Stomach Disorders

Question 1

Gastritis

Answer 1

-Inflammation of gatric mucosa
-erosive versus nenerosived
-Acute gastritis usually heals after several months (irritation of food, alcohol, radiation)
-Chronic is associated with an increased risk of gastric cancer (long-lasting)
-often caused by long-term NSAID use
-can be caused by H. pylori

Question 2

Gastritis: Health Promotion and Maintenance

Answer 2

-eat a well-balanced diet
-regular exercise
-stress-reduction techniques
-limit foods and spices that cause gastric distress
-avoid alcohol, tobacco
-reduce caffeine, chocolate, mustard, spicy peppers

Question 3

Gastritis: Assessment

Answer 3

Acute: rapid onset of epigastric pain and dyspepsia (heartburn), gastric bleeding, hematemesis, or melena, hiccuping
-Chronic: may have few symptoms unless ulceration occurs, N/V, upper abdominal discomfort, periodic epigastric pain may occur after a meal, some pt have anorexia, belching, sour taste in mount, B12 deficiency

Question 4

Peptic Ulcer Disease

Answer 4

-occurs when mucosal defenses become impaired; epithelium not protected from effect of acid and pepsin
-3 types: Duodenal, gastric, and stress ulcers (less common)
-maybe caused by H. pylori
-common route of H. pylori infection transmission: oral to oral or fecal to oral contact

Question 5

Complications of Peptic Ulcers

Answer 5

-Hemorrhage (most serious)
-Perforation: (surgical emergency-life threatening!) occurs when the ulcer becomes so deep that the entire thickness of the stomach or duodenum is worm away
–the stomach or duodenum content can leak into the peritoneal cavity
–hypovolemic shock: bleeding/loss of fluid, lower BP, tachycardia
-Pyloric obstruction: s/s= abdominal bloating, N/V, metabolic alkalosis, hypokalemia
-Intractable disease: may develop from complications of ulcers, excessive stressors in the pt life, or an inability to adhere to long-term therapy

Question 6

PUD: Physical Assessment

Answer 6

-epigartic tenderness and pain
-rigid, board-like abdomen with rebound tenderness and pain= peritonitis

Question 7

Gastric Cancer

Answer 7

-atrophic gastritis, intestinal metaplasia, gastric surgery, Barrett esophagus, and H. pylori are risk factors
-eating pickled foods and those with nitrates increases risk
-spread by direct extension through gastric wall into regional lymphatics

Question 8

Gastric Cancer: Assessment

Answer 8

-maybe asymptomatic in early stage
-dyspepsia (indigestion), and abdominal discomfort are most common symptoms
-anemia
-stool may be + for occult blood
-hypoalbuminemia and abnormal results of liver tests occur with advanced disease and hepatic metastasis
-EGD with biopsy to diagnose

Question 9

Gastric Cancer: Inverventions

Answer 9

Nonsurgical: radiation, chemotherapy
Surgical: removing the tumor, NG tube needed for invasive surgery (conventional open-approach)