NUR 2063 Final Exam Study Guide Essentials of Pathophysiology - Rasmussen (Updated 2023) All Q&As
Gastritis and Etiology and pathophysiology
- Inflammation of stomach's mucosal lining (can involve entire
stomach or region) can be acute or chronic.may be caused by h. pylori infection (imbeds in mucosal layer activating toxins and enzymes that cause inflammation. NSAIDS, chronic alcohol consumption, stress, trauma, burns, or infections, autoimmune conditions
Manifestations of gastritis
- Indigestion, heartburn, epigastric pain, abdominal cramping,
nausea, vomiting, anorexia, fever, malaise.hematemesis and dark, tarry stools indicate ulceration and bleeding.chronic gastritis increases risk for peptic ulcers, gastric cancer, anemia, and hemorrhage.
Gastritis diagnosis/treatment
- H&P, GI tract x ray, egd, serum h. pylori antibodies, h. pylori breath
test, stool analysis (h. pylori and occult blood treatment-acute is self-limiting usually resolves meds-antacids, acid-reducing agents, and mucosal barrier agents other strategies include those for GERD (diet, small meals, antacids)
Peptic ulcer disease (PUD)
- Refers to erosive lesions affecting the muscularis mucosa of the
stomach or duodenum. ulcers vary in size and severity, ranging from superficial erosions to complete penetration through GI tract wall 1 / 4
Peptic ulcer disease etiology and patho
- ETIOLOGY: most commonly H. pylori and NSAID use.
PATHO: develops because of an imbalance between destructive
forces and protective mechanisms
PUD duodenal ulcers
- Most commonly associated with excessive acid or H. pylori
infections typically present with epigastric pain relieved in the presence of food
PUD gastric ulcers
- Less frequent-more deadly
typically associated with malignancy and NSAIDS pain worsens with eating
PUD Stress ulcers
- Develop because of major physiological stressor on body due to local
tissue ischemia, tissue acidosis, bile salts entering stomach, and decreased GI motility most frequently develop in stomach; multiple ulcers can form within hours of the precipitating event often hemorrhage is the first indication (vomiting blood or blood in stool)
PUD manifestations/treatment
- Epigastric, abd. pain, abd. cramping, heartburn, indigestion, chest
pain, nausea/vomiting, melena (dark, tarry stools), fatigue, unexplained weight loss Treatment: same as gastritis: antacids, mucosal barrier agents, acid- reducing agents possible surgical repair 2 / 4
Iron-deficiency Anemia
- Not enough iron for hemoglobin production
Erythrocytes pale and small
ETIOLOGY: decreased iron consumption/absorption, increased
bleeding
MANIFESTATIONS in addition to "anemia": brittle nails,
headache/irritability, pica, cyanosis of sclera of eyes, delayed healing
Anemia
- Common acquired or inherited disorder of erythrocytes that impairs
the bloods oxygen-carrying capacity.
ETIOLOGY: decrease in # of circulating erythrocytes, reduction in
hemoglobin content, presence of abnormal hemoglobin
MANIFESTATIONS : weakness, fatigue, pallor, syncope, dyspnea,
tachycardia
Pernicious anemia
- B12 deficiency or megaloblastic anemia
large, immature erythrocytes.Usually lack of intrinsic factor (protein necessary for b12 absorption in stomach) b12 is needed for cell division and maturity.too little b12 gradually causes neuro problems because of the breakdown in myelin, neuro effects may be seen before anemia is diagnosed.
Additional manifestations: bleeding gums, diarrhea, impaired smell,
DTR loss, anorexia, personality/memory changes, + Babinski sign, stomatitis, paresthesia of hands and feet, unsteady gait
Aplastic anemia
- Bone marrow fails to make enough blood cells leading to
pancytopenia
MANIFESTATIONS : general anemia, leukocytopenia, and recurrent
infections can be caused by cancers, cancer treatment, pesticides 3 / 4
Sickle cell anemia
- Genetic, hemoglobin-s trait vs. gene
crescent shape during times of hypoxia, can clump together and clog vessels.
MANIFESTATIONS : swelling in hands and feet, sickle cell crisis, abd.
pain, bone pain, jaundice, skin ulcers, stroke, chest pain tissue ischemia and necrosis.electrophoresis and stem cell transplant may cure
Thalassemia
- Genetic, not RBC problem, hemoglobin problem. lack one or 2
proteins that make up hemoglobin
MANIFESTATIONS : heart failure, splenomegaly, hepatomegaly, bone
deformities, jaundice, fatigue, dyspnea
Idiopathic thrombocytopenia purpura (ITP)
- Hypo-coagulopathy due to immune system destroying its own
platelets (autoantibodies) Circulating IgG reacts with the platelets which are then destroyed in the spleen and liver.can be acute or chronic
ETIOLOGY: idiopathic, autoimmune disease, live vaccines,
immunodeficiency disorders, viral infections
Manifestations: abnormal bleeding (petechiae, epistaxis [nose bleed],
hematuria)
ACUTE TREATMENT : glucocorticoid steroids, immunoglobulins,
plasmapheresis and platelet pheresis
CHRONIC TREATMENT : splenectomy, blood transfusions,
immunosuppressants
Thrombotic thrombocytopenia purpura
- Coagulation disorder d/t deficiency of enzyme responsible for
cleaving von Willebrand factor Increased clotting which decreases available platelets --> bleeding under skin and purple-colored spots called "purpura"
MANIFESTATIONS: thrombi>thrombocytopenia>bleeding
purpura, LOC changes, confusion, fatigue, fever
- / 4