Medical-Surgical Nursing: Gastrointestinal, Respiratory, and Acid-Base Disorders

Vocabulary review flashcards covering gastrointestinal disorders (cholecystitis, pancreatitis, hepatitis), respiratory conditions (atelectasis, pneumonia, tuberculosis, COPD, asthma, pneumothorax), respiratory pharmacology, diagnostic procedures, acid-base balances, and diabetes insipidus.

Cholecystitis

Inflammation of the gallbladder that causes pain, rigidity, and tenderness in the right upper quadrant radiating to the midsternal area or right shoulder, commonly associated with nausea, vomiting, and signs of acute inflammation.

Calculous cholecystitis

Gallbladder inflammation that occurs when a gallstone obstructs bile outflow through the cystic duct.

Acalculous cholecystitis

Gallbladder inflammation occurring in the absence of gallstones, typically following major surgical procedures, severe trauma, burns, or alterations in fluid and electrolyte balance and regional blood flow.

Cholelithiasis

The formation of calculi or gallstones in the gallbladder, primarily composed of pigment or cholesterol.

Murphy's sign

A clinical diagnostic sign elicited by palpating beneath the ribcage on the right side while the patient inhales; marked tenderness and arrest of inspiration indicate gallbladder inflammation.

Choledochostomy

A surgical procedure involving an incision into the common bile duct to extract obstructing stones and placement of a drainage tube for patients too ill to undergo more invasive surgery.

Pancreatitis

Autodigestion and inflammation of the pancreas occurring when the pancreatic duct becomes obstructed and exocrine enzymes hypersecrete, activate, and reflux into the pancreatic duct with bile.

Turner's sign

Ecchymosis observed on the flanks, signifying retroperitoneal hemorrhage in acute pancreatitis.

Cullen's sign

Ecchymosis located in the periumbilical region, indicating intraperitoneal bleeding in acute pancreatitis.

Steatorrhea

The excretion of frothy, foul-smelling stools containing abnormal quantities of fat due to impaired lipid digestion in chronic pancreatitis.

Pancreaticojejunostomy (Roux-en-Y)

A surgical anastomosis connecting the pancreatic duct directly to the jejunum to divert and facilitate drainage of pancreatic secretions.

Whipple resection

A pancreaticoduodenectomy performed to excise portions of the biliary and pancreatic anatomy to relieve intractable pain or obstruction.

Hepatitis A (HAV)

An acute viral liver infection transmitted via the fecal-oral route through contaminated food, liquids, or poor sanitation; it does not lead to chronic hepatitis.

Hepatitis B (HBV)

A viral liver infection transmitted parenterally and permucosally through blood and body fluids with a long incubation period ($1-6$ months), recognized as a major worldwide cause of cirrhosis and hepatocellular carcinoma.

Hepatitis C (HCV)

A bloodborne viral hepatitis transmitted parenterally through contaminated needles and needlesticks that has no available vaccine or immune globulin and frequently establishes a chronic carrier state.

Pulmonary Function Tests (PFTs)

Diagnostic spirometric procedures that measure lung volumes and gas flow rates to assess respiratory function, quantify dysfunction, and monitor response to medical therapy.

Arterial Blood Gas (ABG) Studies

Diagnostic blood tests obtained from an artery to evaluate gas exchange, alveolar ventilation, systemic oxygenation, and renal-pulmonary acid-base homeostasis.

Thoracentesis

The transcutaneous needle aspiration of fluid or air from the pleural cavity for diagnostic analysis, pleural biopsy, medication administration, or symptomatic decompression.

Bronchoscopy

Direct visual inspection and examination of the larynx, trachea, and bronchi using a flexible fiberoptic or rigid bronchoscope for diagnostic sampling or therapeutic interventions.

Pulmonary Angiography

An interventional radiologic procedure where radiopaque contrast is injected through a venous catheter into the pulmonary artery to visualize pulmonary embolism and vascular anomalies.

Atelectasis

The closure or collapse of pulmonary alveoli, most commonly occurring acutely in postoperative and immobilized patients due to hypoventilation or airway obstruction.

Compressive atelectasis

Alveolar collapse resulting from external mechanical compression on lung parenchyma by pleural effusion, hemothorax, or pneumothorax.

Community-acquired pneumonia (CAP)

Parenchymal lung infection acquired in community settings or diagnosed within the first $48\text{ hours}$ following hospital admission.

Health care-associated pneumonia (HCAP)

Pneumonia occurring in nonhospitalized patients with extensive health care contact, such as a recent hospital stay of $\text{two or more days}$ within $90\text{ days}$, nursing home residence, or chronic hemodialysis.

Hospital-acquired pneumonia (HAP)

Pneumonia developing $48\text{ hours}$ or more after hospitalization that was not apparent or incubating upon patient admission.

Ventilator-associated pneumonia (VAP)

A subcategory of hospital-acquired pneumonia occurring in patients who have received endotracheal mechanical ventilation for at least $48\text{ hours}$.

Tuberculosis (TB)

A communicable infectious disease caused by Mycobacterium tuberculosis, an acid-fast aerobic rod that forms caseating granulomas in pulmonary tissue and spreads via airborne droplets.

Mantoux tuberculin skin test

A diagnostic screening procedure involving an intradermal injection of purified protein derivative (PPD) read $48-72\text{ hours}$ later to evaluate induration and detect prior exposure to Mycobacterium tuberculosis.

Pleural Effusion

An abnormal collection of transudative or exudative fluid exceeding normal baseline lubrication volume ($5-15\text{ mL}$) in the pleural space.

Chemical pleurodesis

The instillation of an irritating substance (such as talc) into the pleural space to induce inflammation and scarring, obliterating the cavity to prevent reaccumulation of fluid.

Pulmonary Embolism (PE)

Occlusion of the pulmonary artery or its branches by an embolus originating from deep venous thrombosis, leading to increased alveolar dead space and acute pulmonary hypertension.

Pneumothorax

The entry of atmospheric air into the pleural space resulting from a visceral or parietal pleural breach, causing loss of negative intrapleural pressure and pulmonary collapse.

Tension pneumothorax

A life-threatening condition where air enters the pleural space during inspiration and cannot escape during expiration, progressively increasing positive intrathoracic pressure and causing total lung collapse and mediastinal shift.

Cardiac Tamponade

Compression of cardiac chambers caused by acute fluid or blood accumulation within the pericardial sac, producing elevated venous pressures, hypotension, and pulsus paradoxus.

Pulsus paradoxus

An abnormal systolic blood pressure decline during inhalation, typically seen in cardiac tamponade.

Subcutaneous Emphysema

Air leakage into subcutaneous tissue planes that produces a characteristic crackling sensation upon palpation and distortion of affected anatomy.

Chronic Bronchitis

A chronic pulmonary disease defined by persistent cough and sputum production for at least $3\text{ months}$ per year for $2\text{ consecutive years}$, featuring goblet cell hyperplasia and bronchial wall thickening.

Emphysema

An irreversible respiratory disorder characterized by permanent enlargement and destruction of alveoli distal to the terminal bronchioles, leading to loss of pulmonary elastic recoil and air trapping.

Status Asthmaticus

An acute, severe asthmatic exacerbation refractory to standard inhaled bronchodilators and systemic corticosteroids that can rapidly deteriorate into asphyxiation and respiratory failure.

Obstructive Sleep Apnea (OSA)

A sleep disorder characterized by recurrent collapse and occlusive obstruction of the upper airway, resulting in airflow cessation for $10\text{ seconds}$ or more at least $5\text{ times per hour}$.

Short-Acting Beta-2 Agonist (SABA)

A fast-acting inhaled sympathomimetic bronchodilator (such as albuterol) used for prompt rescue from acute bronchospasm and prophylaxis against exercise-induced asthma.

Long-Acting Beta-2 Agonist (LABA)

A scheduled maintenance bronchodilator with a $12\text{-hour}$ therapeutic duration (such as salmeterol) used to control nocturnal asthma and chronic airflow limitation, never indicated as acute monotherapy.

Venturi Mask

A high-flow oxygen administration mask that mixes room air with a precise flow of pure oxygen to deliver exact concentrations, commonly used in COPD to avoid suppressing the hypoxic respiratory drive.

Metabolic Acidosis

An acid-base disturbance characterized by an arterial $\text{pH} < 7.35$ and plasma $\text{bicarbonate} < 22\text{ mEq/L}$, secondary to excessive hydrogen accumulation or severe bicarbonate loss.

Metabolic Alkalosis

An acid-base disorder marked by an arterial $\text{pH} > 7.45$ and plasma $\text{bicarbonate} > 26\text{ mEq/L}$, resulting from hydrogen ion loss through vomiting/gastric suction or uncompensated alkali retention.

Respiratory Acidosis

An acid-base imbalance defined by an arterial $\text{pH} < 7.35$ and $\text{PaCO}_2 > 45\text{ mmHg}$, caused by alveolar hypoventilation and inadequate carbon dioxide elimination by the lungs.

Respiratory Alkalosis

An acid-base imbalance marked by an arterial $\text{pH} > 7.45$ and $\text{PaCO}_2 < 35\text{ mmHg}$, stemming from alveolar hyperventilation that excessively blows off carbon dioxide.

Diabetes Insipidus (DI)

An endocrine deficiency of antidiuretic hormone (ADH) or renal resistance to ADH, manifested by the excretion of enormous volumes of dilute urine ($> 250\text{ mL/hr}$, specific gravity $1.001-1.005$) and excessive thirst.