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NUR 326 > GI > Flashcards

GI Flashcards

1
Q

upper GI problems occur in the……

A

Esophagus, Stomach, Beginning of small intestines

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2
Q

lower GI problems occur in the…….

A

Small intestines, colon (large intestines), rectum/anus

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3
Q

define dysphagia

A

Difficulty swallowing.

Begins with solids and progresses to liquids

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4
Q

dysphagia: common causes

A
  1. Mechanical obstruction: Stenosis or stricture, Diverticula, Tumors
  2. Neuromuscular dysfunction: CVA, Achalasia – LES can’t open properly
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5
Q

GERD

A

Backflow of gastric acid from the stomach into esophagus.
Occurs via the lower esophageal sphincter (LES).
Highly ACIDIC material!

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6
Q

GERD: Etiology

A

Anything that alters closure strength of LES or increases abdominal pressure

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7
Q

GERD: Clinical Manifestations

A

Heartburn (pyrosis)
Dyspepsia
Regurgitation
Chest pain
Dysphagia
Pulmonary symptoms

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8
Q

GERD: Complications

A

ulceration
scarring
strictures
Barrett esophagus- most severe.

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9
Q

define Hiatal Hernia

A

A defect in the diaphragm that allows part of the STOMACH to pass into the THORAX

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10
Q

Hiatal Hernia: Pathophysiology

A

Exact cause is unknown.
Age related.
Injury or other damage may weaken the diaphragm muscle.
Repeatedly putting too much pressure on the muscles around the stomach: Severe coughing, Vomiting, Constipation and straining to have a bowel movement.

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11
Q

2 types of Hiatal Hernia

A

Sliding hernia – usually small and often do not need treatment.
Paraesophageal hernia- part of the stomach pushes through the diaphragm and stays there.

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12
Q

Hiatal Hernia: risk factors

A

Age
Obesity
Smoking

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13
Q

Hiatal Hernia: clinical manifestations

A

Asymptomatic
Belching
Dysphagia
Chest or epigastric pain

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14
Q

Hiatal Hernia: treatment

A

Mostly a conservative treatment
Teaching: small, frequent meals, avoid lying down after eating
Avoid tight clothing and abdominal supports
Weight control for obese individuals
Antacids for the GERD/esophagitis symptoms
Surgery if the conservative treatments do not work

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15
Q

define Gastritis

A

Inflammatory condition of the stomach

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16
Q

define acute gastritis

A

TEMPORARY inflammation of the STOMACH lining only (intestines NOT affected)

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17
Q

how long does acute gastritis last?

A

Generally last from 2-10 days

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18
Q

Acute Gastritis Etiology

A

Irritating substances (alcohol)
Drugs (NSAIDs)
Infectious agents- H.Pylori

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19
Q

define chronic gastritis

A

PROGRESSIVE disorder with chronic inflammation in the stomach

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20
Q

how long can chronic gastritis last?

A

Can last weeks to years

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21
Q

Chronic Gastritis: etiology

A
  1. Autoimmune: Attacks parietal cells
  2. H. pylori infection
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22
Q

Chronic Gastritis: complications

A

PUD, bleeding ulcers, anemia, gastric cancers

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23
Q

What is H. pylori?

A

Helicobacter pylori bacterium.
Acidic environment.
Destructive pattern of persistent inflammation: Can cause chronic gastritis, PUD, and stomach cancer

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24
Q

how is H.Pylori transmitted?

A

Person to person via saliva, fecal matter, or vomit
Contaminated food or water

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25
Q

Acute or Chronic Gastritis: Clinical Manifestations

A

Sometimes none
Anorexia
N/V
Postprandial discomfort
Intestinal gas
Hematemesis
Tarry Stools
Anemia

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26
Q

define Acute Gastroenteritis

A

Inflammation of stomach & SMALL INTESTINE

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27
Q

Acute Gastroenteritis: etiology

A

Viral infections: Norovirus and rotavirus
Bacterial infections: E. col, salmonella, campylobacter
Parasitic infections

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28
Q

how long does Acute Gastroenteritis last?

A

Usually lasts 1-3 days but may last as long as 10 days

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29
Q

Acute Gastroenteritis: clinical manifestations

A

Watery Diarrhea: May be bloody if bacterial.
Abdominal pain
N/V
Fever, malaise

30
Q

Acute Gastroenteritis: complications

A

fluid volume deficits

31
Q

Peptic Ulcer Disease (PUD)

A

Ulcerative disorder of the upper GI tract
Esophageal
Stomach: gastric ulcers
Duodenum: peptic ulcer in the first part of the small intestine
Develops when the GI tract is exposed to acid and h. pylori.

32
Q

PUD: Etiology

A

H. pylori
Injury-causing substances: NSAIDs, ASA, alcohol.
Excess secretion of acid
Smoking
Family history
Stress - remember there is increased gastric acid secreted with the stress response

33
Q

Risk factors: NSAID-Induced Peptic Ulcer Disease

A

Age
Higher doses of NSAIDs
History of PUD
Use of corticosteroids and anticoagulants
Serious systemic disorders
H. pylori infection

34
Q

PUD: Pathogenesis

A

Mucosa is damaged
Histamine is secreted, resulting in: Increase in acid and pepsin secretion- causes further tissue damage, Vasodilation– causes edema.
If blood vessels are destroyed, this results in BLEEDING.

35
Q

PUD: Classification

A

Duodenal ulcer Most common type, Age – any; early adulthood
Gastric/peptic ulcer: Age – peak 50 - 70; Why? Increased use of NSAIDS, corticosteroids, anticoagulants and more likely to have serious systemic illnesses

36
Q

PUD: Clinical Manifestations

A

Sometimes none
N/V, anorexia
Weight loss
Bleeding
Burning Pain: in middle of abdomen that is usually worse when the stomach is empty

37
Q

gastric ulcers: characteristics, location, timing

A

characteristics: burning, cramping, gas-like
location: epigastrium, back
timing: 1-2 hours after eating

38
Q

duodenal ulcers: characteristics, location, timing

A

characteristics: burning, cramping, gas-like
location: epigastrium, back
timing: 2-4 hours after eating

39
Q

PUD: Complications

A

“HOP” Complications
H – Hemorrhage
O – Obstruction
P – Perforation and Peritonitis

40
Q

name 5 lower GI problems

A

appendicitis
peritonitis
irritable bowel disorder
inflammatory bowel disorder: crohns, ulcerative colitis.
diverticulosis/diverticulitis.

41
Q

define Appendicitis

A

Inflammation of the appendix

42
Q

Appendicitis: etiology

A

Appendix is OBSTRUCTED
Leads to INFLAMMATION

43
Q

Appendicitis: complication

A

Gangrene
Abscess formation
PERITONITIS

44
Q

Appendicitis s/s

A

Classic Pain: RLQ in periumbilical area.
Rebound Pain= Pain is SEVERE after release of
palpating hand over the RLQ.
Sudden pain relief may indicate rupture: Peritonitis.

low grade fever, Nausea, anorexia

45
Q

define Peritonitis

A

Inflammation of the PERITONEUM.
Serous membrane that lines abdominal cavity & covers visceral organs.

46
Q

Peritonitis: What happens to the peritoneum?

A

INFLAMMATION
Fluid shifts – THIRD SPACING, Can lead to hypovolemic shock and sepsis.
DECREASED PERISTALSIS.
Can lead to paralytic ileus and intestinal obstruction.

47
Q

Peritonitis: Causes

A

Perforated ulcer
Ruptured gallbladder
Pancreatitis
Ruptured spleen
Ruptured bladder
Ruptured appendix

48
Q

Peritonitis: Clinical Manifestations

A

Usually sudden and severe
Abdominal pain*
Tenderness
Rigid “board-like” abdomen
N/V
Fever
Elevated WBC
HR increased
BP decreased

49
Q

define Irritable Bowel Syndrome

A

Chronic condition characterized by: alterations in bowel pattern due to changes in intestinal motility,
Chronic and frequent constipation (IBSC)
Chronic and frequent diarrhea (IBSD)

50
Q

Irritable Bowel Syndrome: Symptoms

A

Abdominal distension, fullness, flatus, and bloating.
Intermittent abdominal pain exacerbated by stress and RELIEVED BY DEFECATION.
Bowel urgency.
Intolerance to certain foods (sorbitol, lactose, gluten).
Non-bloody stool that may contain mucous.

51
Q

Psychosocial Stress and IBS

A

is almost never the result of primarily psychological causes.
can be exacerbated by stress
can cause stress and psychological problems

52
Q

causes of IBS

A

Cause UNKNOWN but thought to be “triggered” by stress, food, hormone changes, GI infections, menses

53
Q

define Inflammatory Bowel Disease (IBD)

A

A group of life-changing, chronic illnesses

54
Q

IBD Characterized by:

A

Chronic inflammation of the intestines.
Exacerbation and remissions.

55
Q

TWO SEPARATE DISORDERS of IBD

A

Crohn’s disease
Ulcerative colitis

56
Q

etiology for IBD

A

Genetically AUTOIMMUNE activated by an infection

57
Q

IBD is most common in

A

WOMEN, Caucasians, persons of Jewish descent, and smokers

58
Q

Crohn’s DiseasePathogenesis

A

Lymph structures of the GI tract are blocked.
Tissue becomes engorged and inflamed.
Deep linear FISSURES and ULCERS develop in a ”patchy” pattern in the bowel wall.
SKIP LESIONS
COBBLESTONE APPEARANCE

59
Q

Crohn’s Disease: complications

A

Malnutrition: Anemia
Scar tissue and obstructions
Fistulas
Cancer

60
Q

Crohn’s Disease: Clinical Manifestations

A

Crampy lower Abdominal pain (RLQ).
Watery diarrhea
SYSTEMIC: Weight loss, fatigue, no appetite, fever, malabsorption of nutrients.
Palpable abdominal mass (RLQ).
Mouth ulcers.
S/S of fistulas.

61
Q

Ulcerative Colitis: define

A

Inflammation of the mucosa of the RECTUM AND COLON. Usually develops in the third decade of life.

62
Q

Ulcerative Colitis is most common in…

A

white people of European descent, esp. Ashkenazi Jewish descent
Occasionally in Black/African Americans
Rare in Asians

63
Q

Ulcerative colitis: pathogenesis

A

Inflammation begins in the rectum and extends in a CONTINUOUS segment that may involve the ENTIRE colon.
Inflammation leads to large ulcerations.
Necrosis of the epithelial tissue can result abscesses – CRYPT ABSCESSES.
Colon and rectum try to repair the damage with new granulation tissue.

64
Q

Ulcerative Colitis:Clinical Manifestations

A

Abdominal pain
Bloody diarrhea
Systemic: Weight loss, fatigue, no appetite, fever

65
Q

ulcerative colitis: complications

A

*Hemorrhage
*Perforation
*Cancer
Malnutrition
Anemia
Strictures
*FISSURES
*ABSCESSES
*TOXIC MEGACOLON – a rapid dilation of the large intestine that can be life-threatening
COLORECTAL CARCINOMA
Liver Disease – from inflammation and scarring of bile ducts
Fluid, electrolyte and PH imbalances

66
Q

Diverticulosis: Pathogenesis

A

Small pouches in lining of colon that bulge outward through weak spots.
May be CONGENITAL or ACQUIRED

67
Q

causes of Diverticulosis

A

low fiber diet with resulting chronic constipation

68
Q

Diverticulosis: usual location

A

DESCENDING COLON

69
Q

Diverticulosis: Clinical Manifestations

A

Usually asymptomatic
Discovered accidentally or with presentation of acute diverticulitis.

70
Q

define Diverticulitis

A

INFLAMMATION of one or more of the pouches (diverticula)
Usually from retained fecal material.

71
Q

Diverticulitis: Clinical manifestations

A

Abdominal pain – LLQ
Fever
WBC’s increased
Constipation or diarrhea
Acute – passage large quantity of frank blood.
May resolve spontaneously

72
Q

Diverticulitis: complications

A

Perforation
Peritonitis
Obstruction

NUR 326 (15 decks)

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