Common diseases Flashcards
Motility Disorders:
- GERD: Reflux of stomach acid causing heartburn and dysphagia.
- Paralytic Ileus: No bowel movement due to intestinal paralysis.
- Intestinal Obstruction: Absent or hypoactive sounds, distension.
Gastric Disorders:
- Gastritis: Stomach lining inflammation (NSAIDs, alcohol).
- Peptic Ulcers:
o Duodenal ulcers: Pain relieved by eating.
o Gastric ulcers: Pain worsened by eating.
Inflammatory Disorders:
- Appendicitis: RLQ pain, fever, nausea.
- Crohn’s Disease: Skip lesions in GI tract, cramping.
- Ulcerative Colitis: Continuous lesions in colon, diarrhea.
Colorectal Cancer
- Definition: Colorectal cancer originates in the colon or rectum, parts of the large intestine.
Risk Factors:
* Age: 50+
* Family History: A history of colorectal cancer or polyps increases risk.
* Lifestyle Factors: Diets high in red and processed meats, physical inactivity, obesity, smoking, and heavy alcohol
Symptoms to Watch For:
* Changes in bowel habits (diarrhea or constipation).
* Blood in stool or rectal bleeding.
* Persistent abdominal discomfort (cramps, gas, or pain).
* Unexplained weight loss and fatigue.
Prevention Strategies:
* Regular Screening: Starting at age 45
* Healthy Diet
* Physical Activity
* Avoid Tobacco and Limit Alcohol
Aging and the Abdomen
- Physical Changes:
o Appearance: Fat redistributes from face/extremities to abdomen and hips. Relaxation of abdominal muscles is common.
o Suprapubic Fat: Increases in women due to decreased estrogen.
o “Big Belly” in Men: Often due to sedentary lifestyle.
Liver Cirrhosis
Scarring of the liver due to chronic injury.
Alcohol, hepatitis, toxins.
Jaundice, **ascites**, fatigue, easy bruising.
Small, firm liver; spider angiomas; portal hypertension signs.
Monitor for ascites, manage fluid retention with diuretics, educate on avoiding alcohol, and provide low-sodium diet support.
Abdominal Ileus
temporary or functional obstruction of the intestines
What causes an ileus?
Surgery, infection, electrolyte imbalances, medications (e.g., opioids), or diseases affecting intestinal motility.
What are the symptoms?
Abdominal pain, bloating, nausea, vomiting, constipation, absent or hypoactive bowel sounds.
How is it diagnosed?
Physical exam (absent bowel sounds, abdominal distension).
Imaging (X-ray, CT scan).
What are non-medication nursing interventions?
NPO (nothing by mouth) to rest the bowel.
Monitor for signs of perforation or worsening obstruction.
Encourage ambulation to stimulate bowel motility.
Frequent abdominal assessments to track changes.
Gastrointestinal Changes with Aging
- Salivation: Decreases → dry mouth, reduced taste.
- Esophageal Emptying: Slows → Increased risk of aspiration, especially when supine.
- Gastric Acid: Decreases → Impaired absorption of:
o Vitamin B12 → Pernicious anemia.
o Iron → Iron-deficiency anemia.
o Calcium → Increased risk of fractures. - Dehydration Risk:
o Reduced water conservation, thirst perception, and temperature regulation.
Liver and Renal Changes with age
- Liver:
o Shrinks in size post-80 years.
o Blood flow and metabolizing enzyme activity decrease → Delayed medication metabolism. - Kidneys:
o Decline in function → Increased risk of adverse effects from medications cleared by kidneys (e.g., NSAIDs, alcohol). - Medication Risks:
o Combining alcohol and drugs increases toxicity risks.
Common Abdominal Conditions in Older Adults
- Gallstones: Up to 20% of women and 10% of men over 60.
- Constipation:
o Causes:
Decreased mobility.
Medications: Opioids, NSAIDs, anticholinergics, diuretics, calcium/iron supplements.
Poor dietary habits: Low fiber and fluid intake.
Sedentary lifestyle, polypharmacy.
o Lifestyle contributors: Ignoring defecation urge, laxative overuse. - Colorectal Cancer:
o Risk increases with age. Screening recommended (see guidelines).
Aortic Aneurysm
Weakening and bulging of the aorta wall.
Hypertension, atherosclerosis, genetic predisposition.
Pulsatile abdominal mass, back pain, hypotension (if ruptured).
Bruit heard on auscultation; avoid palpation to prevent rupture.
Monitor BP; avoid activities that increase intra-abdominal pressure; educate on smoking cessation and follow-up care.
Appendicitis
Inflammation of the appendix.
Obstruction by feces or infection. RLQ pain (McBurney’s point), fever, nausea, rebound tenderness.
Positive rebound tenderness and iliopsoas test.
Assess pain, provide NPO status, monitor for signs of rupture, prepare for possible surgery, and administer IV fluids.
Cholecystitis
Inflammation of the gallbladder.
Gallstones, ******bile****** duct obstruction.
RUQ pain, nausea, vomiting, Murphy’s sign (pain on inspiration during palpation).
Positive Murphy’s sign.
Encourage low-fat diet, administer prescribed pain medication, monitor for signs of infection, and prepare for surgery if needed.
Crohn’s Disease
Chronic inflammation of the GI tract with skip lesions.
Autoimmune factors, genetic predisposition.
Cramping, diarrhea, weight loss, fatigue.
Patchy inflammation seen on imaging; skip lesions.
Provide nutritional support (low-residue diet), educate on medication adherence, monitor for dehydration, and manage stress.
Cushing’s Syndrome
Excess cortisol production. Prolonged corticosteroid use, adrenal or pituitary tumor.
Central obesity, purple striae, thin skin, buffalo hump, moon face.
Purple-blue striae, hyperglycemia, hypertension.
Monitor blood glucose, educate on steroid tapering, provide skin care, and monitor for infection or mood changes.
Dysphagia
Difficulty swallowing.
GERD, esophageal cancer, stroke.
Sensation of food stuck in throat, coughing while eating, chest pain.
Barium swallow test, endoscopy.
Assess swallowing, provide thickened liquids or pureed diet, position patient upright during meals, and educate on safe swallowing techniques.
GERD
Reflux of stomach acid into the esophagus.
Obesity, smoking, alcohol, hiatal hernia. Heartburn, regurgitation, dysphagia, chest pain.
Pyrosis (heartburn), endoscopy findings of esophageal inflammation.
Educate on avoiding trigger foods, elevate head of bed, encourage weight management, and administer prescribed antacids.
Gastritis Inflammation of the stomach lining.
NSAIDs, alcohol, H. pylori infection. Nausea, vomiting, epigastric pain, loss of appetite.
Tender epigastric area; positive test for H. pylori.
Avoid irritants (e.g., NSAIDs, alcohol), administer prescribed medications (e.g., PPIs), and provide small, frequent meals.
Hepatomegaly
Enlarged liver.
Hepatitis, fatty liver, cirrhosis, cancer. RUQ fullness or mass, jaundice, fatigue.
Liver span >12 cm on percussion; abnormal liver function tests.
Monitor liver function tests, educate on alcohol cessation, assess for signs of jaundice, and provide dietary support.
IBD (Crohn’s, UC)
Chronic inflammation of the intestines. Autoimmune factors, genetic predisposition.
Chronic diarrhea, abdominal pain, weight loss, bloody stools (UC). Skip lesions (Crohn’s), continuous lesions (UC).
Monitor hydration, provide a low-fiber diet during flares, educate on stress management, and administer prescribed anti-inflammatory medications.
Intestinal Obstruction Blockage in the intestines.
Tumors, adhesions, hernias.
Abdominal distension, pain, vomiting, constipation.
Absent or hypoactive bowel sounds; visible peristalsis in severe cases.
NPO status, administer IV fluids, insert NG tube for decompression, and monitor for signs of perforation or infection.
Irritable Bowel Syndrome
Functional GI disorder with no structural cause.
Stress, diet, altered gut motility. Abdominal pain, bloating, diarrhea, or constipation.
Normal diagnostic tests; diagnosis based on symptom patterns.
Educate on dietary modifications (e.g., low FODMAP diet), encourage stress management, and monitor for symptom triggers.
Peptic Ulcers
Open sores in the stomach or duodenum.
H. pylori, NSAIDs, alcohol.
Epigastric pain, nausea, vomiting, melena. Pain worsens (gastric) or improves (duodenal) with food. Positive H. pylori test.
Educate on avoiding irritants, administer prescribed PPIs or antibiotics, and monitor for signs of bleeding.
Peritonitis
Inflammation of the peritoneum, usually due to infection.
Ruptured appendix, perforated ulcer, infection.
Severe abdominal pain, guarding, fever, distension.
Rebound tenderness, rigid abdomen, absent bowel sounds. Administer IV antibiotics, prepare for surgery if needed, monitor for sepsis, and provide pain management.
Renal Stones
Crystals forming stones in the kidneys.
Dehydration, dietary factors, genetic predisposition.
Severe colicky flank pain, hematuria, nausea, vomiting.
Positive renal punch test, stone seen on imaging (CT/KUB).
Encourage hydration, administer prescribed pain medication, strain urine for stones, and educate on dietary modifications.
Splenomegaly
Enlarged spleen. Infection, trauma, hematological disorders.
LUQ fullness, fatigue, easy bruising.
Enlarged spleen felt below costal margin; dullness in LUQ on percussion.
Avoid activities that could cause splenic rupture, monitor for signs of infection, and provide supportive care.
Ulcerative Colitis
Chronic inflammation of the colon with continuous lesions.
Autoimmune factors, genetic predisposition.
Bloody diarrhea, cramping, urgency.
Continuous mucosal inflammation seen on colonoscopy.
Provide hydration, administer prescribed corticosteroids or biologics, and educate on flare prevention strategies.
Pyrosis
Burning sensation in the stomach or esophagus.
GERD, gastritis, stress.
Heartburn, nausea.
Associated with reflux episodes, improves with antacids.
Educate on trigger food avoidance, elevate head of bed, and provide prescribed antacids or H2 blockers.
Hiatal Hernia
Stomach pushes into chest through diaphragm.
Aging, obesity, trauma.
Heartburn, regurgitation, chest pain, dysphagia.
Bulging seen on barium swallow or endoscopy.
Encourage weight management, small frequent meals, and educate on avoiding large meals before lying down.
Celiac Disease
Autoimmune response to gluten damaging the intestine.
Genetic predisposition.
Diarrhea, bloating, malabsorption, weight loss.
Positive antibodies for celiac disease; flattened villi on biopsy.
Educate on strict gluten-free diet, provide nutritional supplementation (e.g., iron, calcium), and monitor for deficiencies.
