Exam 1- Adult Health 2

Constipation

Infrequent, difficult, or incomplete passage of stool; hard dry stools.

Constipation Risk Factors

Low fiber diet, dehydration, sedentary lifestyle, opioids, ignoring urge to defecate.

Constipation Treatment

Increase fiber, increase fluids, exercise, stool softeners, establish bowel routine.

Constipation Complications

Fecal impaction, bowel obstruction, hemorrhoids.

Diarrhea

Three or more loose stools per day.

Priority Concern with Diarrhea

Dehydration and electrolyte imbalance.

Diarrhea Assessment

Tachycardia, hypotension, dry mucous membranes, monitor I&O.

Diarrhea Treatment

Fluid replacement, electrolyte replacement, treat underlying cause, skin protection.

C. difficile

Common cause of severe infectious diarrhea often associated with antibiotic use.

C. difficile Precautions

Contact precautions and handwashing with soap and water.

Irritable Bowel Syndrome (IBS)

Functional bowel disorder causing abdominal pain with constipation, diarrhea, or both.

IBS Symptoms

Bloating, abdominal pain, constipation, diarrhea, mixed bowel patterns.

IBS Diet

Avoid trigger foods, increase fiber if constipation predominant, maintain hydration.

Metabolic Syndrome

Cluster of conditions increasing risk of diabetes and cardiovascular disease.

Metabolic Syndrome Diagnostic Criteria

Three or more: abdominal obesity, hypertension, hyperglycemia, elevated triglycerides, low HDL.

GERD

Gastroesophageal reflux disease caused by stomach contents refluxing into esophagus.

GERD Risk Factors

Obesity, smoking, pregnancy, hiatal hernia.

GERD Symptoms

Heartburn, regurgitation, dysphagia, chronic cough.

GERD Complications

Esophagitis, Barrett's esophagus, esophageal cancer.

GERD Teaching

Elevate HOB, avoid meals before bed, avoid smoking and alcohol, lose weight.

Hiatal Hernia

Protrusion of stomach through diaphragm.

Nissen Fundoplication

Surgical treatment for severe GERD; stomach wrapped around lower esophagus.

Acute Gastritis

Inflammation of gastric mucosa often caused by NSAIDs, alcohol, H. pylori, or stress.

Acute Gastritis Symptoms

Epigastric pain, nausea, vomiting.

Acute Gastritis Diet

NPO during flare, then clear liquids to bland diet.

Chronic Gastritis Symptoms

Early satiety, vitamin B12 deficiency, pernicious anemia.

Chronic Gastritis Teaching

Avoid alcohol, smoking, and NSAIDs.

Peptic Ulcer Disease (PUD)

Ulcer caused by imbalance between acid and mucosal protection.

Most Common Cause of PUD

H. pylori infection.

Gastric Ulcer Pain

Pain shortly after meals.

Duodenal Ulcer Pain

Pain 2-3 hours after meals or at night.

Duodenal Ulcer Relief

Pain relieved by food or antacids.

PUD Medications

PPIs, H2 blockers, sucralfate, antibiotics for H. pylori.

PUD Complications

Hemorrhage, perforation, gastric outlet obstruction.

Melena

Black tarry stool indicating upper GI bleeding.

Hematemesis

Vomiting blood.

Acute GI Bleeding Signs

Hematemesis, melena, tachycardia, hypotension.

Chronic GI Bleeding Signs

Fatigue, anemia, weakness.

Appendicitis Pain

RLQ pain at McBurney's point.

Appendicitis Symptoms

Fever, nausea, vomiting, rebound tenderness.

Appendicitis Treatment

NPO, IV fluids, antibiotics, appendectomy.

Appendicitis Complication

Rupture causing peritonitis.

Diverticulosis

Presence of diverticula in colon, usually asymptomatic.

Diverticulosis Diet

High fiber diet and increased fluids.

Diverticulitis

Symptomatic inflammation or infection of diverticula.

Diverticulitis Symptoms

LLQ pain, fever, nausea, elevated WBC.

Diverticulitis Treatment

NPO, IV fluids, antibiotics.

Diverticulitis Diet During Acute Flare

Low residue diet.

Diverticulitis Prevention Diet

High fiber diet.

Crohn's Disease

Inflammatory bowel disease affecting any part of GI tract with skip lesions.

Crohn's Disease Characteristics

Transmural inflammation, fistulas common, nonbloody diarrhea.

Ulcerative Colitis

Inflammatory bowel disease affecting colon and rectum only.

Ulcerative Colitis Characteristics

Continuous lesions and bloody diarrhea.

IBD Complications

Toxic megacolon, perforation, GI bleeding.

IBD Treatment

Corticosteroids, immunosuppressants, anti-inflammatory medications.

Bowel Obstruction Symptoms

Abdominal distention, vomiting, no stool, no flatus.

Bowel Obstruction Treatment

NPO, NG tube, IV fluids, possible surgery.

Priority in Bowel Obstruction

Restore fluids and decompress bowel.

TPN

Total parenteral nutrition administered through a central line.

TPN Indications

Nonfunctional GI tract, severe malnutrition, bowel obstruction.

TPN Complications

Infection, hyperglycemia, electrolyte imbalance, refeeding syndrome.

TPN Nursing Care

Daily weights, blood glucose monitoring, strict I&O.

Perforation of GI Tract

Hole in GI tract allowing contents into peritoneum.

Causes of GI Perforation

Appendicitis, ulcers, diverticulitis, bowel obstruction.

GI Perforation Signs

Sudden severe abdominal pain, rigid abdomen, fever.

Peritonitis

Inflammation of peritoneum due to infection or perforation.

Peritonitis Signs

Board-like abdomen, rebound tenderness, fever, tachycardia.

Healthy Stoma Appearance

Moist, pink to red, slightly swollen.

Colostomy Teaching

Skin care, adequate fluids, empty pouch when 1/3 to 1/2 full.

Ostomy Psychosocial Concern

Altered body image.

Dumping Syndrome

Rapid gastric emptying after gastric surgery.

Dumping Syndrome Symptoms

Tachycardia, diarrhea, dizziness, sweating, abdominal cramping.

Dumping Syndrome Prevention

Small frequent meals, high protein, low sugar, no fluids with meals, lie down after eating.

Cholecystitis

Inflammation of gallbladder usually caused by gallstones.

Cholecystitis Symptoms

RUQ pain, nausea, vomiting, fever, fat intolerance.

Post-op Cholecystectomy Care

Early ambulation, pain control, low-fat diet.

Shoulder Pain After Laparoscopic Cholecystectomy

Caused by retained CO2.

Hepatitis A Transmission

Fecal-oral route.

Hepatitis B Transmission

Blood and body fluids.

Hepatitis C Transmission

Blood exposure and IV drug use.

Hepatitis D

Requires hepatitis B to survive.

Hepatitis Vaccine Available

Hepatitis A and B.

No Vaccine Available

Hepatitis C and E.

Hepatitis Symptoms

Jaundice, fatigue, dark urine, clay-colored stools, RUQ pain.

Cirrhosis

Chronic destruction and scarring of liver tissue.

Common Causes of Cirrhosis

Alcoholism, hepatitis, biliary disease.

Cirrhosis Manifestations

Jaundice, ascites, edema, spider angiomas.

Cirrhosis Labs

Elevated AST, ALT, bilirubin, PT/INR and decreased albumin.

Portal Hypertension

Increased pressure in portal venous system.

Portal Hypertension Complications

Ascites, esophageal varices, splenomegaly.

Ascites

Fluid accumulation in the peritoneal cavity.

Ascites Treatment

Sodium restriction, spironolactone, furosemide, paracentesis.

Esophageal Varices

Dilated veins in esophagus caused by portal hypertension.

Esophageal Varices Symptoms

Hematemesis, melena, shock.

Esophageal Varices Treatment

Banding, sclerotherapy, octreotide.

Hepatic Encephalopathy

Neurologic dysfunction caused by elevated ammonia.

Hepatic Encephalopathy Symptoms

Confusion, asterixis, coma, fetor hepaticus.

Lactulose Purpose

Reduces ammonia levels through stool excretion.

Acute Pancreatitis

Inflammation of pancreas caused by autodigestion.

Most Common Causes of Pancreatitis

Alcoholism and biliary disease.