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Medsurg > GI 2 > Flashcards

GI 2 Flashcards

Exam 3

1
Q

Hiatal Hernia:

Epidemiology

A

Increases with age as supportive structures weaken over time

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2
Q

Hiatal Hernia:

Pathophysiology and clinical manifestations

A

Portion of the stomach protrudes upward through the LES and into the esophagus

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3
Q

Hiatal Hernia:

Pathophysiology and clinical manifestations

What are the two types?

A

Type 1 and type 2

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4
Q

Hiatal Hernia:

Pathophysiology and clinical manifestations

How is Type 1 acquired?

A

Type 1 hiatal hernia is mainly acquired condition that can be caused due to trauma and/or regulatory weakness

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5
Q

Hiatal Hernia:

What are clinical manifestations of Type 1?

A

clinical manifestations include anemia belching dysphasia chest pain regurgitation and heartburn

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5
Q

Hiatal Hernia:

Pathophysiology and clinical manifestations

What is Type 1?

A

the stomach intermittently slides up into the chest through a small opening in the diaphragm.

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6
Q

Hiatal Hernia:

What is Type 2? When does it occur?

A

type 2 is thought to be caused by an on an atomic defect that causes improper anchoring of the stomach below the diaphragm

occurs when part of the stomach migrates into the mediastinum parallel to the esophagus

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7
Q

Hiatal Hernia:

What are the clinical manifestations of Type 2?

A

the clinical manifestations of type 2 hernias include:

feeling full after eating,

feeling breathless after eating,

having chest pain that feels like angina,

feelings of suffocation, and

increased symptoms when laying flat

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8
Q

Hiatal Hernia:

Management: What procedures are done?

A

Upper abdominal x-ray

Endoscopy

Barium swallow with fluoroscopy

Esophagogastroduodenoscopy or EGD

Medications for symptoms of heartburn and acid reflux

Surgery

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9
Q

Hiatal Hernia:

Management: What are risk factors?

A

Obesity, pregnancy, smoking can increase chance of hiatal hernia.

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10
Q

Hiatal Hernia:

Management: What are drug treatments? What are the symptoms of those?

A

Mylanta and malox and tums can be used ot trat hiatal hernia.

But they have symptoms like constipation and diarrhea.

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11
Q

Hiatal Hernia:

Management: What should you teach patients?

A

Teach patients to avoid spicy foods, avoid acidic drinks, elevate head at 30 degrees when eating, they should have food at least 2 hours before they lay down.

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12
Q

INTESTINAL DISORDERS

Hemorrhoids:

Epidemiology: What is it? How common is it and in who?

A

Swollen or dilated veins in the anorectal area
Common disorder that affects both men and women

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13
Q

INTESTINAL DISORDERS

Hemorrhoids:

Epidemiology: What is it? How common is it and in who?

A

Swollen or dilated veins in the anorectal area

Common disorder that affects both men and women

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14
Q

INTESTINAL DISORDERS

Hemorrhoids:

Pathophysiology and clinical manifestations:
Where are hemorrhoids? What may they become? What is used to measure them?

A

Hemorrhoids are internal or external
May become thrombosed, or clotted
Standard grading system

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15
Q

INTESTINAL DISORDERS

Hemorrhoids:

Management: What is done to treat?

A

Conservative and involves relief of pain and symptoms

Cold packs and sitz baths 3-4 x’s/day reduce some swelling and pain

Surgical management

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16
Q

INTESTINAL DISORDERS

Hemorrhoids:

Management: What is surgical management

A

Rubber-band ligation, bipolar, infrared, and laser coagulation, sclerotherapy, cryosurgery, and hemorrhoidectomy

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17
Q

INTESTINAL DISORDERS

Hemorrhoids:

In basic terms, what are they?

A

They are varicose veins of the rectum.

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18
Q

INTESTINAL DISORDERS

Hemorrhoids:

What can they be caused by?

A

They may be caused due to straining during defecation or prolonged Constipation

Heavy lifting

Or prolonged standing and sitting.

As a result of portal hypertension.

Increase Intra abdominal pressure,

pregnancy,

obesity or heart failure.

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19
Q

Intestinal disorders:

Hemorrhoids: What percent are asymptomatic?

A

40% of hemorrhoids are asymptomatic.

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20
Q

Intestinal disorders:

Hemorrhoids: How is bleeding?

A

Bleeding is almost always painless and is observed as happening during a bowel movement and is associated with internal hernias.

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21
Q

Intestinal disorders:

Hemorrhoids: What are external hemorrhoids associated with?

A

External hernias are associated with itching, irritation, and pain to the rectal area.

Clinical manifestations of hernias include pain and peritus in the rectal area

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22
Q

Medical management and diagnosis of Hemorrhoid:

How are external hemorrhoids diagnosed? How are internal hemorrhoids diagnosed?

A

External hemorrhoids are diagnosed with a visual inspection.

An internal Hemorrhoids are diagnosed by digital exam.

23
Q

INTESTINAL DISORDERS

Hemorrhoids:

Management: What should patients be encouraged to do? Why?

A

The patient should be encouraged to consume adequate liquid and fibres intake to decrease Constipation associated with hemorrhoids.

24
Q

INTESTINAL DISORDERS

Hemorrhoids:

Surgical Management: What is the most commonly used technique?

A

A rubber band ligation is the most widely used technique.

The hemorrhoid is identified by using an anoscope and a rubber band is placed around the base of the hemorrhoid, which constricts circulation, causing the hemorrhoid to Slough off in two to four days.

25
Q

INTESTINAL DISORDERS

Hemorrhoids: Surgical management

Bipolar or laser

A

Bipolar or laser? Is a technique using bipolar current or laser light to cause? Coagulation and necrosis of the hemorrhoid.

26
Q

INTESTINAL DISORDERS

Inflammatory bowel disease

Crohn’s disease: What part of the GI tract does it affect?

A

Affect gastrointestinal tract from mouth to anus

27
Q

INTESTINAL DISORDERS

Inflammatory bowel disease

Crohn’s disease: Where is it more common?

A

More common in the terminal ileum and colon

28
Q

INTESTINAL DISORDERS

Inflammatory bowel disease

Crohn’s disease: What does it being a transmural disease mean?

A

a chronic inflammatory bowel disease (IBD) that causes inflammation in all layers of the bowel wall.

29
Q

INTESTINAL DISORDERS

Inflammatory bowel disease

Crohn’s disease: What is the appearance?

A

Not uniform in appearance and noted for having skip lesions with normal-appearing bowel between lesions

30
Q

INTESTINAL DISORDERS

Inflammatory bowel disease

Crohn’s disease: What is common?

A

Strictures and adhesions are common

31
Q

INTESTINAL DISORDERS

Inflammatory bowel disease

Crohn’s disease: How is the diarrhea in comparison to UC?

A

Diarrhea is less severe than in ulcerative colitis

32
Q

INTESTINAL DISORDERS

Inflammatory bowel disease

Crohn’s disease: Where is pain?

A

Pain is worse in the right lower quadrant

33
Q

INTESTINAL DISORDERS

Inflammatory bowel disease

Crohn’s disease: With exacerbation, what happens to the intestines?

A

With exacerbation the intestines become more scarred and leads to less absorption

Fistulas are abnormal tracts, develop anovaginal and retovaginal fistulas

34
Q

INTESTINAL DISORDERS

Inflammatory bowel disease
Ulcerative colitis: What does it affect and what does it involve?

A

Affects large intestine and involves only mucosa and submucosa

35
Q

INTESTINAL DISORDERS

Inflammatory bowel disease
Ulcerative colitis: What is rarely involved?

A

Small intestine is rarely involved

36
Q

INTESTINAL DISORDERS

Inflammatory bowel disease
Ulcerative colitis: What symptom is common?

A

Diarrhea is common

Blood, mucus, and pus are common with ulcerative colitis

Scar tissue is common and interferes with absorption

37
Q

INTESTINAL DISORDERS

Inflammatory bowel disease
Ulcerative colitis: What OTHER symptoms are common?

A

Abdominal pain and tenderness worse in left lower quadrant

Tenesmus (spasm of annual spinter)

38
Q

INTESTINAL DISORDERS

Inflammatory bowel disease
Ulcerative colitis: How does it spread?

A

Spread uniformly beginning at the rectum and spreading upward

39
Q

INTESTINAL DISORDERS

Inflammatory bowel disease
Ulcerative colitis: What may form?

A

Abscess might form

40
Q

INTESTINAL DISORDERS

Inflammatory bowel disease
Ulcerative colitis: What is the surgical care?

A

Total colectomy is the surgical cure

41
Q

INTESTINAL DISORDERS

Inflammatory bowel disease: How is diagnosis made?

A

Colonoscopy, sigmoidoscopy and barium enema are commonly used

42
Q

INTESTINAL DISORDERS:

Appendicitis: What is it?

A

Appendicitis is the acute inflammation of the appendix.

43
Q

INTESTINAL DISORDERS:

Appendicitis: What group of people does it occur in the most?

A

Common condition that occurs highest in 10-19 year-old age group

Affects males more than females

44
Q

INTESTINAL DISORDERS:

Appendicitis: What happens when it occurs in older adults?

A

When it occurs in older adults, it usually ruptures and is more serious and fatal.

45
Q

INTESTINAL DISORDERS:

Appendicitis:

Pathophysiology and clinical manifestations

What does this condition result in?

A

Result of a fecalith or other foreign body blocking the opening

Leads to inflammation and infection

46
Q

INTESTINAL DISORDERS:

Appendicitis:

What are risk factors or preventative measures?

A

There are no particular risk factors or preventative measures that can take place for appendicitis.

47
Q

INTESTINAL DISORDERS:

Appendicitis:

What is the appendix?

A

The appendix is a small, hard, hollow appendage that extends off the cecum. It has no known function.

48
Q

INTESTINAL DISORDERS:

Appendicitis:

What are least common causes of this?

A

Other Least common causes include malignant tumors.

Twisting or kinking of the appendix

eczema on the bowel wall

Adhesions and other infections.

49
Q

Clinical manifestations of appendicitis.

A

A patient with appendicitis presents with Umbilical abdominal pain along with nausea and vomiting.

50
Q

Clinical manifestations of appendicitis:

While the inflammatory process begins, what happens?

A

While the inflammatory process begins, pain shifts to the right lower quadrant of the abdomen and becomes very severe and steady in the area of Mcburney’s Point.

51
Q

What is an indication for appendicitis?

A

When applying and releasing pressure to the area, if the patient notes increased pain when pressure is released, it is called rebound tenderness and this is another indication of appendicitis.

52
Q

Diagnosis of the Appendicitis.

A

It is commonly diagnosed based on clinical presentation and specific physical assessment findings.

An ultrasound may reveal an enlarged appendix, but a CT scan is most commonly used for the diagnostic tests.

52
Q

What should patients avoid using when they have appendicitis? Why?

A

Laxatives and enemas should be avoided

They increase intra-abdominal pressure.

53
Q

Medical Management of acute appendicitis?

A

No medical management was warranted for acute appendicitis.

However, some patients with uncomplicated appendicitis can be treated with seven to 10 days of a course of antibiotics with follow up.

54
Q

Nursing assessments of Appendicitis

A

Tachycardia usually occurs due to fever, pain and fluid loss.

The patient may exhibit pain in the. Bernie’s point?

55
Q

For appendicitis, what should be done after surgery?

A

Advancing the diet after surgery Once they have tolerated it, once bowel sounds are returned, they can begin to have clear liquids and advance their diets slowly as vomiting and nausea are assessed.

Turning coughing, deep breathing and using the incentive spirometer 10 times every hour while awake. to helps to promote lung expansion and prevent atelectasis

Medsurg (21 decks)

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