NR 283 Final Exam Concept Review Pathophysiology

NR 283 Final Exam Concept Review Pathophysiology Gastrointestinal Chapter 17 Hiatal Hernia: causes, Signs and Symptoms • Patho: protrusion or herniation of the upper stomach through the diaphragm • Causes: short esophagus, trauma, weak muscles, increased abdominal pressure • Signs/symptoms: heartburn or pyrosis, frequent belching, increased discomfort when lying down, substernal pain that may radiate to shoulder and jaw Gastritis: Acute vs. Chronic, Signs and Symptoms • Acute: caused by injury to mucosal lining by microorganisms (e-coli), allergies, alcohol, aspirin, corrosive substances, radiation or chemo, increase risk of cancer • Chronic: H-pylori, NSAIDS, alcohol, tobacco • S/S: anorexia, nausea, vomiting, hematemesis (vomiting of blood), abdominal pain Peptic Ulcer Disease: Cause, Signs and Symptoms, location • Duodunal pectic ulcer is the most common due to high acid and inflammation from bacteria • Gastric peptic ulcer • Location: duodenum (#1 place), lower esophagus, stomach • Causes: H.Pylori, NSAIDS, Zollinger Ellison Syndrome, stress, smoking • S/S: pain (specific for each type of ulcer), nausea, vomiting, weight loss Cholelithiasis: gallstone formation, which are masses of solid material or calculi that form in the bile. • Causes: obstruction or inflammation, fat, fertile, forty, female, native American ancestry • S/S: asymptomatic, idiopathic • Types: cholesterol and pigmented • Cholecystitis – inflammation of the gallbladder Hepatitis: • Hepatitis A: • found in feces and bile • Hepatitis B: • Transmitted through infected blood, bodily fluids • Hepatitis C: (most deadly) • Post transfusion, IV drug use (most common in hospital settings), liver cancer • S/S: 3 stages: 1) preicteric or prodromal stage 2) icteric or jaundice stage 3) posticteric or recovery stage ` • Preicteric or prodromal stage: (2 weeks after exposure): may be idiopathic, fatigue, malaise, anorexia, nausea, general muscle aching, fever, headache, mild abdominal discomfort • Icteric or jaundice stage: stool becomes light in color, urine becomes darker, skin becomes pruritic • Posticteric or recovery stage: reduction of signs and symptoms Hepatic Encephalopathy: • Causes: loss of brain function when a damaged liver doesn’t remove toxins from the body • S/S: forgetfulness, musty odor breath, shaking of the hands, slurred speech, round belly • Diagnosis: blood test for abnormalities with liver and kidney functions, medication is given to remove the ammonia. Cirrhosis: • Irreversible, inflammatory liver disease. Decreased blood supply to liver leads to liver disease complications, atrophy, necrosis, and eventual failure • Cause: alcohol and hepatitis • S/S: inflammation, destruction, and scar tissue growth of liver, fatigue, anorexia, weight loss, anemia, diarrhea, ascites(fluid build-up in the peritoneal cavity), peripheral edema, jaundice • Complications: frequent infections, respiratory or skin infections, death, esophageal varices Esophageal varices: • Abnormal veins in lower part of the tube running from the throat to the stomach (esophagus) • Causes: Usually develops when blood flow to the liver is blocked, also occurs with advanced liver disease. • S/S: Sometimes no symptoms, but vomiting blood, tar-like or bloody stool, and shock • Complications: liver failure, bleeding, shock, death Crohn’s disease: • Unknown cause • Recurrent inflammation of small and large intestine • S/S: non-bloody diarrhea, abdominal pain, malabsorption, steatorrhea (fatty diarrhea), malnutrition, weight loss, pallor • Ulcers are throughout the intestines Ulcerative Colitis: • S/S: abdominal pain, bloody diarrhea, tenesmus (spasm of rectum), fever, weight loss • Starts at the rectum and goes up • Small intestine is not involved unless it turns into Crohn’s • Obstruction of rectum interferes with absorption and electrolytes Appendicitis: • Causes: inflammation of the appendix, obstruction, ischemia, increased intraluminal pressure, infection, ulceration • S/S: Epigastric pain, RLQ pain, Rebound tenderness around belly button, fever Intestinal Obstruction: • S/S: Crampy pain followed by vomiting and distension, dehydration, hypovolemia, ischemia and necrosis • Complications: Tissue death, infections • Cause: constipation, surgery, stress, poor muscle movement Gastric Cancer: • Diet is a key factor, smoked foods, nitrites and nitrates, and genetic influence • S/S: dark stool from blood, no appetite, vomiting, nausea, asymptomatic Pancreatitis: • Inflammation of the pancreas • Causes: gallstone, large amount of alcohol • Acute: bile tract disease and alcohol, usually mild and self-limiting. Obstruction of bile duct causes enzymes to collect in pancreas. Enzymes activated causes inflammation. Can get septic ischemia ▪ Complication: adult respiratory distress syndrome and acute renal failure • S/S: constant epigastric and abdominal pain, nausea, vomiting • Chronic: Irreversible structural and function changes to pancreas. • S/S: intermittent pain, weight loss, malabsorption Gastroesophageal reflux (acid reflux) GERD: • Patho: The regurgitation of reflux of chyme within 1-2 hours after eating • Causes: • Weakened LES, increased abdominal pressure, weak esophageal peristalsis, hernia or ulcer • Treatment: avoid spicy foods, antacids, medication • S/S: belching and heartburn Renal