lOMoARcPSD|62982272
NR 507 Final Review
Advanced Pathophysiology (Chamberlain University)
Scan to open on Studocu
Studocu is not sponsored or endorsed by any college or university
Downloaded by elizabeth moses ()
, lOMoARcPSD|62982272
Final Review
GERD- Lower Esophageal Sphincter (LES) dysfunction.
o S/S: Heartburn (burning in chest), regurgitations, dysphagia, and chest pain.
o Treatment: lifestyle modifications-HOB elevated, avoid citrus, alcohol, caffeine, carbonation,
avoid eating before bedtime, smoking cessation as it weakens the sphincter.
o Medications: Antacids, if it doesn’t improve, EGD.
o NP roe in GERD management is to evaluate the effectiveness of treatment.
o Warning signs of GERD: age over 50, dysphagia, odynophagia (pain on swallowing), N/V, wt
loss, melena, feeling full after little food.
Esophageal Stricture- chronic inflammation and the development of scar tissue that thickens the
wall of the esophagus.
o Risk factors: GERD, esophagitis, radiation therapy, ingestion of caustic substances like
strong acids or bases, and tumors.
o S/S: dysphasia, sensation of food sticking to the throat, pain when swallowing, food
regurgitation, unintentional weight loss.
o Diagnosis: Barium swallow or EGD.
o Treatment: Meds to reduce inflammation, dilation of stricture, and addressing underlying
cause.
Appendicitis- involves obstruction of the lumen or the opening of the appendix which leads to a
cascade of events resulting in inflammation, infection, and, if untreated, potential perforation.
o Patho: luminal obstruction -> increased luminal pressure -> compromised blood flow
(ischemia) -> bacterial overgrowth (E. coli) -> acute inflammation (pus formation) ->
Perforation
o S/S: Periumbilical pain, RLQ pain, fever and leukocytosis, N/V
o Diagnosis: WBC > 10,000 and increased neutrophils and CRP, abd. ultrasound, CT scan, MRI
o Treatment: appendectomy
Risk is colon CA among those aged 50-74 y/o
Hiatal Hernia- Major risk factor for GERD.
o Diaphragmatic weakness
o Factors: aging, obesity, pregnancy, increased intra-abdominal pressure (chronic coughing or
Valsalva maneuver), structural abnormalities of diaphragm
o Treatment: lifestyle modification, eating small and frequent meals, meds (antacids, PPI;s,
prokinetic agents), surgery to repair (usually w/ severe S/S).
Duodenal Ulcer- Most common peptic ulcer
o Usually caused by H. pylori 95-100% of the time (bacteria that stimulates gastrin secretion
leading to gastric acid hypersecretion)
o Disruption of the balance between aggressive and defensive factors:
Aggressive: Gastric acid, pepsin, H. pylori, NSAIDS
Defensive: Mucus-bicarbonate layer, prostaglandins, cellular repair mechanisms
o S/S: Pain begins 30min-2hrs after eating when the stomach is empty, not unusual for pain to
occur in the middle of the PM and disappear by AM.
o Exam findings: anemia, dehydrated, pain in upper abd., guarding, rigidity, distention
o Pain is usually relieved by ingestion of food or antacids.
o Diagnosis: EGD (Gold standard), H. pylori testing, imaging studies
o Treatment: lifestyle mods, meds, treat H. pylori if that’s the reason
Gastric Ulcer- Pain is relieved w/ food
o Risk factors: h. pylori, NSAIDS, smoking, alcohol, stress, fam hx, obesity, age >65
Peptic Ulcer Disease (PUD)- a break or ulceration in the protective mucosal lining of the lower
esophagus, stomach, or duodenum.
o Least likely to occur in the Large Intestine
o Erosion- superficial ulcers, don’t penetrate
o Ulcer- damages blood vessels
o S/S: epigastric pain 1-3 hrs after eating, pain relieved by eating
o Zollinger-Ellison syndrome causes increased risk of peptic ulcers d/t increase in gastric acid
Downloaded by elizabeth moses ()
NR 507 Final Review
Advanced Pathophysiology (Chamberlain University)
Scan to open on Studocu
Studocu is not sponsored or endorsed by any college or university
Downloaded by elizabeth moses ()
, lOMoARcPSD|62982272
Final Review
GERD- Lower Esophageal Sphincter (LES) dysfunction.
o S/S: Heartburn (burning in chest), regurgitations, dysphagia, and chest pain.
o Treatment: lifestyle modifications-HOB elevated, avoid citrus, alcohol, caffeine, carbonation,
avoid eating before bedtime, smoking cessation as it weakens the sphincter.
o Medications: Antacids, if it doesn’t improve, EGD.
o NP roe in GERD management is to evaluate the effectiveness of treatment.
o Warning signs of GERD: age over 50, dysphagia, odynophagia (pain on swallowing), N/V, wt
loss, melena, feeling full after little food.
Esophageal Stricture- chronic inflammation and the development of scar tissue that thickens the
wall of the esophagus.
o Risk factors: GERD, esophagitis, radiation therapy, ingestion of caustic substances like
strong acids or bases, and tumors.
o S/S: dysphasia, sensation of food sticking to the throat, pain when swallowing, food
regurgitation, unintentional weight loss.
o Diagnosis: Barium swallow or EGD.
o Treatment: Meds to reduce inflammation, dilation of stricture, and addressing underlying
cause.
Appendicitis- involves obstruction of the lumen or the opening of the appendix which leads to a
cascade of events resulting in inflammation, infection, and, if untreated, potential perforation.
o Patho: luminal obstruction -> increased luminal pressure -> compromised blood flow
(ischemia) -> bacterial overgrowth (E. coli) -> acute inflammation (pus formation) ->
Perforation
o S/S: Periumbilical pain, RLQ pain, fever and leukocytosis, N/V
o Diagnosis: WBC > 10,000 and increased neutrophils and CRP, abd. ultrasound, CT scan, MRI
o Treatment: appendectomy
Risk is colon CA among those aged 50-74 y/o
Hiatal Hernia- Major risk factor for GERD.
o Diaphragmatic weakness
o Factors: aging, obesity, pregnancy, increased intra-abdominal pressure (chronic coughing or
Valsalva maneuver), structural abnormalities of diaphragm
o Treatment: lifestyle modification, eating small and frequent meals, meds (antacids, PPI;s,
prokinetic agents), surgery to repair (usually w/ severe S/S).
Duodenal Ulcer- Most common peptic ulcer
o Usually caused by H. pylori 95-100% of the time (bacteria that stimulates gastrin secretion
leading to gastric acid hypersecretion)
o Disruption of the balance between aggressive and defensive factors:
Aggressive: Gastric acid, pepsin, H. pylori, NSAIDS
Defensive: Mucus-bicarbonate layer, prostaglandins, cellular repair mechanisms
o S/S: Pain begins 30min-2hrs after eating when the stomach is empty, not unusual for pain to
occur in the middle of the PM and disappear by AM.
o Exam findings: anemia, dehydrated, pain in upper abd., guarding, rigidity, distention
o Pain is usually relieved by ingestion of food or antacids.
o Diagnosis: EGD (Gold standard), H. pylori testing, imaging studies
o Treatment: lifestyle mods, meds, treat H. pylori if that’s the reason
Gastric Ulcer- Pain is relieved w/ food
o Risk factors: h. pylori, NSAIDS, smoking, alcohol, stress, fam hx, obesity, age >65
Peptic Ulcer Disease (PUD)- a break or ulceration in the protective mucosal lining of the lower
esophagus, stomach, or duodenum.
o Least likely to occur in the Large Intestine
o Erosion- superficial ulcers, don’t penetrate
o Ulcer- damages blood vessels
o S/S: epigastric pain 1-3 hrs after eating, pain relieved by eating
o Zollinger-Ellison syndrome causes increased risk of peptic ulcers d/t increase in gastric acid
Downloaded by elizabeth moses ()
