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Questions and Answers
What is the primary cause of Peptic Ulcer Disease?
What is the primary cause of Peptic Ulcer Disease?
What symptom is typically associated with Peptic Ulcer Disease?
What symptom is typically associated with Peptic Ulcer Disease?
Which of the following complications is NOT associated with Peptic Ulcer Disease?
Which of the following complications is NOT associated with Peptic Ulcer Disease?
In gastrointestinal bleeding, what does bright red blood indicate?
In gastrointestinal bleeding, what does bright red blood indicate?
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What is NOT a sign of upper gastrointestinal bleeding?
What is NOT a sign of upper gastrointestinal bleeding?
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What is a primary symptom of lower gastrointestinal bleeding?
What is a primary symptom of lower gastrointestinal bleeding?
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Which of the following is a nursing assessment parameter for assessing cardiovascular status?
Which of the following is a nursing assessment parameter for assessing cardiovascular status?
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What is classified as a primary cause of small bowel obstruction?
What is classified as a primary cause of small bowel obstruction?
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What symptom is typically associated with intestinal obstruction?
What symptom is typically associated with intestinal obstruction?
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The condition preventing the normal flow of chime through the intestine is known as?
The condition preventing the normal flow of chime through the intestine is known as?
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Which clinical manifestation indicates a advanced state of intestinal obstruction?
Which clinical manifestation indicates a advanced state of intestinal obstruction?
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In assessing lab values for gastrointestinal bleeding, which electrolyte should be monitored closely?
In assessing lab values for gastrointestinal bleeding, which electrolyte should be monitored closely?
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What type of bowel obstruction is caused by conditions like malignancy?
What type of bowel obstruction is caused by conditions like malignancy?
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What is a common cause of acute gastritis?
What is a common cause of acute gastritis?
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Which symptom is typically associated with GERD?
Which symptom is typically associated with GERD?
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What is a potential complication of Peptic Ulcer Disease (PUD)?
What is a potential complication of Peptic Ulcer Disease (PUD)?
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Which statement about gastrointestinal bleeding is false?
Which statement about gastrointestinal bleeding is false?
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What is a notable feature of chronic gastritis compared to acute gastritis?
What is a notable feature of chronic gastritis compared to acute gastritis?
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Which of the following is NOT a typical symptom of GERD?
Which of the following is NOT a typical symptom of GERD?
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What is a common characteristic of gastrointestinal hemorrhage?
What is a common characteristic of gastrointestinal hemorrhage?
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Which medication could potentially exacerbate acute gastritis?
Which medication could potentially exacerbate acute gastritis?
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Which factor specifically influences the development of Peptic Ulcer Disease?
Which factor specifically influences the development of Peptic Ulcer Disease?
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What does the primary symptom of Peptic Ulcer Disease typically correlate with?
What does the primary symptom of Peptic Ulcer Disease typically correlate with?
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Which complication of Peptic Ulcer Disease can result from scar tissue formation?
Which complication of Peptic Ulcer Disease can result from scar tissue formation?
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How does the presence of an impairment in the mucosa barrier contribute to Peptic Ulcer Disease?
How does the presence of an impairment in the mucosa barrier contribute to Peptic Ulcer Disease?
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What indicates a complication of gastrointestinal bleeding based on the blood’s appearance?
What indicates a complication of gastrointestinal bleeding based on the blood’s appearance?
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Which of the following accurately describes a function of the liver?
Which of the following accurately describes a function of the liver?
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Hepatitis A is primarily transmitted through which route?
Hepatitis A is primarily transmitted through which route?
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What is a key assessment finding indicating liver dysfunction?
What is a key assessment finding indicating liver dysfunction?
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Which statement accurately describes the pathophysiology of Hepatitis A?
Which statement accurately describes the pathophysiology of Hepatitis A?
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What is a consequence of obstruction in hepatic circulation?
What is a consequence of obstruction in hepatic circulation?
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What is a primary factor that may lead to lower gastrointestinal bleeding?
What is a primary factor that may lead to lower gastrointestinal bleeding?
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Which symptom indicates acute cardiovascular issues during a nursing assessment?
Which symptom indicates acute cardiovascular issues during a nursing assessment?
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Which condition is classified as a primary cause of large bowel obstruction?
Which condition is classified as a primary cause of large bowel obstruction?
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In the context of intestinal obstruction, the term 'peristaltic rush' refers to what symptom?
In the context of intestinal obstruction, the term 'peristaltic rush' refers to what symptom?
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What laboratory value requires careful monitoring during gastrointestinal bleeding assessment?
What laboratory value requires careful monitoring during gastrointestinal bleeding assessment?
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Which of the following accurately describes acute gastritis?
Which of the following accurately describes acute gastritis?
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What is a primary affect of chronic inflammation in gastritis?
What is a primary affect of chronic inflammation in gastritis?
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Which statement accurately describes a type of bowel obstruction?
Which statement accurately describes a type of bowel obstruction?
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Which symptom is most associated with a significant degree of intestinal obstruction?
Which symptom is most associated with a significant degree of intestinal obstruction?
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In gastrointestinal dysfunction, which parameter is least likely to be assessed subjectively?
In gastrointestinal dysfunction, which parameter is least likely to be assessed subjectively?
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Which condition is characterized by a backup of digestive contents due to a blockage?
Which condition is characterized by a backup of digestive contents due to a blockage?
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During a nursing assessment, what does a decrease in urine output below 30 cc/hr potentially indicate?
During a nursing assessment, what does a decrease in urine output below 30 cc/hr potentially indicate?
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What is a key clinical manifestation of hepatitis?
What is a key clinical manifestation of hepatitis?
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Which symptom is most indicative of a lower gastrointestinal bleed?
Which symptom is most indicative of a lower gastrointestinal bleed?
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What is the primary pathophysiological factor contributing to ascites development in cirrhosis?
What is the primary pathophysiological factor contributing to ascites development in cirrhosis?
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Which of the following factors is most likely to trigger acute liver dysfunction?
Which of the following factors is most likely to trigger acute liver dysfunction?
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Which clinical manifestation is least likely associated with hepatic encephalopathy?
Which clinical manifestation is least likely associated with hepatic encephalopathy?
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Which assessment technique is crucial for evaluating gastrointestinal function?
Which assessment technique is crucial for evaluating gastrointestinal function?
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What might indicate the development of bacterial peritonitis in a patient with ascites?
What might indicate the development of bacterial peritonitis in a patient with ascites?
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Which of the following treatments is least likely to be effective in managing ascites?
Which of the following treatments is least likely to be effective in managing ascites?
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Which factor among the following does NOT contribute to the pathophysiology of ascites?
Which factor among the following does NOT contribute to the pathophysiology of ascites?
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Which clinical manifestation is most directly associated with fulminant viral hepatitis?
Which clinical manifestation is most directly associated with fulminant viral hepatitis?
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What is a primary consequence of portal hypertension?
What is a primary consequence of portal hypertension?
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Which mechanism is primarily responsible for jaundice resulting from hepatic obstruction?
Which mechanism is primarily responsible for jaundice resulting from hepatic obstruction?
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What is often the first indicator of cirrhosis of the liver in a patient?
What is often the first indicator of cirrhosis of the liver in a patient?
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Which condition is NOT typically a consequence of ascites?
Which condition is NOT typically a consequence of ascites?
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What condition often leads to the development of Non-Alcoholic Steatohepatitis (NASH)?
What condition often leads to the development of Non-Alcoholic Steatohepatitis (NASH)?
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Which symptom is commonly seen in patients with severe portal hypertension?
Which symptom is commonly seen in patients with severe portal hypertension?
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Which of the following is a potential complication of cirrhosis?
Which of the following is a potential complication of cirrhosis?
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Which sign is indicative of liver dysfunction associated with hepatobiliary disease?
Which sign is indicative of liver dysfunction associated with hepatobiliary disease?
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Which of these is NOT a typical clinical manifestation seen in patients with hepatitis?
Which of these is NOT a typical clinical manifestation seen in patients with hepatitis?
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What is a common clinical manifestation associated with a drop in Hemoglobin levels to 70-80 g/L?
What is a common clinical manifestation associated with a drop in Hemoglobin levels to 70-80 g/L?
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Which type of anemia is characterized by small erythrocytes with insufficient hemoglobin?
Which type of anemia is characterized by small erythrocytes with insufficient hemoglobin?
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What distinguishes Absolute Polycythemia from Relative Polycythemia?
What distinguishes Absolute Polycythemia from Relative Polycythemia?
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Which of the following is a characteristic of Aplastic Anemia?
Which of the following is a characteristic of Aplastic Anemia?
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What symptom is generally associated with Hemolytic Anemia?
What symptom is generally associated with Hemolytic Anemia?
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What is a primary cause of thrombocytopenia in disseminated intravascular coagulation (DIC)?
What is a primary cause of thrombocytopenia in disseminated intravascular coagulation (DIC)?
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Which symptom is associated with rapidly developing organ failure in DIC?
Which symptom is associated with rapidly developing organ failure in DIC?
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What is a key laboratory finding in diagnosing thrombocytopenia?
What is a key laboratory finding in diagnosing thrombocytopenia?
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Which type of anemia is characterized by large erythrocytes due to ineffective DNA synthesis?
Which type of anemia is characterized by large erythrocytes due to ineffective DNA synthesis?
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What is the main consequence of the absence of intrinsic factor in pernicious anemia?
What is the main consequence of the absence of intrinsic factor in pernicious anemia?
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Which treatment is essential for managing disseminated intravascular coagulation?
Which treatment is essential for managing disseminated intravascular coagulation?
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What clinical manifestation indicates the rapid development of hemorrhage?
What clinical manifestation indicates the rapid development of hemorrhage?
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What primary factors can lead to anemia?
What primary factors can lead to anemia?
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Which of the following symptoms is commonly associated with hereditary hemochromatosis?
Which of the following symptoms is commonly associated with hereditary hemochromatosis?
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What condition is characterized by an increased number of leukocytes in the blood?
What condition is characterized by an increased number of leukocytes in the blood?
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Which of the following disorders results in a decrease in circulating leukocytes?
Which of the following disorders results in a decrease in circulating leukocytes?
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What clinical manifestation is often seen in myelodysplastic syndrome (MDS)?
What clinical manifestation is often seen in myelodysplastic syndrome (MDS)?
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Which term describes a malignant disorder characterized by uncontrolled proliferation of leukocytes?
Which term describes a malignant disorder characterized by uncontrolled proliferation of leukocytes?
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Which type of alteration is indicated by the presence of eosinophilia?
Which type of alteration is indicated by the presence of eosinophilia?
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What is a common result of granulocyte and monocyte alterations due to microbial invasion?
What is a common result of granulocyte and monocyte alterations due to microbial invasion?
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What condition is characterized by a deficiency in healthy mature blood cell production?
What condition is characterized by a deficiency in healthy mature blood cell production?
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Acute leukemia is characterized by what type of cells?
Acute leukemia is characterized by what type of cells?
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Which condition involves an autosomal recessive disorder with tissue iron deposition?
Which condition involves an autosomal recessive disorder with tissue iron deposition?
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Study Notes
Alterations in Gastrointestinal Function
- This presentation covers alterations in gastrointestinal function, specifically the anatomy and physiology of the GI system and how dysfunction affects the body.
- It also outlines the pathophysiology of various conditions, including:
- Gastritis.
- Gastroesophageal Reflux Disease (GERD).
- Peptic Ulcer Disease (PUD).
- Gastrointestinal (Upper and Lower) Bleed.
- Obstruction/Ileus.
- Hepatitis.
- Acute Liver Dysfunction.
- Hepatic Encephalopathy.
- Cholelithiasis and Cholecystitis.
- Fulminant Hepatic Failure.
- The presentation emphasizes prioritizing conditions related to nursing assessment and clinical manifestations.
Abdominal Assessment
-
Subjective Data:
- Appetite.
- Dysphagia.
- Food intolerance.
- Abdominal pain.
- Nausea/vomiting.
- Bowel habits.
- Past abdominal history.
- Medications.
- Nutritional assessment.
-
Objective Data:
- Inspect (contour, symmetry, umbilicus, skin, hair, movement, and demeanor).
- Auscultate (hyperactive, hypoactive, and absent bowel sounds).
- Percuss.
- Palpate.
Objectives
- Students will identify at least five common issues in the GI system.
- Describe dysfunction associated with the stomach, intestines, and liver.
- Explain three differences in pathophysiology and assessment of stomach/intestinal and liver systems.
- Apply previously learned concepts to GI/liver dysfunction through critical thinking exercises.
Stomach and Intestinal Dysfunction
-
Gastritis (inflammation of the stomach):
- Causes: acute (local irritants) and chronic.
- Chronic can lead to atrophy of the glandular epithelium.
- H. pylori is a common cause.
-
Pathophysiology (Gastritis):
- Breakdown of the gastric mucosal barrier.
- Acid reflux into the mucosal layer.
- Resulting tissue edema, disrupted capillary walls, loss of plasma, and possible hemorrhage.
-
Clinical Manifestations (Gastritis):
- Anorexia, nausea, vomiting, epigastric tenderness, fullness.
- Hemorrhage is commonly associated with alcohol abuse.
-
Causes (Gastritis):
- Drugs (aspirin, corticosteroids, NSAIDs).
- Diet (spicy, irritating foods).
- Microorganisms (H. pylori, Salmonella).
- Environmental factors (radiation, smoking).
- Pathophysiological conditions (burns, large hiatal hernia, physiological stress, reflux of bile, renal failure).
Gastroesophageal Reflux Disease (GERD)
- Pathophysiology: Backflow of stomach contents into the esophagus, regulated by a sphincter at the stomach entrance. Transient relaxation occurs after meals, particularly with fatty foods.
- Clinical Manifestations: epigastric pain or heartburn, sometimes belching, chest pain. Also, respiratory symptoms (wheezing, coughing, dyspnea), and otolaryngologic symptoms (hoarseness, sore throat, globus sensation, choking).
- Nursing Assessment: Assess neuro (dysphagia, PQRST pain), cardiovascular (chest pain, BP changes), respiratory (sore throat, hoarseness, wheezing, coughing), and gastrointestinal (nutritional status, painful swallowing, heartburn, nausea/vomiting, weight loss).
Peptic Ulcer Disease (PUD)
- Pathophysiology: Formation of ulcers on the stomach and/or duodenum, often in the presence of acid environment. Damage to mucosa barrier leads to acid backflow and tissue deterioration..
- Clinical Manifestations: Primary symptom is pain typically on empty stomach; relieved by food or antacids.
- Causes: often by H. pylori or NSAIDs.
- Complications includes: hemorrhage, gastric outlet obstruction, perforation, which can lead to peritonitis.
Gastrointestinal Bleed
- Can occur anywhere in the GI tract (UGIB or LGIB).
- Site of bleeding is indicated by color and texture (bright red to tarry black/melena).
- Upper GI often involves coffee-ground material (partially digested) or bright red blood. Brighter color indicates source is nearer the opening; darker color indicates source is further downstream (eg, hemorrhage in duodenum).
- Lower GI involved with frank red blood.
- Think EMERGENCY situation.
Obstruction/Ileus
- An obstruction prevents the normal passage of chyme through the intestines.
- Loss of intestinal motility.
- Primary causes of small bowel obstruction: adhesions, hernias, tumors
- Primary causes of large bowel obstruction: malignancy, volvulus, strictures related to diverticulitis.
Liver and Gallbladder Dysfunction
- Liver Structure and Function - Contains multiple lobes and is vital for many physiological functions.
- Hepatitis A - Causes widespread inflammation of liver tissue, results from cytotoxic cytokines, and natural killer cells lysing infected hepatocytes. This leads to necrosis and inflammation, often via a contaminated water/food fecal oral route.
- Fulminant Viral Hepatitis - Severe liver impairment or necrosis; often presents after initial symptoms of hepatitis, involves symptoms like anorexia, vomiting, abdominal pain, jaundice, ascites, and gastrointestinal bleeding.
- Jaundice - A possible consequence of liver dysfunction. It results from the inability to process or excrete bilirubin correctly.
- Portal Hypertension - Abnormally high blood pressure in the portal venous system, caused by resistance to portal blood flow.
- Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH)– conditions where fat infiltrates hepatocytes, which can lead to liver damage and potentially liver failure. If not addressed effectively, this condition can lead to scarring and irreversible damage to the liver.
- Cirrhosis - Irreversible inflammatory and fibrotic liver disease and necrosis of liver cells. Scarring of the liver that damages its function is a result..
- Ascites - Accumulation of fluid in the peritoneal cavity, often due to increased pressure in the lymphatic system and capillaries
-
Hepatic Encephalopathy: A complex neurologic syndrome characterized by impaired cognitive function, often progressing to confusion, flapping tremors, stupor, convulsions, and coma.
- Ammonia and GABA levels may play a role in its progression
Gallbladder Disorders
-
Cholelithiasis - Formation of gallstones due to impaired cholesterol, bilirubin, and bile salt metabolism and imbalances.
- Can present as asymptomatic, vague symptoms, or biliary colic (pain from contraction of the gallbladder).
- Cholecystitis - Inflammation of the gallbladder, often caused by gallstones obstructing the cystic duct.
- Diagnostic Tests: ERCP (Endoscopic Retrograde Cholangiopancreatography), plain x-rays, ultrasound, and scintigraphy (HIDA).
Key Points to Remember
- Students can perform a comprehensive abdominal assessment while understanding the physiological landmarks relevant to GI function.
- They can identify the "why" behind GI assessments and relate them to multiple organ systems.
- Students can apply V/Q mismatching concepts to various respiratory conditions and understand the pathophysiology, clinical manifestations, and nursing assessment related to GI and liver dysfunction.
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Description
Test your knowledge on gastrointestinal conditions and their assessments in nursing. This quiz covers topics like peptic ulcer disease, gastrointestinal bleeding, and bowel obstructions. Perfect for nursing students and healthcare professionals looking to refresh their knowledge.
