chapter 9 gastro review

atresia

body passice is closed or missing

ex: esophageal atresia → incomplete formation of esophagus.

dysphagia

difficulty swallowing → from obstruction in esophagus like esophageal atresia/stenosis/diverticula or neurological disorders

can also be caused by surgeries and procedures and meds that relax muscles

clinical manifestations

• sensation of something stuck in throat

• coughing

• pocketing food in mouth

• delayed swallowing

diganostic

• physical exam

• hx

• x rays

• egd

treatment

• speech therapy

• prevent aspiration

hepatomegaly

enlargement of liver → caused by hepatits, CHF, cancer and cirrohsis

s/s → abdominal pain, fatigue, jaundice, obesity

fulminant

severe medical conditions that develop suddenly and progess rapidly often fatal

chyme

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

cholelithiasis

gallstones, stones in the gallbladder

cholecystits

inflmmation or infection in the biliary system caused by calculi

cholecystectomy

removal of gallbladder or calculi

ascites

fluid accumlated in the peritoneal cavity

jaundice

yellowing of the skin and sclera caused by excessive bilirubin

albumin

vital protein produced by liver that maintain fluid blanace, prevent blood vessel leakage, and transports hormones, drugs, and enzymes

ammonia

toxic waste product of protein digestion that healthy liver converts to urea

encephalopathy

any disease or dysfunction of the brain that alters structure and function

paracentesis

low risk prodcedure to remove ascites from abdomen to relieve pressure

bilirubin

yellowish pigment produced when rbc break down

varices

abnormal dilated swollen veins in lower esophagus or stomach caused by high bp in liver due to cirrhosis

bristol stool chart

types

1. separate hard lumps hard to pass

2. sausage shaped but lumpy

3. like a susage with cracks on surface

4. laike a susage smooth and soft

5. soft blobs with clear cut passsed easily

6. fluffy pieces with ragged edges mushy stool

7. watery no solid

melena

black tarry stool indicated upper gi bleed

hematochezia

bright red stool, lower gi bleed

steatorrhea (yellow color)

fatty greasy, foul smell, floating stool indicate malabsoprtion or celiac disease

oocult blood

blood in stool not visible to eye

acholic stool

pale, clay colored indicates lack of bile or gall bladder problems

bilious stool

greenish bile stained stool

acute hepatitis sympotmatic phase

• prodromal phase - 2 wks after exposure to virus, symptoms of nausea, vomiting, malaise, anorexia, low grade fever, headache

• icteric phase - 1-2 wks after prodomal last 6 wks

jaundice, dark color urine - bilirubinuria, clay colored stools, hepatomegaly, ruq pain

• recovery phase - resolution of jaundice 6-8 wks after exposure, liver enlarged for up to 3 months

peritonitis

inflammation fo peritoneum, result from chemical irriation or organism invasion

assessment finding of abdomen from peritonitis

• rigid boardlike abdomen

• abdominal msucle spasm

• tenderness

• pain when flxing hips, pressure

three main nursing problems w GI

imbalanced nutrition
abnormal bm
risk for bleeding

barium swallow

fluoroscopy that uses x ray and chalky contract liquid to examine throat and esophagus

to diagnose

• swallowing difficulties

• reflux

• blockages

upper gi series

x ra test using fluoroscopy and barium contract to image esophagus, stomach, and dodenum

manometry

measures pressure muscle contraction strength and relaxation of esohpagus and sphincters when swallowing

breath test

measure methane and hydrogen gases

acute vs chronic gastritis

acute

• mild, transient irritation

• can be severe ulceration with hemmorhage

• presence of PMNs in mucosa

• nausea epigatric pain

chronic

• develops gradually

• last for months or years

• atrophy or metaplasia seen

• dull epigastric pain

• sensation of fullness after minimal intake

• asymptomatic

pathogensis of hp in gastritis

hp embeds in mucosal layer activating toxins and enzymes that cause inflammation.

symptoms of duodenal vs gstric ulcers

duodenal

• its epigastric pain is relieved with food but returns 2-3 hrs after eating

gastric

• pain worsened with food

pancreatits

inflammation of pancreas

caused by

• cholelithiasis

• alochol abuse

• biliary dysfunction

• hepatotoxic drugs

• metabolic disorders

• trauma

• endocrine disorders

• tumors

leads to

• renal failure

• malnutrition

• cancer

• diabetes

• respiratory distress

s/s

• upper adom pain

• nausea vomiting

• mild jaundice

• fever

• indigestion

• loss of weight

• steatorrhea

• flatulence

diagnostic

• physical

• serum amulase

• lipase level

• serum calcium

• CBC
  liver enzyme panel

• x ray

• ct

bowel obstruction

blockage of intestinal contents

caused by

• gi tract dysfuntion

• foreign bodies

• tumors

• adhesions

• hernia

• volvulus

• stricture

• fecal impact

• intussusception

appendicitis patho

obstruction in appendix caused by lymphoid hyperplasia leading to distention, bacterial overgrowth, ischemia, inflammation.

the inflammation causes edema causing small obstruction as fluid builds microorganisms proliferate it compresses blood vessels in the area.

IBD (inflammatory bowel disease)

chronic inflammation in gi tract usually intestine. seen in women

crohn disease

a chronic inflammatory bowel disease (IBD) causing persistent inflammation of the digestive tract, most commonly the small intestine.

clinical manifestations

• abdominal pain,

• severe diarrhea,

• fatigue,

• weght loss,

• and malnutrition

crohn disease patho

chronic, transmural inflammatory bowel disease driven by a dysregulated immune response to intestinal bacteria in genetically susceptible individuals

ulcerative colitis patho

a dysfunctional immune response (often Th2-mediated) against commensal bacteria, leading to a breached intestinal epithelial barrier, increased mucosal permeability, and chronic inflammation with crypt abscesses and surface ulcers

ulcerative colitis clinical manifest

chronic diarrhea often with blood/mucus, severe fecal urgency, abdominal cramping, and rectal pain.

colorectal cancer s/s

persistent change in bowel habits (diarrhea/constipation), rectal bleeding, unexplained anemia, and abdominal pain