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NUR 303 Pathophysiology - Gastrointestinal
Disorders
Upper GI tract - esophagus, stomach, duodenum Lower GI tract - small and large intestines, rectum GI Bleeding - may be accompanied by nonspecific symptoms esophageal varices - blood vessels around esophagus swell, due to liver cirrhosis radiation of abdominal pain - pancreatitis (to the back), gallbladder disease, right shoulder colicky or crampy pain - suggests an interal hollow organ dull pain - suggests a GI cause constant pain - suggest an inflamed surface epigastric region -
gerd, MI, pancreatitis RUQ - duodenal ulcer, viral hepatitis, cholecystitis LUQ - gastric ulcer, splenic rupture, aortic aneurysm RLQ - appendicitis LLQ - Diverticulitis RLQ or LLQ - inflammatory bowel disease, ectopic pregnancy, bowel obstruction, perforation, ischemia myocardial infarction - abdominal pain with shortness of breath and exertional symptoms duodenal ulcer - 2-5 hours after a meal and at night viral hepatitis - RUQ pain with fatigue Cholecytitis - 4-6 hours with fever, positive murphys sign
barrett's esophagus - precancerous esophageal condition, normal squamous cells become columnar cells esophageal cancer - 30-60 times greater with barret's esophagus, poor prognosis and high mortality rate peptic ulcer disease - inflammatory erosion in the stomach, could be gastric or duodenal H, pylori infection gastroparesis - affects spontaneous movement of the muscles and nerves of the stomach, DM is main risk hiatal hernia - occurs when part of the stomach protrudes up through the diaphragm, older than 65 is the main risk lower GI system role - absorbs nutrients and water to excrete waste and indigestible contents gastroenteritis - inflammation to the lining of the small or large intestines, causes damage to microvilli and leads to impaired absorptive ability of the brush border 10 red flags of diarrhea - volume depletion and dehydration, abnormal electrolytes, bloody stool, weight loss, abdonimal pain, greater than 2 weeks, hospitalization or antibiotic use, older than 65, comorbidities, and pregnancy norovirus - most common cause of gastroenteritis
giardia lamblia - exposure to water in which beavers reside celiac disease - villous atrophy of the small intestine lactose intolerance - lactase deficiency at the intestinal brush border, lactose or lactose containing foods causes hernia - protrusion of the small intestine through a weakened abdominal wall muscle inguinal hernia - males have a higher rate due to allowment of the displacement of the small intestine strangulated hernia - blood supply to incarcerated loop is obstructed and at risk for ischemia ulcerative colitis - chronic inflammation limited to the mucosal layer of the colon chrohns disease - chronic transmural inflammation that may lead to fibrosis, strictures, micropeforations and fistula formation fistula formation in crohns disease - abnormal tunnel that conencts two organs
Alkaline phosphatase - measures hepatocellular damage billirubin indirect - measures excretion bilirubin - measures excretion PT - measures liver function Albumin - measures liver function hepatitis - inflammation of the liver and is most common pathological condition of the liver worldwide
- fatigue, jaundice, pale, clay-colored stools, dark urine complications of chronic hepatitis - liver cirrhosis and hepatocellular carcinoma nonalcoholic fatty liver disease - obesity is the most apparent risk factor liver disease from chronic heavy alcohol use - alcohol is a potent toxin to hepatocytes deficiency in thiamine hemochromatosis -
accumulation of iron in the liver wilson disease - excessive copper levels cirrhosis - silent and gradual disease characterized by progressive hepatic fibrosis portal hypertension - life threatening complication of cirrhosis increased venous pressure within the portal vein increased venous pressure in portal hypertension - causes backup of pressure and causes esophageal varices and hematemesis
