Nursing Assessment: Gastrointestinal Conditions
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Questions and Answers

What is the primary cause of Peptic Ulcer Disease?

  • High carbohydrate diet
  • Chronic stress
  • Excessive alcohol consumption
  • H.pylori infection and NSAIDs (correct)

What symptom is typically associated with Peptic Ulcer Disease?

  • Pain relieved by food or antacids (correct)
  • Nausea and vomiting
  • Persistent diarrhea
  • Heartburn after meals

Which of the following complications is NOT associated with Peptic Ulcer Disease?

  • Severe weight loss (correct)
  • Hemorrhage
  • Gastric outlet obstruction
  • Perforation

In gastrointestinal bleeding, what does bright red blood indicate?

<p>Bleeding from the upper GI tract (D)</p> Signup and view all the answers

What is NOT a sign of upper gastrointestinal bleeding?

<p>Bright red blood in stools (C)</p> Signup and view all the answers

What is a primary symptom of lower gastrointestinal bleeding?

<p>Frank red blood (C)</p> Signup and view all the answers

Which of the following is a nursing assessment parameter for assessing cardiovascular status?

<p>Skin color and hemodynamic status (C)</p> Signup and view all the answers

What is classified as a primary cause of small bowel obstruction?

<p>Tumors (A)</p> Signup and view all the answers

What symptom is typically associated with intestinal obstruction?

<p>Intermittent pain (C)</p> Signup and view all the answers

The condition preventing the normal flow of chime through the intestine is known as?

<p>Obstruction (B)</p> Signup and view all the answers

Which clinical manifestation indicates a advanced state of intestinal obstruction?

<p>Restlessness and awareness of peristaltic movements (B)</p> Signup and view all the answers

In assessing lab values for gastrointestinal bleeding, which electrolyte should be monitored closely?

<p>Potassium (A)</p> Signup and view all the answers

What type of bowel obstruction is caused by conditions like malignancy?

<p>Mechanical (C)</p> Signup and view all the answers

What is a common cause of acute gastritis?

<p>Local irritants (C)</p> Signup and view all the answers

Which symptom is typically associated with GERD?

<p>Dysphagia (D)</p> Signup and view all the answers

What is a potential complication of Peptic Ulcer Disease (PUD)?

<p>Gastrointestinal bleeding (B)</p> Signup and view all the answers

Which statement about gastrointestinal bleeding is false?

<p>It is always accompanied by severe pain. (B)</p> Signup and view all the answers

What is a notable feature of chronic gastritis compared to acute gastritis?

<p>Atrophy of glandular epithelium (D)</p> Signup and view all the answers

Which of the following is NOT a typical symptom of GERD?

<p>Abdominal bloating (B)</p> Signup and view all the answers

What is a common characteristic of gastrointestinal hemorrhage?

<p>Can be acute or chronic (B)</p> Signup and view all the answers

Which medication could potentially exacerbate acute gastritis?

<p>Nonsteroidal anti-inflammatory drugs (NSAIDs) (B)</p> Signup and view all the answers

Which factor specifically influences the development of Peptic Ulcer Disease?

<p>Acidic environment (C)</p> Signup and view all the answers

What does the primary symptom of Peptic Ulcer Disease typically correlate with?

<p>Pain on an empty stomach (D)</p> Signup and view all the answers

Which complication of Peptic Ulcer Disease can result from scar tissue formation?

<p>Gastric outlet obstruction (A)</p> Signup and view all the answers

How does the presence of an impairment in the mucosa barrier contribute to Peptic Ulcer Disease?

<p>Leads to back-diffusion of acid (A)</p> Signup and view all the answers

What indicates a complication of gastrointestinal bleeding based on the blood’s appearance?

<p>Bright red color indicating high source bleeding (C)</p> Signup and view all the answers

Which of the following accurately describes a function of the liver?

<p>Metabolism of Nutrients (CHO, CHON, Fat) (B)</p> Signup and view all the answers

Hepatitis A is primarily transmitted through which route?

<p>Fecal-oral route (D)</p> Signup and view all the answers

What is a key assessment finding indicating liver dysfunction?

<p>Elevated levels of bilirubin in lab tests (B)</p> Signup and view all the answers

Which statement accurately describes the pathophysiology of Hepatitis A?

<p>It involves widespread inflammation mediated by immune cells. (D)</p> Signup and view all the answers

What is a consequence of obstruction in hepatic circulation?

<p>Decreased detoxification of substances (C)</p> Signup and view all the answers

What is a primary factor that may lead to lower gastrointestinal bleeding?

<p>Frank red blood (D)</p> Signup and view all the answers

Which symptom indicates acute cardiovascular issues during a nursing assessment?

<p>Tachycardia (B), Cyanosis (C)</p> Signup and view all the answers

Which condition is classified as a primary cause of large bowel obstruction?

<p>Volvulus (A)</p> Signup and view all the answers

In the context of intestinal obstruction, the term 'peristaltic rush' refers to what symptom?

<p>Intermittent pain (D)</p> Signup and view all the answers

What laboratory value requires careful monitoring during gastrointestinal bleeding assessment?

<p>Potassium (B)</p> Signup and view all the answers

Which of the following accurately describes acute gastritis?

<p>It may or may not present with symptoms. (A)</p> Signup and view all the answers

What is a primary affect of chronic inflammation in gastritis?

<p>Atrophy of the glandular epithelium. (C)</p> Signup and view all the answers

Which statement accurately describes a type of bowel obstruction?

<p>Ileus is a loss of intestinal motility. (A)</p> Signup and view all the answers

Which symptom is most associated with a significant degree of intestinal obstruction?

<p>Sudden onset of vomiting (D)</p> Signup and view all the answers

In gastrointestinal dysfunction, which parameter is least likely to be assessed subjectively?

<p>Skin condition. (C)</p> Signup and view all the answers

Which condition is characterized by a backup of digestive contents due to a blockage?

<p>Obstruction/Ileus. (D)</p> Signup and view all the answers

During a nursing assessment, what does a decrease in urine output below 30 cc/hr potentially indicate?

<p>Decreased blood flow to the kidneys (D)</p> Signup and view all the answers

What is a key clinical manifestation of hepatitis?

<p>Jaundice and abdominal pain. (C)</p> Signup and view all the answers

Which symptom is most indicative of a lower gastrointestinal bleed?

<p>Bright red blood in stool. (B)</p> Signup and view all the answers

What is the primary pathophysiological factor contributing to ascites development in cirrhosis?

<p>Decreased synthesis of albumin by the liver (C)</p> Signup and view all the answers

Which of the following factors is most likely to trigger acute liver dysfunction?

<p>Infections leading to inflammation. (D)</p> Signup and view all the answers

Which clinical manifestation is least likely associated with hepatic encephalopathy?

<p>Fever and chills (B)</p> Signup and view all the answers

Which assessment technique is crucial for evaluating gastrointestinal function?

<p>Inspection of abdominal contours. (D)</p> Signup and view all the answers

What might indicate the development of bacterial peritonitis in a patient with ascites?

<p>Cloudy appearance of ascitic fluid (A)</p> Signup and view all the answers

Which of the following treatments is least likely to be effective in managing ascites?

<p>High-dose diuretics (C)</p> Signup and view all the answers

Which factor among the following does NOT contribute to the pathophysiology of ascites?

<p>Abnormal intestinal peristalsis (C)</p> Signup and view all the answers

Which clinical manifestation is most directly associated with fulminant viral hepatitis?

<p>Dark urine (B)</p> Signup and view all the answers

What is a primary consequence of portal hypertension?

<p>Enlargement of the spleen (B)</p> Signup and view all the answers

Which mechanism is primarily responsible for jaundice resulting from hepatic obstruction?

<p>Inflammation of bile ducts (A)</p> Signup and view all the answers

What is often the first indicator of cirrhosis of the liver in a patient?

<p>Elevated liver enzymes (B)</p> Signup and view all the answers

Which condition is NOT typically a consequence of ascites?

<p>Hypotonic urine (B)</p> Signup and view all the answers

What condition often leads to the development of Non-Alcoholic Steatohepatitis (NASH)?

<p>Obesity and metabolic syndrome (D)</p> Signup and view all the answers

Which symptom is commonly seen in patients with severe portal hypertension?

<p>Melena or hematemesis (D)</p> Signup and view all the answers

Which of the following is a potential complication of cirrhosis?

<p>Esophageal varices (D)</p> Signup and view all the answers

Which sign is indicative of liver dysfunction associated with hepatobiliary disease?

<p>Elevated alkaline phosphatase (C)</p> Signup and view all the answers

Which of these is NOT a typical clinical manifestation seen in patients with hepatitis?

<p>Severe hypotension (D)</p> Signup and view all the answers

What is a common clinical manifestation associated with a drop in Hemoglobin levels to 70-80 g/L?

<p>Fatigue and weakness (C)</p> Signup and view all the answers

Which type of anemia is characterized by small erythrocytes with insufficient hemoglobin?

<p>Microcytic-hypochromic anemia (A)</p> Signup and view all the answers

What distinguishes Absolute Polycythemia from Relative Polycythemia?

<p>It involves abnormal bone marrow stem cell proliferation. (D)</p> Signup and view all the answers

Which of the following is a characteristic of Aplastic Anemia?

<p>Depleted T-cells (D)</p> Signup and view all the answers

What symptom is generally associated with Hemolytic Anemia?

<p>Jaundice due to elevated bilirubin (B)</p> Signup and view all the answers

What is a primary cause of thrombocytopenia in disseminated intravascular coagulation (DIC)?

<p>Consumption of clotting factors (D)</p> Signup and view all the answers

Which symptom is associated with rapidly developing organ failure in DIC?

<p>Microvascular thrombosis (A)</p> Signup and view all the answers

What is a key laboratory finding in diagnosing thrombocytopenia?

<p>Prolonged clotting times (A)</p> Signup and view all the answers

Which type of anemia is characterized by large erythrocytes due to ineffective DNA synthesis?

<p>Macrocytic-Normochromic Anemia (D)</p> Signup and view all the answers

What is the main consequence of the absence of intrinsic factor in pernicious anemia?

<p>Vitamin B12 deficiency (A)</p> Signup and view all the answers

Which treatment is essential for managing disseminated intravascular coagulation?

<p>Treating the underlying cause (B)</p> Signup and view all the answers

What clinical manifestation indicates the rapid development of hemorrhage?

<p>Shock (C)</p> Signup and view all the answers

What primary factors can lead to anemia?

<p>Altered production and blood loss (D)</p> Signup and view all the answers

Which of the following symptoms is commonly associated with hereditary hemochromatosis?

<p>Bronzed skin (D)</p> Signup and view all the answers

What condition is characterized by an increased number of leukocytes in the blood?

<p>Leukocytosis (B)</p> Signup and view all the answers

Which of the following disorders results in a decrease in circulating leukocytes?

<p>Neutropenia (C)</p> Signup and view all the answers

What clinical manifestation is often seen in myelodysplastic syndrome (MDS)?

<p>Frequent infections (D)</p> Signup and view all the answers

Which term describes a malignant disorder characterized by uncontrolled proliferation of leukocytes?

<p>Leukemia (C)</p> Signup and view all the answers

Which type of alteration is indicated by the presence of eosinophilia?

<p>Asthma (B)</p> Signup and view all the answers

What is a common result of granulocyte and monocyte alterations due to microbial invasion?

<p>Increased leukocyte levels (B)</p> Signup and view all the answers

What condition is characterized by a deficiency in healthy mature blood cell production?

<p>Myelodysplastic Syndrome (MDS) (D)</p> Signup and view all the answers

Acute leukemia is characterized by what type of cells?

<p>Blast cells (B)</p> Signup and view all the answers

Which condition involves an autosomal recessive disorder with tissue iron deposition?

<p>Hereditary hemochromatosis (A)</p> Signup and view all the answers

Flashcards

Peptic Ulcer Disease (PUD)

A sore that develops in the lining of the stomach or duodenum, often caused by H. pylori or NSAIDs.

Cause of PUD

Common causes include bacteria (H. pylori) and nonsteroidal anti-inflammatory drugs (NSAIDs).

PUD Pathophysiology

Acid environment weakens the stomach lining, acid diffuses, and erodes the mucosa layers.

PUD Symptom

Stomach pain, often relieved by food or antacids, is a primary symptom.

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Gastrointestinal Bleed (GI bleed)

Bleeding in the stomach or intestinal tract, potentially fatal if large and unaddressed.

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Lower GI Bleed

Bleeding in the lower part of the digestive tract, often presenting with bright red blood in stool.

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What are the typical symptoms of lower GI bleeding?

The main symptom is the presence of frank, bright red blood in the stool.

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Intestinal Obstruction

A blockage in the intestines that prevents the normal flow of food and waste.

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Simple vs Functional Obstruction

Simple obstructions involve physical blockages, while functional obstructions involve problems with the muscles/nerves controlling the gut.

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Causes of Small Bowel Obstruction

Adhesions, hernias, and tumors can create blockages in the small intestine.

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Causes of Large Bowel Obstruction

Tumors, volvulus (twisting), and diverticulitis-related strictures can obstruct the large intestine.

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Clinical Manifestations of an Obstruction

Symptoms like pain, vomiting, bloating, and abnormal bowel sounds are common.

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Treatment of Intestinal Obstruction

The approach depends on the cause, ranging from medications to surgery.

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Gastritis

Inflammation of the stomach lining. Causes include irritants and bacterial infection.

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Acute Gastritis

Sudden onset gastritis caused by irritants like alcohol or spicy foods. May or may not have symptoms.

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Chronic Gastritis

Long-term gastritis that can damage the stomach lining and lead to atrophy (thinning). Often caused by bacteria like H. pylori.

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GERD (Gastroesophageal Reflux Disease)

Acid reflux where stomach contents back up into the esophagus, causing heartburn and other symptoms.

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Obstruction/Ileus

Blockage of the intestines, preventing the passage of food and waste. Can be caused by various factors.

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Hepatitis

Inflammation of the liver, often caused by viral infections or alcohol abuse.

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PUD location

Peptic ulcers usually form in the duodenum or stomach, with the duodenum being the most common site.

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PUD Cause?

H. pylori bacteria and NSAID medications are common causes of peptic ulcer disease.

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PUD Pain Relief?

Peptic ulcer pain is usually relieved by eating or taking antacids.

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GI bleed location

Bleeding in the digestive tract can happen anywhere, but color indicates location: bright red = closer, dark = further.

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PUD danger

Peptic ulcers can lead to serious complications: hemorrhage, obstruction, and even perforation.

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GERD

Gastroesophageal reflux disease. Acidic stomach contents back up into the esophagus, causing heartburn, a burning sensation in the chest.

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What are the potential consequences of untreated PUD?

Untreated PUD can lead to complications such as bleeding, perforation (a hole in the stomach wall), and obstruction (blockage). Rarely, untreated PUD can lead to stomach cancer

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What causes gastrointestinal bleeding?

Bleeding in the gastrointestinal tract (GI tract) can be caused by various factors, including ulcers (PUD), gastritis, tumors, and even trauma like an injury to the gut.

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What is an intestinal obstruction?

A blockage in the intestines that prevents the normal flow of food and waste. Can be caused by various factors including adhesions, tumors, and twisting of the intestines.

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What is hepatitis?

Inflammation of the liver. Often caused by viral infections such as hepatitis A, B, and C, or alcohol abuse.

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What are the differences in the pathophysiology of gastric/intestinal disorders and liver disorders?

Gastric/intestinal disorders primarily involve inflammation, ulcers, and obstruction of the digestive tract. Liver disorders involve inflammation, damage, and dysfunction of the liver, a vital organ for filtering blood and producing essential substances.

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Liver's Role

The liver plays a crucial role in various bodily functions including bile production, metabolism of bilirubin, nutrients, and drugs, detoxification, and storage of minerals.

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Hepatitis A Transmission

Hepatitis A is spread through the fecal-oral route, mainly via contaminated food, water, and blood.

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Hepatitis A Damage

Hepatitis A causes inflammation and damage to liver tissue due to cytotoxic cytokines and natural killer cells that destroy infected hepatocytes.

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Hepatitis A Symptoms

Hepatitis A usually presents with symptoms like fatigue, jaundice, abdominal pain, loss of appetite, and dark urine.

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Hepatitis A Incubation

The incubation period for Hepatitis A is typically 2-7 weeks, which means the virus may exist unnoticed for some time before causing symptoms.

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Lower GI Bleed Symptom

The primary symptom of a lower GI bleed is the presence of bright red blood in the stool.

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Intestinal Obstruction - What is it?

An intestinal obstruction is a blockage in the intestines that prevents the normal flow of food and waste.

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Small Bowel Obstruction - Causes

Common causes of small bowel obstruction include adhesions, hernias, and tumors.

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Large Bowel Obstruction - Causes

Tumors, volvulus (twisting of the intestine), and diverticulitis-related strictures can obstruct the large intestine.

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Obstruction Symptoms

Common symptoms of intestinal obstruction include pain, vomiting, bloating, and abnormal bowel sounds.

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Obstruction Treatment

Treatment for intestinal obstruction depends on the cause and can range from medications to surgery.

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Obstruction Clinical Manifestations

Symptoms of obstruction depend on the severity and duration of the blockage. They can be sudden and severe, including pain, vomiting, and distention.

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Ascites

Fluid buildup in the peritoneal cavity, often caused by cirrhosis, heart failure, or cancer. It disrupts normal physiological functions.

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Ascites Causes

Common causes include portal hypertension, low albumin levels, dilated blood vessels in the gut, and fluid retention by kidneys.

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Ascites Manifestations

Symptoms include abdominal swelling, weight gain, shortness of breath, and leg swelling. Bacterial infection can also occur.

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Hepatic Encephalopathy

A brain disorder caused by liver dysfunction, characterized by confusion, tremors, and altered consciousness. It can be life-threatening.

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Hepatic Encephalopathy Pathophysiology

High ammonia and GABA levels in the brain contribute to neurologic symptoms. This can happen quickly and become dangerous.

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Fulminant Viral Hepatitis

A severe liver disease characterized by rapid and extensive liver cell damage, potentially caused by Hepatitis B, C, or Tylenol overdose.

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Jaundice: What causes it?

Yellowing of the skin and whites of the eyes due to a buildup of bilirubin in the blood, caused by problems with bilirubin processing in the liver or blockage of bile flow.

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Portal Hypertension

High blood pressure in the portal vein system, caused by resistance to blood flow through the liver, often due to cirrhosis, hepatitis, or blockages.

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Varices

Swollen, enlarged veins in the esophagus and stomach, often developing due to portal hypertension, which can cause life-threatening bleeding.

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NAFLD vs NASH

NAFLD: Fatty liver disease without alcohol use. NASH: More serious, with inflammation and scarring of the liver. Both linked to obesity, high cholesterol, and diabetes.

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Cirrhosis of the Liver

Scarring and damage to the liver that disrupts its structure and function, often caused by chronic hepatitis, alcoholism, or fatty liver disease.

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Hepatorenal Syndrome

A complication of advanced liver disease where the kidneys suddenly fail due to impaired blood flow and fluid retention.

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What are the clinical manifestations of cirrhosis?

Symptoms of cirrhosis include abnormal liver function tests, fatigue, abdominal pain, weight loss, jaundice, edema, ascites, portal hypertension, and potentially hepatic encephalopathy or hepatorenal syndrome.

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Microcytic-Hypochromic Anemia

Anemia characterized by small, pale red blood cells with reduced hemoglobin content.

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Sideroblastic Anemia

Anemia caused by ineffective iron uptake, leading to abnormal hemoglobin synthesis.

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Aplastic Anemia

Anemia due to insufficient red blood cell production, often caused by an autoimmune attack on the bone marrow.

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Polycythemia Vera

A condition characterized by an abnormal increase in red blood cell production due to an overproduction of bone marrow stem cells.

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Relative Polycythemia

A condition where there is an apparent increase in red blood cells, but the actual number is normal. This is caused by a decrease in plasma volume, making the red blood cells appear more concentrated.

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Polycythemia

A condition characterized by an abnormally high red blood cell count, leading to increased blood viscosity and potential complications like blood clots.

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Hereditary Hemochromatosis

A genetic disorder causing excessive iron absorption, leading to iron buildup in tissues and potential organ damage.

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What are the symptoms of Hemochromatosis?

Symptoms include fatigue, abdominal pain, joint pain, impotence, hepatomegaly, abnormal liver enzymes, bronzed skin, diabetes, and heart enlargement.

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Leukocytosis

An increase in white blood cells in the blood, often indicating an infection or inflammation.

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Leukopenia

A decrease in white blood cells in the blood, increasing susceptibility to infections.

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Neutrophilia

An increase in neutrophils, a type of white blood cell, often seen in early stages of infection or inflammation.

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Neutropenia

A decrease in neutrophils, increasing the risk of severe infections.

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Myelodysplastic Syndrome (MDS)

A group of disorders where the bone marrow fails to produce enough healthy blood cells, leading to various complications.

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Leukemia

Cancer of the blood and bone marrow, characterized by uncontrolled proliferation of abnormal white blood cells.

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Acute Leukemia

A fast-growing type of leukemia characterized by immature white blood cells (blasts) and a rapid onset.

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Disseminated Intravascular Coagulation (DIC)

A life-threatening condition where the body's clotting system is overactivated, leading to widespread clotting in small blood vessels and excessive bleeding.

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DIC Symptoms

DIC can present with both bleeding and clotting problems, causing rapid development of hemorrhage, shock, low blood pressure, and organ failure due to microvascular blockages.

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DIC Diagnosis

Diagnosis of DIC is based on clinical presentation, laboratory tests like prolonged clotting time, low platelet count (thrombocytopenia), and elevated D-dimer.

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Anemia: Definition

A condition characterized by a deficiency in red blood cells (erythrocytes) or hemoglobin, leading to reduced oxygen-carrying capacity of the blood.

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Anemia: Types

Anemia can be classified by its cause: altered production, blood loss, increased destruction of red blood cells, or a combination. Anemia can also be classified by changes in red blood cell size, shape, or substance.

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Macrocytic-Normochromic Anemia

This type of anemia is characterized by large red blood cells (erythrocytes) due to ineffective DNA synthesis, often caused by Vitamin B12 or folate deficiency.

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Pernicious Anemia

Caused by a lack of intrinsic factor, a protein needed to absorb Vitamin B12 from the diet, leading to a deficiency and impaired DNA synthesis in red blood cells.

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Folate Deficiency Anemia

Occurs when there's insufficient folate (folic acid) in the body, which is crucial for DNA synthesis and red blood cell production.

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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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Related Documents

Week 9- Alterations in Gastrointestinal Function-Student PDF
Week 11 - Pain & Hematological Function & Pediatrics (Student) PDF

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.

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