Alterations in Digestion, Bowel Elimination, and Tissue Integrity

Vocabulary practice flashcards covering gastrointestinal disorders, bowel elimination alterations, hepatobiliary conditions, and tissue integrity concepts for NCLEX-PN review.

Lower Esophageal Sphincter (LES)

A muscular ring that stays closed at rest to prevent stomach acid and contents from refluxing into the esophagus, opening upon swallowing under regulation by the afferent sensory branch of the vagus nerve (cranial nerve X).

Herpes Simplex (HSV-1)

A contagious viral infection presenting as clusters of painful vesicles on or near the lips, which recurs with stress, illness, or sun exposure, and spreads via direct contact.

Aphthous Ulcers (Canker Sores)

Non-contagious, shallow, painful ulcers inside the mouth with a white or yellow center and red rim, linked to stress, local trauma, and nutritional deficiencies in iron, vitamin B12, or folate.

Oral Candidiasis (Thrush)

The most common fungal oral disease, affecting about 2 million people annually; presents as creamy white patches that scrape off to leave a red, raw surface, frequently linked to inhaled corticosteroids, immunosuppression, or antibiotic use.

Periodontitis

Advanced gum disease where bacteria and chronic inflammation destroy the periodontal ligament and alveolar bone socket, leading to tooth loosening and adult tooth loss; linked with increased risk of coronary artery disease.

Barrett's Esophagus

A metaplastic alteration of the esophageal lining caused by chronic acid inflammation from GERD, where normal squamous mucosa is replaced by columnar epithelium, carrying an increased risk for esophageal adenocarcinoma.

Hiatal Hernia

A condition where part of the stomach pushes upward through the diaphragm's esophageal hiatus into the chest cavity, compromising LES barrier function and causing postprandial heartburn and sour regurgitation.

Gastroparesis

A chronic neuromuscular disorder characterized by delayed gastric emptying in the absence of mechanical obstruction, marked by nausea, vomiting of undigested food hours after eating, early satiety, and abdominal bloating.

Metoclopramide (Reglan)

An antidopaminergic prokinetic and antiemetic agent that stimulates stomach contractions to accelerate gastric emptying; carries a black box warning for irreversible tardive dyskinesia if used long-term.

Erythromycin (Prokinetic)

An antibiotic administered at low doses to stimulate upper GI motility by mimicking motilin, an endogenous hormone responsible for triggering gastric migrating motor complexes.

Melena

Black, tarry stool containing digested blood, indicating slow or significant bleeding in the upper gastrointestinal tract (stomach or duodenum).

Gastric Ulcer

A peptic erosion within the stomach lining characterized by epigastric pain that worsens 30 to 90 minutes after eating, often leads to weight loss from food avoidance, carries a higher malignancy risk, and requires biopsy.

Duodenal Ulcer

A peptic erosion in the duodenum commonly caused by Helicobacter pylori, producing pain that is relieved by eating, recurs 2 to 3 hours postprandially and at night, and is frequently accompanied by stable weight or weight gain.

Crohn's Disease

A form of inflammatory bowel disease featuring transmural inflammation and skip lesions anywhere from the mouth to the anus (commonly terminal ileum and colon), presenting with non-bloody diarrhea, a 'cobblestone' mucosa, and complications like fistulas and strictures.

Ulcerative Colitis (UC)

A chronic inflammatory condition restricted to the mucosa and submucosa of the colon and rectum, marked by continuous inflammation starting at the rectum, bloody diarrhea with mucus (often 10 or more stools/day in flares), and curable by total colectomy.

Toxic Megacolon

A life-threatening complication of severe colitis characterized by rapid colon dilation, abdominal distension, fever, tachycardia, absent bowel sounds, and a sudden cessation of diarrhea.

Diverticulitis

Inflammation or infection of small colonic outpouchings (diverticula), presenting with lower left quadrant abdominal pain, fever, nausea, elevated white blood cell count, and altered bowel habits.

Celiac Disease (Gluten Enteropathy)

An autoimmune disorder triggered by gluten ingestion (wheat, barley, rye) leading to destruction of small intestinal villi, resulting in malabsorption, iron-deficiency anemia, and steatorrhea.

Steatorrhea

Pale, bulky, foul-smelling, and floating stools caused by fat malabsorption, characteristically seen in pancreatic insufficiency, celiac disease, or small-bowel diseases.

Hepatitis A and E

Enteric hepatitis viruses transmitted primarily via the fecal-oral route through contaminated food or water; typically cause acute, self-limiting disease, though Hepatitis E carries severe risks in pregnancy.

Hepatitis B, C, and D

Blood-borne and body-fluid-transmitted hepatitis viruses capable of causing chronic liver infection, progressive fibrosis, cirrhosis, and hepatocellular carcinoma.

Calculous Cholecystitis

Gallbladder inflammation triggered by gallstones (cholelithiasis) obstructing the cystic duct, commonly manifesting as right upper quadrant pain that radiates to the right shoulder or scapula after fatty meals.

Acalculous Cholecystitis

Severe gallbladder inflammation occurring without gallstones, seen primarily in critically ill patients receiving total parenteral nutrition or prolonged fasting, carrying high rates of necrosis and perforation.

Murphy's Sign

A clinical exam maneuver where the patient experiences sharp pain and sudden arrest of inspiration during palpation beneath the right costal margin, indicating acute cholecystitis.

Acute Pancreatitis

Acute inflammatory autodigestion of the pancreas triggered by premature activation of trypsinogen into trypsin, causing sudden severe epigastric pain radiating to the back that improves when leaning forward.

Ileostomy

A surgical opening bringing the ileum to the abdominal surface, draining continuous liquid to pasty, enzyme-rich output that poses a high risk for dehydration, skin irritation, and sodium and potassium loss.

Epidermis

The thin, avascular outer skin layer that provides a waterproof barrier against microbial entry; superficial injuries affecting only this layer heal rapidly.

Dermis

The highly vascular and innervated middle layer of skin housing collagen, hair follicles, nerves, and sweat glands; exposed nerve endings make partial-thickness wounds reaching this layer acutely painful.

Hypodermis

The subcutaneous layer beneath the dermis consisting of adipose and connective tissue that insulates, cushions, and anchors skin to muscle; involved in full-thickness wounds.

Proliferation Phase

The second phase of wound healing (occurring roughly from day 3 to 3 weeks) where fibroblasts synthesize collagen, new blood vessels form, and bright red, bumpy granulation tissue fills the defect prior to epithelialization.

Shear

An interior mechanical force where skin remains stationary against a surface while underlying deep tissue and bone slide in the opposite direction, stretching and tearing microvasculature and causing deep tissue injury.

Hypertrophic Scar

An elevated, red, thick scar resulting from excessive collagen production that remains strictly confined within the boundaries of the original wound margin.

Keloid

An exuberant, raised fibrous scar tissue mass that extends beyond the original borders of the wound and fails to regress spontaneously.

Chronic Wound

A wound that fails to progress through the normal stages of repair and remains open for more than one month, frequently stalling in the inflammatory phase due to infection, ischemia, pressure, or metabolic disease.

Arterial Ulcer

A painful, 'punched-out,' deep wound with a pale or necrotic dry base located on the toes, feet, or heels; associated with absent/diminished pulses, hairless shiny skin, and pain that worsens with leg elevation.

Venous Ulcer

A shallow, irregularly shaped, moist ulcer typically found on the lower leg or inner ankle (gaiter area), presenting with heavy exudate, surrounding edema, brownish skin staining, and aching pain relieved by elevation.

Diabetic (Neuropathic) Ulcer

A deep ulcer with calloused margins located on plantar pressure points (heel or ball of the foot), typically painless due to peripheral sensory neuropathy.

Ankle-Brachial Index (ABI)

A noninvasive vascular assessment ratio comparing systolic blood pressure at the ankle to that in the arm; values below 0.9 indicate peripheral artery disease, while values over 1.4 suggest non-compressible, calcified vessels.

Undermining

Tissue destruction extending beneath intact skin along the margins or edges of a wound, resembling a cave or shelf under the perimeter.

Tunneling

A narrow tract or pathway of tissue destruction that extends from the wound bed through subcutaneous tissue in a single direction.

Purulent Drainage

Thick, opaque wound exudate that is yellow, green, tan, or brown, commonly accompanied by a foul odor; a definitive clinical indicator of wound infection.

Negative Pressure Wound Therapy (NPWT)

A sealed vacuum dressing system applying controlled negative pressure to evacuate wound fluid, reduce localized edema, draw wound edges together, and stimulate granulation tissue formation.