Lewis ch 41 - upper GI problems Flashcards
feeling of discomfort in epigastric area; need to vomit
nausea
forceful ejection of partially digested food and
secretions
vomiting/emesis
where is the “vomiting center” in the brain
medulla
2 most common ABG alterations associated with vomiting
- metabolic alkalosis
2. metabolic acidosis
Chronic syndrome of mucosal
damage due to reflux of stomach
acid into lower esophagus
GERD
factors affecting LES with GERD (5)
- obesity
- smoking
- hiatal hernia of mucosal damage
- alcohol
- fatty foods
4 S+S GERD
- heartburn
- dyspepsia
- regurgitation
- respiratory symptoms
4 complications GERD
- esophagitis
- barrett’s esophagus
- respiratory (coughing, asthma, spasm)
- dental erosion
treatments for GERD (5)
- low fat diet
- no alcohol, smoking, caffeine
- upright position after meals
- lose weight
- don’t eat 3 hours before bed
4 most common and effective drugs for GERD
- proton pump inhibitors
- histamine receptor blockers
- prokinetics
- antacids
2 types hiatal hernia
sliding (most common)
rolling
S+S hiatal hernia (5)
- heartburn
- dyspepsia
- regurgitation
- chest pain
- respiratory symptoms
complications of hiatal hernia (7)
- GERD
- esophagitis
- ulcers
- hemmorhage
- stenosis
- strangulation
- aspiration
S+S eosinophilic esophagitis (6)
- heartburn
- dysphagia
- food impaction of esophagus
- nausea
- vomiting
- weight loss
possible triggers of eosinophilic esophagitis
- food: milk, eggs, wheat, rye, beef
- environmental: pollens, molds, cat, dog, dust mite allergens
treatment eosinophilic esophagitis (3)
- avoid known allergens
- PPIs
- corticosteroids
S+S esophageal strictures (3)
- dysphagia
- regurgitation
- weight loss
dilated, tortuous veins due to portal hypertension;
complication of cirrhosis
esophageal varices
- Erosion of GI mucosa from HCl acid and pepsin
- Susceptible areas of GI tract: lower esophagus, stomach, duodenum
peptic ulcer disease
risk factors gastric ulcers
H pylori
NSAIDs
bile reflux
risk factors duodenal ulcers
COPD
cirrhosis
pancreatitis
zollinger-ellison syndrome
major risk factor with peptic ulcer disease
h pylori
risk factors peptic ulcer disease (lifestyle and meds - 5)
- alcohol
- smoking
- caffeine
- NSAIDs
- corticosteroids
S+S gastric ulcer (3)
- epigastric discomfort 1-2 hours after meal
- burning or gaseous pain
- sometimes perforation is first symptom
S+S duodenal ulcer (2)
- burning/cramplike pain in midepigastric or back
- pain 2-5 hours after meal
3 major complications peptic ulcer disease
- hemorrhage
- perforation
- gastric outlet obstruction
most common complication with duodenal ulcer
hemorrhage
S+S perforation with PUD (5)
- sudden severe abdominal pain
- no relief with food or antacids
- abdomen rigid/boardlike
- bowel sounds absent
- N/V
Inflammation of gastric mucosa
gastritis
causes gastritis (5)
- NSAIDs or corticosteroids
- alcohol
- spicy foods
- H pylori
- smoking
S+S acute gastritis (4)
- anorexia
- N/V
- epigastric tenderness
- hemorrhage
S+S chronic gastritis
- similar to acute
- asymptomatic
- pernicious anemia
most common cause upper GI bleed
peptic ulcer disease
what is considered a massive GI bleed
greater than 1500 mL blood loss
25% intravascular volume
first line management of GI bleed
endoscopic therapy
3 methods used to coagulate/thrombose GI bleed during endoscopy
- clips or bands
- thermal ablation
- injection
how much blood loss is required to do surgery for GI bleed
2000 mL or shock
S+S foodborne illnesses (4)
- nausea
- vomiting
- diarrhea
- cramping abdominal pain
S+S botulism (4)
- onset 12-36 hr
- inability to talk or swallow
- dizziness
- abdominal distention
sources of botulism
- home preserved vegetables
- improperly canned or preserved food
S+S clostridial food poisoning (3)
- onset 8-24 hr
- midepigastric pain
- diarrhea
sources of clostridial food poisioning
- meat dishes cooked at lower temp
- rewarmed meat dishes
S+S E Coli food poisoning (3)
- onset 8 hr-1 week
- bloody stools
- hemolytic uremic syndrome
sources of E Coli
contaminated beef, pork, milk, cheese, fish, cookie dough
S+S salmonella (2)
- onset 8 hr-several days
- fever and chills
sources of salmonellla
improperly cooked poultry, pork, beef, lamb, and eggs
S+S staphylococcal food poisoning (2)
- onset 30 min-7 hr
- V/N/D
sources of staph food poisoning
meat, bakery products, cream fillings, salad dressings, milk
what can Escherichia Coli o157:H7 lead to
hemorrhagic colitis
kidney failure
