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53 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Risk behaviors for gastrointestinal disease
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Especially smoking and alcohol. In addition ingestion of caustic agents, low-fiber diet, ingestion of certain medications ie NSAIDS and anticoagulants, and of course stress.
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Definition of Peristalsis
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Rhythmic contractions of the esophagus which push food along.
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31.6
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Functions of the cardiac sphincter
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Controls the amount of food that moves back up the esophagus.
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Side effects of ETOH & fatty food consumption
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Drinking alcohol with a fatty meal will delay gastric emptying, as the stomach works to digest the difficult fat.
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31.6
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Organs that empty into the duodenum
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The pancreas, liver, gallbladder, and of course the stomach.
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31.6
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Where glycogen is converted into glucose
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The liver
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Functions of the Liver
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Creates bile store in the gallbladder use to break down fat. Carbohydrates metabolism, providing the brain with glucose its necessary food source. In addition the liver detoxifies drugs, completes the breakdown of dead blood cells, stores vitamins and minerals.
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31.7
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Where most digestive processes occur
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The small intestine where ~90% absorbs
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Side effect of water not reabsorbed in the colon
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soft stool, diarrhea
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31.7-8
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What pain over the suprapubic region can suggest
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A bladder injury
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Physiologic causes of hypotension in dehydration
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If a person becomes hypotensive during a dehydration episode, it means that they are no longer able to pull fluid from the interstitial space and cellular area.
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S&S of foodborne illness
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Stomach aches, N/V/D
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Causes of peritonitis
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Inflammation of the lining of the abdominal wall.
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Early signs of hepatitis
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Joint aches, weakness, fatigue, n/v, anorexia, urticaria, and pruritus.
Later signs acholic stools-light, clay colored stools caused by liver failure. darken urine, jaudice, icteric sclera (yellow sclera), and abd pain to right upper quad. |
31.21
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Causes of esophageal varices
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When the amount of pressure within the blood vessels surrounding the esophagus increase, depositting the blood into the portal system. Thus the portal vessels back up, dilating the vessels and causing the capillary network of esophagus to begin leaking. The vessel walls may fail, causing bleeding.
Alcohol is the main cause of portal hypertension. |
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Medication causes of peptic ulcer disease
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Erosion of the protective lining of the stomach and duodenum. Often cause by infection, however a major cause is the chronic use of NSAIDs.
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S&S of choleocyctitis
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Obstruction of the cyst duct leading from the gallbladder to the duodenum, usually by gallstones.
Severe upper right quad pain, radiating to the right shoulder. Other common signs are Murphy's sign, N/V, fever, jaundice, and tachycardia. |
31.11-12
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Common causes of Crohn’s disease
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Autoimmune like disease of the GI system where the body attacks the GI system. To date, no definitive cause for Crohn disease has been identified. However, the presence of s/s outside the GI system supports the hypothesis that some autoimmune component is operating within the disease. Another hypothesis is that the immune system creates antibodies for an antigen that does not exist, initiating a cascade reaction to ghost invaders.
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31.13
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Hepatitis types and how they are individually spread
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Currently 7 types A through F
A and E move by fecal-oral route, ie countries where food and water are not cleaned well. Types B,C, and D are transmitter by person-to-person/blood-to-blood contact (sex and dirty needles). |
31.13
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Patient position presentation with abdominal pain
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A pt experiencing abdominal pain will often curl up into the fetal position to relieve the pressure of the abdomen.
Picture page 31.14. |
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Volume loss & Orthostatic Vital Signs
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When a patient has had a significant loss of fluid, when changing from POC to standing you should see an 10-beat increase in the heart rate and/or a 10 mmHg drop in BP.
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31.15
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Clinical significance of striae
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Indicates a change in the size of the the abdomen over a short period of time. Recent increases or decrease in weight, often from pregnancy, and severe abdominal edema.
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31.16
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Causes of protuberant abdomen
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When weight becomes extreme.
Pregnancy, organ enlargement, or fluid build up in the abdomen (ascites). |
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Pancreatitis presentation
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Pain tends to be localize to the epigastric area or upper right quadrant, often sharp and severe pain follow with N/V, fever, tachycardia, hypotensive, and muscle spasm. Can occur suddenly, or it may persist for many months.
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Characteristics of a positive Murphy’s sign
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A positive Murphy's sign suggest the presence of cholecystitis. If the pt has rt upper quad pain, have the pt breathe out. With the tips of your fingers palpate rt upper quad. Have pt take a deep breathe in, if they stop inspiring due to sharp increase in pain, positive Murphy's sign.
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31.18
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Characteristics of coffee ground emesis
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Hematemesis
Dark, granular material that is the color black or very dark red. The slurry of material may have food within it. The food and blood are indistinguishable. Blood form upper GI bleed including esophagus or stomach. |
31.19
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The name of the middle layer of the kidneys
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The medulla
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Main blood filter in the kidney
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glomerulus
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The primary structural component of the kidney
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Nephrons, which form urine, composed of the glomerulus (Bowman's) capsule, the proximal convoluted tubule (PCT), loop of Henle, and the distal covoluted tubule (DCT).
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32.21
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Definition of the glomerular filtration rate
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The rate at which blood is filtered through the glomerula.
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Kidney process that leads to urine
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Abdominal aorta--> Renal artery -->into the kidney through the hilus--> afferent arteriole --> into glomerulus where it filters out salts, minerals, glucose, water, and other metabolic waste --> Renale tubule --> Loop of Henle --> Distal covoluted tule --> Urethra --> bladder
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32.5
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Renin composition and where it is released from
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At the site where the efferent arteriole comes in contact with DCT, a structure called the juxtaglomerular apparatus is formed. It monitors BP releasing renin which initiates a cascade of reactions in the body by converting plasma protein angiotension into Angiotensin I. Other enzymes present in the body covert I into II.
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32.5
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Properties of Angiotensin II
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Potent vasoconstrictor
Promotes smooth muscle contraction in the arterioles throughout the body raising BP. Also increase reabsorption of sodium from the PCT, as water tends to follow sodium. |
32.5
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How Lasix causes diuresis
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Inhibits the sodium importers in the DCT and collecting ducts. Remember water tends to follow sodium.
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32.6
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Definition of the micturition reflex and what it causes
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A spinal reflex that causes contraction of the bladder's smooth muscles, producing the urge to void as pressure is exerted on the internal urinary sphincter.
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32.21
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Characteristics of the male vs. female urethra
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The female urethra is shorter than the male's, 4 cm vs 20 cm.
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32.6
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Characteristics of pyelonephritis
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Inflammation of the kidney lining, when lower UTI are left untreated, possibly leading to sepsis.
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Characteristics of kidney stone pain
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11/10 starts vague discomfort in flanks becoming very intense in 30 to 60 mins often causing agitation and restless as others must remain motionless, pain cause BP and pulse to increase.
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Treatment of the isolated renal calculus
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Supportive care including POC, and consider pain medications.
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Definition of acute renal failure
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A sudden (possibly over a period of days) decrease in filtration through the glomeruli.
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32.8
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Causes of chronic renal failure
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Progressive and irreversible inadequate kidney function due to permanent loss of nephrons, which develops over months to years. Use medical controls when giving medications.
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Skin conditions in the chronic renal failure patient
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Pale, cool, and moist, and may appear jaundice due to nitrogenous waste build up.
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32.9
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Uremic frost definition and where it occurs
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A powdery accumulation of uric acid, especially around the face, often present with chronic renal failure.
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32.9
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Components of peritoneal dialysis
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Large amounts of specially formulated dialysis fluid are infused into the abdominal and back out after in ~an hour or two, allowing equilibrium to occur. High risk of peritoutis, yet it is often performed at home.
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Hemodialysis
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Hemodialysis allows blood to circulate through a shut to a dialysis machine functioning much like a normal kidney.
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Where the AV fistula is located
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An arteriovenous [AV] fistula is an artificial connection between a vein and an artery that is usually located in the forearm or upper arm. Remember to use other arm for BP and IVs.
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32.9
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Chronic dialysis and treatment frequency
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Usually ever 2 to 3 days for 3 to 5 hours.
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32.10
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Definition of a pheochromocytoma
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Tumor of the adrenal gland, usually in the medulla, which causes excess release of epinephrine and norepinephrine. < 10% are malignent.
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High risk situations for bladder injury
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Blunt trauma and pelvis fx. A seat belt may cause contusions along the lower abd causing blunt trauma to the bladder. Often seen with drunk drivers who are likely to have a full bladder.
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Assessment goals in the genitourinary emergent patient
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To detect and prevent life threats and provide supportive care for the patient.
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Treatment consideration for the renal failure patient
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Use medical control when giving medications.
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Presentation elements to pyelonephritis
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Skin pale, cool, and moist to warm, and dry. V/S vary but palpation of abdomen will usually reveal tenderness over the pubis or pain in the flank, depending on the area of infection.
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Treatment considerations for the symptomatic dialysis patient
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Dialysis pt are very prone to hyperkalemia since they are unable to excrete ingested potassium. Often have profound muscular weakness, and on the ECG have peaked T waves and prolonged QRS, sometimes disappearance of P waves, may also show as complete heart block and asystole. Consider Sodium Bicarb and Calcium Chloride.
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32.10
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