what is inflammation? - Answers swelling and redness of tissue with or without infection
what are the 5 cardinal symptoms of inflammation? - Answers - warmth
- redness
- swelling
- pain
- decreased function
what labs would be different for infection? - Answers - increased WBCs (normal is 5000-10,000) but can
also be increased due to trauma or stress
- basophils/eosinophils with allergic reaction
Stage I: Vascular Response - Answers acute swelling, redness, pain, tenderness
Stage II: Cellular Exudate Response - Answers regenerative stage, less pain and tenderness, body starts
to repair itself
Stage III: Tissue Repair and Replacement - Answers scar formation, function and mobility back, less or no
pain, swelling, etc
when the infection is more systemic, what manifestations would you see? - Answers malaise, fatigue,
increased WBC, effects whole body
what are priority assessment pieces or questions to ask for GI system? - Answers - do they have strain or
pain with BM?
- how often do they have BM?
- when was last BM?
- consistency?
- changes in habits, new meds,
- change in health or new diagnosis
- physical assessment: inspect, auscultate, percuss, palpate
what changes with age in the GI system? - Answers - reduced secretions
- slowed GI mobility
,- decreased muscle atrophy makes the elderly more susceptible to constipation
what is gastritis? how can it manifest? - Answers inflammation of the lining of the stomach, can be acute
(something irritated it short term) or chronic, can be erosive (break through, ulcers) or non-erosive
(superficial, redness)
what things places a person at risk for gastritis or can exacerbate it? - Answers - alcohol intake
- caffeine
- cigarette smoking
- stress
- meds like steroids or NSAIDS
what is the most common reason or cause for someone to have gastritis? - Answers H. pylori
what are clinical manifestations of gastritis? - Answers - epigastric pain
- dyspepsia (heartburn)
- hematemesis (vomiting blood)
- melena (dark/tarry stools) due to old blood
- abrupt onset with acute
- less symptoms with chronic gastritis (unless they have an ulcer)
- hiccuping
- nausea or vomiting with loss of appetite
what is the most important GOLD STANDARD diagnostic test for gastritis and peptic ulcer disease?
what should you do for the patient before and after the test? - Answers - EGD
- it visualizes tissue and biopsies if needed
- keep pt NPO
- check for gag reflex after, sore throat is common
what should be stopped before an EGD and why? - Answers - stop taking antacids and PPIs for at least 1
week
- to not mask symptoms of H. pylori
, what are some interventions needed to treat and prevent gastritis/H. pylori? - Answers - remove cause
(NSAIDs, smoking, stress, poor nutrition)
- limit foods or drink that cause distress like spicy foods, alcohol, or caffeine
- small meals can ease discomfort
- bland diet
- H. pylori needs treated with antibiotics
what are medications used to treat gastritis? - Answers PPIs, h2 receptor agonists, antacids, and mucosal
barrier fortifiers
what is peptic ulcer disease? - Answers a break or ulceration in the protective mucosal lining of the
lower esophagus, stomach, or duodenum
what are the different kinds of ulcers? - Answers duodenal, gastric, or stress
what is a duodenal ulcer? - Answers ulcer in the duodenum caused high gastric acid secretion
what is a gastric ulcer? - Answers ulcer on the stomach lining caused by high gastric acid secretion and
H. Pylori
what is a stress ulcer? - Answers ulcer in the fundus or body of the stomach caused by a break in mucosa
after medical crisis or trauma, being NPO, or gastritis
what are priority assessments and questions for peptic ulcer disease? - Answers history of:
- H. Pylori, taking corticosteroids, chemo, excessive use of NSAIDs, GI surgery, alcohol intake, tobacco
use, do certain foods worsen symptoms?
physical assessment:
- epigastric tenderness and pain, initial hyperactive bowel sounds, dyspepsia (heart burn)
overall monitoring of:
- VS, labs, physical and psychological assessment
how would someone present with gastric ulcers? - Answers - pain 30-60 minutes after a meal, at night
- rarely worsens by indigestion of food