NR507 Week
NR507
5–6
Week
NR507
Gastrointestinal
5–6
Week
Gastrointestinal
5–6
Disorders
Gastrointestinal
Disorders
Course Notes
Disorders
Course
PDFNotes
–
Course
Comprehensive
PDFNotes
– Comprehensive
PDF –
Study
Comprehensive
Guide
Study
withGuide
Key
Study
Concepts,
withGuide
Key Concepts,
with
Questions,
Key Concepts,
Questions,
Answers,Questions,
and
Answers,
Detailed
and
Answers,
Explanations
Detailed
andExplanations
Detailed
for Nursing
Explanations
forPathophysiology.pdf
NursingforPathophysiology.pdf
Nursing Pathophysiology.pdf
NR507 Week 5–6
Gastrointestinal Disorders
Course Notes PDF –
Comprehensive Study
Guide with Key Concepts,
Questions, Answers, and
Guidehttps://www.stuvia.com/dashboard!@_)#*)(@$)($@*($@)($@*_
NR507 Week
NR507
5–6Week
NR507
Gastrointestinal
5–6
WeekGastrointestinal
5–6
Disorders
Gastrointestinal
Course
Disorders
Notes
Disorders
Course
PDF –
Notes
Course
Comprehensive
PDF
Notes
–PDF
Comprehensive
–
Study
Comprehensive
GuideStudy
with Key
Guide
Study
Concepts,
with
Guide
Keywith
Questions,
Concepts,
Key Concepts,
Answers,
Questions,
Questions,
and
Answers,
Detailed
Answers,
and
Explanations
Detailed
and Detailed
Explanations
for Nursing
Explanations
Pathophysiology
for Nursing
for Nursing
Pathophysiology
Pathophysiology.pdf
,NR507 Week
NR507
5–6
Week
NR507
Gastrointestinal
5–6
Week
Gastrointestinal
5–6
Disorders
Gastrointestinal
Disorders
Course Notes
Disorders
Course
PDFNotes
–
Course
Comprehensive
PDFNotes
– Comprehensive
PDF –
Study
Comprehensive
Guide
Study
withGuide
Key
Study
Concepts,
withGuide
Key Concepts,
with
Questions,
Key Concepts,
Questions,
Answers,Questions,
and
Answers,
Detailed
and
Answers,
Explanations
Detailed
andExplanations
Detailed
for Nursing
Explanations
forPathophysiology.pdf
NursingforPathophysiology.pdf
Nursing Pathophysiology.pdf
Detailed Explanations for
Nursing Pathophysiology
Guidehttps://www.stuvia.com/dashboard!@_)#*)(@$)($@*($@)($@*_
NR507 Week
NR507
5–6Week
NR507
Gastrointestinal
5–6
WeekGastrointestinal
5–6
Disorders
Gastrointestinal
Course
Disorders
Notes
Disorders
Course
PDF –
Notes
Course
Comprehensive
PDF
Notes
–PDF
Comprehensive
–
Study
Comprehensive
GuideStudy
with Key
Guide
Study
Concepts,
with
Guide
Keywith
Questions,
Concepts,
Key Concepts,
Answers,
Questions,
Questions,
and
Answers,
Detailed
Answers,
and
Explanations
Detailed
and Detailed
Explanations
for Nursing
Explanations
Pathophysiology
for Nursing
for Nursing
Pathophysiology
Pathophysiology.pdf
, lOMoARcPSD|62982272
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
Week 5 GI
GERD
Pretest:
● Commonly associated with the loss of muscle tone at the lower esophageal sphincter (LES)
● Larger volumes of gastric contents generally increase gastric pressure, stimulating peristalsis and promoting a
faster rate of gastric emptying. Hypertonic solutions (and hypotonic), having a higher osmotic pressure than the
surrounding tissues, tend to delay gastric emptying.
● Obesity, smoking, and hiatal hernia = risk factors
Physiology of GI tract
● Mouth, esophagus, stomach, small intestine, large intestine, rectum, anus
● Responsible for breaking down ingested food, nutrient absorption, maintaining body water, eliminating waste
● Hormones and the autonomic nervous sys. regulate most digestive activities: hormone release, gastric motility,
substance for digestion
Physiology of Gastric Emptying
● Depending on volume, osmotic pressure, and chemical composition of gastric contents
● Longer to digest and break solids and fat == slower rate of emptying
Pathophysiology of GERD: backflow of acid or bile, caused by:
● Lower esophageal sphincter fn: decreased tone allows acid to regurg into the esophagus
● Esophageal motility: disrupted coordinated contraction causes delayed gastric emptying
● Delayed gastric emptying: causes esophagitis by extending the period during which reflux can occur and
increasing the acid content of chyme.
Clinical Manifestations: classic symptom = heartburn (pyrosis)
● Typical
○ Pyrosis: behind the sternum. HALLMARK
○ Regurgitation: sour or bitter taste
● Atypical
○ Chronic cough (irritation of the airway): persistent and not
always accompanied by heartburn
○ Asthma exacerbation (acid regurg into the airways):
triggers or worsens asthma
○ Laryngitis: inflammation of the voiced box
○ Sinusitis: irritation and inflammation of the sinuses
● Associated symptoms
○ Upper abd pain, especially within one hour of eating
○ Dysphagia: food sticking in the throat or hard to
swallowing
○ Belching and flatulence
○ Sleep disturbances
○ Worsening of s/s in supine, esp. after meals
Risk factors: obesity, smoking, hiatal hernia
● Obesity: slows gastric emptying == prolonged retention of food in the stomach and risk of reflux
● Smoking: weakens the lower esophageal sphincter Fn
● Hiatal hernia: a structural risk factor. The stomach protrudes through the diaphragmatic opening, impacting
sphincter == less effective in preventing the backflow of stomach contents into the esophagus
Dx and Tx
● Dx: based on hx and clinical manifestations.
● Tx:
1
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nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
○ Initially includes PPI (1st thing in the morning) and lifestyle changes (diet, weight loss, smoking cessation,
elevating the HOB, avoid tight clothing) == 6 weeks
○ If no change with PPI and lifestyle change in 6 weeks == esophageal endoscopy to confirm a dx or rule out
other conditions (can show esophagitis, gastric ulcers, presence of hiatal hernia, esophageal strictures).
Impedance/pH monitoring can measure acidity and mvt of stomach contents into esophagus. Fundoplication
= most common surgical intervention if medical tx fails.
○ Persistent esophagitis suggests that the inflammation of the esophagus has not responded adequately to the
prescribed interventions. The client continuing to have symptoms may be due to the development of
esophageal strictures, which can hinder the passage of food and contribute to ongoing discomfort. If gastric
ulcers are detected, it could explain ongoing symptoms and suggest that acid suppression therapy might not
be effectively controlling acid production. Identification of a hiatal hernia may contribute to ongoing
symptoms, as it can facilitate the reflux of stomach contents into the esophagus.
○ Diet: see below + oatmeal, broccoli, salad of non-acidic veggies and lean proteins, brown rice, lean proteins
(chicken etc.) are low in fact. Avoid carbonated drinks.
2
nr507-week-5-6-gastrointestinal-disorders-course-notes
nr507-week-5-6-gastrointestinal-disorders-course-notes
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
Downloaded by elizabeth moses ()
NR507
5–6
Week
NR507
Gastrointestinal
5–6
Week
Gastrointestinal
5–6
Disorders
Gastrointestinal
Disorders
Course Notes
Disorders
Course
PDFNotes
–
Course
Comprehensive
PDFNotes
– Comprehensive
PDF –
Study
Comprehensive
Guide
Study
withGuide
Key
Study
Concepts,
withGuide
Key Concepts,
with
Questions,
Key Concepts,
Questions,
Answers,Questions,
and
Answers,
Detailed
and
Answers,
Explanations
Detailed
andExplanations
Detailed
for Nursing
Explanations
forPathophysiology.pdf
NursingforPathophysiology.pdf
Nursing Pathophysiology.pdf
NR507 Week 5–6
Gastrointestinal Disorders
Course Notes PDF –
Comprehensive Study
Guide with Key Concepts,
Questions, Answers, and
Guidehttps://www.stuvia.com/dashboard!@_)#*)(@$)($@*($@)($@*_
NR507 Week
NR507
5–6Week
NR507
Gastrointestinal
5–6
WeekGastrointestinal
5–6
Disorders
Gastrointestinal
Course
Disorders
Notes
Disorders
Course
PDF –
Notes
Course
Comprehensive
Notes
–PDF
Comprehensive
–
Study
Comprehensive
GuideStudy
with Key
Guide
Study
Concepts,
with
Guide
Keywith
Questions,
Concepts,
Key Concepts,
Answers,
Questions,
Questions,
and
Answers,
Detailed
Answers,
and
Explanations
Detailed
and Detailed
Explanations
for Nursing
Explanations
Pathophysiology
for Nursing
for Nursing
Pathophysiology
Pathophysiology.pdf
,NR507 Week
NR507
5–6
Week
NR507
Gastrointestinal
5–6
Week
Gastrointestinal
5–6
Disorders
Gastrointestinal
Disorders
Course Notes
Disorders
Course
PDFNotes
–
Course
Comprehensive
PDFNotes
– Comprehensive
PDF –
Study
Comprehensive
Guide
Study
withGuide
Key
Study
Concepts,
withGuide
Key Concepts,
with
Questions,
Key Concepts,
Questions,
Answers,Questions,
and
Answers,
Detailed
and
Answers,
Explanations
Detailed
andExplanations
Detailed
for Nursing
Explanations
forPathophysiology.pdf
NursingforPathophysiology.pdf
Nursing Pathophysiology.pdf
Detailed Explanations for
Nursing Pathophysiology
Guidehttps://www.stuvia.com/dashboard!@_)#*)(@$)($@*($@)($@*_
NR507 Week
NR507
5–6Week
NR507
Gastrointestinal
5–6
WeekGastrointestinal
5–6
Disorders
Gastrointestinal
Course
Disorders
Notes
Disorders
Course
PDF –
Notes
Course
Comprehensive
Notes
–PDF
Comprehensive
–
Study
Comprehensive
GuideStudy
with Key
Guide
Study
Concepts,
with
Guide
Keywith
Questions,
Concepts,
Key Concepts,
Answers,
Questions,
Questions,
and
Answers,
Detailed
Answers,
and
Explanations
Detailed
and Detailed
Explanations
for Nursing
Explanations
Pathophysiology
for Nursing
for Nursing
Pathophysiology
Pathophysiology.pdf
, lOMoARcPSD|62982272
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
Week 5 GI
GERD
Pretest:
● Commonly associated with the loss of muscle tone at the lower esophageal sphincter (LES)
● Larger volumes of gastric contents generally increase gastric pressure, stimulating peristalsis and promoting a
faster rate of gastric emptying. Hypertonic solutions (and hypotonic), having a higher osmotic pressure than the
surrounding tissues, tend to delay gastric emptying.
● Obesity, smoking, and hiatal hernia = risk factors
Physiology of GI tract
● Mouth, esophagus, stomach, small intestine, large intestine, rectum, anus
● Responsible for breaking down ingested food, nutrient absorption, maintaining body water, eliminating waste
● Hormones and the autonomic nervous sys. regulate most digestive activities: hormone release, gastric motility,
substance for digestion
Physiology of Gastric Emptying
● Depending on volume, osmotic pressure, and chemical composition of gastric contents
● Longer to digest and break solids and fat == slower rate of emptying
Pathophysiology of GERD: backflow of acid or bile, caused by:
● Lower esophageal sphincter fn: decreased tone allows acid to regurg into the esophagus
● Esophageal motility: disrupted coordinated contraction causes delayed gastric emptying
● Delayed gastric emptying: causes esophagitis by extending the period during which reflux can occur and
increasing the acid content of chyme.
Clinical Manifestations: classic symptom = heartburn (pyrosis)
● Typical
○ Pyrosis: behind the sternum. HALLMARK
○ Regurgitation: sour or bitter taste
● Atypical
○ Chronic cough (irritation of the airway): persistent and not
always accompanied by heartburn
○ Asthma exacerbation (acid regurg into the airways):
triggers or worsens asthma
○ Laryngitis: inflammation of the voiced box
○ Sinusitis: irritation and inflammation of the sinuses
● Associated symptoms
○ Upper abd pain, especially within one hour of eating
○ Dysphagia: food sticking in the throat or hard to
swallowing
○ Belching and flatulence
○ Sleep disturbances
○ Worsening of s/s in supine, esp. after meals
Risk factors: obesity, smoking, hiatal hernia
● Obesity: slows gastric emptying == prolonged retention of food in the stomach and risk of reflux
● Smoking: weakens the lower esophageal sphincter Fn
● Hiatal hernia: a structural risk factor. The stomach protrudes through the diaphragmatic opening, impacting
sphincter == less effective in preventing the backflow of stomach contents into the esophagus
Dx and Tx
● Dx: based on hx and clinical manifestations.
● Tx:
1
nr507-week-5-6-gastrointestinal-disorders-course-notes
nr507-week-5-6-gastrointestinal-disorders-course-notes
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
Downloaded by elizabeth moses ()
, lOMoARcPSD|62982272
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
○ Initially includes PPI (1st thing in the morning) and lifestyle changes (diet, weight loss, smoking cessation,
elevating the HOB, avoid tight clothing) == 6 weeks
○ If no change with PPI and lifestyle change in 6 weeks == esophageal endoscopy to confirm a dx or rule out
other conditions (can show esophagitis, gastric ulcers, presence of hiatal hernia, esophageal strictures).
Impedance/pH monitoring can measure acidity and mvt of stomach contents into esophagus. Fundoplication
= most common surgical intervention if medical tx fails.
○ Persistent esophagitis suggests that the inflammation of the esophagus has not responded adequately to the
prescribed interventions. The client continuing to have symptoms may be due to the development of
esophageal strictures, which can hinder the passage of food and contribute to ongoing discomfort. If gastric
ulcers are detected, it could explain ongoing symptoms and suggest that acid suppression therapy might not
be effectively controlling acid production. Identification of a hiatal hernia may contribute to ongoing
symptoms, as it can facilitate the reflux of stomach contents into the esophagus.
○ Diet: see below + oatmeal, broccoli, salad of non-acidic veggies and lean proteins, brown rice, lean proteins
(chicken etc.) are low in fact. Avoid carbonated drinks.
2
nr507-week-5-6-gastrointestinal-disorders-course-notes
nr507-week-5-6-gastrointestinal-disorders-course-notes
nr507-week-5-6-gastrointestinal-disorders-course-notes.pdf
Downloaded by elizabeth moses ()
