Medical Issues Ch. 9 Flashcards
viral gastroenteritis (stomach flu)
- S/S
- Tx
- referral
S/S -diarrhea -nausea -vomiting -abdominal spasms -fever -aches and chills -only lasts up to 48 hours Tx -supportive treatment -attention to hydration -OTC anti-diarrheals and antiemetics -BRAT diet refer if symptoms persist >48 hours
BRAT diet
bananas
rice
apple sauce
toast
food poisoning
- S/S
- Tx
- Referral
- RTP
S/S -diarrhea -nausea -vomiting -severe abdominal cramping -high fever -lasts longer than 48 hours Tx -OTC meds. -supportive treatment Refer if blood in stool or severe symptoms RTP when symptoms have completely resolved -no fever for 24 hours
traveler’s diarrhea
- S/S
- Tx
- Referral
- RTP
S/S -diarrhea -abdominal spasm -fatigue Tx -OTC meds -avoid contamination -supportive treatment Refer if blood in stool or symptoms >3 days RTP when symptoms have completely resolved
parasitic infections
- S/S
- x
- Referral
S/S -giardia --significant gas --diarrhea --dull abdominal cramping and bloating -entamoeba --chronic intermittent diarrhea --bloody diarrhea --abdominal pain --weight loss Tx -prompt diagnosis and referral is paramount physician will determine RTP and treatment guidelines
dyspepsia
- S/S
- Tx
- referral
S/S
-irritation of the mucosum in the upper GI
-common heartburn
-indigestion
-burning under the sternum
Tx
-dietary changes
-OTC antacids (taken after meals and before bedtime)
-separate dosing of antacids with other drugs at least 2 hours
Refer for stronger meds. with chronic heartburn
refer
-weight loss
-abnormal masses in the abdomen
-hematochezia
-fever
dyspepsia DDx
gastroesophageal reflux
ulcer
gastroesophageal reflux (GERD)
- S/S
- Tx
- Referral
gastroesophageal sphincter malfunctions
S/S
-more frequent and intense than dyspepsia
-heartburn
-chest pain
-belching
-regurgitation of food and acid
-possible
–asthma-like symptoms
–chronic cough and laryngitis
Tx
-changes in lifestyle behaviors (stress, food, etc.)
-PPI and H2 blockers inhibit acid production (taken before a meal)
Referral necessary if persists for several weeks or becomes worse
PPI
proton pump inhibitor
-nexium
H2 blockers
reduce acid
hiatal hernia
- S/S
- Tx
small HH's = to sx causes GERD -gastroesophageal sphincter is forced open worse when lying down relieved when sitting up Tx -medication and surgery
peptic ulcer disease
- S/S
- Tx
intermittent pain in the upper and middle abdomen
pain can radiate to the thoracic spine, chest and neck
eating may make it better or worse
pain at night is common
recurrent vomiting and loss of appetite may cause weight loss
perforated ulcers can cause bloody vomit (hematemesis) or “coffee ground” vomit
Tx
-treat the cause
-avoid irritants
-antacids and antibiotics for H Phlori
-PPIs and H2 blockers help
-scope to make sure no tumors are present
inflammatory bowel disease
-types
autoimmune disease
- Crohn’s Disease
- Ulcerative Colitis
inflammatory bowel disease
- S/S
- Tx
S/S -abdominal pain -chronic diarrhea -hematochezia -weight loss -palpable abdominal mass -loss appetite -skin rash -intermittent joint pain Tx -no cure -managed --diet --lifestyle changes --medication --surgery
irritable bowel syndrome (IBS)
- 4 types
- S/S
- Tx
4 types -diarrhea -constipation -diarrhea alternating with constipation -bloating and generalized abdominal discomfort S/S -complaints of urgency or incomplete evacuation Tx -treat cause --psychosocial evenst --poor diet --reasonable physical activity -OTC meds -no limitatins with IBS
appendicitis
-S/S
S/S
- begins as generalized abdominal pain
- pain centralizes to the LRQ in about 12 to 18 hours
- McBurney’s Point; “Jar Sign”
- nausea and loss of appetite; not relieved with a bowel movement
- low grade fever may be present with infection
- patient has an unwillingness to stand straight up
McBurney’s Point
halfway between ASIS and belly button
Jar Sign
rebound tenderness
-pain when you release after pushing into a tissue
diverticulosis and diverticulitis
diverticulosis -herniations of the mucosa and submucosa through the muscular layer of the intestinal wall -10% of Americans diverticulitis -obstruction of the herniation (feces)
diverticulosis and diverticulitis
- S/S
- Tx
S/S -diverticulosis is commonly asymptomatic -diverticulitis --severe abdominal cramping --constant pain in LLQ --radiating pain --constipation --diarrhea --fever -rectal bleeding Tx -high fiber diet -light exercise -severe cases --antibiotics --emergency surgery
hemorrhoids
- S/S
- Tx
S/S -blood with defecation -pain and itching, especially during sitting Tx -changes in diet -topical medications -surgery
abdominal trauma
- refer if…
- most susceptible organs
refer if... -persistent abdominal pain -localized tenderness -abdominal rigidity -upper GI signs -bruising ...following trauma most susceptible -spleen -liver
spleen trauma
-S/S
shock Kehr's sign -left shoulder persistent abdominal pain, local tenderness in the LUQ, abdominal rigidity nausea and vomiting
splenomegaly
enlarged spleen
-associated with mono
liver trauma
-S/S
persistent abdominal pain
RUQ tenderness
upper GI signs (nausea, vomiting)
hepatic-biliary diseases
hepatitis
cirrhosis
gallstones and gallbladder disease
pancreatitis
hepatitis
- what is it?
- stages of infection
what is it? -"inflammation of the liver" -viral infection or liver toxicity -A, B, C, D - type refers to the virus -A: close personal contact -B-D: body fluids stages -initial: asymptomatic, virus highly communicable -icteric: general S/S appear --fatigue, loss of appetite, nausea, diarrhea, weight loss, joint pain -recovery -->4 months --fatigue is common
cirrhosis
- result of
- what is it?
- S/S
- Tx
result of chronic liver disease and malnutrition produces cellular damage and necrosis S/S -ascites -splenomegaly -central and peripheral neurological signs -GI system signs and symptoms not curable address the underlying cause
gallstones and gallbladder disease
cholelithiasis: gallstones
cholecystitis: gallbladder disease
both produce intermittent RUP pain that worsens after meals that include fatty foods
-gallstones account for nearly 20% of all hospital admissions among adults
-cholecystitis results when gallstones block the cystic duct
–fever, jaundice, vomiting, RUQ tenderness, referred right should pain suggest an acute gallbladder attack
pancreatitis
occurs when pancreatic enzymes become active within the pancreas rather than the duodenum, resulting in self-digestion of pancreatic cells
- S/S
- -severe peritonitis
- -sudden and excruciating epigastric and LUQ pain
- -left shoulder pain
- -LUQ rigidity
- -shock
- medical emergency
fecal-oral route
sewage contamination
-relates to stomach flu
