GI Dysfunction Flashcards
What is cholecystitis?
inflammation of the gallbladder
acute or chronic
associated with gallstones
s/sx of cholecystitis
N/V indigestion belching, flatulence RUQ pain guarding, rigidity, rebound tenderness mass palpated in RUQ elevated temp tachy s/sx of dehydration epigastric pain that radiations to scapula 2-4 hours after eating; lasting 4-6 hours \+ Murphy's sign
what is Murphys sign?
can not take a deep breath when examiners fingers are passed below the hepatic margin
s/sx if there is a biliary obstruction r/t to cholecystitis
jaundice
dark orange, foamy urine
steatorrhea, clay colored feces
pruritus
take morphine or codeine during cholecystitis may cause what?
spasm of the sphincter of Oddi and increase pain
Diet for cholecystitis
NPO during N/V episodes
low-fat meals more frequently in small amounts
Chenodeoxycholic acid (Chenodiol) and ursodiol (Actigal) are administered PO for what?
to decrease the size of gallstones or to dissolve small stones
What is cholecystectomy?
removal of the gallbladder
can be done laparoscopically
What is choledochotomy?
incision into the common bile duct to remove the stone
can be done laparoscopically
What is a hernia?
protrusion of viscus through an abnormal opening or a weakened area in the wall of the cavity in any part of the body
commonly occurs in the abdominal cavity
Reducible vs. irreducible/incarcerated hernia
R: can be placed back into the abdominal cavity
I: cannot be placed back into the abdominal cavity
What are the 4 types of hernias?
inguinal
femoral
umbilical
ventral/incisional
What is an inguinal hernia?
point of weakness in the abdominal wall where the spermatic cord in men and round ligament in women emerge
What is a femoral hernia?
protrusion through the femoral ring canal
can become easily strangulated; occurs more frequently in women
What is an umbilical hernia?
occurs when the rectus muscle is weak, or the umbilical fails to close after birth
most commonly seen in children
What is a ventral/incisional hernia?
d/t weakness of the abdominal wall at the site of a previous incision
What is a truss?
device that applies pressure to the hernia, keeping it in the abdominal cavity
What is appendicitis?
inflammation of the appendix
causes of appendicitis
appendix may be gangrenous or rupture
perforation
abscesses
s/sx of appendicitis
periumbilical pain that shifts to RLQ at McBurney's point low grade fever anorexia N/V localized tenderness rebound tenderness/muscle guarding Rovsing's sign
what is Rovsing’s sing?
pain felt in the RLQ when the LLQ is palpated
What is peritonitis?
inflammation of the peritoneum
causes of peritonitis
adhesions (scar tissue) ileus PNA hypovolemic shock septicemia intrabdominal abscess paralytic ileus organ failure
s/sx of peritonitis
abdominal pain tenderness over involved area rebound tenderness muscular rigidity spasms abdominal distention or ascites fever tachy N/V altered bowel habits
What is peptic ulcer disease?
any ulceration of the mucosa of the esophagus, stomach, or duodenum
What are the most common peptic ulcers?
gastic ulcers
duodenal ulcers
Typical age range for PUD
45-70 y/o
risk factors for PUD
chronic use of ASA, NSAIDS, corticosteroids smoking family hx alcohol use gastritis
s/sx of PUD
gnawing, sharp pain that occurs to the L of or mid-epigastric region 1-2 hours after eating
N/V
bleeding
PUD treatment
rest
bland diet (6 small meals daily)
stop smoking
antacids (Ca carbonate, Al hydroxide gels)
H2 Receptor blockers (Tagamet, Zantac, Pepcid)
Anticholinergic (ProBanthine)
What is diverticulitis?
complication from diverticulosis in which an inflammation of perforation of the diverticulum results
About ___% of the the population ___ y/o and older have diverticula and the percentage increases with age.
50%
40 y/o
more common in men than women
diverticulitis risk factors
increasing age
stress
lack of fiber and bran in the diet
cause of diverticulitis
when food particles and bacteria becomes trapped in the diverticulum, creating a hardened mass known as fecalith
s/sx of diverticulitis
many pts are asymptomatic abdominal pain D/C bleeding gas formation abdominal distention fever
What is IBS?
disorder of GI motility with progressive changes in bowel function from diarrhea and constipation, or alternating between the 2
s/sx of IBS
episodic abdominal pain, cramping
bloating
flatulence
alternating D/C
IBS treatment/care
well-balance, high fiber diet for constipation
limit fiber and irritating foods for diarrhea
8 glasses of water daily
record amount, consistency of stools
establish a regular time for BM daily
discourage alcohol and caffeine use
What are hemorrhoids?
dilated and distended veins in the anal and rectal areas that are located either internally or externally
hemorrhoids are typically seen in adults age ___ - ___ y/o
20-50
risk factors for hemorrhoids
pregnancy
prolonged constipation
straining during defecation
portal HTN
s/sx of hemorrhoids
bleeding with BM
itching and pain
internal/external bulge
mucous discharge
What are the 5 different types of ostomies?
colostomy ileostomy cecostomy loop colostomy double-barrel colostomy
What is a colostomy?
surgical opening created from the colon through the abdominal wall
What is a ileostomy?
opening from the ileum through the abdominal wall
What is a cecostomy?
opening of the cecum through the abdominal wall
What is a loop colostomy?
temporary colostomy that is made when immediate relief is needed for the bowel, often r/t obstruction
What is a double-barrel colostomy?
temporary colostomy that is made after bowel resection if anastomosis is not an option at the time of surgery
When should an ostomy pouch be emptied?
when it is no more than 1/2 full
What and how much should a colostomy be irrigated with?
500-1000 mL of warm, tap water
How to introduce foods after an ostomy
slowly, one at a time to check for tolerance
