m2 day 3 Flashcards
Gastritis
what is it, clinical manifestations, daignostic studies, risk factors
inflammatio of the gastric mucisa
- resulting in tissue edema which can cause a gastric hemorage
Clinical manifestations
Anorexia, Epigastric tenderness
Hemorrhage
Diagnostic studies
Endoscopy – biopsy
NG suction
H. pylorim (serum blood sample, biopsy)
CBC
Stool
Risk factors
Drug-related gastritis (ASA, corticosteroids, non steroidal anti imflammitories)
Helicobacter pylori
burns , chrons disease GERD, hernia
Vitamibn b12 deficiency
upper GI bleeding
esophageal, stomach and duodenal oigin and diagnostic studies
80-85% spontaneously resolve
esophageal
Varices
Any types of drugs that irritate the esophagus
Mallory weis tear
Stomach and duodenal origin (50% of all GI bleed)
Cancer
ulcers
diagnostic studies
CBC, lytes, BUN, glucose, PTT, PT/INR, ABG, T&C
Urinalysis
acute abdominal pain
risks, diagnostic studies, treatment
risks
perforation –> septic shock
hypovolemic shock
diagnostic studies
Pelvic exam and pregnancy test
Bloodwork
Urinalysis
Abdominal x-ray
CTa
emergency managment (ABCs)
Oxygen
IV –-> NS or RL
NPO
treatment/care
Pain medication
Antibiotics
I/O – (emesis)
NG tube
foley
inflammatory disorders
appendicitis
cause, clinical manifestations, diagnose w?, managment
Often caused by an occlusion of the appendicile lumen or accumulation of feces, hypergrowth of lyphoid tissue, infection
Clinical manifestations
- Abdominal pain, the pain will radiate to the RLQ, lying still with right leg flexed
diagnose with
- abominal CT
- elevated WBC
Nursing Management:
- NPO in case of surgery
- Pain control (opiods)
- heat is not advised because it may cause the appendix to rupture.
- The patient should be observed for evidence of peritonitis.
- Surgery
inflammatory disorder
peritonitis
clinical manifestations, diagnistic, nsg manamnet
Localized/generalized inflammation of peritoneum
Can be acute or chronic
Ruptured organs can lead to organs into the peritoneal cavity
Clinical manifestations
Pain, rebound tenderness (gently palpate hold it for 10-15 seconds secer paiun upon release), distension, fever
Diagnostic studies
xray
U/S or CT
Peritoneoscopy
Nursing Management:
Fluid replacement, intake and output necessary to determine if we need to replace
Antibiotics
narcotics
NPO
inflammatory disorders
gastroenteritis
S/S, nursing managment
Inflammation of mucosa of the stomach and small intestine
Often misdiagnosed with appendicitis
Signs and symptoms
Nausea vomiting dirahhrea, fever, ncreased WBC, blood in mucosa
Age-related considerations
Nursing management
NPO
IV fluids (glucose + electrolytes)
what is ulcerative colitis
clinical maifestations, diagnostic studies , drug/surgical therapies
Inflammation and ulceration of rectum and colon → bleeding, decreased muscosal area → protein loss
Starts in rectum and spread proximally along colon
Mucosa becomes edematous with multiple abscesses developing in submucosa
clinical manifestations
- Bloody diarrhea and abdominal pain with/without systemic response
diagnostic studies
- Colonoscopy
- barium enema,
- CBC (risk of blood loss)
- stool testing (C&S, C-Diff)
drug therapy
Antimicrobial (Metronidazole)
5-ASA
Corticosteroids (prednisone)
Antidiarrheal (decreasing GI motility, Loperomize, diphenoximate)
Immunosuppressant
surgical therapy
Total proctocolectomy with permanent ileostomy
Removal of colon, rectum, and anus with closure of anus
- End of ileum becomes stoma (right lower quad)
orrr Total protocolectomy with ileoanal reservoir
what is chrons disease
manifestations, complications, tests, diagnostic drug therapy
- A chronic IBD of unknown origin that can affect any part of the GI tract from the mouth to anus
- Elevated TNF-alpha levels, low RBC (ESR)
- Skip lesions, abscesses or fistulas
- Thick walls with narrowing of lumen
clinical manifestations
- Non-bloody diarrhea
- stiaterria (fat in stool)
- Pain (constant or intermittent)
- electrolyte imbalance,
- anemia
complications
- Scar tissue from inflammation narrows lumen
Strictures and obstructions
- Fistulas between segments of bowel, urinary tract, perianal areas
- Intra-abdominal abscesses and peritonitis
Diagnostic studies
- Colonoscopy, sigmoidoscopy
- Biopsy
drug therapy
- Antimicrobials
- Corticosteroids
- Immunosuppressants
- Immunodilators
- TPN
indications of surgical therapy for chrons
hemorrhage
failure to respond to conservative therapy
Fistulas
inability to decrease corticosteroids
perforation
celiac disease
manifestations
Celiac Disease
Immune mediated response
Chronic inflammation from the ingestion of gluten because it contains prolamins
This causes the partial digestion of gluten releasing prolamins which are releases the prolamin peptides into the intestinal mucosa
Clinical manifestations
Foul smelling diahreea
Stinerrhea (fat in stool)
Flatulence
Abdominal distention after gluten consumption
Malnutrition (may look overweight but will be malnourished)
Decreased bone density (no Ca absorption)
Associated w arthritis, hypothyroid, diabetes
intestinal obstruction
mechanical vs nonmechanical, care?Surgery?
Types of intestinal obstruction
Mechanical
Occlusion of lumen of intestinal tract
Small intestine: Adhesions, hernias, neoplasms
Large intestine: cancer, diverticular disease
Nonmechanical
Neuromuscular or vascular disorder
Paralytic ileus
Collaborative care
NG tube – decompress bowel
IV fluids
TPN
Surgery – partial or total colectomy, colostomy, ileostomy
ostomy surgery
types
Types
Ileostomy (Brooke ileostomy)
Colostomy
End stoma
Loop stoma
Double-barrelled stoma
diverticulitis and diverticulosis
Diverticuila → outpouching of the colon
Diverticulitis → when outpoaching becomes inflamed
Divertuculosis → multiple non inflamed diverticula
etiology of diverticula
- Due to fibre deficiency
- Slows passage of stool with narrowed lumen of sigmoid colon causes high intraluminal pressure
- Diverticulitis- due to retention of stool and bacteria in diverticulum
- Increased risk for complete perforation with peritonitis
Clinical manifestations
- Cramping in left lower quadrant relieve with flatus or BM
- Alternating constipation and diarrhea
- Fever, n & v, anorexia, elevate
Diverticulitis and diverticulosis
diagnostic studies and therapy
Diagnostic testing
Barium enema
Sigmoidoscopy
Colonoscopy
CT with contrast
CBC
Blood culture
collaborative therapy
High-fibre diet (during non-symptomatic periods)
Bulk laxatives
Stool softeners
Clear liquid diet
Oral antibiotics
Possible colon resection if perforation 30%
kidney transplant complications
Rejection
Infection
Cardiovascular disease
Malignancies
Recurrence of original renal disease
Corticosteroid-related complications
