EXAM #2 - CHAP. 9

atresia *

incomplete formation of a body passage (closed or missing)

• includes lack of valve opening in the heart to allow blood flow (pulmonary atresia) + lack of an external ear canal (aural atresia)

• esophageal atresia → incomplete formation of the esophagus

dysphagia *

difficulty swallowing

• develops secondary to a condition that causes mechanical obstruction of esophagus or impaired esophageal motility

dysphagia causes

• mechanical obstruction → congenital atresia, esophageal stenosis, esophageal diverticula, tumors

• neurologic disorders → stroke, cerebral damage, achalasia, parkinson’s, alzheimer’s, huntington, cerebral palsy, multiple sclerosis

• muscular disorders

dysphagia manifestations *

sensation of food being stuck in the throat, choking, coughing, pocketing food in cheeks, difficulty forming a food bolus, delayed swallowing, painful swallowing (odynophagia)

dysphagia treatment

speech therapy, maintain nutritional status + prevent aspiration (soft, pureed foods, thickened liquids, small bites, no straw usage, gastrostomy tube)

hepatomegaly *

abnormal enlargement of the liver

• indicates underlying conditions → fatty liver, hepatitis, congestive heart failure, tumor

fulminant *

severe and sudden in onset

• ex: fulminant hepatitis → uncommon, rapidly progressing form that can quickly lead to liver failure, hepatic encephalopathy, or death within 3 weeks

chyme *

mixture of food that has been chemically digested and churned in the stomach

cholelithiasis *

gallstones; common condition affecting both genders + all ethnic groups

cholelithiasis risk factors

advancing age, obesity, diet, rapid weight loss, pregnancy, hormone replacement, certain chronic diseases, long-term parenteral nutrition

cholelithiasis manifestations

biliary colic, abdominal distention, abdominal distention, N/V, jaundice, clay-colored stools, fever, leukocytosis, tachycardia, hypotension

cholelithiasis treatment

low-fat diet, meds to dissolve calculi, antibiotic therapy

cholecystitis *

inflammation or infection in billary system caused by calculi

cholecystectomy *

surgical removal, usually laparoscopically, of calculi or gallbladder

ascites *

fluid that accumulates in the peritoneal cavity

jaundice *

yellowish discoloration of the skin + sclera caused by excessive amount of bilirubin in the bloodstream

• result from → bile entering the bloodstream or erythrocyte lysis

albumin *

protein produced by liver

• maintains oncotic pressure (keeps fluid within blood vessels)

• transports hormones, meds, enzymes

• aids in tissue healing

ammonia *

metabolic waste managed by kidneys

• highly toxic product that results from the breakdown of amino acids in liver

encephalopathy *

brain disease, damage, or malfunction that alters brain function or structure

• causes → infections, liver/kidney failure, toxins, lack of oxy.

• GI bleeding w/ high-protein diet, renal failure, and infection, can cause protein levels to increase → in turn, excessive protein levels lead to a rapid onset of encephalopathy

paracentesis *

low-risk, 20-45 min procedure to remove excess fluid (ascites) from abdomen by using a needle or catheter

• used to TREAT ascites

bilirubin *

yellow pigment that forms when RBCs break down (processed by liver + excreted)

• sickle cell anemia → causes hemolysis, leading to the formation of multiple, small, black stones

varices *

abnormally enlarged, swollen veins in lower esophagus

• usually caused by cirrhosis

  • cirrhosis → chronic, progresssive, irreversible, diffuse damage to liver resulting in decreased liver function

stool

large, loose, and provoked by diarrhea originating in the small intestine

• usually accompanied by pain in right lower quadrant

• baristol stool chart

stool type 1 *

separate hard lumps, like nuts (hard to pass)

stool type 2 *

sausage-shaped but lumpy

stool type 3 *

like a sausage but w/ crack on the surface

stool type 4 *

like a sausage or snake, smooth + soft

stool type 5 *

soft blobs w/ clear-cut edges (passed easily)

stool type 6 *

fluffy pieces w/ ragged edges (mushy stool)

stool type 7 *

watery, no solid pieces (entirely liquid)

hepatitis *

inflammation of liver that can be caused by infection (viral), alcohol, meds, autoimmune disease

acute hepatitis symptomatic phases *

1. prodromal phase

2. icteric phase

3. recovery phase

phase 1 - prodromal phase *

starts 2 weeks after exposure to virus

• viral symptoms → N/V, malaise, anorexia, low-grade fever, headache

phase 2 - icteric phase *

begins 1-2 weeks after prodromal phase + lasts up to 6 weeks

• jaundice, dark tea-colored urine (bilirubinuria) or clay-colored stools (due to lack of bilirubin, hepatomegaly, right upper quadrant pain )

phase 3 - recovery phase *

resolution of jaundice approx. 6-8 weeks after exposure

• liver may remain enlarged for up to 3 months

peritonitis *

inflammation of the peritoneum (membrane that lines abdominal wall + abdominal organs) that can be life threatening

• presents as an acute condition

• treatment centers on resolving underlying cause

peritonitis key assessment findings in abdomen *

3 main nursing problems related to GI system

barium swallow

upper GI series

EGD

colonoscopy

manometry

breath test

acute gastritis *

develops quick w/ bleeding

• accompanied by NAUSEA + epigastric pain

• mild or severe

• transient irritation or a severe ULCERATION w/ hemorrhage

• characterized by presence of polymorphonuclear leukocytes (PMNs) in mucosa

chronic gastritis *

develops gradually

• accompanied by DULL, epigastric pain + sensation of FULLNESS after minimal intake

• can be asymptomatic

• can last months to years

• some degree of atrophy or mataplasia

• common cause → h. pylori (causes non-erosive gastritis)

h. pylori pathogenesis *

most common cause of chronic gastritis

• embeds itself in mucosal layer, activating toxins + enzymes that cause inflammation

duodenal ulcer symptoms *

most common peptic ulcers, associated w/ excessive acids or h. pylori infec.

• epigastric pain that is usually absent when awaken, appears mid-morning, and arouses at night

  • relieved in presence of food but returns 2-3 hours after eating

• hemorrhage → in infants + young children

gastic ulcers symptoms *

less frequent but deadlier

• associated w/ malignancy and NSAID use

• typically worsens w/ eating

pancreatitis

inflammation of pancreas

bowel obstructions

appendicitis

inflammation of the vermiform appendix

• inflammation can be life threatening + most often caused by infection

appendicitis pathophysiology

chronic inflammatory bowel disease (IBM)

chronic inflammation of the gastrointestinal tract; usually intestines

types of chronic inflammatory bowel disease

chronic inflammatory bowel disease pathophysiology

chronic inflammatory bowel disease manifestations

colorectal cancer

caner of the colon and/or rectum

colorectal manifestations

colorectal early detection