Chapter 16A - Gastrointestinal Emergencies Flashcards

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0
Q

Hemoptysis

A

Coughing up or spitting up of bright red blood usually from blood that entered the respiratory system

usually from a tear in an artery in the posterior pharynx or somewhere in the respiratory system

because it promotes coughing, it can spray dramatically - take BSI

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1
Q

Hematemesis

A

Vomiting of partially digested blood that has entered the stomach

it has a brownish coffee grounds appearance

could be from a nosebleed, or esophageal varices, or perforated bleeding ulcer

if large amount of blood, may appear like one wine.

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2
Q

Melena

A

Passing black, tarry stools indicates intestinal bleeding, but the blood has been completely digested therefore it is not rectal bleeding

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3
Q

Hematochezia

A

Indicates bleeding in the last few inches of the intestine, usually the rectum, and usually indicates hemorrhoids

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4
Q

Hematuria

A

Passing blood in the urine usually appears as a rust colored urine if the problem is in the kidneys, and bits of bright red blood if the problem is in the bladder or urethra

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5
Q

Ascites

A

Distention of the abdomen due to Free Water in the peritoneal cavity

having leaked or backed up into the cavity due to liver failure

account for the huge abdomen seen in alcoholics

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6
Q

Gastric ulcer – pathophysiology

A

Erosion or ulceration of the stomach wall

Are stomach infections caused by bacteria (helicobacter pylori)

Can be cured with antibiotics not antacids or Tagamet, Axid, or Pepcid

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7
Q

Gastric ulcer – signs and symptoms

A

– Persistent pain in the upper abdomen, often described as burning
– pain is somewhat or completely relieved by eating bland foods (sponge-up the acids)
- often have hematemesis, or melena

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8
Q

Gastric ulcer – treatment

A

– Supportive

– transport in shock position (the raised legs take pressure off the abdominal wall, which lessens the pain)

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9
Q

Abdominal aortic aneurysm – pathophysiology

A

A ballooning of the wall of the artery as a result of defects, leading to dissecting (separating the layers) which thins the number of layers containing the blood pressure and as some of the ballooning pushes inward, can decrease aortic blood flow

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10
Q

Abdominal aortic aneurysm – signs/symptoms

A

O – lifting heavy weights, straining
Q – tearing, hot, knifelike
R – pain from anterior abdomen, boring through the back
S – very severe and hits maximum at time of onset (doesn’t build up)
T – sudden onset

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11
Q

Abdominal aortic aneurysm – associated signs/symptoms

A

All due to internal ballooning decreasing the inside diameter of the aorta and decreasing one opening more than the other (right versus left femoral)
– Unequal femoral pulses
– may have severe signs of shock if leaking

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12
Q

Abdominal aortic aneurysm – treatment

A

– Supportive
– transport in shock position
– transport RLS code 3

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13
Q

Appendicitis – pathophysiology

A

Inflammation/infection of the appendix which can rupture or become infected

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14
Q

Appendicitis – signs/symptoms

A

– Fever
– anorexia
- nausea/vomiting
– sharp right lower quadrant pain, guarding, rebound tenderness (increases over several hours)

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15
Q

Appendicitis – treatment

A

– Supportive

– transport in Shock position (raised legs lessens pain)

16
Q

Esophageal varices – pathophysiology

A

Varicose veins in the esophagus (enlarged veins) usually from chronic, excessive alcohol abuse, which also tends to damage that esophageal lining. Chronic alcoholism causes cirrhosis of the liver which damages it’s filtering mechanism and results in a back up of blood into veins that flow into the liver (from the intestines and esophagus) those varicose veins can rupture – if they do, severe, catastrophic bleeding occurs

17
Q

Esophageal varices – signs/symptoms

A

– Massive hematemesis
– dramatic hemoptysis
– life threatening hypovolemia

18
Q

Esophageal varices – treatment

A

– Supportive
– airway maintenance = a major problem
– treat for shock
– transport code 3

19
Q

Gallbladder inflammation/cholecystitis – pathophysiology

A

Gallstone production and blockage of the bile ducts, with inflammation and digestive upset from lack of bile

20
Q

Gallbladder inflammation/cholecystitis – signs/symptoms

A

– History of recent ingestion of a meal with a lot of fat
– gradual onset of sharp pain in the right upper quadrant, possibly the right shoulder area, especially after a fatty meal
– possible Jaundice
– nausea/vomiting

21
Q

Gallbladder inflammation/cholecystitis – treatment

A

– Supportive
– transport in shock position (raised legs lessens the pain)
– no code 3

22
Q

Kidney stones – pathophysiology

A

Stone production and blockage of the ureters

23
Q

Kidney stones – signs/symptoms

A
  • tremendous pain in the lower quadrants, radiating in pulse like waves from the rear flank downward towards the pubic synthesis (bladder) worsens as the stone is pushed along
    – anxieties, restlessness
    – Nausea/vomiting
    – hematuria
24
Q

Kidney stones – treatment

A

– Supportive
– transport instruct position (patient may assume a fetal position = on his side)
– no code 3

25
Q

Bowel obstruction – pathophysiology

A

Typically occurs in the elderly (or younger people dieting). Constipation and then obstruction. Sometimes there is a history of recent abdominal surgery. The obstruction may be feces, a tumor or scar tissue.

26
Q

Bowel obstruction – signs/symptoms

A
– Crampy pain in the abdomen (in spasms, usually diffuse) 
– often has abdominal distention 
– anorexia 
– nausea/vomiting 
– fever
27
Q

Bowel obstruction – treatment

A

– Supportive
– transport in shock position
– no code 3

28
Q

Chronic liver disease – pathophysiology

A

(Hepatitis but not necessarily infections) destruction of liver cells with formation of scar tissue which prevent normal functioning and obstructs blood flow into the liver

  • there by backing up fluid into the hepatic-portal system, causing acsites

– may be the result of chronic alcohol abuse, tumors, Tylenol overdose or viral hepatitis

29
Q

Chronic liver disease – signs/symptoms

A
– Jaundice 
– ascites
- pedal edema 
– muscle atrophy 
– decreased clotting (therefore bruising) 
– petechiae 
– varicose vein or spider veins
30
Q

Chronic liver disease – treatment

A

– Supportive

– transport in shock position or transport in semi Fowler’s if that is more comfortable

31
Q

Pancreatitis – pathophysiology

A

Inflammation of the pancreas with enzyme leakage, causing tissue destruction that - often in chronic alcoholics (may be mistaken for an MI)

32
Q

Pancreatitis – signs/symptoms

A

– Sudden, severe left upper quadrant epigastric pain
– steady, boring to the back of may radiate to the left shoulder or back
– usually with a history of chronic alcohol abuse
– may have abdominal distention and or tenderness
– nausea/vomiting
– may develop shock

33
Q

Pancreatitis – treatment

A

– Supportive

– transport in shock position

34
Q

Irritable bowel syndrome - signs/symptoms

A

Abdominal pain, abdominal cramping, gas, bloating, diarrhea or constipation. The pain is described as worse than childbirth – a sudden knife like pain that doubles you over – can bring you to your knees

35
Q

Diverticulitis – pathophysiology

A

Inflammation of small pouches formed on the intestinal wall (diverticulosis)

36
Q

Diverticulitis – signs/symptoms

A

– Abdominal pain (LLQ)
– fever
– vomiting
– constipation

37
Q

Gastroesophageal reflux disease

A

Presents as heartburn