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GNUR 293 pathophysiology > gastrointestinal disorders > Flashcards

gastrointestinal disorders Flashcards

1
Q

define anorexia?

A
  • A lack of desire to eat despite physiologic stimuli that would normally produce hunger
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2
Q

define vomiting

A
  • The forceful emptying of the stomach and intestinal contents through the mouth
  • puts at risk for metabolic alkalosis
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3
Q

define nausea?

A
  • A subjective experience associated with a number of conditions
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4
Q

what is retching?

A
  • dry heaving
  • non productive vomiting
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5
Q

what is projectile vomiting?

A
  • Spontaneous vomiting that does not follow nausea or retching
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6
Q

define constipation?

A
  • Infrequent or difficult defecation
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7
Q

define diarrhea?

A
  • Increased frequency of bowel movements
    ▪ Increased volume, fluidity, weight of the feces
  • May result in dehydration, electrolyte imbalance, metabolic acidosis, and weight loss
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8
Q

what is parietal abdominal pain?

A
  • it’s intense sharp stomach pain
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9
Q

what is visceral pain? abdominal specific

A
  • inside pain, coming off as dull
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10
Q

define referred pain?

A
  • hard to pinpoint where the pain is
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11
Q

what does the upper GI consist of?

A
  • esophagus, stomach, duodenum
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12
Q

what organs does the lower GI consist of?

A
  • the jejunum, ileum, colon, rectum
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13
Q

define hematemsis?

A
  • vomit blood or black vomit
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14
Q

define hematochezia

A
  • red blood/ fresh blood in stool
  • typically, not super inside bleeding, lower GI if that
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15
Q

define melena

A
  • black stool which coincides with internal bleeding
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16
Q

define occult bleeding?

A
  • bleeding in stool that is not visible bc its sch a small amount
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17
Q

what is GERD

A
  • Reflux of chyme from the stomach to the esophagus through the lower esophageal sphincter
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18
Q

what are the contributing factors of GERD?

A
  • conditions that increase abdominal pressure like vomiting, cough, lifting, obesity (!), pregnancy (!)
  • composition of gastric contents (ex: if super acidic)
  • length of time in contact with mucosa (acid)
  • inflammatory response w/ reflect esophagitis
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19
Q

what is composed of gastric contents?

A
  • Highly acidic chyme or chyme with bile
    salts/pancreatic enzymes
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20
Q

if there’s GERD with no symptoms what does that mean?

A
  • physiological reflux
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21
Q

if a Pt has the symptoms of a nonproductive tickle in throat, no fever, and feel fine overall what should the nurse think?

A
  • think GERD
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22
Q

what are the C.M of GERD?

A
  • heart burn (pyrosis)
  • regulation of acid
  • chronic cough (!)
  • asthma
  • dysphagia (!)
  • mid epigastric pain within 1 hr of eating
  • symptoms worsen w/ recumbent position (laying)
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23
Q

how do we diagnose GERD

A
  • History & physical
  • esophageal endoscopy (to see damage)
  • pH monitoring
  • antagonist & antiacids
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24
Q

what is the TX for GERD?

A
  • weight loss
  • elevate head of bed
  • small/frequent meals (for less acid)
  • avoid eating b4 bed
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25
what is a hiatal hernia?
- Herniation of upper portion of stomach through diaphragm into thorax - associated w/ other GI issues
26
what are the two types of hiatal hernia's?
1. sliding hiatal hernia - more common - stomach slides up 2. periesophageal hiatal hernia - greater curvature (of stomach) also herniates
27
what are the CM of hitral hernia's?
- Asymptomatic or patient complains of heart burn
28
TX for hiatal hernia's?
- conservative treatment: - small & frequent meals - upright position after meals
29
define gastritis
- Inflammatory disorder of the gastric mucosa
30
what is acute gastritis?
- surface epithelium erosion, typically superficial -
31
what is gastritis due to?
- injury to mucosal barrier caused by drugs/chemicals causing inflammation - NASIDS (ibuprofen, aspirin)
32
what is chronic gastritis?
- chronic inflammation to the mucosal lining causing damage - due to Helicobacter pylori (multi antibiotic use) - Destructive pattern of persistent inflammation - may result in peptic ulcer disease (# 1 disease)
33
what are the C.M of chronic gastritis?
- anorexia, nausea, vomming, postprandial (after you eat) discomfort, hematemesis (vomit blood)
34
define peptic ulcer disease (PUD)
- A break or ulceration in the protective mucosal lining of the upper GI tract caused by HCl and pepsin
35
what is pepsin?
- strong enzyme in gastric juice that digest protein
36
define HCI
- is primary component of stomach acid
37
what part of the GI tract does peptic ulcer disease effect?
- duodenal (!) and gastric/stomach ulcers - not in other parts of the small intestines and not in colon
38
what are the 2 types of ulcers
- superficial ulcers = erosions - deep = true ulcers
39
what is the patho of PUD?
- Developmental factors cause acid/pepsin in duodenum to penetrate mucosal barrier and cause an ulcer
40
what are the 4 causes of PUD in the duodenum? (duodenal ulcer)
1. helicobacter pylori infection - toxins and enzymes that promote inflammation and ulceration 2. use of NSAIDs (stopping prostaglandins which maintain mucosal barrier) 3. high gastrin levels (fam hx) 4. acid production by cig smoking
41
what are the CM from duodenal ulcers?
- chronic intermittent epigastric pain - pain occurring 2 - 3 hrs postprandial (!) - pain food relief pattern - blooding (in stool) due to perforation - obstruction is possible - sudden severe pain w/ perforation
42
how is PUD evaluatied & Tx?
Evaluated: - endoscopy & biopsy - H. Pylori screening Tx: - antacids = proton pump inhibitors to decrease acid secretion - antibiotics for H. pylori - lifestyle = smoking cessation, avoidance of NSAIDs, caffeine & EthOH
43
where do gastric ulcers typically form?
- in lower region of the stomach
44
what are the contributing factors to PUD?
- NSAIDS and H. PYLORI (!!!!) - chronic gastritis = bc limiting protective mucous layer - decreased prostaglandin synthesis - Increased mucosal permeability to hydrogen ions
45
what are the C.M of gastric ulcers?
- similar to duodenal ulcers - pain on an empty stomach or IMMEDIATLEY after eating - anorexia & vom (risk for metabolic acidosis) - weight loss
46
Tx for gastric ulcers?
- test for h - pylori & antibiotics - life style changes
47
define gastroenteritis?
- inflammation of the stomach and small intestine
48
define IBS?
- Functional GI disorder of abdominal pain and altered bowel habits, which negatively impact quality of life
49
what are the C.M & of IBS?
- low abdominal pain, diarrhea, constipation, gas, bloating, nausea - umbrella term for chrones & ulcerative colitis
50
what happens w/ Inflammatory Bowel Diseases
- chronic, relapsing inflammatory bowel disorders w/ unknown origin - has periods of remissions & relaxations - diarrhea that impacts daily life
51
define ulcerative colitis?
- chronic inflammatory disease that causes ulceration of the Sigmoid colon and rectal mucosal LAYER only (inner most layer)
52
why do large areas of ulcerations form in ulcerative colitis?
- epithelial damage causes leukocyte invasion & abscess formation causing abscesses coalesce (when the walls of the colon come together into an ulcer)
53
CM of ulcerative colitis?
- abdominal pain - diarrhea (!!) = 10 - 20 times a day - hematochezia (bloody stools) - exacerbations & remissions - increased colon cancer risk - risk for dehydration (not reabsorbing fluid from feces)
53
what's the patho behind Crohn's disease?
- Lymphoid and lymphatic structures in GI obstructed → inflammation and deep linear ulcers in bowel wall
53
Tx of ulcerative colitis?
▪ Broad-spectrum antibiotics and steroids ▪ Immunosuppressive agents ▪ Surgery
54
as Crohn's disease is transdermal what can that cause?
- All layers of GI wall involved = transdermal ▪ Can produce longitudinal and transverse inflammatory fissures and perianal abscesses ▪ Produce fistulas ▪ Strictures that extend into the adjacent organs or narrow sections may lead to blockage
54
define Crohn's disease?
- Idiopathic inflammatory disorder; affects any part of the digestive tract, from mouth to anus - Causes “skip lesions” or patchy wounds (!!!) - Difficult to differentiate from ulcerative colitis (similar risk factors and theories of causation)
55
C.M of Crohn's?
fistulas, strictures, perianal abscesses (possible) - abdominal pain constant in R lower quad - possible bloody stool but less than UC
56
define fistula?
- hole that connects 2 different parts of body
57
Tx of Crohn's?
- anti inflammatory & antibiotics - management

GNUR 293 pathophysiology (21 decks)

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