Ch.19 Gastro/urologic Flashcards
1
Q
The study of how normal physiologic processes are affected by disease
A
Pathophysiology
2
Q
Solid organs include the
A
Liver, spleen, pancreas, kidneys, and ovaries(in women).
3
Q
Solid masses of tissue where much of the chemical work of the body takes place(eg, the liver, spleen, pancreas, and kidneys)
A
Solid organs
4
Q
Structures through which materials pass, such as the stomach, small intestines, large intestines, ureters, and urinary bladder
A
Hollow organs
5
Q
Technically, organs such as the kidneys, ovaries, and the pancreas are ____(behind the peritoneum). Because they lie next to the peritoneum, they can cause abdominal pain.
A
Retroperitineal
6
Q
Definition
Behind the abdominal cavity
A
Retroperitoneal
7
Q
The membrane lining the abdominal cavity (parietal peritoneum) and covering the abdominal organs(visceral peritoneum)
A
Peritoneum
8
Q
An injury to a __ organ can cause shock and bleeding because of the amount of blood vessels contained in the organ
A
Solid organ
9
Q
Hollow organs include the
A
Gallbladder, stomach, small intestine, large intestine, and urinary bladder
10
Q
The __ system is responsible for the digestion process
A
The GI system
11
Q
Definition
The processing of food that nourishes the individual cells of the body
A
Digestion
12
Q
___ begins when food is put into the mouth and chewed; the salivary glands secrete saliva and begin to break down the food, then it is swallowed. The food travels down the esophagus to the stomach. The stomach is the main organ of the digestive system.
A
Digestion
13
Q
Absorption of nutrients occurs at various places along the digestive tract. Sugars start to be absorbed while in the mouth. Most digestion takes place in the __, where gastric juice break down food to a form that can be used by the body
A
Stomach
14
Q
The __ secretes bile, which aids in the digestion of fats. The _ also filters toxic substances produced by digestion, creates glucose stores, and produces substances necessary for blood clotting and immune function.
A
The liver
15
Q
A large, solid organs that lies in the right upper quadrant immediately below the diaphragm; it produces bile, stores glucose for immediate use by the body, and produces many substances that help regulate immune responses
A
Liver
16
Q
The __ is a hollow pouch located beneath the liver that acts as a reservoir for bile
A
The gallbladder
17
Q
A sac on the undersurface of the liver that collects bile from the liver and discharges it into the duodenum through the common bile duct
A
Gallbladder
18
Q
From the stomach, food travels down into the __, which consists of three sections: the duodenum, jejunum, and the ileum.
A
Small intestine
19
Q
The portion of the digestive tube between the stomach and the cecum, consisting of the duodenum, jejunum, and ileum
A
Small intestine
20
Q
The __ is where digestive juices from the pancreas and liver mix together
A
The duodenum
21
Q
The pancreas secretes juice containing __ that help break down starches, fats, and proteins.
A
Enzymes
22
Q
__, which breaks down starches into sugar, is one enzyme the pancreas secretes
A
Amylase
23
Q
The pancreas also produces bicarbonate, insulin, and glucagon. __ neutralizes the stomach acid in the duodenum. __ and __ help regulate the levels of glucose in the bloodstream
A
Bicarbonate
Insulin and glucagon
24
Q
A hormone produced by the islets of Langerhans(endocrine gland located throughout the pancreas) that enables glucose in the blood to enter cells; used in synthetic form to treat and control diabetes mellitus
A
Insulin
25
The_, the next part of the small intestine, plays a major role in the absorption of digestive products. The__ comprises a large amount of the surface area of the small intestine and does much of the work.
jejunum
26
The final part of the small intestine is the_, which absorbs the remaining nutrients. It also absorbs bile acids so they can be returned to the liver for future use and vitamin B12, for making nerve cells and red blood cells.
ileum
27
The portion of the digestive tube that encircles the abdomen around the small bowel, consisting of the cecum, the colon, and the rectum. It helps regulate water balance and eliminate solid waste
Large intestine
28
The food that was not broken down and used as nutrients then moves into the __, or large intestine, as waste products. A wavelike contraction of smooth muscle called peristalsis moves the waste matter through the intestines. Water is absorbed and stool is formed. The stool passes through the rectum to the anus, where it is defecated
Colon
29
The wavelike contraction of smooth muscle by which the ureters or other tubular organs propel their contents
Peristalsis
30
Definition
The lowermost end of the colon
Rectum
31
The_ is also located in the abdomen but has no digestive system function. The__ is part of the lymphatic system and plays a significant role in relation to red blood cells and the immune system. It assists in the filtration of blood, removes old red blood cells, recycles iron, and serves as a blood reservoir. The__ also produces antibodies to help the body fight off disease and infection.
spleen
32
A passive circulatory system in the body that transports a plasmalike liquid called lymph, a thin fluid that bathes the tissues of the body
Lymphatic system
33
The male reproductive system consists of the
Testicles, epididymis, vasa deferentia, seminal vesicles, prostate gland, and penis
34
Storage sacs for speem and seminal fluid, which empty into the urethra at the prostate
Seminal vesicles
35
A small gland that surrounds the male urethra where it emerges from the urinary bladder; it secretes a fluid that is part if the ejaculatory fluid
Prostate gland
36
The female reproductive system includes the
Ovaries, fallopian tubes, uterus, cervix, and vagina
37
The primary female reproductive organs that produce an ovum, or egg, that, if fertilized, will develop into a fetus
Ovaries
38
The tubes that connect each ovary with the uterus and are primary location for fertilization of the ovum
Fallopian tubes
39
The muscular organ where the fetus grows; also called the womb; responsible for contractions during labor
Uterus
40
The lower third, or neck, of the uterus
Cervix
41
The outermost cavity of a womans reproductive tract; the lower part of the birth canal
Vagina
42
The urinary system controls the discharge of certain waste materials filtered from the blood by the __
Kidneys
43
In the urinary system, the kidneys are __ organs, and the ureters, bladder, and urethra are __ organs
Solid
Hollow
44
Two retroperitoneal organs that excrete the end products of metabolism as urine and regulate the bodys salt and water content
Kidneys
45
The canal that conveys urine from the bladder to outside the body
Urethra
46
Ordinarily, the urinary and genital systems are referred to jointly as the_ system because they share many organs. One system can directly affect the other. For example, if the prostate gland in the male genital system enlarges, then the urethra will narrow, impairing emptying of the bladder, and eventually leading to urinary retention.
genitourinary system
47
The urinary system lies in the __ space behind the organs of the digestive system
Retroperitoneal
48
The body contains two_, one on each side, which lie on the posterior muscular wall of the abdomen behind the peritoneum in the retroperitoneal space. The__ play an important role in the regulation of the acid-base balance (the body's pH) and blood pressure. Blood pressure regulation is associated with the__ ability to remove sodium chloride from the body.__ disease is a common cause of secondary hypertension. Most patients with chronic__ disease also have hypertension. The__ also rid the body of toxic wastes and control the body's balance of fluid and electrolytes. Blood flow in the__ is high. Nearly 20% of the output of blood from the heart passes through the__ each minute. Large vessels attach the__ directly to the aorta and the inferior vena cava. Waste products and water are constantly filtered from the blood to form urine. The__ continuously concentrate this filtered urine by reabsorbing the water as it passes through a system of specialized tubes within them. The tubes eventually unite to form the renal pelvis, a cone-shaped collecting area that connects the ureter and the_.
kidneys
49
A cone-shaped area that collects urine from the kidneys and funnels it through the ureter into the bladder
Renal pelvis
50
A ureter passes from the renal pelvis of each kidney along the surface of the posterior abdominal wall behind the peritoneum to drain into the urinary bladder. The ureters are small (0.2 inch in diameter), hollow, muscular tubes.__ occurs in these tubes to move the urine to the bladder.
Peristalsis
51
The urinary bladder is located immediately behind the__ in the pelvic cavity and is composed of smooth muscle with a specialized lining membrane. The two ureters enter posteriorly at its base on either side. The bladder empties to the outside of the body through the urethra. In the male body, the urethra passes from the anterior base of the bladder through the penis. In the female body, the urethra opens at the front of the vagina. The healthy adult forms 1.5 to 2 liters of urine every day, which is held in the urinary bladder until it is excreted through the urethra.
pubic symphysis
52
A hard, bony, and cartilaginous prominence found at the midline in the lowermost
portion of the abdomen where the two halves of the pelvic ring are joined by
cartilage at a joint with minimal motion.
Pubic symphysis
53
The abdominal cavity is lined by a membrane called the
Peritoneum
54
The __ peritoneum lines the walls of the abdominal cavity, and the __ peritoneum covers the organs themselves
Parietal
Visceral
55
The abdominal space normally contains a small amount of peritoneal fluid to bathe and lubricate the organs in the abdominal cavity. Any foreign material, such as blood, pus, bile, pancreatic juice, or amniotic fluid, can cause irritation of the peritoneum, called_.
peritonitis
56
Definition
Inflammation of the peritoneum
Peritonitis
57
A condition of sudden onset of pain within the abdomen, usually indicating peritonitis; immediate medical or surgical treatment is necessary
Acute abdomen
58
Peritonitis typically causes__, or paralysis of the muscular contractions that normally propel material through the intestine. The retained gas and feces, in turn, cause abdominal distention. Distention usually begins after the muscular contractions cease. In the presence of such paralysis, nothing that is eaten can pass normally out of the stomach or through the bowel. In this situation, the only way the stomach can empty itself is by emesis, or vomiting. For this reason, peritonitis is frequently associated with nausea and vomiting. These symptoms do not point to a particular cause because they can accompany almost every type of gastrointestinal disease or injury.
ileus
59
Paralysis of the bowel; arising from any one of several causes; stops contractions that move material through the intestine
ileus
60
__can be associated with a loss of body fluid into the abdominal cavity. The loss of fluid usually results from abnormal shifts of fluid from the bloodstream into body tissues. This fluid shift decreases the volume of circulating blood and may lead to decreased blood pressure or even shock. The patient may have normal vital signs or, if the__ has progressed further, the patient may present with tachycardia and hypotension. When__ is accompanied by hemorrhage, the signs of shock are much more apparent.
Peritonitis
61
Fever may or may not be present, depending on the cause of the peritonitis. Patients with__ (inflammation in small pockets at weak areas in the muscle walls of the intestines) or__ (inflammation of the gallbladder) may have a substantial elevation in body temperature. However, patients with acute appendicitis may have a temperature within normal limits until the appendix ruptures and contaminates the peritoneal cavity.
diverticulitis
cholecystitis
62
Inflammation in small pockets at weak areas in the muscle walls of the intestines
Diverticulitis
63
Inflammation of the gallbladder
Cholecycstitis
64
Abdominal pain can have different qualities be use two different types of nerves supply the peritoneum. The _ and _
Nerves from the spinal cord and the autonomic nervous system
65
The nerves from the spinal cord that supply the skin of the abdomen also supply the__ peritoneum. Therefore, the__ peritoneum and the skin of the abdomen can perceive much the same sensations: pain, touch, pressure, heat, and cold. These sensory. nerves can easily identify and localize a point of irritation.
parietal
66
In contrast, the__ peritoneum is supplied by the autonomic nervous system. These nerves are far less able to localize sensation. This means that your patient will not be able to describe exactly where the pain is located. The__ peritoneum is stimulated when distention or contraction of the hollow abdominal organs activates the stretch receptors. Patients sometimes describe itlas a deep pain. Other painful sensations that occur because of an irritated__ peritoneum may be perceived at a distant point on the surface of the body, such as the back or shoulder. This phenomenon is called referred pain.
visceral
67
Pain felt in an area of the body other than the area where the cause of pain is located
Referred pain
68
__is the result of connections between the body's two separate nervous systems. The nerves connecting the somatic nervous system and autonomic nervous system cause the stimulation of the autonomic nerves to be perceived as stimulation of the spinal sensory nerves. For example, acute cholecystitis may cause pain in the right shoulder because the autonomic nerves serving the gallbladder lie near the spinal cord at the same anatomic level as the spinal sensory nerves that supply the skin of the shoulder
Referred pain
69
Acute __ causes referred pain in the right shoulder as well as in the abdomen
Cholecystitis
70
Localization of pain
Right lower quadrant (direct); around navel (referred); rebound tenderness (pain felt on the rebound after palpation)
Appendicitis
71
Localization of pain
Right upper quadrant (direct); right shoulder (referred)
Cholecysititis
72
Localization of pain
Upper midabdomen or upper part of back
Ulcer
73
Localization of pain
Left lower quadrant
Diverticulitis
74
Localization of pain
Low part of back and lower quadrants
Abdominal aortic aneurysm (ruptured or dissecting)
75
Localization of pain
Lower midabdomen (retropubic)
Cystitis (inflammation of the bladder)
76
Localization of pain
Costovertebral angle
Kidney infection
77
Localization of pain
Right or left flank, radiating to genitalia
Kidney stone
78
Localization of pain
Upper abdomen (both quadrants); back
Pancreatitis
79
Localization of pain
Anywhere in the abdominal area
Hernia
80
Localization of pain
Diffuse abdominal pain area
Peritonitis
81
Almost any problem with an abdominal organ can cause an acute abdomen. Some of the more common causes are discussed here. It is rare for the EMT to determine the exact cause. Because the__ peritoneum is usually irritated first, early abdominal pain tends to be vague and poorly localized. As the parietal peritoneum becomes irritated, pain becomes more severe and may be more specifically located.
visceral
82
The stomach and duodenum are subjected to high levels of acidity. To prevent damage to these organs, protective layers of mucus line both organs. In_, the protective layer is eroded, allowing the acid to eat into the organ itself over the course of weeks, months, or even years.
peptic ulcer disease (PUD)
83
The watery secretion of the mucous membranes that lubricates the body openings
Mucus
84
Definition
An abrasion of the stomach or small intestine
Peptic ulcer disease
85
Most___ are the result of infection of the stomach with Helicobacter pylori bacteria. Another major cause is chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. Alcohol and smoking can also affect the severity of PUD by increasing gastric acidity.
peptic ulcers
86
Patients with___ experience a classic sequence of burning or gnawing pain in the stomach that subsides or diminishes
immediately after eating and then reemerges 2 to 3 hours later. The pain usually presents in the upper abdomen, but sometimes may be found below the sternum. With some patients, the pain occurs immediately after eating. Nausea, vomiting, belching, and heartburn are common symptoms. If the erosion is severe, gastric bleeding can occur, resulting in hematemesis (vomiting blood) and melena (black, tarry stools containing blood).
Peptic ulcer disease PUD
87
The gallbladder is a storage pouch for digestive juices and waste from the liver.__ can form and block the outlet of the gallbladder, causing pain. Sometimes the blockage will pass, but if not, it can lead to severe inflammation of the gallbladder, called cholecystitis. This is a condition in which the wall of the gallbladder becomes inflamed. In severe cases, the gallbladder may rupture, causing inflammation to spread and irritating surrounding structures such as the diaphragm and bowel.
Gallstones
88
This condition presents as a constant, severe pain in the right upper or midabdominal region and may refer to the right upper back, shoulder area, or flank. The pain may steadily increase for hours or may come and go.__ commonly produces symptoms about 30 minutes after a particularly fatty meal and usually at night. Other symptoms include general GI distress such as nausea and vomiting, indigestion, bloating, gas, and belching. People at a higher risk for the development of__ include women, older adults, obese people, and people of Scandinavian, Native American, and Hispanic descent. Older adults may present without the normal symptoms described here. Localized tenderness may be the only finding.
Cholecystitis
89
The pancreas forms digestive juices and is also the source of insulin and glucagon. Inflammation of the pancreas is called_.__ can be caused by an obstructing gallstone, alcohol abuse, and other diseases. Severe pain may present in the upper left and right quadrants and may often radiate to the back. In addition, the patient may report that the pain is worse after eating. Other signs and symptoms accompanying the pain are nausea and vomiting, abdominal distention, and tenderness. Complications such as sepsis or hemorrhage can occur, in which case assessment may also reveal fever or tachycardia.
pancreatitis
90
The appendix is a small recess in the large intestine. Inflammation or infection in the appendix is called_, and it is a frequent cause of acute abdomen. This inflammation can eventually cause the tissues to die and/or rupture, causing an abscess, peritonitis, or shock. Initially, the pain caused by__ is generalized, dull, and diffuse and may center in the umbilical area. The pain later localizes to the right lower quadrant of the abdomen.__ can also cause referred pain. The patient may also report nausea and vomiting, anorexia (lack of appetite for food), fever, and chills. A classic symptom of__ is rebound tenderness. Rebound tenderness is a result of peritoneal irritation. This can be assessed by pressing down gently and firmly on the abdomen and then quickly releasing the pressure. The patient will feel pain when the pressure is released. Women with appendicitis who are also pregnant may not exhibit this symptom. Because the pain often increases when the patient's legs are straightened, the patient is often more comfortable in the fetal position.
appendicitis
91
Black, foul-smelling, tarry stool containing digested blood
Melena
92
Bleeding in the upper GI tract occurs from the __ to the upper small intestine. In the __, problems might include esophagitis, esophageal varices secondary to liver failure, or a Mallory-Weiss tear, which results from excessive retching or vomiting.
Esophagus
93
__ is frequently seen in patients with upper GI bleeding. The blood is either bright red or has the appearance of coffee grounds, depending on where in the GI tract it originated and how briskly it is occurring. In upper GI bleeding, the bleeding often manifests as melena, or dark tarry stools, as a result of partial digestion of the blood
Hematemesis
94
__ occurs when the lining of the esophagus becomes inflamed by infection or from the acids in the stomach(gastroesophageal reflux disease[GERD]).
Esophagitis
95
__is a condition in which the sphincter between the esophagus and the stomach opens, allowing stomach acid to move up into the esophagus. Also referred to as acid reflux disease, this condition can cause a burning sensation within the chest (heartburn). It is estimated that 60 million people in the United States have_. This is approximately 18% of the total population, making__ extremely common.
gastroesophageal reflux disease [GERD]
96
__occur when the pressure within the blood vessels surrounding the esophagus increases, frequently as a result of liver failure. The esophageal blood vessels eventually drain their blood into the liver. If the liver becomes damaged and blood cannot flow through it easily, blood begins to back up into these portal vessels, dilating the vessels and causing the capillary network of the esophagus to begin leaking. If pressure continues to build, the vessel walls may fail, causing massive upper GI bleeding and, quickly afterward, hematemesis.
Esophageal varices
97
In industrialized countries,__ is the main cause of liver damage. Long-term__ consumption damages the interior of the liver (cirrhosis, leading to slower blood flow. In developing countries, viral hepatitis is the main cause of liver damage
alcohol
98
Presentation of __takes two forms. Initially, the patient shows signs of liver disease fatigue, weight loss, jaundice, anorexia, edema in the abdomen, abdominal pain, nausea, and vomiting. This gradual disease process takes months to years before the patient reaches a state of extreme discomfort.
By contrast, the rupture of the varices is far more sudden. The patient may report sudden-onset discomfort in the epigastric region or sternum. He or she may have severe difficulty swallowing, vomiting of bright red blood, hypotension, and signs of shock. If the bleeding is less dramatic, hematemesis and melena are likely. Regardless of the speed of bleeding, damage to these vessels can be life threatening. Spontaneous rupture is often life threatening and significant blood loss at the scene may be evident. Major ruptures can lead to death in a matter of minutes.
esophageal varices
99
A__ is a tear in the junction between the esophagus and the stomach, causing severe bleeding and potentially death. Primary risk factors include alcoholism and eating disorders.
Violent coughing or vomiting is the principal cause. In women, this syndrome may be associated with severe vomiting related to pregnancy. The extent of the bleeding can range from minor bleeding, resulting in little blood loss, to severe bleeding and extreme fluid loss. In extreme cases, patients may experience signs and symptoms of shock, upper abdominal pain, hematemesis, and melena.
Mallory-Weiss tear
100
Infection from the bacterium__ presents with GI symptoms such as diarrhea. You can spread__ to other patients if proper hand hygiene is not employed and proper decontamination is not performed after each call.
Transmission of__ occurs in susceptible patients by contact with surfaces contaminated with feces. The bacterium can occasionally be transmitted to patients by contact with the unwashed hands of health care providers. Infections with __are generally related to use of antibiotics in patients who are being treated for other infections.
__is not inactivated by alcohol-based hand products. Glove use, good handwashing technique, and cleaning of contaminated
surfaces with a chlorine-based cleaning agent are important in preventing spread of this bacterium.
Clostridium difficile (commonly referred to as C diff)
101
__comprises a family of conditions revolving around a central theme of infection combined with diarrhea, nausea, and vomiting. Bacterial and viral organisms can cause this condition. These organisms typically enter the body through contaminated food or water. Patients may begin to experience an upset stomach and diarrhea as soon as several hours or several days after contact with the contaminated matter. The disease can then run its course in 2 to 3 days or continue for several weeks.__ may also be caused by noninfectious conditions such as adverse reactions to medications, exposure to certain toxins, or chemotherapy. The symptoms are similar regardless of the underlying cause.
Diarrhea is the principal symptom in both infectious and noninfectious_. Patients may experience large dumping-type diarrhea or frequent small liquid stools. The diarrhea may contain blood and/or pus, and it may have a foul odor or be odorless. Abdominal cramping is frequently reported. Nausea, vomiting, fever, and anorexia are also present. If the diarrhea continues, dehydration will result. As the volume of fluid loss increases, the likelihood of shock increases.
Acute Gastroenteritis
102
As the amount of fiber consumed as part of the diet decreases, the consistency of the normal stool becomes more solid. This hard stool requires more intestinal contractions, subsequently increasing pressure within the colon. In this environment, small defects within the colonic wall that would otherwise never pose a problem now fail, resulting in bulges in the wall. These small outcroppings eventually turn into pouches, called diverticula. Feces may become trapped within these pouches. When bacteria grow there, they cause localized inflammation and infection.
The most common cause of lower Gl bleeding in the United States is diverticulosis. Bleeding from diverticulosis is usually
bright red (as the blood products do not have time to be digested) and typically painless.
The main symptom of diverticulitis is abdominal pain, which tends to be localized to the left side of the lower abdomen.
Classic signs of infection include fever, malaise, body aches, chills, nausea, and vomiting. Bleeding is rare with this condition. Because of the local infections of these pouches, scar tissue forms, causing the tissue to stick together. This narrows the diameter of the colon and results in constipation and bowel obstruction. In severe cases, these infected outcroppings may burst, causing perforation of the affected segment of colon. This may lead to peritonitis, severe infection, and if left untreated, septic shock.
Diverticulitis
103
__are created by swelling and inflammation of the blood vessels surrounding the rectum. They are a common problem, with almost half the population having at least one__ by age 50 years.___ may result from conditions that increase pressure on the rectum or irritation of the rectum. Pregnancy, straining at stool, and chronic constipation cause increased pressure. Diarrhea can cause irritation.
Hemorrhoids may be internal (high in the rectum, usually not visible, often painless, and often associated with bright red,
brisk bleeding) or external (low in the rectum, often clearly visible, and painful).
__present as bright red blood during defecation. This bleeding tends to be minimal and is easily controlled.
Additionally, patients may experience itching and a small mass on the rectum. Typically, this mass is a clot formed in response to the mild bleeding.
Hemorrhoids
104
Inflammation of the bladder
Cystitis
105
An infection, usually of the lower urinary tract (urethra and bladder), that occurs when normal flora bacteria enter the urethra and grow
Urinary tract infection (uti)
106
Issues in the urinary system can cause acute abdominal pain. Bladder inflammation, called__, is common, especially in women. This condition is generally caused by a bacterial infection and can be referred to as a urinary tract infection (UTI). A bladder infection can be painful. Patients with__ usually have midline lower abdominal pain. They may also report blood in the urine, an urgency and frequency in urination, and pressure and pain around the bladder. If the infection is severe, the urethra can become inflamed, causing urinary retention. When you are assessing a patient with_, the patient may report tenderness when you are palpating the abdomen over the bladder (just above the pubic bone).__ can become a serious health problem if the infection spreads to the kidneys.
cystitis
107
Definition
A balance of all systems of the body
Homeostasis
108
The kidneys play a major role in maintaining homeostasis, or keeping all body systems in balance. The kidneys preserve this balance by eliminating waste from the blood. When the kidneys fail, the patient loses the ability to excrete waste from the body, leading to a condition called__. This means that the waste product, urea, which is normally excreted into the urine, remains in the blood.
uremia
109
Severe kidney failure resulting in the buildup of waste products within the blood. Eventually brain functions will be impaired
Uremia
110
Chemicals may crystallize in the urine and form_.__ can grow over time, and if a stone passes into the ureter, it can cause a blockage. Pressure will build up behind the__ and cause swelling in the kidney. Patients with a__ blockage may initially report vague discomfort in the flank, but the pain can become quite intense and typically will radiate to the groin. These patients are often agitated and restless as they try to get into a comfortable position to relieve the pain. They may also report nausea and vomiting. The pain from__ is often caused when the stone moves within the ureter. Stones cause blockage that prevent urine from passing, stretching and dilating the ureter behind the location of the stone, which is the source of the pain. In many cases, the stone will pass on its own, but in other cases it may have to be surgically removed (or broken up). A slight amount of blood in the urine (hematuria) before or after the stone passes may be present because of irritation of the ureter.
kidney stones (renal calculi)
111
Solid crystalline, masses formed in the kidney, resulting from an excess of insoluble salts or uric acid crystallizing in the urine; may become trapped anywhere along the urinary tract
Kidney stones
112
Kidney (renal) failure can be acute or chronic.__ is a sudden (possibly over a period of days) decrease in function. It occurs from a variety of causes including hemorrhage, dehydration, trauma, shock, sepsis, heart failure, medications, drug abuse, and kidney stones.__ very often can be reversed with prompt diagnosis and treatment.
Acute kidney injury (AKI)
113
__is irreversible. It is progressive and develops over months and years. It is often caused by diabetes or hypertension. The kidney tissue shrinks and function diminishes. Eventually the patient requires dialysis or a kidney transplant to remove waste products from the bloodstream.
Patients with untreated__ or patients with__ who have missed scheduled dialysis may exhibit a wide variety of symptoms ranging from simply not feeling well to an altered level of consciousness. In later stages, seizures and coma are possible. Additional signs and symptoms include lethargy, nausea, headaches, cramps, and edema in the extremities and face because of fluid imbalances. Patients with__ have a high incidence of heart disease and tend to bleed easily. There is an increased risk of heart failure and cardiac arrest in these patients.
Chronic kidney disease (CKD)
114
Gynecologic problems are a common cause of acute abdominal pain. Always consider that a woman with lower quadrant abdominal pain and tenderness may have a problem related to her
ovaries, fallopian tubes, or uterus.
115
The aorta lies immediately behind the peritoneum. In older people, the wall of the aorta sometimes develops weak areas that swell to form an_. A pulsating mass may be felt in the abdomen, although this is a rare sign and is often hard to detect. Use extreme caution when trying to assess or detect this condition.
abdominal aortic aneurysm (AAA)
116
A swelling or enlargement of the wall of a blood vessel that results from weakening of the vessel wall
Aneurysm
117
A__ is a protrusion of an organ or tissue through a hole or opening into a body cavity where it does not belong.
__can occur as a result of the following:
• A congenital defect, as around the umbilicus
• A surgical wound that has failed to heal properly
• A natural weakness in an area, such as in the groin
__do not always produce a mass or lump that the patient will notice. At times, the mass will disappear back into the body cavity in which it belongs. In this case, the hernia is said to be reducible. If the mass cannot be pushed back within the body, it is said to be incarcerated
A_ that can gently be pushed back through the abdominal wall is reducible. Reducible hernias pose little risk to the patient; some people live with them for years. When a__ is incarcerated, however, its contents may become seriously compressed by the surrounding tissue, eventually compromising the blood supply. This situation, called strangulation, is a serious medical emergency. Immediate surgery is required to remove any dead tissue and repair the_.
hernia
118
Complete obstruction of blood circulation in a given organ as a result of compression or entrapment; an emergency situation causing death of tissue
Strangulation
119
A hernia that can gently be pushed back through the abdominal wall is __
Reducible
120
When a hernia is __, its contents may become seriously compressed by the surrounding tissue, eventually compromising the blood supply
Incarcerated
121
If your call involves a patient on dialysis, start with the _
XABCs
122
