NURS 5315 GI
1. Upper GI organs: mouth,pharynx, esophagus, stomach, and duodenum
2. Lower GI organs: small intestine, large intestine, rectum and anus
3. Hepatoportal circulation: hepatic artery receives oxygenated blood from the
inferior mesenteric, gastric, and cystic veins. The hepatic portal vein receives
deoxygenated blood from the inferior and superior mesenteric vein and splenic
vein and delivers nutrients that have been absorbed from the intestinal system
4. Osmotic diarrhea: Caused by the presence of a nonabsorbable substance in
the intestines. This pulls water by osmosis into the intestinal lumen and results
in large volume diarrhea. This is how mag citrate, lactulose and miralax work.
Causes include: excessive ingestion of nonabsorbable sugars, tube feedings,
dumping syndrome, malabsorption, pancreatic enzyme deficiency, bile salt
deficiency, small intestine bacterial overgrowth or celiac disease
5. Secretory diarrhea: Results in large volume losses secondary to infectious
causes such as rotavirus, bacterial enterotoxins, or c-diff.
6. Motility diarrhea: AKA short bowel syndrome. Results from resection of small
intestine or surgical bypass of small intestine, IBS, diabetic neuropathy,
hyperthyroidism, and laxative abuse. Fatty stools and bloating are common in
malabsorption syndrome. Complications include: dehydration, electrolyte
imbalance, metabolic acidosis, weight loss and malabsorption.
7. Upper GI bleed: bleeding that occurs in the esophagus, stomach or duodenum
commonly caused by bleeding varices, peptic ulcers or Mallory-Weiss
tear(tearing of esophagus from stomach) Characterized by frank, bright red or
coffee ground emesis.
8. Lower GI bleed: Bleeding in the jejunum, ileum, colon or rectum from
inflammatory bowel disease, cancer, diverticula or hemorrhoids. Hematochezia,
or the presence of bright red blood in the stools, suggest a lower GI bleed
usually in the rectum, sigmoid colon or descending colon
9. Peptic Ulcer Disease: Is a break in the integrity of the mucosa of the
esophagus, stomach or duodenum resulting in exposure of the tissue to gastric
acid. Risk factors include smoking, advanced age, NSAID use, ETOH, chronic
disease, acute pancreatitis, COPD, obesity, socioeconomic status, gastrinoma,
and infection with Helicobacter pylori. S&S: Epigastric pain is worse with eating,
melena or hematemesis
10. Duodenal ulcers: most common and tend to develop in younger patients. S&S:
epigastric pain that is relieved by food. Patients may have melena(black and
tarry stool) or hematemesis
11. Ulcerative colitis (UC): Inflammatory disease of the large instestine in persons
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, NURS 5315 GI
20-40y/o. Less common in people who smoke. Has periods of remission and
exacerbations. Characterized by inflammation and ulcerations that remain
superficial and in the small intestine.
12. UC S&S: recurrent diarrhea, bloody stools, febrile, polyarthritis, uveitis,
sclerosing cholangitis, erythema nodosum and pyoderma gangrenosum
13. UC complications: fissures, hemorrhoids, perirectal abscess, toxic megacolon,
colon perforation, and colorectal adenocarcinoma. Increased risk of VTE and
microthrombi, and colon cancer
14. Crohn's disease: Chronic inflammatory disorders that can affect any portion of
the GI tract but most often in the ileum and proximal colon. Affects persons in
their 20-30s and of jewish decent. CARD15/NOD2 gene mutation commonly
associated.
15. Crohn's disease risk factors: smoking, family history, Jewish decent, age less
than 40, slight predominance in women and altered gut microbiome.
16. Crohn's disease patho: includes trasmural involvement of the affected
area(entire wall of intestine is affected) and the presence of skip lesions.
Disease progression may lead to abscess formation in GI tract. Possible causes
include infectious agents, autoimmune, psychosomatic, impaired T-cell
immunity
17. Crohn's disease S&S: abd pain, diarrhea, dehydration, bloody stools,
malabsorption, malnutrition, weight loss, intestinal obstruction from chronic
inflammation, fistulas and perforation of the intestine
18. Diverticular disease: Characterized as the presence of diverticula in the large
intestine. Risk factors include older age, genetic predisposition, obesity,
smoking, diet, lack of exercise, ASA and other NSAIDS, altered DI microbiome
and abnormal colonic peristalsis
19. Diverticulosis/Diverticulitis: Diverticula are outpouchings of mucosa from the
muscle layer of the intestine that protrude into the intestinal lumen most
commonly in the sigmoid colon. Diverticulosis is the presence of diverticula in
an asymptomatic person. Diverticulitis is an inflammation of diverticula and
cause LLQ pain. Results in abscess formation, rupture and peritonitis
20. Appendicity: Inflammation of the appendix usually in persons 10-19. S&S:
periumbilical pain, RLQ pain, nvd, anorexia. Pain may initially be epigastric or
periumbilical then settle in RLQ. Perforation, peritonitis and abscess formation
are all potential complications
21. Small bowel obstruction: Most commonly caused by postop adhesions,
tumors, Crohn's disease, hernias and intussusception. SBO causes distention
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1. Upper GI organs: mouth,pharynx, esophagus, stomach, and duodenum
2. Lower GI organs: small intestine, large intestine, rectum and anus
3. Hepatoportal circulation: hepatic artery receives oxygenated blood from the
inferior mesenteric, gastric, and cystic veins. The hepatic portal vein receives
deoxygenated blood from the inferior and superior mesenteric vein and splenic
vein and delivers nutrients that have been absorbed from the intestinal system
4. Osmotic diarrhea: Caused by the presence of a nonabsorbable substance in
the intestines. This pulls water by osmosis into the intestinal lumen and results
in large volume diarrhea. This is how mag citrate, lactulose and miralax work.
Causes include: excessive ingestion of nonabsorbable sugars, tube feedings,
dumping syndrome, malabsorption, pancreatic enzyme deficiency, bile salt
deficiency, small intestine bacterial overgrowth or celiac disease
5. Secretory diarrhea: Results in large volume losses secondary to infectious
causes such as rotavirus, bacterial enterotoxins, or c-diff.
6. Motility diarrhea: AKA short bowel syndrome. Results from resection of small
intestine or surgical bypass of small intestine, IBS, diabetic neuropathy,
hyperthyroidism, and laxative abuse. Fatty stools and bloating are common in
malabsorption syndrome. Complications include: dehydration, electrolyte
imbalance, metabolic acidosis, weight loss and malabsorption.
7. Upper GI bleed: bleeding that occurs in the esophagus, stomach or duodenum
commonly caused by bleeding varices, peptic ulcers or Mallory-Weiss
tear(tearing of esophagus from stomach) Characterized by frank, bright red or
coffee ground emesis.
8. Lower GI bleed: Bleeding in the jejunum, ileum, colon or rectum from
inflammatory bowel disease, cancer, diverticula or hemorrhoids. Hematochezia,
or the presence of bright red blood in the stools, suggest a lower GI bleed
usually in the rectum, sigmoid colon or descending colon
9. Peptic Ulcer Disease: Is a break in the integrity of the mucosa of the
esophagus, stomach or duodenum resulting in exposure of the tissue to gastric
acid. Risk factors include smoking, advanced age, NSAID use, ETOH, chronic
disease, acute pancreatitis, COPD, obesity, socioeconomic status, gastrinoma,
and infection with Helicobacter pylori. S&S: Epigastric pain is worse with eating,
melena or hematemesis
10. Duodenal ulcers: most common and tend to develop in younger patients. S&S:
epigastric pain that is relieved by food. Patients may have melena(black and
tarry stool) or hematemesis
11. Ulcerative colitis (UC): Inflammatory disease of the large instestine in persons
1/7
, NURS 5315 GI
20-40y/o. Less common in people who smoke. Has periods of remission and
exacerbations. Characterized by inflammation and ulcerations that remain
superficial and in the small intestine.
12. UC S&S: recurrent diarrhea, bloody stools, febrile, polyarthritis, uveitis,
sclerosing cholangitis, erythema nodosum and pyoderma gangrenosum
13. UC complications: fissures, hemorrhoids, perirectal abscess, toxic megacolon,
colon perforation, and colorectal adenocarcinoma. Increased risk of VTE and
microthrombi, and colon cancer
14. Crohn's disease: Chronic inflammatory disorders that can affect any portion of
the GI tract but most often in the ileum and proximal colon. Affects persons in
their 20-30s and of jewish decent. CARD15/NOD2 gene mutation commonly
associated.
15. Crohn's disease risk factors: smoking, family history, Jewish decent, age less
than 40, slight predominance in women and altered gut microbiome.
16. Crohn's disease patho: includes trasmural involvement of the affected
area(entire wall of intestine is affected) and the presence of skip lesions.
Disease progression may lead to abscess formation in GI tract. Possible causes
include infectious agents, autoimmune, psychosomatic, impaired T-cell
immunity
17. Crohn's disease S&S: abd pain, diarrhea, dehydration, bloody stools,
malabsorption, malnutrition, weight loss, intestinal obstruction from chronic
inflammation, fistulas and perforation of the intestine
18. Diverticular disease: Characterized as the presence of diverticula in the large
intestine. Risk factors include older age, genetic predisposition, obesity,
smoking, diet, lack of exercise, ASA and other NSAIDS, altered DI microbiome
and abnormal colonic peristalsis
19. Diverticulosis/Diverticulitis: Diverticula are outpouchings of mucosa from the
muscle layer of the intestine that protrude into the intestinal lumen most
commonly in the sigmoid colon. Diverticulosis is the presence of diverticula in
an asymptomatic person. Diverticulitis is an inflammation of diverticula and
cause LLQ pain. Results in abscess formation, rupture and peritonitis
20. Appendicity: Inflammation of the appendix usually in persons 10-19. S&S:
periumbilical pain, RLQ pain, nvd, anorexia. Pain may initially be epigastric or
periumbilical then settle in RLQ. Perforation, peritonitis and abscess formation
are all potential complications
21. Small bowel obstruction: Most commonly caused by postop adhesions,
tumors, Crohn's disease, hernias and intussusception. SBO causes distention
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