exam 3 - GI disorders
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exam 3 - GI disorders
acute inflammation of the veriform appendix (the blind pouch attached to the cecum of the colon)
what is the initial manifestation of appendicitis
abd pain in epigastric or periumbilical area
is mcburney's point an early or late sign of appendicitis?
what are s/s of perforation
increase pain with coughing
relief of pain w/ fetal position
*no perforation wbc 10-18000
other s/s of appendicitis
where is mcburney's point located?
causes of appendicitis
obstruction of opening of appendix by fecaliths,
pathophysiology of appendicitis
infection (as bacterial invades pancreas walls)>
increased internal pressure>
decreased blood flow>
appendicitis w/ perforation has increased risk for what?
no laxatives or enemas
why would someone suspected of having an appendicitis be put in a semi-fowler's position
prevent infected fluids from going up
keep abd fluid localized
what is done to rule out appendicitis
surgical management of appendicitis
post op care of appendectomy
this is a life-threataening acute inflammation of visceral/parietal peritoneum and endothelial lining of abd cavity or peritoneum
*contaminated by bacteria > walling off (a localized area)> inflamm reaction
if walling off fails what happens???
massive inflammation and contamination
what are some causes of peritonitis
leakage/contamination during surgery
infected CAPD catheter
perforation (appendicitis, diverticulitis, peptic ulcer disease)
external penetrating wound
gangrenous gall bladder
why might diffuse peritonitis occur?
if theres a delay in diagnosis or treatment
what can DIFFUSE PERISTALSIS do to the peristalsis
slows or stops it
*potential for septicemia
DIFFUSE PERITONITIS may increase abd presure and distention. this increases the risk for what??
risk for resp problems
*bigger and bigger stomach pushes diaphragm up decreasing deep breathing
what can third spacing into the peritoneal cavity result in?
loss of circulatory volume
*increase risk for hypovolemic shock and kidney failure
how does third spacing happen in peritonitis?
infection continues therefore shunting extra blood to that area continues
fluid shifts from the extracellular fluid compartment into the peritoneal cavity, connective tissue, and GI tract
cardinal signs of of peritonitis
***start thinking peritonitis
other manifestations of peritonitis
rigid, boardlike abd
low urine ouput
compromised resp status
dx of peritonitis
xray - dilation, edema, and inflammation of small and large intestine
nonsurgical management of peritonitis
broad spectrum ABX
daily wt monitored
fluid volume assessed
ng suction - rid of fluid
*avoid resp issues by decompression of stomach
surgical management of peritonitis
post op care
semi fowlers position
care of incisions and drains
IV fluid replacement
inflammation of the gastrointestinal tract
increase int he frequency and water content of stools or vomiting results form this condition
gastroenteritis - inflamm of mucous membranes of stomachand intestinal track
which part of the GI tract does gastroenteritis mainly affect
the gastroenteritis the same as food poisoning?
*differens from food poisoning with regard to transmission in the body, incubation time, and effect on immunity
*2 forms of travellers diarrhea
gastroenteritis occurs in epidemic outbreaks where?
*most common cause of morbidity and morality
manifestations of GASTROENTERITIS
foul smelling stool
*depends on causative organism; varies based on incubation time, trasmission, effects
what's important to know about gastroenteritis
it's self limiting unless complications occur
nursing interventions for gastroenteritis
anticholinergics and antiemetics are not routinely given
abx if bacterial
dysenteries affect the ____ bowel while gastroenteritis affects the ____ bowel
name the 3 round worms
1. enterobiasis "pinworms"
3. hook worms
pinworms are aka
how is enterobiasis transmitted
oral intake contaminated food or drink
name some manifestation of pinworms or "enterobiasis"
perianal itching esp at night
vague GI sx
: abd pain, nvd
how is the enterobiasis dx
eggs from perianal
how is enterobiasis treated??
what is the most common helminthic infection in the US
the incidence of this type of roundworm infection is low in the US, but many mild or asymp cases go undx
Trichinosis is caused by what?
intestine of humans, pigs, bears, rats
how is trichinosis transmitted?
eating undercooked pork or pork products
manifestations of trichinosis
*wk 1, 2, 3, recovery
first week parasite invades gut:
second week larvae invade muscle:
hypersensitivity rxn w/ fever
edema of face, around eyes
2-3 weeks after infection:
muscle wkness - low back pain neck, jaw , biceps
recovery can last several months:
fague muscle pain
how is a trichimosis infection dx?
wbc - elevated 2 wks after meat consumption
muscle biopsy - shows larvae
*worms are rarely seen in feces
what meds are used to treat trichomosis
high dose corticosteroids
what's different about hook worms in terms of how they enter the body?
they enter thru the SKIN
*infection occurs when larvae penetrate thru the skin
how long are hook worms infective outside the body?
1 wek in moist soil
how does the hook worm make its way around the body?
travels to lungs (alveoli) thru bloodstream
how does the hook worm make its way to the GI tract
when they enter the alveoli > cilia carry the organism up the resp treat > pharynx > mouth > swallowed > enters GI tract
what are early sx of hook worm disease
itchy, red, reaised, blister-like infalmmation of skin
infection of hookworm in the GI tract manifestations
mild abd pain
bleeding - when worms suck blood at sites in GI tract
anemia - if blood loss is severe
this infection infects quarter of the world's population mainly in the tropics
how is hookworm infection dx
eggs in feces
occult blood in stool
what's the difference in dx between trichinosis and hookworms?
trichinosis - larvae in muscle not feces
hookworms - eggs in feces
how to treat a hookworm infection
iron therapy for anemia
high protein diet
how bad are tapeworm infections
nd, abd pain
how is tapeworm infection dx
laboratory examination of eggs found in stool
what can cause a tapeworm infection
consumption of undercooked:
contaminated food or water
accidental swallow of infecgted lice or fleas from dogs or COCKROACH
how is tapeworm infection treated
how to prevent tapeworm infection