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

2023
Views:

46

Pages:

3
Author:

Niklas

Peptic Ulcer Disease Erosion of GI mucosa from HCl acid Susceptible areas: Lower esophagus, stomach, duodenum Types: Acute: Superficial erosion Chronic: Erosion of muscular wall Gastric Ulcer Most prevalent in rectum High recurrence Risk factors: H. pylori, NSAIDs, bile reflux Duodenal Ulcer 1-2 cm Most common Risk factors: H. pylori, NSAIDs, Zollinger-Ellison Syndrome, bile reflux High HCl secretion Clinical Ulcer Disease Episodic symptoms: 1-2 hrs post meals (burning, gnawing pain) Worsening: Persisten pain, vomiting, green/tarry stool Complications: Hemorrhage (most common) Perforation (most lethal) Obstruction Diagnostic Studies: Endoscopy: Direct visualization Urea breath test Acute Care: Hemorrhage: IV fluids, NG tube, blood transfusions Perforation: Open or laparoscopic surgery Obstruction: IV fluids, NG tube Drug Therapy: Reduce gastric acid secretion H2 receptor blockers PPIs Peptic Ulcer Disease Risk Factors: Smoking Elderly Frequent use of NSAIDs Symptom onset: 1-2 hrs post meals Gastritis Inflammation of gastric mucosa Breakdown in gastric mucosal barrier Types: Acute, chronic Causes: NSAIDs, corticosteroids, alcohol, digitalis, spicy foods, environmental radiation, smoking Management: Identify cause, eliminate/prevent, avoid irritants Rest, NPO, IV fluids Risk for hemorrhage Drugs: PPIs, H2 receptor blockers Diagnostic Studies Based on symptoms H. pylori testing CBC, albumin Nursing Interventions: Monitor for hemorrhage Clear liquids, ice chips Avoid irritants Alcohol, caffeine, nicotine Gastritis Acute: Nausea, vomiting, anorexia, belching Resolve after removing irritant Chronic: Recurrent epigastric distress H. pylori screening Risk-limiting behaviors Medications Manifestations (Upper GI bleed) Clinical Findings: Fever, tachycardia, pallor, diaphoresis Rapid, shallow respirations Hypotension, ↓ urine output, rigid abdomen Diagnostic Findings: Hematemesis, hematochezia ↓ hematocrit, ↓ hemoglobin Labs: CBC, PT, PTT, ABGs, liver enzymes Occult stool blood Interventions: Clear liquids, ice chips Monitor for hemorrhagic gastritis Avoid irritants Alcohol, caffeine, nicotine GI Bleeds: Emergency Management Interventions: Assess airway, circulation, breathing Establish IV access Give O₂ NC Insert NG tube Monitor VS Keep patient NPO Lower GI Issues Structural: Bowel looks abnormal Hemorrhoids Anal fissures Abscess Diverticulitis Functional: GI tract looks normal, does not work correctly Constipation IBS Interventions: Prevention: Correct food preparation, cleanliness Avoid irritants Adequate cooling Acute Care: Correct fluid and electrolyte imbalances Monitor CNS E. coli can cause kidney failure → life-threatening Transmission: Ingesting infectious organisms Major Concerns: Dehydration Electrolyte imbalance Acid-base imbalance Treatment: Treat underlying illness Avoid foods that cause diarrhea Antidiarrheals only if not infectious E. coli infection: Contact precautions, gown & gloves #1: Diarrhea Passage of 3 or more loose stools in a day Persistent: >10 days Causes: Infectious organisms, IBS, medications, toxins Severe diarrhea: Electrolyte imbalance, acid-base imbalance Interventions: Replace fluids & electrolytes Antidiarrheals Avoid irritants Clear liquids, ice chips Monitor CNS