NR 283 Exam Review 3 PATHOPHYSIOLOGY

Gastrointestinal • GI bleeding a. Upper GI bleeding: esophagus, stomach, duodenum b. Lower GI bleeding: jejenum, ileum, colon, rectum Hematemesis: bloody vomit (from esophagus) Hematochezia: bright-red blood (colon, rectum “hemmoroid”) Melena: burgundy color (old blood; jejunum) Occult bleeding: hidden bleeding (blood cells present in feces) Hiatal Hernia: • part of the stomach protrudes through the opening (hiatus) in the diaphragm into the thoracic cavity • Cause: too much pressure (repetitively) on stomach muscles; coughing, vomiting, straining during BM a. Sliding: ususally when pt is in supine position; common b. Paraesophogeal/Rolling: due to weak or enlarged hiatus in diaphragm; leads to ulceration • s/s: heartburn “pyrosis”, frequent belching, discomfort when laying down, substernal pain radiating to shoulder & jaw Gastritis: Acute vs. Chronic, Signs and Symptoms • Inflammation of stomach • Acute -characteristics: red & edematous, ulcerated & bleeding -s/s: anorexia, nausea, vomiting, hematemesis (bleeding in stomach), epigastric pain, cramps, fever/headache, diarrhea • Chronic -characteristics: atrophy of mucosa of stomach, loss of intrinsic factor for absorbing B12 -s/s: vague; mild epigastric discomfort, intolerance for spicy/fatty foods Pts w chronic g. at risk for peptic ulcers & gastric carcinoma Peptic Ulcer Disease: • Cause: common- H. pylori infection or vasoconstrictions by stress smoking, shock, circulatory impairment in elderly, scar tissue, severe anemia • s/s: epigastric burning, localizing pain, stomach emptying, heartburn, nausea, vomiting, weight loss • location: proximal duodenal, antrum of stomach,