Chapter 16A - Gastrointestinal Emergencies Flashcards
Hemoptysis
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
Hematemesis
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.
Melena
Passing black, tarry stools indicates intestinal bleeding, but the blood has been completely digested therefore it is not rectal bleeding
Hematochezia
Indicates bleeding in the last few inches of the intestine, usually the rectum, and usually indicates hemorrhoids
Hematuria
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
Ascites
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
Gastric ulcer – pathophysiology
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
Gastric ulcer – signs and symptoms
– 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
Gastric ulcer – treatment
– Supportive
– transport in shock position (the raised legs take pressure off the abdominal wall, which lessens the pain)
Abdominal aortic aneurysm – pathophysiology
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
Abdominal aortic aneurysm – signs/symptoms
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
Abdominal aortic aneurysm – associated signs/symptoms
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
Abdominal aortic aneurysm – treatment
– Supportive
– transport in shock position
– transport RLS code 3
Appendicitis – pathophysiology
Inflammation/infection of the appendix which can rupture or become infected
Appendicitis – signs/symptoms
– Fever
– anorexia
- nausea/vomiting
– sharp right lower quadrant pain, guarding, rebound tenderness (increases over several hours)