GI Flashcards
gastritis?
inflammation of gastric mucosa
how is chronic gastritis divided?
autoimmune
diffuse antral
multifocal
autoimmune gastritis
involves body and fundus of stomach
diffuse antral gastritis
affects antrum
multifocal gastritis
diffuse throughout the stomach
gastritis occurs as a result of…
breakdown in the normal gastric mucosal barrier
what does the mucosal barrier do?
protects stomach tissue from autodigestion of HCL and pepsin enzyme
what happens when mucosal barrier is broken?
HCL can diffuse into mucosa
what does HCL diffusing into mucosa lead to?
tissue edema, disruption of capillary walls with loss of plasma into gastric lumen, possibly hemorrhage
drugs that cause gastritis
ASA, NSAIDS, corticosteroid drugs
diet that causes gastritis
alcohol, spicy food
microorganisms that cause gastritis
helicobacter pylori, salmonella, staphylococcus
environment that causes gastritis
radiation, smoking
pathophysiological conditions that cause gastritis
burns, crohns, hernia, physioogical stress, reflux of bile and pancreatic secretions, renal failure, sepsis, shock
other factors that cause gastritis
- endoscopy
- nasogastric suction
- psychological stress
symptoms of acute gastritis
anorexia, N & V, epigastric tenderness, fullness feeling , hemorrhage
symptoms of chronic gastritis
same as acute
diagnostics for acute gastritis
hx of drug and alcohol use
diagnostics for chronic gastritis
endoscopic exam with biopsy, CBC
if vomiting accompanies acute gastritis, what is prescribed?
bed rest, NPO, IV fluids
what drugs are given for N & V in acute gastritis?
antiemetics
in those with acute gastritis and hemorrhage is likely, what do we do?
VS frequently, check vomit for blood
what drugs are given to relieve symptoms of abdominal discomfort in those with acute gastritis?
antacids
treatment of chronic gastritis focuses on?
eliminating the cause such as cessation of alcohol and drugs
diet of those with chronic gastritis
non irritating, 6 meals a day, use of antacid after meals, smoking contraindicated
what PUD?
erosion of the GI mucosa
what does PUD result from?
digestive action of HCL and pepsin
how are acute ulcers characterized?
superficial erosion and minimal inflammation
whats more common, acute or chronic ulcers?
chronic
what type of environment do peptic ulcers develop in?
acidic
where are gastric ulcers commonly found?
lesser curvature close to the antral junction
whats more common, gastric or duodenal ulcers?
duodenal
whats stress related mucosal disease?
condition of acute ulcers that develop after a major insult such a trauma or surgery
do those with gastric or duodenal ulcers commonly experience pain?
no as there are not many pain receptors
clinical manifestations of gastric ulcer?
- burning, cramping, pressure like pain is upper mid epigastric region
- pain 1-2 hours post meals
- pain can be worse with food intake
- N&V
- weight lss
clinical manifestations of duodenal ulcers
- pain 2-4 hours after meals
- N & V
how is pain of duodenal ulcers relieved?
- antacids or food
major complications of chronic PUD?
hemorrhage, perforation, gastric outlet obstruction
diagnostics of PUD?
- hx
- physical exam
- endoscopy
- urea breath test
- barium studies
- gastric analysis
- CBC
acute management of acute PUD?
- NPO
- ABCS and VS
- IV fluid replacement
- best rest
- blood transfusions
- NG suction
conservative management of PUD?
adequate rest bland diet 6 smalls day per day no smoking or alcohol or caffeine or irritating food reduce stress
nursing diagnoses of PUD?
acute pain
ineffective health management
N
appendicitis?
inflammation of appendix
cause of appendicitis
occlusion of appendiceal lumen by feces
what can occlusion of appendiceal lumen lead to?
infection, abscesses, gangrenem perforation, peritonitis
S&S of appendicitis
- periumbilical pain
- anorexia
- N&V
- leukocytosis
physical assessment findings of appendicitis
mcburney point rebound tenderness muscle guarding lies still with flexed right leg low grade fever movement aggravates pain
diagnostic studies of appendicitis
- hx and physcial exam
- WBC count
- imaging studies like x ray ct and ultrasound
collaborative care for appendicitis
no use of laxatives NPO no heat monitor for peritonitis appendectomy antibiotics IV fluids
peritonitis
inflammation of peritoneum
what causes peritonitis
trauma or rupture of an organ containing bacteria or irritants
most common symptom of peritonitis
abdominal pain
universal sign of peritonitis
tenderness
diagnostic studies of peritonitis
CBC hx physical exam serum electrolytes abdominal radiographic exam abdominal paracentesis and culture of fluid ct scan ultrasiund peritonoscopy
therapy for non op or pre op in those with peritonitis
npo O2 fluid replacement antibiotics NG suction analgesics
therapy for post op in pt with peritonitis
NPO NG suction semi fowlers IV fluids antibiotics blood transfusions sedatives
inflammatory bowel disease
crohns and ulcerative colitis
ulcerative colitis
inflammation of rectum and colon
when does UC peak
ages 15-25
what does UC cause
hyperemia and edema
malabsorption
what do ulcers cause
bleeding and diarrhea
what does inflammation cause
decreased surface area for absorption
major symptoms of UC
bloody diarrhea and abdominal pain
what does a mild case of UC look like
1-2 semi formed stools with small amounts of blood per day
what does a moderate case of UC look like
increased stool, 4-5 stools per day, increased bleeding with fever and anorexia
what does a severe case of UC look like
10-20 loose stools per day with increased bleeding and contains mucous, weight loss, tachycardia, dehydration, anemia
complications of UC
hemorrhage perforation toxic megacolon fulminant colitis greater risk of colon cancer
toxic megacolon
extensive dilation and paralysis of colon
fulminant colitis
severe form of acute colitis
extraintestinal manifestations of UC
arthritis osteoporosis finger clubbing ulcers of mouth conjuctivitis erythema thromboembolism clostridium difficile gall stones kidney stones
diagnostics of UC
hx physical exam cbc wbc ct mri barium enema
collaborative care for UC
- rest bowel inflammation/infection
manage fluids and nutrition
manage stress
nursing management for UC
pain control
fluid and electrolyte balance
i and os
monitor stool
crohns disease
chronic inflammatory bowel disorder
origin of crohns
unknown
affects what part of the body
from mouth to anus (GI tract)
what ages does crohns commonly affect
15-30
cm of crohns
diarrhea, fatigue, abdominal pain, weight loss, fever, dehydration, anemia, perineal disease
extra intestinal complications of crohns
arthritis
finger clubbing
complications of crohns
fistulas malabsorption arthritis liver disease bowel perforation
diagnostics of crohns
-hx physical endoscopy barium studies electrolytes cBC ESR check stool for blood
diet for crohns
high calorie high vitamin high protein dairy free low residue low fat inj of vit b 12
drugs for crohns
antimicrobial agents
corticosteroid drugs
immunosuppressnts
immunomodulators
