Block 1: End of Life Pathophys Flashcards
What is the difference between nausea and vomiting?
Nausea: unpleasant sensation that can precede vomiting
Vomiting: neuromuscular reflex that results in forceful expulsion of gastric contents
Vomiting to lead to ___?
- dehydration
- Electrolyte deficits
- Metabolic alkalosis from loss of gastric acid
- Fatigue from decreased caloric intake
What stimulates nausea and vomiting?
- Brain and abdominal organs signal stomach to launch lunch
- Bloodborne molecules and sensory impulses stream → emetic center of the medulla
- Chemoreceptor trigger zone
What is the the CTZ?
Area of the medulla oblongata that receives inputs from bloodborne drugs or hormones and communicates with the vomiting center to initiate vomiting.
What is emetic response?
Transmission of neural impulses by one of four pathways
What are the pathways of the emetic response?
- Stimuli originating in the cerebral cortex and vestibular system (direct)
- Stimuli from the GI tract and blood (indirect)
- Efferent motor and parasympathetic neural impulses
How do you diagnose nausea and vomiting?
- Examination of abdomen (distention, inaudible bowel sounds, tenderness)
- Potential causes (GI motility changes, obstruction)
- Neurologic and eye examinations
What are the treatments for constipation?
Laxatives
What are the treatment fo GI stasis?
Prokinetic agents
What are the treatment for bowel obstruction?
Octreotide
What are the treatments for GI infection?
Antimicrobial agents
What are the the treatments for gastric irritation?
histamine receptor antagonists, proton pump inhibitors (PPIs)
What are the treatments for inflammation from tumor or intracranial pressure?
corticosteroids
What med should be avoided with GI disorders?
NSAIDs
What are the types of anti nausea and antiemetic?
- Dopamine (D2) receptor antagonists
- Serotonin (5-HT3) receptor antagonists
- Histamine (H1) receptor antagonists
- Muscarinic (M1) receptor antagonists (Anticholinergics)
