Term
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Definition
| 3 loose or liquid stools per day. |
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Term
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Definition
| inflammatory condition affecting the colon and results in bloody diarrhea and abdominal cramping. |
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Term
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Definition
an inflammation of the stomach and intestinal tract associated with abdominal cramps, diarrhea, vomiting, and fever. Spec gravity will be high (dehydration).
Causes: Infectious agent (F->O route), antibiotic therapy, laxatives, fructose (apple juice) |
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Term
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Definition
specific gravity will be high.
Treatment: correct fluid and electrolyte imbalances, antibiotics
Keep NPO->Oral rehydration->Normal diet |
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Term
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Definition
Can lead to hypovolemic shock
Treatment: Restore fluid and electrolyte imbalances, IV bolus 20mg/kg NS or LR (isotonic). Never bolus K!!
Nursing: Monitor IV fluids, Assess I&O, Assess hydration |
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Term
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Definition
| caused by excessive fruit juice intake |
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Term
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Definition
| a feeling of discomfort in the epigastrum with a conscious desire to vomit |
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Term
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Definition
| the forceful ejection of partially digested food/secretions. Causes: obstruction (fecal odor and bile or partially digested food) Risk for: dehydration: loss of H2O & electrolytes, aspiration, metabolic alkalosis (loss of stomach acid) Position on side and semi-fowlers to reduce aspiration Treatment: NPO, NG, IV fluids (NS or LR bolus), electrolytes, Reglan, Zofran Start with clear liquid with electrolytes |
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Term
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Definition
Erosion of the GI mucosa resulting from the digestive action of HCL acid and pepsin.
Gastric-any portion of the stomach
• Duodenal-80% of PUD
• Stress-related
Causes: NSAIDs, alcohol, H.Pylori (urea breath test), reflux, COPD
X-ray ineffective in differentiating an ulcer from a malignant tumor. Endoscopy best way to see ulcer.
Treatment: antacids, PPIs, H2 blockers, Carafate
Avoid: Hot, spicy foods and pepper, alcohol, carbonated beverages, tea, coffee, broth, caffeine, high fiber |
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Term
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Definition
• Pain high in epigastric area 1-2 hrs after meals
• Food aggrevates pain |
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Term
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Definition
• mid epigastric & back pain 2-5 hrs after meals
Food alleviates pain |
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Term
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Definition
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Term
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Definition
Lethal complication of ulcer
Spillage of their gastric or duodenal contents into peritoneal cavity
Signs: sudden, severe upper abdominal pain-->shoulder pain, rigid and board-like with shallow, fast respirations, BOS absent, N/V |
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Term
| Gastric Outlet Obstruction |
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Definition
vomiting with offensive odor, visible peristaltic waves
NG, NPO, rest, IV fluid/lyte imbalances, pain relief |
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Term
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Definition
| vital sign changes, decreased abdominal pain (neutralizes) |
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Term
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Definition
| A protrusion of a portion of an organ or organs through an abdominal opening. |
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Term
| Congenital Diaphragmatic Hernia |
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Definition
CDH results when the diaphragm does not form completely, resulting in an opening between the thorax and the abdominal cavity.
• Compresses the lungs, don’t develop correctly
Treatment: immediate surgical repair, do not BVM patient (more compression of lungs) |
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Term
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Definition
| Infant's fusion of the umbilical ring is incomplete Spontaneously resolve 3-5 years |
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Term
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Definition
where spermatic cord or round ligament emerge
Common in men (turn and cough) |
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Term
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Definition
Common in women
Protrusion through the femoral ring into the femoral canal (below inguinal) |
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Term
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Definition
Melena (black tarry stools)- slow bleed
Mallory-Weiss tear= torn varices from wretching
Caused by peptic ulcers, cirrhosis->varices,
Treat: Lavage prior to endoscopy to have a clear view. NG.
epinephrine->edema->pressure to site.
Vasopressin->vasoconstricts
H2blockers and PPI's to reduce acid secretion
Nursing: Accurate I&O record, at least 0.5ml/kg/hr for adequate renal perfusion or 50mL/hr
2 IVs (fluid and blood), whole blood, packed RBCs and fresh frozen plasma, foley |
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Term
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Definition
| Blockage of lumen by feces. Signs: RLQ pain (McBurneys point), rebound tenderness, Rovsing's sign (palpate LLQ->pain in RLQ), increased WBC. Diagnose w/ Spiral CT (best) or US Nursing: Pain meds, ice pack (NO HEAT->rupture), NO LAXATIVE OR ENEMAS->increased peristalsis->perforation, NPO b4 surgery |
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Term
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Definition
| 3 types 1) restrictive: stomach size is decreased 2) malabsorptive (length of small intestine is decreased 3) combinations Nursing: Airway (no neck, difficult intubation), Pulmonary compression due to size, support wound with splinting->wound dehiscence->fat doesn't heal well. Don't irrigate NG, skin breakdown, early ambulation, HOB 53-40 degrees reduces abdominal pressure and increases tidal flow |
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Term
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Definition
| reflux of gastric contents into the lower esophagus causes mucosal damage Complications: aspiration->pneumonia, esophagitis->Barrett's esophagus->esophageal cancer Signs: Adults: heartburn (pyrosis), indigestion (dyspepsia), hiccups, vomiting and regurgitation Toddlers: congestion, asthma, hoarseness All should be considered for GERD! Infants:Colic, spitting up, feeding difficulties. Treatment: HOB up when sleeping and after meals, antacids, OTC H2 blockers->prescription H2 blockers->PPIs Surgery: Nissen Fundoplication: (wrapping and suturing of the gastric fundus around the esophagus to reinforce the LES and anchor it below the diaphragm) so stomach contents can't come up into the esophagus Nursing: Infants:HOB 60 degrees 30 min after feeding. Don't put babies on tummy, burp often Adults:HOB up, left side, less fluids with meals, no HS eating, |
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Term
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Definition
| is absence of a normal opening at any place leading to an obstruction. |
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Term
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Definition
| failure of the palatine plates to fuse. Common in twins & Native Americans LT consequences- speech, dental, appearance, recurrent OM, hearing impairment-->cognitive/motor delays Surgery: Palatoplasty @ 10-15 months so pallet grows and maximize speech. Nursing: feeding difficult-->leaks out nose, special nipples |
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Term
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Definition
Surgery- Cheiloplasty at 10 weeks & 10 pounds. Supine or side lying with elbow restraints post op. Scar massage 2 weeks
breastfeeding encouraged |
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Term
| Esophageal Atresia & Tracheoesophageal Fistual |
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Definition
| Rare malformations that represent a failure of the esophagus to develop as a continuous passage & failure of the trachea & esophagus to separate Esophagus ends, not connected to trachea=drooling Esophagus ends, trachea goes into stomach- distended abdomen Both of the above- risk for aspiration pneumonia Signs: frothy saliva, drooling, sudden cough and gag, when fed->fluid out the nose Diagnosis- unable to pass NG, Polyhydramnios (>2000cc) Nursing: Maintain patent airway. Suction frequently Prevent pneumonia. Upright position, antibiotics NPO, NG to low suction, IV fluids, HOB, antibiotics. Post op: oral feedings begin w/sterile water |
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Term
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Definition
a compete obstruction that needs immediate repair
Absence of rectal opening, flat perineum, meconium.
Abdominal distention, meconium in urine, vomiting.
Nursing: NPO, IV fluids, stool softeners, |
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Term
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Definition
have an anal opening which appears normal. There is a midline groove and usually no fistula
Signs: ribbon-like stools, distended abdomen |
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Term
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Definition
| no obvious opening→gets a fistula |
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Term
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Definition
| complex, when the rectum, vagina & urethra drain into a common opening |
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Term
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Definition
Abdominal contents herniate through the umbilical ring with intact peritoneal sac
Other anomalies…cardiac, neuro, skeletal, trisomies 13, 18,21
Surgery: 7-10 days up to 1 year. Use silo first.
Nursing: loosely covered saline soaked pads and plastic drape. Keep moist and free from infection |
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Term
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Definition
Herniation of intestine is lateral to the umbilical ring with no sac. No concurrent anomalies.
Surgery: w/in 24 hrs (unstable temp, infection), silo used if too big.
Nursing: loosely covered saline soaked pads and plastic drape. Keep moist and free from infection, IV fluids x3 (no sac), right lateral decubitus position |
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Term
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Definition
o Pyloric Stenosis
o Intussesception
o Malrotation/Volvulus |
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Term
| Hypertrophic Pyloric Stenosis |
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Definition
| Pyloric sphincter becomes thickened resulting in elongation and narrowing of the pyloric canal→ outlet obstruction -> hypertrophy of the pyloric muscle & hyper peristalsis Common in first born boys Signs: projectile brown-tinged vomiting, hunger, olive shaped mass in RUQ, visible peristalsis, dehydration & weight (check sunken fontanelles), metabolic alkalosis (loss of gastric acid), FTT Labs: Decreased: Cl, NA, K Increased: pH, HCO3, Spec Grav, BUN |
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Term
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Definition
proximal segment of the bowel telescopes into a more distal segment
Males, cystic fibrosis.
Signs: PAIN, CURRANT JELLYLIKE STOOLS, PALPABLE SAUSAGE-SHAPED MASS, knees to chest, bilous vomiting |
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Term
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Definition
Abnormal rotation of the intestine around the superior mesenteric artery
Volvulus- completely twists around itself → necrosis→perforation→death
Signs: Intermittent bilious vomiting, distention, pain.
Upper GI for diagnosis, surgery needed |
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Term
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Definition
Inflammation and obstruction of bile ducts->hepatic bile duct fibrosis.
linked to CMV, EB, Girls
Signs: jaundice after 2 weeks, dark urine, pale and clay-like stools (no bile)
Treatment: Kasai procedure->liver transplant, vitamins, tube or parental nutrition. |
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Term
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Definition
Congenital Aganglionic Megacolon
Congenital anomaly that results in mechanical obstruction from inadequate motility of part of the intestine
Males, Down
Signs: failure to pass meconium, bilious vomiting, abdominal distention, visible peristalsis, ribbon-like, foul smelling stools with chronic constipation
Need surgery- removal of aganglionic portion
Nursing: prevent abdominal distention, I&O, measure abdominal circumference, s/s perforation |
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Term
| Inflammatory Bowel Disease |
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Definition
Crohn's & Ulcerative colitis.
Characterized by periods of remission and exacerbation.
Autoimmune disease, chronic inflammation, no cure
Treatment: REST bowel (NPO), control inflammation, correct malnutrition, perineal skin care, AMINOSALICYLATES: maintenance of remission, low fiber and fat, high calorie and protein
Goal: decrease # & severity of exacerbations, fluid/lyte balance, pain relief, improve quality of life
Corticosteriods: for flare-ups to ACHIEVE remission
Immunosuppressive drugs: MAINTAIN remission |
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Term
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Definition
| Affects colon and rectum. Bloody diarrhea. Aminosalicylates & steroids. |
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Term
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Definition
| Affects any part of GI tract. All layers, cobblestone. Fistulas. All drugs used |
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Term
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Definition
| Autoimmune disease. Damage to small intestine mucosa from ingestion of gluten. Signs: villous atrophy, bulky, greasy, frothy, malodorous stools Celiac crisis- severe watery diarrhea, malnutrition |
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Term
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Definition
| 3 or more days without passage of stool. Causes: low fiber, activity, fluid intake, & narcotics, ignoring urge to defecate Treatment: stool softeners, laxatives, dietary changes |
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Term
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Definition
intermittent and recurrent abdominal pain and stool pattern irregularities over a 3 month period.
Women x2, seasonal or cyclic patterns
Nursing: support & education, high fiber. |
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Term
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Definition
| a saccular dilation or outpouching of the mucosa through the circular smooth muscle of the intestinal wall. |
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Term
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Definition
infection of the diverticular sacs, most common cause of lower GI bleeding
Left sided: sigmoid, descending, Western, old, low fiber
Right sided: ascending, Asian, young
Typically asymptomatic
Treatment: Rest Colon (NPO), high fiber, low fat and red meat
Acute diverticulitis: no BE or colonoscopy->perforation/peritonitis |
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Term
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Definition
| multiple inflamed diverticula |
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Term
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Definition
| Inflammation of the liver Causes: acute viral hepatitis, drugs (tylenol), alcohol, virus hepatic cell necrosis->slows bile drainage->cholestasis Acute phase: 1-4 months incubation, malaise, fatigue, RUQ pain, rash, angioedema, jaundice, dark urine, light colored stools, pruritis (accumulation of bile salts) Convalescent phase: 2-4 months, jaundice disappears, malaise Labs: ALT, AST increased with jaundice, bilirubin increased, PTT increased. No specific treatment. Adequate nutrition (high carb & protein), no alcohol |
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Term
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Definition
| RNA, F->O, transmission occurs before symptoms, not chronic. Vaccine available. |
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Term
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Definition
DNA, percutaneous & fluids & mom->baby, liver failure & cirrhosis. Vaccine available.
Treatment: prevent cirrhosis with alpha interferon |
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Term
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Definition
RNA, percutaneously & fluid, healthcare workers, blood transfusions
Treatment: alpha interferon & Ribaviron |
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Term
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Definition
| "Delta virus", RNA, needs HepB, percutaneously, no vaccine |
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Term
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Definition
| RNA, F->O, contaminated water |
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Term
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Definition
| RNA, transfusion & sex, no damage by itself |
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Term
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Definition
chronic progressive disease of the liver characterized by extensive degeneration and destruction of the liver parenchymal cells
1. Alcoholic (Laennec's or nutritional)
2. Post necrotic- viral, toxic, or idiopathic hep
3. Biliary- obstruction, UC
4. Cardiac-RHF
Early Signs: insidious onset, GI disturbances, dark brown urine, gray stools, weight loss, lethargy
Late Signs: Jaundice, pruritis, edema, ascites, skin lesions (estrogen), spider angiomas, palmar erythema,
Labs: AST, ALT, bilirubin, ammonia increased, PTT prolonged, albumin decreased
Nursing: daily weights, measure abdominal girth, high calorie & carb diet |
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Term
| Peripheral edema & ascites |
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Definition
decreased albumin->reduced colloid oncotic pressure->fluid shift
Nursing: High carb, low Na diet, diuretics, paracentesis, watch for hypovolemia, position in high Fowler's or side of bed, lyte balance, accurate I&O, weights, measure girth |
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Term
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Definition
| compression of the hepatic veins→ obstruction of normal blood flow |
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Term
| Esophageal/Gastric varices: |
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Definition
Complex of twisted veins at lower end of esophagus->rupture. Most life-threatening
Nursing: goal to avoid bleeding, constipation, manage airway (turn to side, HOB up, suction), IV therapy, blood, fresh frozen plasma, antibiotics, Vasopressin to control bleeding
Treatment: Balloon tamponade- compresses varices with Sengstaken-Blakemore tube- applies pressure to cardiac portion of stomach and esophageal varices
Nursing for Balloon tamponade: check for potency, verify by X-ray, deflate q8-12 hr, saline lavage & suction, watch for aspiration pneumonia, scissors at bedside |
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Term
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Definition
| due to dilation of mesenteric veins and rectal veins. |
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Term
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Definition
| ring of varices around umbilicus |
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Term
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Definition
| Continuous reinfusion of ascitic fluid from the abdomen to the vena cava |
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Term
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Definition
Liver not able to convert ammonia to urea->increased ammonia levels->neurologic toxic manifestations. Stages 0-4
Signs: confused, combative, lethargy, coma, asterixis (flapping tremors), fector hepaticus (musty, sweet breath)
Treatment: Lactulose traps ammonia and expels in bowel- monitor ammonia levels b4 & after, Neomycin decreases ammonia, transplant
Nursing: asses LOC, responsiveness, fluid/lyte imbalances, acid-base balance, ammonia levels. |
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Term
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Definition
functional renal & liver failure
Signs: azotemia, oliguria
Nursing: fluid/lyte balance, I&O |
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Term
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Definition
inflammation of the gallbladder caused by obstruction by gallstones or sludge.
Treatment: Laparoscopic cholecystectomy (injury to common bile duct may occur), analgesics, anticholinergics, fat soluble vitamins, Questran (binds to bile salts for excretion), low fat diet, no dairy
Nursing: Surgical site is high→impairs deep breathing and coughing→ need to prevent respiratory complication→turn, cough, and deep breath. |
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Term
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Definition
| inflammation of the gallbladder without obstruction. Occurs with prolonged immobility, fasting, prolonged TPN and DM |
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Term
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Definition
stones (made of cholesterol) in the gallbladder or biliary tract. Unknown cause.
Treatment: ERCP to retrieve stone, Lithotripsy breaks up stones, |
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Term
| Cholecystitis/Cholelithiasis |
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Definition
Signs: Indigestion, N/V, Pain in RUQ->radiate to back & shoulder 3-6 hrs after a high fat meal or upon laying down, abdominal rigidity
Diagnosis: US, WBC elevated
Nursing: pain meds, NPO, NG, IV, fluid/lyte |
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Term
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Definition
acute inflammation of pancreas causing auto digestion of the pancreas. Caused by alcoholism, trauma, etc. A.A. x3
Signs: Pain in LUQ->back, sudden onset, eating makes it worse, elevated WBC, low grade fever, vomiting. Grey Turner's sign- ecchymosis of flanks. Cullen's sign- peri-umbilical discoloration
Labs: elevated serum amylase, lipase, hypocalcemia (tetany), hyperglycemia. Diagnosis with US, CT is best
Nursing: pain meds (morphine), antacids, H2blockers, PPIs, NPO (decreases pancreas stimulation), TPN, monitor respiratory status-> high carb & protein, low fat |
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Term
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Definition
fibrotic replacement of pancreatic tissue caused by ETOH, gallstone, tumor. Two types:obstructive and calcifying.
Signs: abdominal pain not relieved with food or antacids, weight loss, and constipation.
Nursing: prevention of attacks, relief of pain, pancreatic enzymes with meals, control of diabetes |
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Term
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Definition
| (large fluid containing cavity WITHIN PANCREAS from excessive necrosis), upper abdominal pain, mass, high fever, leukocytosis, requires prompt SURGICAL INTERVENTION. |
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Term
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Definition
| (cavity continuous with or surrounding the OUTSIDE OF THE PANCREAS filled with necrotic products & liquid)…abdominal pain, palpable epigastric mass, N/V, anorexia, serum amylase is elevated, usually RESOLVE SPONTANEOUSLY, may perforate → leads to peritonitis. |
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