Podcast
Questions and Answers
In the context of esophageal disorders, if a patient presents with absent or ineffective peristalsis in the distal esophagus, accompanied by a failure of the esophageal sphincter to relax, which of the following interventions would be MOST directly contradicted?
In the context of esophageal disorders, if a patient presents with absent or ineffective peristalsis in the distal esophagus, accompanied by a failure of the esophageal sphincter to relax, which of the following interventions would be MOST directly contradicted?
- Administration of Isosorbide Dinitrate to promote smooth muscle relaxation.
- Botulinum Toxin Injection into the lower esophageal sphincter via endoscopy.
- Initiation of small, frequent feedings designed to easily pass through the esophagus.
- Performance of a Nissen Fundoplication to reinforce the lower esophageal sphincter. (correct)
A patient is diagnosed with Type III Achalasia. Considering the characterizing feature of this specific type, which potential complication should the healthcare provider prioritize monitoring for?
A patient is diagnosed with Type III Achalasia. Considering the characterizing feature of this specific type, which potential complication should the healthcare provider prioritize monitoring for?
- Complete obstruction of the lower esophageal sphincter (LES). (correct)
- Spasms of normal amplitude throughout the esophagus.
- Esophageal hypermotility leading to frequent regurgitation.
- Uncoordinated esophageal contractions causing severe chest pain.
A patient with a known esophageal disorder experiences chest discomfort. If Calcium Channel Blockers (CCBs) are prescribed, based on their mechanism of action, how would the effects of CCBs differ from those of Isosorbide Dinitrate in this clinical context?
A patient with a known esophageal disorder experiences chest discomfort. If Calcium Channel Blockers (CCBs) are prescribed, based on their mechanism of action, how would the effects of CCBs differ from those of Isosorbide Dinitrate in this clinical context?
- Isosorbide Dinitrate directly reduces pressure in the LES, facilitating easier passage of food, while CCBs primarily target and relax smooth muscles throughout the esophagus.
- Isosorbide Dinitrate selectively targets esophageal spasms, whereas CCBs serve as more general muscle relaxants to improve overall esophageal function. (correct)
- CCBs are primarily used as muscle relaxants to enhance overall esophageal movement, whereas Isosorbide Dinitrate is specifically for relieving esophageal spasms.
- CCBs specifically target and relax the lower esophageal sphincter (LES), while Isosorbide Dinitrate acts as a broader muscle relaxant to improve esophageal function.
A patient undergoes a Laparoscopic Heller Myotomy with fundoplication for the treatment of achalasia. Postoperatively, which intervention is MOST critical to prevent the recurrence of dysphagia while minimizing the risk of reflux?
A patient undergoes a Laparoscopic Heller Myotomy with fundoplication for the treatment of achalasia. Postoperatively, which intervention is MOST critical to prevent the recurrence of dysphagia while minimizing the risk of reflux?
A patient presents with symptoms suggestive of a hiatal hernia. If the diagnostic workup confirms a paraesophageal hiatal hernia (Type II), what specific risk should be prioritized in the patient's plan of care?
A patient presents with symptoms suggestive of a hiatal hernia. If the diagnostic workup confirms a paraesophageal hiatal hernia (Type II), what specific risk should be prioritized in the patient's plan of care?
A patient exhibiting clinical manifestations of a sliding hiatal hernia reports increased symptoms after meals. Which of the following multifaceted interventions is MOST appropriate for the patient to implement immediately?
A patient exhibiting clinical manifestations of a sliding hiatal hernia reports increased symptoms after meals. Which of the following multifaceted interventions is MOST appropriate for the patient to implement immediately?
To discern the underlying cause of a patient’s new-onset dysphagia and regurgitation, what is the MOST critical diagnostic study to differentiate between mechanical obstruction, achalasia, and diffuse esophageal spasm?
To discern the underlying cause of a patient’s new-onset dysphagia and regurgitation, what is the MOST critical diagnostic study to differentiate between mechanical obstruction, achalasia, and diffuse esophageal spasm?
A patient undergoing evaluation for gastroesophageal reflux disease (GERD) is found to have a hiatal hernia. If typical GERD management strategies prove ineffective, which of the following surgical interventions should be considered to definitively address both conditions?
A patient undergoing evaluation for gastroesophageal reflux disease (GERD) is found to have a hiatal hernia. If typical GERD management strategies prove ineffective, which of the following surgical interventions should be considered to definitively address both conditions?
A patient with GERD reports persistent symptoms despite adherence to prescribed proton pump inhibitors (PPIs). Given this scenario plus the information provided, which intervention would be MOST appropriate?
A patient with GERD reports persistent symptoms despite adherence to prescribed proton pump inhibitors (PPIs). Given this scenario plus the information provided, which intervention would be MOST appropriate?
A patient presenting with acute gastritis is suspected of having developed the condition due to the ingestion of a corrosive substance. Based on the information provided, which assessment finding would suggest likely progression towards a life-threatening complication?
A patient presenting with acute gastritis is suspected of having developed the condition due to the ingestion of a corrosive substance. Based on the information provided, which assessment finding would suggest likely progression towards a life-threatening complication?
For a patient diagnosed with gastritis secondary to Helicobacter pylori infection, what BEST exemplifies a multi-faceted approach that simultaneously eradicates the bacterial infection while protecting the gastric mucosa?
For a patient diagnosed with gastritis secondary to Helicobacter pylori infection, what BEST exemplifies a multi-faceted approach that simultaneously eradicates the bacterial infection while protecting the gastric mucosa?
In a patient with symptomatic peptic ulcer disease (PUD), which clinical finding necessitates immediate intervention to prevent life-threatening complications?
In a patient with symptomatic peptic ulcer disease (PUD), which clinical finding necessitates immediate intervention to prevent life-threatening complications?
A patient with peptic ulcer disease (PUD) is prescribed a proton pump inhibitor (PPI). What is MOST important to emphasize regarding the medication schedule to optimize the therapeutic effect?
A patient with peptic ulcer disease (PUD) is prescribed a proton pump inhibitor (PPI). What is MOST important to emphasize regarding the medication schedule to optimize the therapeutic effect?
A patient has a history of NSAID-induced peptic ulcer disease (PUD) with a high risk of re-bleeding. Which multifaceted approach is MOST indicated to prevent recurrence?
A patient has a history of NSAID-induced peptic ulcer disease (PUD) with a high risk of re-bleeding. Which multifaceted approach is MOST indicated to prevent recurrence?
A patient presents with clinical manifestations suggesting celiac disease. If initial serologic tests are positive, which diagnostic procedure provides definitive confirmation of the condition?
A patient presents with clinical manifestations suggesting celiac disease. If initial serologic tests are positive, which diagnostic procedure provides definitive confirmation of the condition?
A patient newly diagnosed with celiac disease is overwhelmed by dietary restrictions. What is the MOST critical and individualized approach for supporting the patient?
A patient newly diagnosed with celiac disease is overwhelmed by dietary restrictions. What is the MOST critical and individualized approach for supporting the patient?
In assessing a patient with a suspected small bowel obstruction, which clinical finding is MOST indicative of a closed-loop obstruction with a high risk of strangulation?
In assessing a patient with a suspected small bowel obstruction, which clinical finding is MOST indicative of a closed-loop obstruction with a high risk of strangulation?
A patient diagnosed with a partial small bowel obstruction is being managed conservatively. Which multifaceted assessment BEST informs a strategy to preserve bowel viability?
A patient diagnosed with a partial small bowel obstruction is being managed conservatively. Which multifaceted assessment BEST informs a strategy to preserve bowel viability?
Following surgical resection of a portion of the small intestine due to a bowel obstruction, what multifaceted strategy is MOST likely to prevent short bowel syndrome and maximize nutritional outcomes?
Following surgical resection of a portion of the small intestine due to a bowel obstruction, what multifaceted strategy is MOST likely to prevent short bowel syndrome and maximize nutritional outcomes?
A patient with Crohn's disease develops a fibrostenotic obstruction in the terminal ileum. Which intervention would MOST appropriately manage this specific complication while also addressing the underlying inflammatory process?
A patient with Crohn's disease develops a fibrostenotic obstruction in the terminal ileum. Which intervention would MOST appropriately manage this specific complication while also addressing the underlying inflammatory process?
A patient with a long-standing history of Crohn's disease presents with persistent abdominal pain, weight loss, and signs.
A patient with a long-standing history of Crohn's disease presents with persistent abdominal pain, weight loss, and signs.
A patient with severe ulcerative colitis experiences frequent bloody stools, abdominal pain, and weight loss. The symptoms are refractory to medical management. Which long-term management must be considered?
A patient with severe ulcerative colitis experiences frequent bloody stools, abdominal pain, and weight loss. The symptoms are refractory to medical management. Which long-term management must be considered?
What diagnostic is BEST for distinguishing the pattern of the colonic involvement in a patient presenting with chronic bloody diarrhea.
What diagnostic is BEST for distinguishing the pattern of the colonic involvement in a patient presenting with chronic bloody diarrhea.
How does Crohn's disease differ from ulcerative colitis?
How does Crohn's disease differ from ulcerative colitis?
What is the primary mechanism by which tumor necrosis factor (TNF) inhibitors work for inflammatory bowel disease (IBD)?
What is the primary mechanism by which tumor necrosis factor (TNF) inhibitors work for inflammatory bowel disease (IBD)?
After ileal pouch-anal anastomosis (IPAA) performed for ulcerative colitis, which long-term complication is MOST critical to diagnose early to reduce patient mortality?
After ileal pouch-anal anastomosis (IPAA) performed for ulcerative colitis, which long-term complication is MOST critical to diagnose early to reduce patient mortality?
When providing dietary recommendations to a patient with a Crohn’s flare, what principles are most indicated?
When providing dietary recommendations to a patient with a Crohn’s flare, what principles are most indicated?
A patient is diagnosed with microscopic colitis. Which medication causes the biggest concern here?
A patient is diagnosed with microscopic colitis. Which medication causes the biggest concern here?
A patient is diagnosed with acute colonic pseudo-obstruction, also known as Ogilvie’s syndrome. What is the MOST appropriate intervention to consider first?
A patient is diagnosed with acute colonic pseudo-obstruction, also known as Ogilvie’s syndrome. What is the MOST appropriate intervention to consider first?
In caring for a patient with toxic megacolon, a life-threatening complication of inflammatory bowel disease, which clinical indicators suggest imminent risk of colonic perforation and MOST necessitate emergent surgical intervention?
In caring for a patient with toxic megacolon, a life-threatening complication of inflammatory bowel disease, which clinical indicators suggest imminent risk of colonic perforation and MOST necessitate emergent surgical intervention?
A patient with ulcerative colitis develops primary sclerosing cholangitis (PSC). What periodic surveillance is MOST important to consider?
A patient with ulcerative colitis develops primary sclerosing cholangitis (PSC). What periodic surveillance is MOST important to consider?
For a patient with an ileostomy, what assessment suggests a peritonitis?
For a patient with an ileostomy, what assessment suggests a peritonitis?
Which surgical procedure should be chosen when a patient with ulcerative colitis has fulminant colitis, toxic megacolon, or perforation?
Which surgical procedure should be chosen when a patient with ulcerative colitis has fulminant colitis, toxic megacolon, or perforation?
In the management of a patient with an exacerbation of ulcerative colitis, which indicator would the health care team use to see if interventions are working?
In the management of a patient with an exacerbation of ulcerative colitis, which indicator would the health care team use to see if interventions are working?
Flashcards
Dysphagia
Dysphagia
Difficulty swallowing, a primary symptom in esophageal disorders.
Gastroesophageal Reflux
Gastroesophageal Reflux
Backward flow of gastric contents, causing irritation and damage.
Achalasia
Achalasia
A disorder characterized by absent or ineffective peristalsis in the esophagus, preventing food passage.
Jackhammer Esophagus
Jackhammer Esophagus
Signup and view all the flashcards
Isosorbide Dinitrate
Isosorbide Dinitrate
Signup and view all the flashcards
Hiatal Hernia
Hiatal Hernia
Signup and view all the flashcards
Hiatal Hernia Pathophysiology
Hiatal Hernia Pathophysiology
Signup and view all the flashcards
Diverticulum
Diverticulum
Signup and view all the flashcards
Calcium Channel Blockers
Calcium Channel Blockers
Signup and view all the flashcards
Pneumatic Balloon Dilation
Pneumatic Balloon Dilation
Signup and view all the flashcards
Laparoscopic Heller Myotomy
Laparoscopic Heller Myotomy
Signup and view all the flashcards
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal Reflux Disease (GERD)
Signup and view all the flashcards
Lower Esophageal Sphincter (LES)
Lower Esophageal Sphincter (LES)
Signup and view all the flashcards
Pyrosis
Pyrosis
Signup and view all the flashcards
GERD Management
GERD Management
Signup and view all the flashcards
Antacid
Antacid
Signup and view all the flashcards
H2 Receptor Antagonists
H2 Receptor Antagonists
Signup and view all the flashcards
Proton Pump Inhibitors (PPIs)
Proton Pump Inhibitors (PPIs)
Signup and view all the flashcards
Gastritis
Gastritis
Signup and view all the flashcards
Erosive Form of Acute Gastritis
Erosive Form of Acute Gastritis
Signup and view all the flashcards
Nonerosive Form of Acute Gastritis
Nonerosive Form of Acute Gastritis
Signup and view all the flashcards
Local Irritants
Local Irritants
Signup and view all the flashcards
Helicobater Pylori
Helicobater Pylori
Signup and view all the flashcards
Peptic Ulcer Disease (PUD)
Peptic Ulcer Disease (PUD)
Signup and view all the flashcards
Gastric Ulcer Pain
Gastric Ulcer Pain
Signup and view all the flashcards
Antibiotics in PUD Treatment
Antibiotics in PUD Treatment
Signup and view all the flashcards
Nursing Management for Gastritis & PUD
Nursing Management for Gastritis & PUD
Signup and view all the flashcards
Celiac Disease
Celiac Disease
Signup and view all the flashcards
Gluten
Gluten
Signup and view all the flashcards
Steatorrhea
Steatorrhea
Signup and view all the flashcards
Intestinal Obstruction
Intestinal Obstruction
Signup and view all the flashcards
Mechanical Obstruction
Mechanical Obstruction
Signup and view all the flashcards
Functional/Paralytic Obstruction
Functional/Paralytic Obstruction
Signup and view all the flashcards
Clinical Manifestations of Intestinal Obstruction
Clinical Manifestations of Intestinal Obstruction
Signup and view all the flashcards
Inflammatory Bowel Disease
Inflammatory Bowel Disease
Signup and view all the flashcards
Causes of Inflammatory Bowel Disease
Causes of Inflammatory Bowel Disease
Signup and view all the flashcards
Crohn's Disease
Crohn's Disease
Signup and view all the flashcards
Characteristic of Crohn's Disease
Characteristic of Crohn's Disease
Signup and view all the flashcards
Ulcertive Colitis
Ulcertive Colitis
Signup and view all the flashcards
Study Notes
- Module 1 includes disturbances in ingestion, digestion, absorption, and elimination
Main Functions of the GI System
- Ingestion
- Digestion
- Absorption
- Excretion
A. Disturbances in Ingestion
- Achalasia
- Esophageal Spasm
- Hiatal Hernia
- Diverticulum
- Gastroesophageal Reflux
Achalasia
- A rare disorder that may progress slowly
- Caused by a malfunction of the nerves controlling food movement through the esophagus
- Absent or ineffective peristalsis in the distal esophagus
- Failure of the esophageal sphincter to relax in response to swallowing
- Three types of esophageal spasms: jackhammer esophagus, diffuse esophageal spasm, and type III achalasia
Clinical Manifestations of Disturbances in Ingestion
- Dysphagia (difficulty swallowing) is a hallmark sign
- Regurgitation is common
- Chest discomfort may occur
- Weight loss can be a long-term problem
- Pyrosis is also known as heartburn
Pathophysiology of Disturbances in Ingestion
- Cause is unknown
- Decreased or absent peristalsis in the distal portion of the esophagus
- Normal swallowing doesn't occur
- The lower esophageal sphincter muscle does not relax properly
- This prevents the passage of swallowed food
Assessment and Diagnostic Findings for Disturbances in Ingestion
- Endoscopy is commonly used in the Philippines
- Esophageal manometry is a definite diagnostic method
- Esophagrams and X-rays reveal esophageal dilation above the lower gastroesophageal sphincter.
- This narrowing is called "bird's beak" deformity
Management of Disturbances in Ingestion
- The condition cannot be repaired
- Patients should eat slowly and drink fluids with meals; warm water is preferred for vasoconstriction
- Thorough chewing of food is important
- Patients should stay upright while eating and for at least 1 hour afterward
- A full glass of water should be taken with pills
- Pharmacological options include Isosorbide Dinitrate or Calcium Channel Blockers
Isosorbide Dinitrate
- Primarily an anti-anginal drug for managing chest pain (angina) related to coronary artery disease
- Vasodilatory effects help relax smooth muscles, including those in the esophagus, reducing spasms
Calcium Channel Blockers
- Relaxes the smooth muscles
- Reduces the pressure in the LES, which allows food to pass more easily, decreasing dysphagia and chest pain
- Muscle relaxants improve esophageal function
Other Treatments
- Botulinum Toxin Injection/Botox Injection (via endoscopy; blocks acetylcholine)
- Pneumatic Balloon Dilation to stretch the narrowed area of the esophagus, with a high success rate, requires sedation due to pain
- Surgical option: Laparoscopic Heller Myotomy (small cut made in the lower sphincter) followed by fundoplication
Hiatal Hernia
- The upper part of the stomach pushes through an opening in the diaphragm, and up into the chest
- Defined as the protrusion of the upper part of the stomach
Diverticulum
- An out-pouching mucosa and submucosa protrudes to a weak portion of the musculature of the esophagus
Types of Hiatal Hernia
- Sliding Hiatal Hernia (Type 1): the junction between the stomach and esophagus slides up through the hiatus during moments of increased pressure in abdominal activity
- Paraesophageal Hiatal Hernia: a portion of the stomach remains stuck in the chest cavity
Paraesophageal Hiatal Hernia details
- Remains in the chest at all times
- It is less common than sliding hiatal hernias
- Further classified as types II, III, or IV, depending on the extent of herniation
Pathophysiology of Hiatal Hernia
- The esophageal hiatus in the diaphragm has a larger opening than normal
- A portion of the upper stomach slips up or passes through that hiatus and enters into the chest
Causes of Hiatal Hernia
- Heavy lifting
- Hard coughing or sneezing
- Pregnancy and delivery
- Vomiting
- Constipation
- Obesity
Clinical Manifestations of Hiatal Hernia
- Heartburn
- Regurgitation
- Dysphagia
- Sense of fullness after eating
- Note: many patients are asymptomatic, and symptoms are intermittent and worsen after meals
Assessment and Diagnostic Findings for Hiatal Hernia
- Chest X-ray
- Barium Swallow/X-ray
- Upper endoscopy or Esophagogastroduodenoscopy (EGD) is the passage of a fiberoptic tube through the mouth and throat for visualization of the esophagus, stomach, and small intestine
Management of Hiatal Hernia
- Frequent, small feedings that can pass easily through the esophagus
- Avoid reclining for 1 hour after eating.
- Elevate the head of the bed to prevent the hernia from sliding upward
- Pharmacologic interventions include PPIs (taken after meals) and Antacids (taken before meals)
- Nissen Fundoplication involves wrapping a portion of the gastric fundus around the sphincter area of the esophagus
Gastroesophageal Reflux Disease (GERD)
- A common disorder marked by backflow of gastric or duodenal contents into the esophagus
- Troublesome symptoms and/or mucosal injury to the esophagus may result
- Due to a weak or damaged lower esophageal sphincter (LES)
Types of GERD
- Physiologic GERD: Postprandial, short-lived, asymptomatic, no nocturnal symptoms
- Pathologic GERD: Symptoms, mucosal injury, nocturnal symptoms
Causes of GERD
- Incompetent lower esophageal sphincter (LES)
- Aging
- C-A-S-H (coffee, alcohol, spicy, and hot foods)
- Hiatal hernia
Position Management
- Remain upright
- During sleep: semi-fowler’s or use two pillows
Clinical Manifestations of GERD
- Pyrosis (burning sensation in the esophagus) is a hallmark sign
- Regurgitation (increases while lying down) is also a hallmark sign
- Dyspepsia (indigestion)
- Dysphagia or odynophagia
- Hypersalivation
- Dry cough (worst at night)
Assessment and Diagnostic Findings for GERD
- Patient’s history aids in obtaining accurate diagnosis
- Barium swallow and Endoscopy procedures
- pH monitoring involves transnasal catheter placement or endoscopic wireless capsule placement for approximately 24 hours
- Esophageal manometry test
Management of GERD
- Educating the patient to avoid situations that cause esophageal irritation
- Lifestyle modifications such as eating a low-fat diet, limiting alcohol, avoiding caffeine, tobacco, beer, milk, greasy foods, peppermint or spearmint, carbonated beverages, weight loss, elevating the head of the bed, and avoiding eating before bed
Nausea and Vomiting Treatment
- Give ice chips
- If the patient vomited, remain NPO(nothing by mouth)
- GIve cold water instead of warm
- Administer antiemetic medications like metoclopramide, ondansetron, granisetron
- Ondansetron lessens salivation for pre-operative patients
Ptyalism Management
- Chew sugarless gum or hard candy
- Toothbrushing
Dysphagia Management
- Flex the neck
- Use thickened liquids for swallowing to not choke
- Chew food properly
Pharmacological Management
- Antacids neutralize acid
- H2 Receptor Antagonists decrease gastric acid production
- Proton Pump Inhibitors/PPIs decrease gastric acid production
Surgical Management
- Nissen Fundoplication
B. Disturbances in Digestion
- Gastritis
- Peptic Ulcer Disease
Gastritis
- Inflammation of the gastric mucosa
- It may be acute, lasting several hours to a few days, or chronic, resulting from repeated exposure to irritating agents or recurring episodes of acute gastritis
Acute Gastritis
- Erosive form most often caused by local irritants like aspirin/NSAIDs/corticosteroids/alcohol
- Nonerosive form most often caused by infection (Helicobacter Pylori)
Causes of Gastritis
- Local irritants (aspirin, NSAIDs, alcohol)
- Helicobacter Pylori
- Ingestion of strong acid or alkali (may cause the mucosa to become gangrenous or to perforate)
- Major traumatic injuries (burns or infection) and stress-related gastritis
Pathophysiology of Gastritis
- Disruption of the mucosal barrier that normally protects the stomach tissue from digestive juices (e.g., HCl and pepsin)
- Corrosive agent (HCl, pepsis, alcohol) comes in contact and inflammation occurs
Clinical Manifestations of Gastritis
- Epigastric pain
- Dyspepsia (indigestion; gnawing and burning sensation)
- Anorexia, hiccups, nausea, and vomiting
- Melena (black, tarry stools)
- Hematochezia (bright red, bloody stools)
- Pyrosis
- Anemia and Nutrient deficiencies
Medical Management of Gastritis
- Gastric mucosa is capable of repairing itself
- Supportive therapy includes nasogastric (NG) intubation, antacids, H2 blockers, proton pump inhibitors, and IV fluids
- Emergency surgery may be required to remove gangrenous or perforated tissue.
- Gastrojejunostomy (gastric resection) may be necessary to treat gastric outlet obstruction
Nursing Management of Gastritis
- Reducing anxiety and promoting optimal nutrition
- Provide physical and emotional support and help the patient manage the symptoms
- Relieving pain and instructing the patient to avoid foods and beverages that may irritate the gastric mucosa
Peptic Ulcer Disease (PUD)
- Excavation that forms in the mucosa of the stomach
- Ulceration forms in the GI tract and depends on its location (gastric, duodenal, or esophageal ulcer)
Causes of PUD
- NSAID use
- H. Pylori infection acquired through ingestion and person-to-person transmission
- Smoking and alcohol
- Genetics
Pathophysiology of PUD
- Increased concentration of acid/pepsin or decreased resistance of the protective mucosal barrier
- Exposure of damaged mucosa to irritants, and the formation of peptic ulcers
Clinical Manifestations of PUD
- Gastric Ulcer: pain immediately after eating, makes it worse, dull gnawing pain, weight loss, vomiting coffee ground or beef red
- Duodenal Ulcer: pain 2-3 hours after eating makes it better, wakes up at night with pain, normal weight, stool is dark and tarry
Assessment and Diagnostic Findings for PUD
- A physical examination may reveal pain, epigastric tenderness, or abdominal distention
- Upper endoscopy allows direct visualization of inflammatory changes, ulcers, and lesions
Medical Management of PUD
- Treated with antibiotics to eradicate H. Pylori have a lower recurrence rate than those not treated with antibiotics
- Diet modifications: avoid spicy, acidic, fried foods
Dietary Recommendations for PUD
- Avoiding extremes of temperature in food and beverages and overstimulation from the consumption of alcohol, coffee, and other caffeinated beverages
- Neutralize acid by eating three regular meals a day
- Small, frequent feedings are not necessary
- Patients should only eat foods that are tolerated
Complications of PUD
- Hypovolemic shock may cause from ulcer bleeding extensively
- Perforation, causing potential contamination
C. Disturbances in Absorption and Elimination
- Celiac Disease
- Intestinal Obstruction
- Crohn’s Disease
- Ulcerative Colitis
Celiac Disease
- A disorder of malabsorption caused by an autoimmune response to consumption of products that contain the protein gluten
- Found in: wheat, barley, rye, and other grains, malt, dextrin, and brewer’s yeast
Causes of Celiac's Disease
- Autoimmune
- Familial Risk
- Diagnosed with: Type 1 diabetes mellitus, down syndrome, and turner syndrome
Pathophysiology of Celiac's Disease
- Consumption of gluten causes inflammation in the epithelial cells
- Mucosa villi of the SI becomes denuded and function
Manifestations of Celiac's Disease
- Diarrhea or steatorrhea
- Abdominal pain and distention
- Flatulence
- Weight loss
- Non-GI Symptoms: fatigue, depression, migraine, anemia, seizures
Diagnostics for Celiac's Disease
- Assessment and Diagnostic Findings
- Immunoglobulin A (IGA) and Anti-Tissue Transglutaminase (TTG)
- Upper Endoscopy with biopsies of proximal small intestine
Treatment for Celiac's Disease
- Gluten-free diet is treatment
- Consume naturally gluten-free options: Fresh fruits and vegetables, Meat and poultry, Fish and seafood, Dairy, Beans, legumes, and nuts, Corn, rice, soy, quinoa, and potato
Intestinal Obstruction
- Blockage prevents the normal flow of intestinal contents through the tract
- Can be partial or complete, with severity depending on the bowel region affected
Diagnostics for Intestinal Obstruction
- Mechanical obstruction
- Functional/Paralytic obstruction
Mechanical obstruction
- An intraluminal obstruction or a mural obstruction from pressure on the intestinal wall occurs
- Adhesions, tumor, hernia, volvulus (twisting of the intestine), and intussusception
Functional Obstruction
- the intestinal musculature cannot propel the contents along the bowel
- Interruption in the innervation or vascular supply. (DM or Parkinson's)
Pathophysiology
- Intestinal contents, fluid, and gas accumulate, leading to abdominal distension and retention of fluids
- Reduced absorption and stimulated gastric juices cause increased lumen size leading to decreased venous pressure
- May cause third-spacing of fluids
Symptoms of Intestinal Obstruction
- Crampy pain that is wavelike and colicky due to persistent peristalsis above and below the blockage
- Blood and stool mixed in mucus comes out, may come out as flatus
- Peristaltic waves are vigorous
- Vomiting
Medical and Nursing Management
Signs of dehydration
- Oliguria
- Generalized malaise
- Drowsiness
- Abdomen distention
Diagnosis and Treatment
- Diagnosis: Imaging Studies and CBC
- Insert a NG tube
- Hypertonic water is administered
Nursing Interventions
- Monitor the levels and balance of electrolytes
- Follow the patient post surgery
Inflammatory bowel disease
- A group of chronic disorders
Causes of IBD
- Familial Risk
- Smoking, Ex-Smoker
- Altered immune response
Crohn’s Disease
- Subacute and chronic inflammation of GI
- Characterized by Exacerbations and periods of remission
Symptoms of Crohn's
- Crypt inflammation and accesses form. which cause ulcers and become inflamed
Clinical Manifestations of Crohn’s Disease
- Crampy lower quadrant
- Weight loss
- Nutrition loss
- Chronic diarrhea
- Fever
Diagnostics and Treatment
- String sign of the terminal Ileum
- Low fiber and high protein diet
- Monitor complications: strictures, fistulas, and malnutrition
Ulcerative colitis
- Chronic and Inflammatory disease of the mucosal and submucosal layers of the colon and rectum
- Unpredictable reoccurs with period of pain
- Bloody, purulent diarrhea
- Progression of the inflammatory stage starts in the lower left quadrant region
Clinical Manifestations of Ulcerative Colitis
- Bowel shortens
- Bowel narrows
- Diarrhea with mucus
- Electrolytes and Anemia
Diagnostics of Ulcerative Colitis
- Complete Blood count
- Albumin
- Check for C- reactive protein
- Stool cultures
Medical Interventions
- Diagnose and manage the symptoms and conditions with medications (e.g. antibiotics)
Side Effects of Ulcerative Colitis
- Extended inflammatory stage, which inhibits the constriction that leads to an opening in the colon
Interventions for Ulcerative Colitis
- Surgical operations may be required to remove the damaged areas if the area is perforated
- Colectomy may be an option
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Overview of disturbances affecting the gastrointestinal system, including those related to ingestion, digestion, absorption, and excretion. Covers conditions such as achalasia, esophageal spasm, and gastroesophageal reflux. Includes clinical manifestations, pathophysiology, and potential complications.
