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Questions and Answers

What characterizes peptic ulcer disease?

  • Severe inflammation of the stomach due to long-term irritation
  • Infection of the gastrointestinal tract that causes diarrhea
  • A break in the mucosal lining of the stomach or duodenum (correct)
  • Inflammation of the serosal membrane lining the abdominal cavity
  • What is hematemesis indicative of?

  • Active bleeding from the upper gastrointestinal tract (correct)
  • Older blood that appears black due to degradation
  • Foul-smelling black stool resulting from digestion
  • Severe inflammation of the stomach lining
  • Which condition is associated with prolonged irritation of the stomach?

  • Gastroesophageal reflux disease
  • Hiatal hernia
  • Gastritis (correct)
  • Gastroenteritis
  • What is a hernia characterized by?

    <p>Protrusion of abdominal contents through a weakened muscle</p> Signup and view all the answers

    What does melena refer to?

    <p>Black stool with a foul odor due to blood degradation</p> Signup and view all the answers

    Which of the following is most likely a complication of untreated gastroesophageal reflux disease (GERD)?

    <p>Esophageal erosion or damage</p> Signup and view all the answers

    Which statement accurately describes diverticulum?

    <p>It refers to a small pouch-like protrusion usually seen in the colon.</p> Signup and view all the answers

    What might sudden pain relief indicate in the context of appendicitis?

    <p>There may be a rupture of the appendix.</p> Signup and view all the answers

    What is a typical symptom of bowel obstruction?

    <p>Pain or tenderness in the abdominal area</p> Signup and view all the answers

    Which area is commonly associated with rebound pain in appendicitis?

    <p>Right lower quadrant at McBurney's point</p> Signup and view all the answers

    Study Notes

    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.

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