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Patho > GI disorders > Flashcards

GI disorders Flashcards

1
Q

What is GORD?

A

Transient LOS (lower oesophageal sphincter) Relaxation
* LOS pressure abnormalities
* Reflux of acid, bile, pepsin & pancreatic enzymes – oesophageal mucosal injury
* Symptoms of reflux (i.e. heartburn and regurgitation) impair the quality of life of a person or put them at risk of complications e.g. Barrett’s esophagus

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2
Q

what is GORD caused or exacerbated by?

A
  • Hiatus hernia (when the oesophageal junction is displaced)
  • Central obesity (increases the pressure gradient between the abdomen and thorax, increasing the number of reflux episodes and the likelihood of hiatus hernia occurring)
  • Impaired oesophageal or gastric clearance (slows the movement of material down the digestive tract)
  • Stress is a causative factor for symptoms in 60% of ppl with GORD. Symptoms of GORD may be aggravated by diet and lifestyle, e.g. high-fat foods, spicy foods, caffeine, alcohol, and smoking
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3
Q

Treatment for GORD

A

“Zole” treatments: Omeprazole, pantonprazole, lansoprazole
PPI’s (30-60 min before meals)
-fundoplication : wraps the top of the stomach around the lower esophagus

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4
Q

what are some issues when having GORD?

A
  • Dysphagia (difficulty with swallowing)
  • Odynophagia (pain with swallowing)
  • Haematemesis (vomiting blood)–> needs immediate attention is vomit looks like coffee grounds
  • unexplained weight loss
  • ppl over 55yrs with persistent dyspepsia at higher risk of gastric and esophageal cancer
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5
Q

GORD complications

A
  • Erosive oesophagitis occurs when excessive gastric reflux
  • Barrett’s esophagus is a complication of chronic GORD
  • peptic stricture is a narrowing of the esophagus
    risk of oesophageal adenocarcinoma - correlated with the frequency, severity, and duration of symptoms
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6
Q

What is the role of prostaglandins in the GI tract?

A

-help with smooth muscles contractions, and gastric secretion, help stop cells from breaking down in Gi tracts, Helps with increased mucus secretion
-NSAIDS stops prostaglandins, reducing mucus secretion and protection, which is why you need to take with food

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7
Q

what are some Selective NSAIDS

A

Celevrax, Mobic

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8
Q

What are some Nonselective NSAIDs

A

Aspirin, Diclofenac, ibuprofen, Naproxen, Mefenamic acid, indomethacin, indomethacin, keptoprofen

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9
Q

what is H.pylori ?

A

Heliobacter pylori
- Damages stomach mucosa by inducing a chronic inflammatory response
- Protective layers destroyed. Reduce mucosal blood flow
- Hypersecretion in acid
- Increase in mass parietal cells due to: Pro-inflammatory mediators and Increase in the release of GIT hormone gastrin
- Decreases release of somatostatin -an inhibitor of acid secretion

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10
Q

Diagnosis of H.pylori

A

a breath test on Carbon 14 urea test

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11
Q

what are the investigations & findings for helicobacter pylori?

A
  • full blood count may reveal anemia (due to bleeding, malabsorption, and not consuming enough)
  • breath, blood, and/or stool test may reveal the presence of H. pylori
  • endoscopy may demonstrate eroded gastric mucosa.
  • fecal test may reveal melena (blood in stool, looks black)
  • assessment of vomitus may reveal haematemesis
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12
Q

WHat is malabsorption?

A
  • Condition characterized by a loss of mucosal tissue, resulting in decreased absorptive surface of the gut and/or availability of intestinal enzymes.
  • Include coeliac sprue (coeliac disease) and tropical sprue
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13
Q

signs and symptoms of malabsorption

A
  • Diarrhoea and steatorrhea (Fatty stools- clay colored)
  • Vomiting
  • Abdominal distension and pain
  • Anorexia
  • Glossitis
  • Malnutrition (tested in urine sample)
  • Electrolyte imbalance
  • Anaemia
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14
Q

what is Lactose Intolerance?

A

A deficiency in lactase results in:
o fermentation of lactose by large bowel gut flora
o large amounts of gas production in the gut lumen
o an increase in gut osmotic pressure from undigested lactose

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15
Q

What is Celiac disease?

A
  • Autoimmune
  • damages the villi, - unable to absorb nutrients
  • also called celiac sprue or gluten-sensitive enteropathy
    • an immune reaction to eating gluten, a protein found in wheat, barley, and rye
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16
Q

What is the pathophysiology to Celiac disease?

A

Results from an improper immune response to the storage of gluten:
o associated with a T cell–mediated inflammation
o production of antibodies against gliadin and antitransglutaminase
o enterocyte destruction, villous atrophy, mucosal flattening and malabsorption

accompanied by intraepithelial lymphocytes and hyperplasia of the intestinal glands

17
Q

what are Diagnostic tools for Celiac disease

A
  • Biochemistry: folate and vitamin B12 deficiency.
  • Faecal collection tests to determine the degree of steatorrhoea
  • Barium swallow and endoscopy (oesophagoduodenoscopy):
    maybe beneficial to identify mucosal changes or exclude other disease processes
  • There would most likely be mucosal flattening: associated with enterocyte destruction and villous atrophy
18
Q

what is management for Celiac D.

A
  • Nutritional support
  • Correction of anemia: folic acid, vitamin B12, iron supplementation.
  • Antibiotics
19
Q

What is Giardia Lamblia

A

A parasite that you get from water, lives in GI tracts folds. Make more cysts. Interferes with Vit A and fat absorption.
-causes malnutrition

20
Q

What is dumping syndrome? and signs and symptoms?

A

Gastric emptying
Early dumping syndrome
* Nausea
* vomiting
* abdominal pain and cramping
* diarrhoea
* feeling uncomfortably full or bloated after a meal
* sweating
* weakness
* dizziness
* flushing, or blushing of the face or skin
* rapid or irregular heartbeat
Late dumping syndrome
* hypoglycaemia ( moves too quickly, unable to absorb)
* flushing

21
Q

What is appendicitis

A

appendix becomes inflammed and edematous as a result of either becoming kinked or occluded by a fecolith (ie, hardened mass of stool), tumor, or foreign body.
* Reduced blood flow to the tissue
* Bacteria multiplies – pus fills up
* Ischaemia - Pressure within lumen increases & reduce venous drainage
* Untreated leds to necrosis and gangrene
* Risk for perforation – 72hrs from obstruction. When burst can cause Peritonitis

22
Q

clinical manifestations for appendicitis

A

*Epigastric (around stomach) or periumbilical pain progresses to the right lower quadrant. Usually worse on coughing and movement.
*Low-grade fever
- nausea and sometimes vomiting.
- Loss of appetite.
*Local tenderness is elicited at McBurney’s point when pressure is applied
*Rebound tenderness (ie, production or intensification of pain when pressure is released) may be present.
*Rovsing’s sign - elicited by palpating the left lower quadrant; this causes pain to be felt in the right lower quadrant

23
Q

What are the diagnostics around appendicitis?

A
  • Complete blood cell count (looking at WBC)
  • Imaging studies (X-rays, ultrasounds scans)
  • Pregnancy test: rule out ectopic pregnancy
  • C-reactive protein: protein produced by liver when bacterial infections occur and rapidly increase within the first 12 hours
24
Q

Nursing interventions for appendicitis

A
  • Monitor frequently for signs and symptoms of worsening condition, indicating perforation, abscess, or peritonitis (increasing severity of pain, tenderness, rigidity, distention, absent bowel sounds, fever, malaise, and tachycardia). Extra aware of heart rate, temp., and pain)
  • Notify medical team immediately if pain suddenly ceases, this indicates perforation, which is a medical emergency.

*Assist patient to position of comfort such as semi-fowlers with knees are flexed.
*Do not give analgesics/antipyretics to mask fever, and do not administer cathartic (Laxative- can potentially cause rupture) because they may cause rupture.

25
Q

Medical and surgical management for appendicitis

A
  • before surgery: correction or prevention of fluid and electrolyte imbalances and dehydration through antibiotics and IV fluids
    -Analgesics can be given after diagnosis
  • appendectomy, laparotomy or laparoscopy
26
Q

Nursing Management

A

*Prepare the patient for surgery, which includes an intravenous infusion to replace fluid loss and promote adequate renal function and antibiotic therapy to prevent infection.
*Post-operatively, Place the patient in a semi-Fowler position to reduce the tension on the incision and, thus, reduce pain.
*Administer painkillers (usually morphine sulfate), as prescribed.
- Start oral fluids when tolerated and intravenous fluids as indicated. Food is provided as desired and tolerated on the day of surgery

27
Q

Nursing Responsibilities

A
  • Relieving Pain.
  • Preventing Fluid Volume Deficit.
  • Reducing Anxiety.
  • Eliminating Infection.
  • Maintaining Skin Integrity. Prevent DVT
  • Attaining Optimal Nutrition

Patho (5 decks)

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