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05 > Nursing 1005 > Flashcards

Nursing 1005 Flashcards

1
Q

List Examples of Biomolecules

A

Proteins, Lipids, Polysaccharides, Nucleic acids, Hormones, Metabolites

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2
Q

What are Monosaccharides?

A

Smallest unit of carbohydrates.

This includes glucose, fructose, deoxyribose, ribose and galactose.

Combines to form diasaccharides.

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3
Q

What are Disaccharides?

A

Forms from two monosaccharides and water removed.

This includes lactose, sucrose, maltose.

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4
Q

How are Diasaccharides absorbed?

A

They are hydrolyzed in the Small Intestine to form Monosaccharides which is absorbed across intestinal wall into the bloodstream

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5
Q

What are Polysaccharides?

A

Chain of simple sugars linked together via dehydration synthesis.

Includes Glycogen, starch and cellulose.

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6
Q

Use of Polysaccharides in the body - What is Gluconeogenesis?

A

Used as storage products.

Glycogen is stored in muscle and liver and is release as glucose into the blood when needed

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7
Q

What are Lipids?

A

Organic molecules which are insoluble in water.

Examples includes triglycerides, phospholipids and cholesterol.

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8
Q

Describe the process of food passing through the digestive system

A

Food –> Mouth –> Teeth (Mechanical Breakdown) –> Salivary glands excrete saliva containing enzymes that chemically breakdown food –> passes by the pharynx into the oesophagus –> Stomach (continues to chemically and physically breakdown food –> food released to small intestine –> signals release of enzymes stored and produced in the accessory digestive organs (liver, gall bladder, pancreas) –> most nutrients will be absorbed in the Small Intestine where water is absorbed —> waste leaves the body via the rectum and anus

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9
Q

What is the function of the Digestive System

A
  • Reduce particle size
  • Helps to absorb micro nutrients and trace elements
  • Sets a phyical and immunologic barrier
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10
Q

What does digestion break down?

A
  • Carbohydrates (starch and sugar) –> single sugar molecules
  • Proteins –> amino acids
  • Fats –> fatty acids, glycerol
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11
Q

How is food moved through the digestive system?

A

Via peristalsis

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12
Q

What is the role of saliva?

A

Contains:

  • Amylase to break down starch (inactivated in the stomach)
  • Lipase begins fat digestion
  • Mucus lubricates the food for easier swallowing
  • Lysozyme kills bacteria
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13
Q

What is the function of the oesophagus?

A
  • Connects pharynx to stomach
  • Peristalsis occurs due to muscle contraction
  • Lower oesophageal sphincter stops food from re-entering the oesophagus from the stomach
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14
Q

What is the function of the stomach?

A
  • Lower OS and plyoric sphincter control entry and exit from stomach
  • secretion of HCL, enzymes including protease, gastric lipase; mucus, hormone gastrin and intrinsic factor (B12)
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15
Q

What is the function of Stomach Acid?

A
  • Activates digestive enzymes - pepsinogen activated –> pepsin (enzyme that digest proteins)
  • Assists in calcium absorption
  • makes dietary minerals soluble for absorption
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16
Q

Function of the Small Intestine

A
  • Most digestion and absorption occurs here
  • Folded walls with villi projections
  • Absorptive cells are located on the villi
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17
Q

Digestive System – The Process of Absorption

A
  • Through SI walls
  • Absorbed into blood (water soluble nutrients), Lymph (fat soluble nutrients)
  • Blood –> liver (detoxifies and repackages) –> general circulation
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18
Q

What is the function of the Large Intestine?

A
  • No villi or enzymes present
  • Little digestion occurs
  • Absorption of water, some minerals, vitamins
  • Bacteria break down fibre; produce vitamin K
  • Formation of faeces for elimination
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19
Q

What is the function of the Rectum?

A
  • Stool remains and stimulates nerve endings for elimination
  • Muscle contraction and the opening of the anal sphincter to elimination
  • Voluntary control
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20
Q

What is Nausea?

A
  • Sensation of the need to vomit
  • Prolonged nausea is debilitating and cause physiological strain
  • Can be result of both physical and physiological
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21
Q

Causes and Diagnosis of Nausea

A
  • Anything that slows GI motility can cause nausea
  • Result of stimulation of the SNS which decreases blood flow to the GI tract
  • Pain, motion, disease and certain medications can also cause nausea
  • Diagnosis is difficult, however, its known to be cause by stimulation of the vomiting centre of the brain
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22
Q

What is Vomiting?

A
  • Forceful emptying of stomach contents and intestinal chyme through the mouth
  • Vomiting centre is stimulated in the brain which triggers the vomiting reflux
  • Stimuli includes severe pain, distention of the stomach or duodenum and trauma to the testes, ovaries, bladder or kidney
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23
Q

What is Diarrhoea?

A
  • Increased frequency of defecation and fluidity of volume of faeces
  • There are different types of diarrhoea include Steatorrhea (fat in stools) may occur in malabsorption syndromes
  • Systemic effects may includes dehydration, electrolyte imbalance, metabolic acidosis and weight loss
24
Q

What is Osmotic Diarrhoea?

A
  • Occurs when substance in the intestine can’t be absorbed and instead draws water into the lumen via osmosis
  • Examples include lactase deficiency (when ingested cannot be absorbed in the small intestine), and Sorbitol (Non absorbable synthetic sugar)
25
Q

What is Secretory Diarrhoea?

A
  • Caused by excessive mucosal secretion of fluid and electrolytes or inhibition of NaCl absorption
  • Can be caused by bacterial endotoxins (e.g. cholera), IBD, Crohn’s disease and neoplasms (cancer)
26
Q

What is Constipation?

A
  • Difficulty defecation or infrequent
  • Caused by function or mechanical problems (muscle weakness or pain)
  • Diet of highly refined foods and low fibre can result in constipation
27
Q

Gastrointestinal Bleeding

A
  • Need to determine whether its upper or lower GI tract
  • Severe bleeding may cause hypovolemic shock
  • Clinical manifestations include haematemesis (vomiting blood), Occult blood, Melena (black, foul smelling), Haematochezia (bright red)
  • Complications include Diarrhoea, anaemia, elevated blood urea nitrogen (indicates injury of the kidney - due to the digestion of blood proteins - UGI bleed)
28
Q

What is Anorexia?

A
  • Lack of desire to eat despite physiologic stimuli that would normally produce hunger
  • Accompanied by end stage cancer, heart disease, kidney failure, liver failure
29
Q

What is Abdominal Pain?

A
  • Caused by mechanical or chemical stressors
  • May be visceral or referred
  • Visceral pain is caused by inflammation/injury to an abdominal organ - pain is poorly localised and dull until the nerve endings are overwhelmed

-Referred pain is visceral pain which is felt some distance from the affected organ - usually localised and felt in skin or deeper tissues that share a central afferent pathways with the affected organ, e.g. gall bladder apin referred to the back between the scapulae

30
Q

What is Mechanical Dysphagia?

A
  • Difficulty swallowing
  • Caused by mechanical (can be intrinsic and extrinsic) obstruction
  • Intrinsic obstruction may originate in the wall of the oesophageal lumen
  • Extrinsic obstruction may originate outside the oesophageal lumen and narrow the oesophagus by pressing inwards on the oesophageal wall
31
Q

What is Functional Dysphagia?

A
  • Difficulty swallowing
  • Neural or muscular disorder that interfere with swallowing and oesophageal peristalsis
  • May be caused by disorders that affect muscles in the upper oesophagus which interferes with voluntary swallowing, Dermatomyositis (muscle disease), neuro impairment from CVA, Parkinson’s disease
32
Q

What is Gastro Oesophageal Reflux Disease (GORD)?

A
  • Reflux of chyme from the stomach to the oesophagus
  • Usually lower OS maintains a zone of high pressure to prevent chyme reflex

There are different types of reflux - physiologic reflux (There are no symptoms) and Reflux Oesophagitis (inflammatory response to reflux)

  • Vomiting, coughing, lifting and bending increases abdomoinal pressure and relfux incidence
  • Delay in gastric emptying contributes to reflux and increasing the acid content of chyme
  • Gastric and duodenal ulcers may also delay gastric emptying by causing pyloric oedmea and narrowing
  • Presence of hiatal hernia can also contribute to reflux by weakening the lower OS
33
Q

Clinical manifestation of COPD in Adults

A
  • Heartburn
  • Acid Regurgitation
  • Dyshagia (difficulty swallowing)
  • Chronic cough
  • Asthma
  • Upper abdominal pain within 1 hour of eating

Often symptoms worsen when individual lies down or intra-abdominal pressure increases

34
Q

Clinical manifestation of COPD in infants

A
  • Excessively vomiting during first week of life
  • Aspiration pneumonia
  • Chronic cough
  • Anaemia
35
Q

What is intestinal obstruction?

A
  • Failure of normal intestinal motility
  • Prevention of the flow of chyme through intestinal lumen
  • May be due to mechanical obstruction e.g. tumour
36
Q

Describe the pathophysiology of Bowel Obstruction

A
  • increase in fluid and gas may accumulate in the bowel proximal to the obstruction
  • leads to development of inflammation and oedema of the bowel
  • odema can lead to large amounts of fluid moving to the bowel which can result in hypovolemic shock
  • electrolyte imbalances may occur
37
Q

What is Acute Gastritis?

A

Acute inflammation of gastric mucosa

  • infection
  • NSAIDS (Nonsteroidal anti-inflammatory drugs) use which inhibits protective prostaglandin secretion resulting in decreased mucous production and surface erosion
  • mucosal injury from drugs
  • alcohol and histamine release contribute to surface erosion
38
Q

What is Chronic Gastritis?

A

Inflammation of gastric mucosa

  • occur predominantly in the elderly and results in degeneration of stomach wall
  • this occurs due due to autoimmune cause, helicobactor pylori bacterium and chronic bile reflux
39
Q

What is Peptic Ulcer Disease?

A

Breakdown and ulceration of protective mucosal lining

  • occur in the oesophagus, stomach or duodenum
  • imbalance between gastric acid production and mucosal barrier protection is an important factor in the development of PUD
  • Duodenum ulcers are most common
40
Q

What factors increase gastric acid production?

A
  • increase in the number of parietal/chief cells
  • decrease in the inhibition of gastric secretions
  • increased sensitivity to food/other stimuli such as caffeine and histamine
  • excessive vagal (one of the cranial nerves) stimulation
41
Q

What factors impair mucosal barrier protection?

A
  • Ischemia can lead to loss of integrity of the mucosa, smoking can also lead to vasoconstriction reducing blood supply
  • Sympathetic stimulation will decrease secretions
  • Bile or pancreatic enzyme reflux from duodenum
  • protective prostaglandin secretion is inhibited by NSAIDS
  • Alcohol consumption
  • H. Pylori colonization
42
Q

Describe the Diverticular disease of the colon

A
  • Diverticula are small herniations that occur through the muscle layer of the colon wall (commonly sigmoid colon)
  • many patients will be asymptomatic
  • Diverticulitis is defined as the inflammatory stage of diverticulosis
43
Q

Describe the pathophysiology of Diverticular Disease

A
  • Patient present with history of low fibre, which leads to reduced faecal bulk, reduce colon diameter thus increasing the pressure on the colon wall
  • pressure leads to development of outpouchings at weak points of the colon walls
44
Q

What is Appendicitis?

A

Inflammation of the Vermiform appendix

  • obstruction of the lumen of the vermiform appendix with hardened with faecal matter, a tumour or foreign body leads to development of an enclosed environment where bacteria divide rapidly causing infection
  • Increased oedema due to inflammation increases the pressure within appendix
  • ischemia and hypoxia develop and ulceration can occur
  • Rupture of the appendix, peritonitis and abscess formation may develop
  • Most serious complication is peritonitis - inflammation of the membrane lining the abdominal wall and covering the abdominal organs
45
Q

What is Peritonitis?

A

Inflammation of the peritoneum

  • results from contamination of the space between the parietal and visceral layers of the peritoneum (which is normally sterile) by chemical or infectious agents
  • often result from bacteria
  • inflammation may result in fluid shifts in peritoneal space
  • leads to hypovolemic shock and hypovolemia developing
  • Septicaemia (bacteria in the blood) & septic shock may also occur
46
Q

Define Maldigestion

A

It is the failure of the chemical processes in digestion which break down food

47
Q

Define Malabsorption

A

It is the failure of the intestinal mucosa to absorb the nutrients that have been made available from digestion

48
Q

Clinical manifestation of Malabsorption Syndromes

A
  • Diarrhoea or Steatorrhea
  • Abdominal distention and cramping
  • Weight loss and weakness
  • Anaemia and bone pain
  • muscle cramps
  • tendency to bleed/bruise easily
49
Q

Explain Bile salt deficiency

A

Conjugated bile salts are needed to emulsify and absorb fats and fat soluble vitamins

  • bile salts may occur from cholesterol in the liver
  • decrease in bile salts may occur when there is either liver disease or bile obstruction

Symptoms include

  • fatty stools
  • Diarrhoea
  • Deficiency in fat-soluble vitamins
50
Q

What enzymes does the pancreas produce?

A
  • Pancreas produces the enzymes lipase, amylase, trypsin and chymotrypsin
51
Q

List the fat soluble vitamin deficiencies

A 
Vitamin A
- Night Blindness
Vitamin D 
- Decreased calcium absorption, bone pain, fractures and osteoporosis
Vitamin K
- Prolonged prothrombin time, purpura and petechiae
Vitamin E
- Unknown
52
Q

What is lactase deficiency?

A

Inability to break down lactose into monosaccharides thus lactose can’t be digested
- leads to fermentation of lactose by bacteria resulting in gas production and osmotic diarrhoea

53
Q

What is Inflammatory Bowel Disease (IBD) ?

A

Diseases with malabsorption e.g. Crohn’s disease and ulcerative colitis

  • Several factors are thought to contribute to the development of these diseases including
  • Genetics
  • Alterations to epithelial barrier functions
  • Immune reactions to intestinal flora
  • Abnormal T cell reponses
54
Q

Describe the “Elderly Mouth”

A

Older ppl have

  • loss of tooth enamel and dentin which can lead to pin during eating
  • lost teeth
  • denatures
  • Periodontal disease and gum recession is common
55
Q

Age related changes to digestion

A

As we age the number of taste bud decline which can make most foods taste bland

  • elderly have a diminished sense of smell which also can lead to food seeming less appealing
  • salivary secretions decrease and thus they are more prone to gum disease
  • swallowing is more difficult and carbohydrate breakdown in the mouth decreases
  • have decrease in the motility of both the oesophagus and the stomach which can lead to feelings of nausea and difficult in moving food through the upper GI tract

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