Untitled Quiz

Hernia

• A protrusion of abdominal contents through a weakened abdominal muscle.
• Pathophysiology: Intestines protrude through abdominal opening; this can be reducible or incarcerated. Strangulation occurs when blood flow to the intestines is affected.
• Causes: Straining, lifting heavy objects, sudden twists/pulls, muscle strain, weight gain, chronic coughs, and previous abdominal surgery.
• Types: Inguinal (indirect and direct), femoral, umbilical, and ventral/incisional. Aging is a factor.

Risk Factors

• Obesity, smoking, excessive wound tension, malnutrition, pregnancy, and immunosuppressive agents.

Signs and Symptoms

• Bulge, swelling, abdominal distention, nausea, vomiting, pain, and fever, tachycardia.
• Strangulation can lead to additional symptoms.

Irritable Bowel Syndrome (IBS)

• Pathophysiology: Unknown cause, abdominal pain, and altered bowel habits can occur.
• Subtypes: Constipation-dominant, diarrhea-dominant, mixed, and unclassified.
• Factors: Gastrointestinal motility, visceral hypersensitivity, intestinal inflammation, post-infectious, bacterial overgrowth, food sensitivity, carbohydrate malabsorption, gluten sensitivity, genetics, and psychosocial factors.

Signs/Symptoms of IBS

• Abdominal pain and altered bowel habits.

Nursing Interventions (IBS)

• Assessments: Vitals, pain levels, I&O, surgical site, and deep breathing, early ambulation, pain medications, ice packs, and clear liquid diet.
• Teaching: Discourage coughing, heavy lifting, and observe incisions for infection.

Diverticulitis

• Pathophysiology: Outpouching of intestinal wall inflamed or infected.
• Symptoms: Pain, fever, leukocytosis, palpable mass, increased flatulence, anorexia, abdominal bloating, diarrhea, or constipation, or stools with blood/mucous. Potential perforation or peritonitis in advanced cases.
• Older adults may show mental status changes.
• Complications: Perforation, microperforation, abscess formation, fistula, bowel obstruction, and bleeding.
• Nursing Management: Assess vitals (fever, tachycardia, and serum potassium levels), I&O, pain, mental status, and administer IV fluids, antibiotics, and consider a nasogastric tube for low intermittent suction.

Appendicitis

• Pathophysiology: Opening to the appendix becomes blocked. Inflammation progresses, typically developing severe pain in RLQ, (McBurney's point).
• Symptoms: Periumbilical pain, anorexia, nausea, vomiting, RLQ pain (becoming severe). Rebound tenderness at McBurney's point.
• Complications: Rupture and sepsis. Increased WBC count (10,000-18,000 or >20,000 in perforated cases) might accompany symptoms.
• Sudden pain relief may indicate rupture.
• Nursing Management: Assess vitals, I&O, pain, rebound tenderness, WBC count, and differential. Administer IV fluids, antibiotics. NPO status.

Bowel/Intestinal Obstruction

• Blockage of food/liquid passage through the small or large intestine.
• Symptoms: Pain, loud bowel sounds (borborygmi), vomiting, distention, hypovolemia, and electrolyte imbalances.
• Treatment: Antibiotics, IV fluids, decrease abdominal distention, and other interventions.

Hiatal Hernia

• Stomach portion protrudes upward through the esophageal lining.
• Risk Factors: Residing in western countries- unnatural sitting positions used for defecating and lack of dietary fiber, obesity, pregnancy, and smoking.
• Types: Sliding (GEJ disruption), and paraesophageal (rolling).
• Symptoms: Heartburn, regurgitation, chest pain, dysphagia, belching.

Gastroesophageal Reflux Disease (GERD)

• Relaxation of the lower esophageal sphincter (LES).
• Symptoms: Heartburn, severe atypical chest pain, painful swallowing, hemorrhage, dental caries.
• Complications: Barrett's epithelium (increased malignancy risk); strictures; progressive dysphagia.

Gastritis

• Prolonged stomach irritation.
• Causes: H. pylori, alcohol, NSAIDs, Crohn's disease, tuberculosis, and bile reflux.
• Symptoms: Epigastric pain, nausea, vomiting, weight loss, decreased appetite, altered stool color, dehydration, and GI bleeding.
• Treatments: Triple (or quadruple) therapy, proton pump inhibitors.

Gastroenteritis

• Caused by virus, bacteria, or parasite.
• Symptoms: Diarrhea, nausea, vomiting, anorexia, abdominal distention, poor skin turgor, dehydration, and hyperactive bowel sounds.
• Treatment: Oral and IV rehydration, and medications (loperamide, bismuth subsalicylate).

Peptic Ulcer Disease

• Break in the lining of the stomach or duodenum (submucosa).
• Types: Gastric and duodenal.
• Symptoms: Burning epigastric pain, often worsened by fasting, alleviated by food or antacids, and possible presence of bleeding (hematemesis or melena).
• Complications: Perforation, obstruction, and possible GI hemorrhage.

Gastrointestinal Bleeding

• Hematemesis (bright red) or coffee ground emesis, and/or melena.
• Can occur from peptic ulcers/diseases.