Digestion Flashcards
Digestive S&S
- anorexia
- nausea/vomiting
- diarrhea/contsitpation
- fluid and electrolytes imbalances
- pain
- malnutrition
- impaired mobility
Diagnostic testing
Common therapies
Radiographs - CT - MRI - EGD - Colo - laparoscopy - stool analysis - blood tests
Team approach - dietary - stress reduction - meds - mobility tx
GI divisions
Upper, lower, visceral
- separated by ligament of treitz, located at the duodeno-jejunal flexure
Temporomandibular disorder
Upper and lower jaw imbalances
- arthritis, clenching, mm spasms
- S&S: pain, stiffness, decreased ROM, clicking, HA, mal-occlusion
- Rx: soft food, splints, modalities, meds, surgery, manual techniques, relaxation and postural edu
Hiatal hernia
Stomach protrudes thru gap in diaphragm
- etiology: weak diaphragm, increased abdominal pressure
- enlarges lower esophagus allowing stomach acids into esophagus and food can lodge in pouch
- S&S: heartburn, burning, acid reflux, dysphasia, pt unable to lie flat
- prognosis: can lead to GERD due to incompetent sphincter and acid reflux
- Tx: antacids, elevate head of bed
GERD
Gastroesophageal reflux disease
- backflow of stomach acid into esophagus
- lower esophageal sphincter defect, slow stomach emptying, and hiatal hernia
- S&S: bruins and pressure behind breastbone, bleeding, paring after meals, belching sore throat, N/V, difficulty swallowing
- tx: lifestyle change (avoid caffeine, fats, ETOH, spice, smoking) antacids, meds surgeries
- can lead to esophagus CA
Ulcers
Crater like lesions in mucosa of stomach, duodenum, esophagus
- hemorrhage as acid penetrates musical barries, continues inflammation and damage walls, invades blood vessels which leads to bleeding, can perforate smooth muscles, may lead to systemic inflammation
- etiology: infection, H pyloric bacteria secretes cytotoxic and enzymes, pain meds (ASA, NSAIDS), ETOH, virus, smoking, GERD and stress
- S&S: pain after meals, heartburn, N/V, weight loss or gain, fatigue
- Tx: antibiotics, acid reducers, surgery, decrease exacerbating factors (coffee)
Gastritis
Stomach lining inflammation
- erosive gastritis = hemorrhage = peptic ulcer
- non-erosive = chronic gastritis
Gastroparesis
- slow emptying of the stomach due to weakness of stomach mm
- etiology: idiopathic - diabetes - neurologic dx
- S&S: vomiting, weight loss, bloating, heartburn, and loss of appetite
- Dx: EGD, US
- Tx: small, frequent meals; reglan
Gastroenteritis
Stomach and intestine inflammation due to bacteria, virus, parasites, allergies
- traveler, food poisoning, flu, norovirus, spreads easily
- S&S: diarrhea, fever, pain, n?v, seat, bloating, flatulence, fatigue, HA, dehydration
- Dx: upper GI endoscopy, US
- Tx: hand washing to prevent spread and dependent upon cause, antibiotics
Crohn’s
Chronic inflammatory bowel syndrome (teens), ulcerative colitis (adults), pattern of remission. Exacerbation
- etiology: autoimmune, genetic
- any area of GI tract and most common in small intestines. Inflammation, skip lesions distribution
- S&S: diarrhea with blood, cramping, RLQ pain, anorexia, fatigue, malnutrition, anemia, arthritis
Celiac spruce
Small intestine malabsorption due to gluten intolerance
- immunological disease damage to small instinct lining which interferes with absorption
- 1/3000
- no cure
Appendicities
Common in young adults 1/2000
- etiology: inflammation of appendix after infection due to blockage of opening of appendix
- S&S: abnormal pain, right lower abdomen = McBurney’s point, diarrhea/constipation, n/v, loss of appetite
- sepsis can occur
Diverticulitis
Inflammation of pouch in colon, can perforate, abscess, peritoriets, fistula
- risks: low fiber diet, no exercise, processed food
- S&S: abdominal pain, anorexia, constipation/diarrhea, fever, flatulence, n/v, bowel changes
- rx: change diet, surgery, meds, ed rest, potassium, antimicrobials, liquid diet
IBS
Doesn’t damage intestines
- S&S: alternating diarrhea/constipation, abdominal pain, bloating, urgent BM, depression, >12 was/year
- to: diet, increase fiber/small/frequent, decrease stress, meds, sleep, teach relation and exercise
Pancreatitis
Acute (med emergency) or chronic
- inflammation o pancreas due to auto digestion of tissue (inflammation, bleeding, necrosis, peritoneal inflammation)
- risks: etoh, severe gallstones, trauma, viral infections, meds, hyper calcium/lipids, CF
- S&S: sever left upper abdominal pain into back, shock signs, low BP, sweating, low grade fever, weakness
- Tx: stop oral intake, shock, electrolyte balance, pain meds, decrease ETOH, change diet, decrease fats
Cholelithiasis
Gallbladder stones block common bile duct
- males > females
- genetic predisposition, high chosterol or bilirubin, DM, Crown’s, obesity, cirrhosis, trauma
- gallbladder inflammation = cholecystitis
- S&S: severe bouts of pain right upper abdomen/scapula (MI), fever, jaundice, indigestion, acid reflux, gas
Cirrhosis
Fibrosis of the liver leading to liver failure d/t permanent scarring
- liver enlarges ethen reduces and unable to function, feels hard and effects other systems
- due to ETOH, obesity, hepatitis, CF
- S&S: diarrhea, malnutrition, enlarged spleen, bruise easily, jaundice
- Tx: transplant, meds
Urinary system
- removes waste
- regulates water/electrolytes
- regulates BP
- activates vitamin D
Urinalysis
- Hematuria
- Proteinuria
- Bacteria
- Urinary casts
Normal clear straw color, mild odor, pH 4.5-8.0
- Blood associated with infection, inflammation, or tumors
- Albumin or plasma proteins
- Indicates infection
- Cylindrical structures proved by kidneys glucose and ketones
Incontinence
Loss of voluntary control
- stress: increased intra-abdominal pressure forces ruin, coughing, lifting, laughing
- overflow: incompetent bladder sphincter
- retention: inability to empty
- catheter: tube inserted into urethra drains into bag
Neurogenic bladder
Spastic smooth mm
- nerve supply interrupted by SCI, tumo, Alzheimer’s, MS
- incontinence, decreased capacity, inability to empty
Cystitis
- bladder wall and urethra inflamed, so wall irritable reducing capacity due to infection
- interstitial cystitis or painful bladder syndrome
- S&S: pain in lower abdomen, dysuria, urgency, nocturia, systemic infection signs, cloudy or unusual odor urine
UTI
Women > men, men secondary to prostatic hypertrophic, congenital abnormalities
- growth of microorganisms (e coli) in UT, perineal area - bladder - ureters - kidneys
- tx: antimibrial/biotic/bacterial meds, increase fluid intake, diet modification to decrease acid, pelvic floor exercises
Kidney stones
1/2 million to ER / year
- calculi = urinary stones
- excessive insoluble salts, decreased fluid intake
- S&S: sudden/severe pain at night, sweat, n/v, urgency/frequency
- Tx: small stones passed, large stones fragmented (lithotripsy or surgery)
Renal failure
Acute kidney failure = loss of funciton of kidneys with change in electrolytes and fluid balance
- chronic and irreversible
- due to reduced blood flow to kidneys, dehydration, systemic diseases, hypotension
- S&S: malaise, weakness, n/v, seizures, disorientation, mood changes, bad breath, LE edema
Dialysis
- Artificial kidney indicated for: acute renal failure or end stage kidney failure
- Hemodialysis: at hospital, shunt, 3x/week 3-6 hrs
- Peritoneal: home unit
Fluid and electrolyte imbalance
- burns - surgery - diabetes - cancer - ETOH abuse - meds
- S&S: fluid overload (confusion, headache seizures, pulmonary congestion, outdoing pulse, increase BP and JVD, tachycardia, anorexia, nausea) or dehydration (low BP, headache, confusion, irritability, rapid pulse)
Electrolytes
- Sodium: influences water retention and loss
- Potassium: needed for these pumps
- Calcium: important for bone, GI tract, kidney, mm and nerve excitation
- Magnesium: works at the myoneural junction
5 signs of dehydration
- Dry, chapped lips
- Headaches
- Dry skin
- Achy joints
- Fatigue
- older adults have decreased thirst!
- referred pain: affects stomach, pancreas, ovaries
