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State Study > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What is hepatitis?

A

Liver inflammation

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2
Q

What is the pathophysiology of viral hepatitis?

A

the virus enters the body via various routes, which infect hepatocytes (liver cells).
The immune system responds to infection by activating immune cells (T cells + macrophages) - inflammation occurs in the liver as immune cells infiltrate the tissue to combat the virus
The immune response & viral replication can lead to hepatocyte injury & death

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3
Q

S&S of hepatitis?

A

often many pt are asymptomatic
or if symptoms present they are either intermittent or ongoing

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4
Q

What is hepatitis A & how do you get it?

A
  • mild/acute liver failure
  • not chronic
  • incidence decreases with vaccination
  • RNA virus transmitted via fecal-oral route
  • contaminated food/drinking water
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5
Q

What is hepatitis B & how do you get it?

A
  • acute or chronic
  • incidence decreases with vaccination
  • DNA virus transmitted = perinatally, percutaneously & via mucosal exposure to infections
  • blood & bodily fluids
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6
Q

What is Hepatitis C & how do you get it?

A
  • acute = asymptomatic
  • chronic = liver damage
  • RNA virus transmitted percutaneously
  • IV drug use (share), increase in sexual behaviour, perinatal exposure
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7
Q

What is hepatitis D & how do you get it?

A
  • defective single strand of RNA virus
  • needs HEP B to replicate
  • transmitted percutaneously (denoting passage of substances through unbroken skin)
  • no vaccine
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8
Q

What is hepatitis E & how do you get it?

A
  • RNA virus
  • transmitted via fecal-oral or drinking contaminated water
  • occurs primarily in developed countries
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9
Q

What are some risk factors for hepatitis

A
  • contaminated food + water
  • sexual contact (HEP A+B) w/ multiple partners
  • IV drugs + sharing needles
  • increase consumption of alcohol
  • working in environment where exposed to body fluids
  • autoimmune disease
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10
Q

What are the signs & symptoms of Acute phase - incubation phase of hepatitis?

A
  • malaise
  • anorexia
  • weight loss
  • fatigue
  • n+v
  • abdo discomfort
  • joint stiffness
  • distaste for cigarettes
  • decrease sense of smell
  • headache + low grade fever
  • skin rash
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11
Q

What are the signs & symptoms of acute phase of hepatitis?

A
  • hepatomegaly
  • lymphadenopathy
  • splenomegaly
  • jaundice
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12
Q

What are the signs & symptoms of of the convalescent phase of hepatitis?

A
  • begins as jaundice leaves (weeks - months)
  • malaise + easily fatigued
  • hepatomegaly
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13
Q

What are the signs & symptoms of recovery phase of hepatitis?

A
  • homologous immunity to HAV or HBV
  • can be reinfected
  • most recover completely with no complications
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14
Q

What are the medications/management of hepatitis?

A
  • rest
  • administer B-complex vitamins
  • ascites
  • prevent bleeding/hemorrhage
  • hepatic encephalopathy
  • nutritional therapy
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15
Q

What should someone avoid if they have hepatitis?

A
  • alcohol
  • aspirin
  • paracetamol
  • NSAIDs
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16
Q

What are nursing priorities for caring someone with hepatitis?

A
  • assessment & monitoring (monitor hepatic function)
  • infection control
  • pain + symptom management
  • nutritional support
  • fluid + electrolyte imbalance
  • hepatitis vaccine
  • pt education
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17
Q

What is crohn’s disease?

A

Inflammatory bowel disease
- chronic inflammation of the lower GIT characterised by remission & exacerbations

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18
Q

What is the pathophysiology of crohn’s disease?

A

sharply demarcated grannulamotouse lesions that are surrounded by normal-appearing mucosal tissue
when multiple lesions, the adjacent mesentery may become inflamed & the regional lymph nodes & channels may enlarge
Chronic inflammation of T cells activation leads to tissue injuries

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19
Q

What are the S&S of crohn’s disease?

A
  • diarrhoea
  • weight loss
  • fatigue
  • abdo pain
  • fever
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20
Q

What are the risk factors for crohn’s disease?

A
  • <30yrs of age
  • family hx
  • smoking
  • NSAIDs
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21
Q

What are the nursing priorities for someone with crohn’s disease?

A
  • pain assessment
  • vital obs
  • maintain hydration
  • enc. low fiber diet
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22
Q

What medications are used for someone with crohn’s disease?

A
  • anti-inflammatory
  • corticosteroids
  • immunodulators
  • metronidazol
  • nutritional supplements
  • analgesia
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23
Q

What is the management of crohn’s disease?

A
  • meds
  • nutritional management + dietary adjustment
  • inflammation management
  • no smoking
  • stress management
  • surgery
24
Q

what do anti-inflammatory meds do for someone with crohn’s disease + example

A

Decrease inflammation in intestinal lining

Aminosalicylates

25
What do corticosteroids do for someone with crohn's disease + example
Rapidly decreases inflammation & major flare ups SHORT TERM Prednisone + budesonide
26
What do immunomodulators do for someone with crohn's disease + example
Modify immune system response to inflammation Maintains remission Azathioprine + Methtrexale
27
What is ulcerative colitis?
Inflammatory Bowel Disease chronic inflammation of large bowel primarily affecting the colon
28
What is the pathophysiology of ulcerative colitis?
inflammation & ulceration of mucosal lining of colon the immune system mistakenly attacks gut lining
29
What are the S&S of ulcerative colitis?
- bloody stools - diarrhoea - rectal bleeding - abdo pain
30
What are the risk factors of ulcerative colitis?
- family hx - early adulthood - high sugar + fat diet - stress - immune system abnormalities - smoking - prior GI infections - appendectomy
31
What are the nursing priorities for someone with ulcerative colitis?
- administer meds - treat/manage pain + symptoms - observe stool frequently - bowel chart - daily weight - vitals - administer fluid + blood as prescribed
32
What medications are used for someone with ulcerative colitis?
- aminosalicylates - corticosteroids - immunosuppressants - antibioitics - stool softeners
33
What management can be done for someone with ulcerative colitis?
- meds - dietary & lifestyle changes - surgery
34
What dietary & lifestyle changes can be done for someone with ulcerative colitis?
- fiber supplements - hydration - stress management - regular exercise
35
What do aminosalicylates do for someone with ulcerative colitis + example
Decrease inflammation in colon & manage mild-moderate symptoms Mesalamine & Sulfasalazine
36
What do immunosuppressants do for someone with ulcerative colitis + example
suppress immune systems over-reactive response & maintain remission Azathioprine
37
What is a bowel obstruction?
When food + liquid + gas can't move through the intestines
38
What is a partial bowel obstruction?
Can be resolved in conservative treatment
39
What is a complete bowel obstruction?
Requires surgery
40
What is a mechanical bowel obstruction?
Detectable occlusion of intestinal lumen most often small bowel
41
what is the most common cause of a mechanical bowel obstruction?
Surgical adhesions
42
What is a non-mechanical bowel obstruction?
Result of a neuromuscular or vascular disorder
43
What is the most common cause of a non-mechanical bowel obstruction?
Paralytic Ileus (after surgery)
44
What are the S&S of a bowel obstruction in the small intestines
- rapid onset - frequent vomiting - cramps/intermittent pain - feces for short time - great increase distention
45
What are the S&S of a bowel obstruction in the large intestines
- gradual onset - no vomiting - low grade pain/cramps - acute constipation - increase distention
46
What are the risk factors of a bowel obstruction?
- abdo surgery - diverticulitis - cancer - IBD - swallowed foreign objects - chronic constipation
47
What is the nursing management of a bowel obstruction?
- vital signs - monitor fluid input + output - pain assessment + analgesia - oral & nasal cares - assess drip, NGT drainage & bowel sounds - monitor nutritional status
48
What to look out for when someone has a bowel obstruction?
- hypotension - hypovolemic shock - septic shock
49
What is the treatment of a bowel obstruction?
- IVF - analgesia - abx - surgery
50
What is appendicitis?
A condition in which the appendix becomes inflamed and filled with pus, causing pain
51
What is the pathophysiology of appendicitis - obstruction/inflammation/pain/pus formation?
- appendix becomes inflamed & edematous as a result of becoming kinked or occluded - inflammatory process increases intraluminal pressure, initiating progressively severe, generalised, or periumbilical pain - pain becomes localised to the RIGHT LOWER QUADRANT of abdo within a few hrs - eventually inflamed appendix fills with pus
52
What are the risk factors of appendicitis?
- high carb & low fiber diets - genetics - GI infections - IBD
53
What are the S&S of appendicitis?
- low grade fever - anorexia - tachycardia - fetal position decreases pain - RLQ tenderness - diarrhoea/constipation - abdo pain
54
What are the nursing interventions of appendicitis?-
- pre & post op cares - monitor vital signs + pain level - fluid balance - administer medications - auscultate for bowel sound changes
55
What are the medications + management of appendicitis?
- IVF - analgesia - abx - surgery

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