causing increased gastric juices)
30
r/f for NSAID induced PUD
age, higher doses of NSAIDs, history of PUD, use of corticosteroids and anticoagulants, serious system disorders, and H. pylori infection
31
Patho of PUD
-mucosa is damages, histamine is secreted resulting in an increase in acid and pepsin secretion -vasodilation causing edema -if blood vessels are destroyed there will be bleeding
32
what is the most common type of PUD?
duodenal ulcer
33
S/S of a PUD
sometimes none, N/V, anorexia, weight loss, bleeding, burning pain (in the mid of abdomen usually worse when stomach is empty)
34
What is the main clinical difference between gastric and duodenal PUDs?
the duration before pain starts after eating. gastric= 1-2 hrs after eating duodenal= 2-4 hrs after eating
35
PUD complications
"HOP" hemorrhage, obstruction, perforation and peritonitis
36
What are the lower GI disorders?
appendicitis, peritonitis, irritable bowel disorder, Inflammatory bowel disorders (Chron's UC), diverticulosis/diverticulitis
37
What is appendicitis?
inflammation of the appendix
38
Etiology of appendicitis
appendix is obstructed causing inflammation
39
Complications of appendicitis
gangrene, abscess formation, and peritonitis
40
What is peritonitis?
inflammation of peritoneum (serous membrane that lines abdominal cavity)
41
Pain with appendicitis
RLQ in periumbilical area, rebound pain (severe pain after release of palpation), sudden pain relief is NOT good (indicative of rupture)
42
What happens to the peritoneum during peritonitits?
inflammation, fluid shifts (3rd spacing), decreased peristalsis
43
Complication of peritonitis
paralytic ileus and intestinal obstruction
44
What causes peritonitis?
perforated ulcer, ruptured gallbladder, pancreatitis, ruptured spleen, ruptured bladder, and ruptured appendix
45
S/S of peritonitis
sudden and sever abdominal pain and tenderness, rigid "board-like" abdomen, N/V, fever, increased WBC, tachycardia, and hypotension
46
What is IBS?
chronic condition characterized by alterations in bowel pattern due to changes in motility
47
S/S of IBS
vary by individual -abdominal distension, fullness, flatus, and bloating -intermittent abdominal pain, relieved after BM -food intolerance -non bloody stools that may contain mucous
48
What exacerbates IBS?
STRESS, food, hormone changes, GI infections, and menstruations
49
What are the two inflammatory bowel disease
Chron's disease and ulcerative colitis
50
R/F for inflammatory bowel disease
women, Caucasians, Jewish descent, and smokers
51
What is the pathogenesis of Crohn's disease?
lymph structures of the GI tract are blocked causing tissue to become engorged and inflamed. This leads to deep linear fissures and ulcers developing
52
Complications of Chron's disease
malnutrition, anemia, scar tissue, obstruction, fistula, and cancer
53
S/S of Crohn's disease
crampy RLQ, watery diarrhea, palpable RLQ mass, mouth ulcers, S/S of fistulas, weight loss, fatigue, anorexia, fever, malabsorption
54
What is Ulcerative Colitis (UC)?
inflammation of the mucosa of the rectum and colon
55
R/F for UC
white people, third decade of life (lol), Ashkenazi Jewish decent Rare in Asians
56
Pathogenesis of UC
Inflammation begins in the rectum and extends in a continuous segment that may involve the entire colon. The inflammation leads to large ulcerations and necrosis that can lead to abscesses Colon and rectum try to repair the damage with new granulation tissue
57
What is crypt abscesses?
abscesses that result from necrosis of epithelial tissue
58
What is the problem with "new granulation tissue"?
tissue is fragile and bleeds easily
59
S/S of UC
abdominal pain, bloody diarrhea, weight loss, fatigue, no appetite, fever
60
Complications of UC
hemorrhage, perforation, cancer, malnutrition, anemia, strictures, fissures, abscesses, toxic mega-colon, colorectal cancer, liver disease, and F&E imbalances
61
What is diverticulosis's pathogenesis?
development of diverticula, which are small pouches in lining of the colon that bulge outward though the weak spots
62
Diverticulosis can be?
congenital or acquired
63
What is thought to be the cause of diverticulosis?
low fiber diet with resulting chronic constipation
64
Where does diverticulosis typically occur?
descending colon
65
S/S of diverticulosis
usually asymptomatic, discovered accidentally or with acute diverticulitis
66
What is diverticulitis?
inflammation of one or more of the diverticula (pouches)
67
S/S of diverticulitits
abdominal pain (LLQ), fever, increased WBC, constipation or diarrhea, passing frank blood
68
Complications of diverticulitis
perforation, peritonitis, and obstruction

ABSN NUR 326 (10 decks)

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