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GI, BILIARY, PANCREATIC DISORDER
Heath Deviations I, SSC
109
Nursing
Undergraduate 1
05/07/2013
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Term
What percent of obstructions occur in the large intestine?
 Definition
25%
Term
What percent of obstructions occur in the small intestine?
 Definition
75%
Term
What would cause a functional based blockage?
 Definition
Motility Failure, maybe by trauma, electrolyte imbalance, spasmolytic agents. Anything that will cause peristalsis to decrease.
Term
What would the source of a mechanical blockage?
 Definition
A lesion, foreign body, adhesions, tumor, hernia, volvulus, impaction, or intussusception.
Term
What is a volvulus?
 Definition
A twisting of the intestine.
Term
What is intussusception?
 Definition
Telescoping of the intestine.
Term
S/S of Obstruction?
 Definition
Sudden Pain, Constipation, Obstipation, Fecal Vomiting, Abd Distention, Watery Stools, Cramping, Decreased Respiratory Expansion.
Term
What is obstipation?
 Definition
The inability to pass gas or stool.
Term
Treatments for obstruction?
 Definition
NGT, Bowel Rest, Medications to increase motility, Surgery
Term
What is gastritis?
 Definition
Inflammation of the gastric mucosa.
Term
Is gastritis acute or chronic?
 Definition
Both.
Term
What is the result of the gastric mucosa inflammation?
 Definition
There is a breakdown of the normal barrier that protects from gastric acid.
Term
Once HCL diffuses into the mucosa, what happens?
 Definition
Tissue edema, loss of plasma, and POSSIBLE HEMORRHAGE
Term
What causes gastritis?
 Definition
ASA, NSAIDS, Steroids, ETOH, Smoking, Radiation, Stress, Chronic H. pylori, Staph, Salmonella, Spicy food, trauma.
Term
S/S Acute Gastritis:
 Definition
Anorexia, N/V, epigastric tenderness, pain, feeling full, hemorrhage (ETOH)
Term
S/S Chronic gastritis?
 Definition
Same as acute plus B12 deficient anemia.
Term
The difference between acute and chronic gastritis?
 Definition
Acute is self-limiting.
Term
Acute gastritis tx:
 Definition
Avoid cause, symptom care, bedrest, F&E Replacement, NGT, antacids, Histamine-2 antagonist, Clear liquids/Bland foods, surgery for hemorrhage.
Term
Chronic gastritis tx:
 Definition
Eliminate cause, antibiotics, B12 injections, Bland diet, Antacids, No smoking
Term
Different types of peptic ulcer disease?
 Definition
Acute, chronic, gastric, duodenal
Term
What causes PUD?
 Definition
A buildup of acid and then the release of histamine which stimulates more acid and pepsin
Term
Causes of PUD:
 Definition
Stress, heredity (duo,) Type O (duo) Type A (gastric), increased acid secretion (duo), inadequate mucous production (gastric), h, pylori
Term
Complications of PUD:
 Definition
Hemorrhage, chronic inflammation (obstruction,) perforation
Term
S/S of PUD:
 Definition
May be none, may be pain, reflux, acid/burning stomach
Term
PUD Tx:
 Definition
antibiotic for h. pylori, antacids, H2 antagonists, diet change, quitting ETOH, smoking, ASA, NSAIDS
Term
Crohn's is...
 Definition
an idiopathic, chronic inflammation or bowel, usually effects the ileum, jejunum, or colon. May result in fistulas.
Term
Crohn's results in...
 Definition
impaired absorption of nutrients, fat malabsorption, vitamin deficiency. Other complications include arthritis, liver disease, cholelithiasis, renal disorders.
Term
Crohn's S/S:
 Definition
Diarrhea, fatigue, pain/cramping, wt loss, fever, eventually malnutrition, dehydration, lyte imbalances, anemia.
Term
Crohn's Tx
 Definition
Diet, bland food, steroids
Term
Gastroschisis:
 Definition
Protrusion of the intra-abdominal contents through a wall defect lateral to umbilical ring. No sac.
Term
Omphalacele:
 Definition
protrusion of intra-abd viscera into the base of the umbilical cord. Sac covered with peritoneum.
Term
Inguinal hernia:
 Definition
protrusion of abd contents through inguinal canal into scrotum.
Term
Cleft lip anatomy:
 Definition
maxillary and median nasal processes don't fuse
Term
Hirschprung's is also called:
 Definition
Megacolon
Term
Esophageal Atresia:
 Definition
Failure of esophagus to develop as a continual tract.
Term
Five categories of Esophageal Atresia:
 Definition
There may be no fistula, an upper fistula into the trach, a lower fistula into the trach, both upper and lower, and an intact esophagus with a trach fistula.
Term
S/S Esophageal Atresia:
 Definition
COUGHING, CHOKING, CYANOSIS, excessive salivation, apnea, increase respiratory distress, abd distention
Term
S/S pyloric stenosis:
 Definition
Projectile vomiting, hunger, no pain, weight loss, dehydration, distended upper abd, visible gastric peristaltic waves.
Term
Cholecystitis:
 Definition
Inflammation of the gallbladder
Term
Choledocholithiasis:
 Definition
Stones in the common bile duct
Term
Three types of stones:
 Definition
Cholesterol (90%), pigment stones made of bilirubin, mixed stones
Term
Causes of stones:
 Definition
gallbladder stasis, infection, hormone changes and TPN which delay emptying.
Term
S/S of Gallstones:
 Definition
RUQ Pain, intolerance to fatty food, NV, chills, severe pain during acute attack, palpable gallbladder, jaundice, clay stool
Term
Who's at risk for gallstones?
 Definition
Female, Fat, Forty, Flatulent, Fair, Fatty intolerance, fever
Term
Pancreatitis:
 Definition
Acute inflammation of the pancreas
Term
Acute pancreatitis:
 Definition
potentially lethal, pancreatic edema, fat necrosis, hemorrhage, severe pain
Term
Chronic pancreatitis:
 Definition
degenerative condition resulting in pathologic, structural, and functional changes. Severe pain
Term
Glomerulonephritis Type I
 Definition
Idiopathic, antigens pair with antibodies along the basement wall of glomeruli and block it.
Term
Glomerulonephritis Type II
 Definition
Caused by bacteria, chemicals, drugs, viruses. Antigens bind with non-glomeruli antibodies and deposit on the basement wall.
Term
Acute Poststreptococcal Glomerulonephritis
 Definition
Most common type of GN, occurs in children and young adults 5-21 days post-infection. Strep A.
Term
Goodpasture Syndrome
 Definition
Rare autoimmune disease linked to virus and hydrocarbons that targets kidney and lung. Seen in young male smokers.
Term
Types of Kidney Stones
 Definition
Calcium oxalate, calcium phos, uric acid, cystine, struvite
Term
Nephrotic Syndrome is when...
 Definition
the glomerulus is excessively permeable to protein. Causes loss of protein and albumin.
Term
What causes nephrotic syndrome?
 Definition
Lupus, DM, bacteria, viruses, drugs, malaria, cancer, allergens
Term
Signs and symptoms of Nephrotic Syndrome?
 Definition
3.5g or protein in urine/daily, anasarca, peri edema, ascites, HTN, loss of clotting factors, hyperlipidemia
Term
Nephrotic Syndrome Tx:
 Definition
S/S management, daily wts, freq small meals, treat primary dx, low protein intake, diuretics, antilipidemics, anti-coagulants
Term
Pyelonephritis:
 Definition
Inflammation of renal parenchyma. Kidney infection.
Term
What is a Wilm's Tumor?
 Definition
Embryonal Tumor made of blastemic cells, most common childhood cancer.
Term
At what age is a Wilm's diagnosed?
 Definition
1-5yrs of age.
Term
What is STAGE ONE of Wilm's?
 Definition
Limited to kidney and completely excised.
Term
STAGE TWO of Wilm's Tumor?
 Definition
Extends beyond kidney but is completely excised.
Term
STAGE THREE Wilm's tumor.
 Definition
Unabled to be completely resected, spread to lymph nodes.
Term
STAGE IV Wilm's Tumor:
 Definition
Metastasized to other organs, liver, long bones, brain.
Term
STAGE FIVE Wilm's Tumor:
 Definition
Bilateral disease, each kidney must be staged differently.
Term
Most common treatment for GN?
 Definition
Plasmapheresis.
Term
Plasmapheresis:
 Definition
Remove plasma & antigen antibodies and replace the blood with added albumin.
Term
Kidney Stone TX:
 Definition
Strain urine, S/S treatment, Cystoscopy, Lithotripsy
Term
Types of Lithotripsy:
 Definition
Percutaneous Ultra Sonic, Electrohydraulic, Extracorporeal Shockwave (Poss. with Laser)
Term
General Renal Tx:
 Definition
Decrease Calcium, Protein, Phosphorus in diet.
Term
Rapidly Progressive GN:
 Definition
Associated c Acute Renal Failure, Secondary, Treat S/S
Term
Chronic GN:
 Definition
Reflects end stage glomerular inflammatory disease, ends up in renal failure.
Term
BUN Values:
 Definition
11-23
Term
Creatinine Values:
 Definition
0.6-1.5
Term
K+ Values:
 Definition
3.5-5.5
Term
Na+ Values:
 Definition
135-145
Term
Phosphorus Values:
 Definition
2.4-4.4
Term
Albumin:
 Definition
3.5-5.5
Term
Equinovarus:
 Definition
Inversion c plantar flexion
Term
Equinus:
 Definition
Plantar Flexion
Term
Calcaneus:
 Definition
Dorsiflexion
Term
Varus:
 Definition
Inversion
Term
Valgus:
 Definition
Eversion
Term
Bone Formation Phase I:
 Definition
Stimulus activates bone precursors and osteoclast activity.
Term
Bone Formation Phase II:
 Definition
Osteoclasts form cutting cone that reabsorbs bone. Leaves resabsorption cavity.
Term
Bone Formation Phase III:
 Definition
Osteoblast layers new bone in reabsoption cavity until filled in around blood vessel.
Term
Bone Formation takes...
 Definition
Four Months
Term
Nonunion:
 Definition
Bone fragments too far apart to heal.
Term
Delayed Union:
 Definition
Longer healing process.
Term
Pseudoarthrosis:
 Definition
A false joint, the bone does not heal properly and will not join without intervention.
Term
Pathological Fracture:
 Definition
Fracture due to normal forces being applied. Could be osteoporosis, bone tumor, or infection.
Term
5 P's of Fracture:
 Definition
Pain, Parathesis, no Pulse, Paralysis, Pallor
Term
Compartment Syndrome:
 Definition
buildup of pressure in a compartment because of a lack of circulation
Term
How to test for Gower's Sign:
 Definition
Start on all fours and have them walk up to standing.
Term
Positive Gower's Sign:
 Definition
Enlarged calves and winged scapulae.
Term
Bone Tumors:
 Definition
Primary: benign or malignant, secondary is result of metastasis.
Term
Preluxation:
 Definition
No hip dislocation
Term
Subluxation:
 Definition
Partial dislocation. Most Common.
Term
Dislocation:
 Definition
Complete Dislocation.
Term
Ortolani's Maneuver
 Definition
Flex the hips and knees at right angles and touch the knees to the table. If a click happens, it's positive for dysplasia.
Term
Duchenne's risk factors:
 Definition
Sex linked recessive, male, delay in walking, diagnosed 2-3 years.
Term
Duchenne's manifestations:
 Definition
Symmetrical wasting/weakness, clumsy gait, toe-walking, difficulty climbing stairs, hypertrophy (false and true) spine disorder, muscle shortening, resp infection/failure
Term
First stage of bone HEALING:
 Definition
Hematoma at fracture site. 24 hours.
Term
Second Stage of Bone HEALING:
 Definition
Cellular Proliferation/Granulation. Cells and capillary buds invade matrix. Capillaries and tissues replace hematoma. Debris removed, spaces filled.
Term
Stage III Bone HEALING:
 Definition
Callus Formation. Collagen/other tissues invade granulated area to form trabecular bridge. Callus is extra bone that gets absorbed and shrinks. Temporary splint.
Term
Stage IV Bone HEALING
 Definition
Ossification. Calcium salts are deposited and layered into the trabeculae to convert callus into true bone. 3-10 weeks.
Term
Stage V Bone HEALING
 Definition
Remodeling. Bone is broken down and relayed repeatedly until callus and excess bone is chiseled, sculpted and smoothed.
Term
OsteoCLASTS...
 Definition
break it down.
Term
OsteoBLASTS
 Definition
rebuild it.
Term
Bone Healing Time frames:
 Definition
1 day, 6-10, 14-21 days, 3-10 weeks
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