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ABSN NUR 326 > Week 5: GI Problems > Flashcards

Week 5: GI Problems Flashcards

1
Q

What is considered upper GI?

A

esophagus, stomach and beginning of small intestine

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2
Q

What is considered lower GI?

A

small intestine, colon, rectum and anus

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3
Q

What are common upper GI problems?

A

Esophageal = GERD and hiatal hernia
Stomach = gastritis, acute gastroenteritis, and PUD

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4
Q

What is GERD?

A

backflow of gastric acid from the stomach into the esophagus, occurs at the lower esophageal sphincter

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5
Q

Etiology of GERD

A

anything that alters closure strength of the lower esophageal sphincter OR increases abdominal pressure

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6
Q

S/S of GERD

A

heartburn, dyspepsia, regurgitation, chest pain. dysphagia, and pulmonary symptoms

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7
Q

Complications of GERD

A

ulceration, scarring, strictures, and Barrett esophagus (development of abnormal metaplastic tissue)

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8
Q

What is a hiatal hernia?

A

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

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9
Q

What the two main types of hiatal hernias?

A
  1. sliding hernia
  2. paraoesophageal hernia
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10
Q

Need to know about sliding hernia

A

usually small and don’t need surgery

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11
Q

What is the patho of a paraoesophageal hernia?

A

part of the stomach pushes through the diaphragm and stays there

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12
Q

Patho for a hiatal hernia?

A

exact cause unknown. Can occur from damage to the diaphragm, or by repeatedly putting too much pressure on the muscle around the stomach (severe coughing, vomiting, straining for a BM)

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13
Q

S/S of a hiatal hernia

A

asymptomatic, belching, dysphagia, chest or epigastric pain

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14
Q

Treatment for hiatal hernia

A

Mostly a conservative treatment of teaching, but surgery may be necessary

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15
Q

What teachings go along with having hiatal hernias?

A

small, frequent meals, avoid lying down after eating, avoid tight clothes, weight control, and antacids to alleviate GERD symptoms

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16
Q

What is acute gastritis?

A

TEMPORARY inflammation of the stomach lining only, lasts 2-10days

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17
Q

Etiology of acute gastritis

A

irritating substance (alcohol), NSAIDs, and infectious agents

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18
Q

What is chronic gatritis?

A

Progressive disorder with inflammation that lasts weeks to years

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19
Q

Complications of chronic gastritis

A

PUD, bleeding, ulcers, anemia, and gastric cancers

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20
Q

What are the 2 main etiologies of chronic gastritis?

A

autoimmune = attacks parietal cells
H. pylori infection

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21
Q

What is H. pylori?

A

Helicobacter pylori bacterium, causing destructive pattern of persistent inflammation

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22
Q

How is H. pylori transmitted?

A

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

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23
Q

S/S of acute or chronic gastritis

A

sometimes none, anorexia, V/V, postprandial discomfort, intestinal gas, hematemesis, tarry stools, anemia

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24
Q

What is acute gastroenteritis?

A

inflammation of stomach AND small intestine

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25
Q

Etiology of gastroenteritis?

A

Viral infections = norovirus, rotavirus
Bacterial infections= E. col, salmonella, campylobacter
Parasitic infection

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26
Q

S/S of gastroenteritis

A

watery diarrhea (sometimes bloody) , abdominal pain, N/V, fever, malaise

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27
Q

Complications of gastroenteritis

A

fluid volume deficits

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28
Q

What is peptic ulcer disease (PUD)

A

ulcerative disorder that effects the esophagus, stomach, and duodenum

29
Q

Etiology of PUD

A

H. pylori, injury causing substances (NSAIDs, ASA, and alcohol), smoking, family hx, and stress (increased stress causing increased gastric juices)

30
Q

r/f for NSAID induced PUD

A

age, higher doses of NSAIDs, history of PUD, use of corticosteroids and anticoagulants, serious system disorders, and H. pylori infection

31
Q

Patho of PUD

A

-mucosa is damages, histamine is secreted resulting in an increase in acid and pepsin secretion
-vasodilation causing edema
-if blood vessels are destroyed there will be bleeding

32
Q

what is the most common type of PUD?

A

duodenal ulcer

33
Q

S/S of a PUD

A

sometimes none, N/V, anorexia, weight loss, bleeding, burning pain (in the mid of abdomen usually worse when stomach is empty)

34
Q

What is the main clinical difference between gastric and duodenal PUDs?

A

the duration before pain starts after eating.
gastric= 1-2 hrs after eating
duodenal= 2-4 hrs after eating

35
Q

PUD complications

A

“HOP” hemorrhage, obstruction, perforation and peritonitis

36
Q

What are the lower GI disorders?

A

appendicitis, peritonitis, irritable bowel disorder, Inflammatory bowel disorders (Chron’s UC), diverticulosis/diverticulitis

37
Q

What is appendicitis?

A

inflammation of the appendix

38
Q

Etiology of appendicitis

A

appendix is obstructed causing inflammation

39
Q

Complications of appendicitis

A

gangrene, abscess formation, and peritonitis

40
Q

What is peritonitis?

A

inflammation of peritoneum (serous membrane that lines abdominal cavity)

41
Q

Pain with appendicitis

A

RLQ in periumbilical area, rebound pain (severe pain after release of palpation), sudden pain relief is NOT good (indicative of rupture)

42
Q

What happens to the peritoneum during peritonitits?

A

inflammation, fluid shifts (3rd spacing), decreased peristalsis

43
Q

Complication of peritonitis

A

paralytic ileus and intestinal obstruction

44
Q

What causes peritonitis?

A

perforated ulcer, ruptured gallbladder, pancreatitis, ruptured spleen, ruptured bladder, and ruptured appendix

45
Q

S/S of peritonitis

A

sudden and sever abdominal pain and tenderness, rigid “board-like” abdomen, N/V, fever, increased WBC, tachycardia, and hypotension

46
Q

What is IBS?

A

chronic condition characterized by alterations in bowel pattern due to changes in motility

47
Q

S/S of IBS

A

vary by individual
-abdominal distension, fullness, flatus, and bloating
-intermittent abdominal pain, relieved after BM
-food intolerance
-non bloody stools that may contain mucous

48
Q

What exacerbates IBS?

A

STRESS, food, hormone changes, GI infections, and menstruations

49
Q

What are the two inflammatory bowel disease

A

Chron’s disease and ulcerative colitis

50
Q

R/F for inflammatory bowel disease

A

women, Caucasians, Jewish descent, and smokers

51
Q

What is the pathogenesis of Crohn’s disease?

A

lymph structures of the GI tract are blocked causing tissue to become engorged and inflamed. This leads to deep linear fissures and ulcers developing

52
Q

Complications of Chron’s disease

A

malnutrition, anemia, scar tissue, obstruction, fistula, and cancer

53
Q

S/S of Crohn’s disease

A

crampy RLQ, watery diarrhea, palpable RLQ mass, mouth ulcers, S/S of fistulas, weight loss, fatigue, anorexia, fever, malabsorption

54
Q

What is Ulcerative Colitis (UC)?

A

inflammation of the mucosa of the rectum and colon

55
Q

R/F for UC

A

white people, third decade of life (lol), Ashkenazi Jewish decent

Rare in Asians

56
Q

Pathogenesis of UC

A

Inflammation begins in the rectum and extends in a continuous segment that may involve the entire colon. The inflammation leads to large ulcerations and necrosis that can lead to abscesses

Colon and rectum try to repair the damage with new granulation tissue

57
Q

What is crypt abscesses?

A

abscesses that result from necrosis of epithelial tissue

58
Q

What is the problem with “new granulation tissue”?

A

tissue is fragile and bleeds easily

59
Q

S/S of UC

A

abdominal pain, bloody diarrhea, weight loss, fatigue, no appetite, fever

60
Q

Complications of UC

A

hemorrhage, perforation, cancer, malnutrition, anemia, strictures, fissures, abscesses, toxic mega-colon, colorectal cancer, liver disease, and F&E imbalances

61
Q

What is diverticulosis’s pathogenesis?

A

development of diverticula, which are small pouches in lining of the colon that bulge outward though the weak spots

62
Q

Diverticulosis can be?

A

congenital or acquired

63
Q

What is thought to be the cause of diverticulosis?

A

low fiber diet with resulting chronic constipation

64
Q

Where does diverticulosis typically occur?

A

descending colon

65
Q

S/S of diverticulosis

A

usually asymptomatic, discovered accidentally or with acute diverticulitis

66
Q

What is diverticulitis?

A

inflammation of one or more of the diverticula (pouches)

67
Q

S/S of diverticulitits

A

abdominal pain (LLQ), fever, increased WBC, constipation or diarrhea, passing frank blood

68
Q

Complications of diverticulitis

A

perforation, peritonitis, and obstruction

ABSN NUR 326 (10 decks)

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