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NUR 326: exam 3 > upper GI disorders > Flashcards

upper GI disorders Flashcards

1
Q

upper GI consists of…

A

esophagus
stomach
beginning of small intestines

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2
Q

upper GI problems

A

esophageal disorders —> GERD, hiatal hernial
inflammatory disorders of the stomach —> gastritis, acute gastroenteritis, PUD

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3
Q

common causes of dysphagia

A

mechanical obstruction –> stenosis or stricture, diverticula, tumors

neuromuscular dysfunction –> CVA, achalasia (LES can’t open properly)

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4
Q

who is most likely to experience dysphagia?

A

intubated & trach patients

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5
Q

GERD

A

back flow of gastric acid from the stomach into esophagus

open LES leads to stomach conten (highly acidic) coming back up

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6
Q

causes of GERD

A

~anything that alters closure strength of LES or increases abdominal pressure~

ex:
-fatty, spicy, tomato-based, & citrus foods
-caffiene
-large amt of alcohol
-smoking
-sleep position
-obesity
-pregnancy
-meds

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7
Q

clinical manifestations of GERD

A

heartburn (pyrosis) ***
dyspepsia (indigestion)
regurgitation
chest pain
dysphagia
pulmonary symptoms

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8
Q

other S/S of GERD

A

mouth- tooth decay, gingivitis, bad breath
chest- chronic cough, worsening asthma, recurrent PNA’s
abdomen- bloating, belching
ears- earache
throat- hoarseness, chronic sore throat, throat clearing, laryngitis, lump in throat, post nasal drip

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9
Q

complications of GERD

A

ulcers
scarring
strictures
BARRETTs ESOPHAGUS*

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10
Q

Barrett’s esophagus

A

development of abnormal metaplastic tissue - premalignant
*3-fold increased risk of developing adenocarcinoma of the esophagus (esophageal cancer)
*survival only 17%

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11
Q

hiatal hernia

A

a defect in the diaphragm that allows part of the stomach to pass into thorax

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12
Q

2 types of hiatal hernia

A
  1. sliding hernia: small, no treatment
  2. paraesophageal hernia: part of stomach pushes through diaphragm and stays there
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13
Q

causes of hiatal hernia

A

*exact cause is unknown

-age-related (older)
-injury or other damage may wearing diaphragm muscle
-repeatedly putting too much pressure on the muscles around the stomach (severe coughing, vomiting, constipation and straining to have BM)

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14
Q

clinical manifestations of hiatal hernia

A

asymptomatic

belching
dysphagia
chest or epigastric pain

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15
Q

T/F: GERD and hiatal hernia are common to coexist

A

TRUE

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16
Q

risk factors for hiatal hernia

A

age (older)
obesity
smoking

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17
Q

acute gastritis

A

temporary inflammation of stomach lining only – lasts 2-10 days

*intestines NOT affected

18
Q

causes of acute gastritis

A

irritating substances (alc)
drugs (NSAIDs)
infectious agents (H. pylori)

19
Q

considerations with NSAIDs

A

block prostaglandin synthesis
*prostaglandins stimulate secretion of mucus in stomach (protective coating)

20
Q

chronic gastritis

A

progressive disorder with chronic inflammation in stomach — lasts weeks to years

21
Q

complications of chronic gastritis

A

PUD, bleeding ulcers, anemia, gastric cancers

22
Q

2 main causes of chronic gastritis

A

autoimmune – attacks parietal cells
H. pylori infection

23
Q

what is H. pylori?

A

helicobacter pylori bacterium lives in acidic environment

destructive pattern of persistent inflammation –> can cause chronic gastritis, PUD, and stomach cancer

24
Q

how is H. pylori transmitted?

A

person to person via saliva, fecal matter, or vomit
contaminated food or water

25
Q

clinical manifestations of ACUTE/CHRONIC gastritis

A

~sometimes none~

anorexia (loss of appetite)
N/V
postprandial discomfort (stomach pain after eating)
intestinal gas
hematemesis (blood in vomit)
tarry stools (black)
anemia
stomach burning

26
Q

acute gastroenteritis

A

inflammation of stomach AND small intestine

27
Q

cause of acute gastroenteritis

A

viral infections: norovirus and rotavirus
bacterial infections: E. coli, salmonella, campylobacter
parasitic infections

28
Q

clinical manifestations of acute gastroenteritis

A

watery diarrhea (if bacterial, blood)
abd pain
N/V
fever, malaise

generally last 1-3 days - can last as long as 10 days

29
Q

complications of acute gastroenteritis

A

FVD

30
Q

peptic ulcer disease

A

ulcerative disorder of the upper GI tract –> esophageal, stomach (gastric ulcer), duodenum (peptic ulcer)

develops when GI tract is exposed to acid and H. pylori

31
Q

agressive factors in GI tract

A

H. pylori
NSAIDs
acid
pepsin (digestive enzyme in stomach)
smoking

32
Q

defensive factors in GI tract

A

mucus
bicarbonate
blood flow
prostaglandins (stimulate release of mucus)

33
Q

cause of PUD

A

H. pylori
injury causing substances –> NSAIDs, ASA, alcohol
excess secretion of acid
smoking
fam hx

34
Q

stress and PUD

A

stress worsens gastric ulcers but does not cause

increased gastric acid secreted with the stress response

35
Q

risk factors of PUD

A

age
higher doses of NSAIDs
hx of PUD
use of corticosteroids and anticoagulants
serious systemic disorders
H. pylori infection

36
Q

patho of PUD

A
  1. mucosa is damaged
  2. histamine is secreted –> increases acid and pepsin secretion –> causes further tissue damage; + vasodilation –> causes edema
  3. if blood vessels are destroyed, this results in bleeding
37
Q

PUD: duodenal ulcer

A

most common type
age: any; early adulthood

38
Q

PUD: gastric/peptic ulcer

A

age: peak 50-70

result of an increased use of NSAIDs, corticosteroids, anticoagulants and more likely to have serious systemic illnesses

39
Q

PUD: clinical manifestations

A

sometimes none

N/V, anorexia, weight loss, bleeding, burning pain (middle of abd that is usually worse when stomach is empty)

40
Q

characteristics of a gastric + duodenal ulcer

A

burning, cramping, gas-like

located: epigastrium (upper abd), back

timing:
gastric –> 1-2 hours after eating
duodenal –> 2-4 hours after eating

41
Q

characteristics of duodenal ulcer

A

burning, cramping, gas-like (same as gastric)

NUR 326: exam 3 (14 decks)

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