University:
York University
Course:
NURSING 2534 | Pathophysiology
Academic year:

2023
Views:

48

Pages:

4
Author:

Niklas

Inflammation of Appendix Etiology: Idiopathic Probable Cause: Infection, Fecalith, Seeds VS/SX: Mcburney's sign: Pain at Mcburney's point Similar: Mittelschmerz: Halfway between umbilicus and iliac crest Blumberg's sign: Rebound tenderness (increased pain upon release of palpation) Rovsing's sign: Pain at right lower quadrant if left lower quadrant is palpated Psoas sign: Hip flexion causes pain Infection signs/symptoms: Fever is the earliest sign, WBC count (leukocytosis) Diagnostic Test: NONE will only cause rupture, laparoscopy is confirmatory Screening Test: Ultrasound: Visualize enlargement Blood Test: WBC count Management: APENDICS (removal of appendix) Cathartics (laxatives) Avoid heat, enemas, laxatives Pain medication: Not given, masks rupture Encourage rest: Peristalsis decreases rupture risk Unruptured: Any position of comfort Ruptured: Semi-Fowler's position (30-45 degrees) to prevent ascending infection NPO (Nil Per Os): Prepare for surgery Do not frequently palpate IV fluid balance: D5LRS Ulceration of GI Lining Etiology: THCI (increased hydrochloric acid) Mucus: Protection Risk Factors: Bacterial Infection: H. pylori Medications: NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) Take with full stomach/after meal Aspirin (ASA)/salicylates Naproxen Stress: Non-specific response to anything done in the body GI Irritants: Smoking Alcohol Caffeine: Coffee, Tea, Soft drinks, Chocolates Spicy Milk (alkaline) CHON-T (proteins): Overly release HCl DOC (Drug of Choice): H2 Blockers (reduce HCl) Ranitidine (Zantac) Cimetidine (Tagamet) Famotidine (Pepcid) Heading: 5. Hereditary Gastric: A blood Duodenal: O blood Types Duodenal: most common, SI bicarbonate not used to buffer acid Gastric: stomach Esophageal: rare, secondary to vomiting, GERD VS/SX (Signs and Symptoms) Gastric Pain with meal Pain immediately after meal Pain if awake Pain due to vomiting Weight loss Upper quadrant pain Hematemesis (vomiting blood) Coffee ground vomitus Duodenal Pain 1-2 hours after meals Pain during sleep Pain with food intake Weight gain Upper quadrant pain Melena (black tarry stool, upper gastrointestinal bleeding) Dx Test (Diagnostic Test): EGD (Esophago Gastro Duodenoscopy) Endoscopic visualization Preparations: NPO (nothing by mouth) for 6-12 hours Medications: Atropine: Reduces secretions Diazepam: Sedative, relaxes muscles Lidocaine spray: Reduces gag reflex Heading: 3. Position GI (Gastrointestinal): Side-lying position to prevent aspiration, compression of vena cava, and palpitations Respiratory: Supine position with neck hyperextended, head tilt-chin lift to open airway Post (After procedure): NPO (nothing by mouth) until gag reflex returns Assess gag reflex using tongue depressor/blade or popsicle stick Bedrest, consider diazepam to prevent falls Prevent falls: Raise handrails if ambulating, lower bed if not ambulating Report: Hematemesis (vomiting blood), respiratory abnormalities Management: Nursing Management: Rest to conserve oxygen and promote healing Diet: Bland diet: Avoid seasoning, spices Small, frequent feedings: 6 times per day Regular and balanced diet: Include carbohydrates, proteins, fats