NUR 339 Exam
- Dysphagia pathophysiology
Answer difficulty swallowing, due to strokes, esophageal strictures, or cancer
- Hiatal hernia pathophysiology
Answer opening in diaphragm where esophagus pass- es becomes enlarged and the stomach pushes up into lower thorax; type 1 sliding, stomach and esophagus slides in and out of thorax; type 2 paraoesophageal, all or part of stomach pushes up beside esophagus
- Hiatal hernia clinical manifestations
Answer can be asymptomatic; heartburn (pyro- sis), regurgitation, dysphagia, large hernia can lead to food intolerance, nausea, vomiting; hemorrhage or obstruction are more common with type 2
- Hiatal hernia diagnosis
Answer Xray, EGD, chest CT, barium swallow
- Hiatal hernia treatment
Answer small and frequent meals, sitting up after eating, head of bed up at night (surgery if severe)
- GERD pathophysiology
Answer there is a weak lower esophageal sphincter and in- creased intraabdominal pressure, causes reflux of stomach contents into esophagus which causes mucosal injury
- GERD risk factors
Answer high fat foods, caffeine, fluids, gastric distention, cigarette smoking, recumbent posture 1 / 4
- GERD clinical manifestations
Answer heartburn, regurgitation of gastric contents into esophagus; may also have indigestion, dysphagia, hypersalivation, esophagitis
- GERD diagnostics
Answer history and patient complaints, Xrays or scopes
- GERD treatment
Answer medications like antacids or antihistamines; avoid large meals, sit up and avoid bending after meals, weight reduction, avoid aggravating foods, sleep with head elevated
- Barrett's Esophagus pathophysiology
Answer lining of esophageal mucosa is al- tered
- Barrett's esophagus risk factors
Answer GERD, smoking, obesity
- Barrett's esophagus clinical manifestations
Answer GERD, frequent heartburn
- Barrett's esophagus diagnosis
Answer EGD shows cell changes
- Barrett's esophagus treatment
Answer monitor, ablation 2 / 4
- Acute gastritis pathophysiology
Answer inflammation of gastric mucosa; usually due to a local irritant, like ASA, NSAIDs, alcohol, corticosteroids, viral/bacterial toxins
- Acute gastritis clinical manifestations
Answer heartburn, stomach upset, vomiting, GI bleeding with hematemesis
- Acute gastritis treatments
Answer self limiting with complete recovery within several days
- Chronic gastritis pathophysiology
Answer chronic inflammatory changes and atro- phy of epithelium; common cause is H. Pylori, which disrupts gastric mucosa and causes inflammatory response
- Chronic gastritis clinical manifestations
Answer fatigue, heartburn after eating, belching, sour taste in mouth, halitosis, early satiety, anorexia, nausea, vomiting; risk for pernicious anemia due to loss of intrinsic factor produced in stomach cells
- Chronic gastritis diagnostics
Answer endoscope with biopsy, CBC
- Chronic gastritis treatments
Answer lifestyle modifications, eradication of microor- ganisms; meds include H pylori antibiotics, proton pump inhibitors or H2 receptor agonist, and bismuth preparation (Pepto-Bismol, kaopectate) 3 / 4
Answer
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- Peptic Ulcer Disease pathophysiology
Answer mucosa exposed to gastric acid and pepsin causes ulceration (most common in duodenum)
- Peptic ulcer disease causes and risk factors
- pylori infection is most common cause, NSAID/aspirin ingestion; other factors are family
Answer
history, blood group O, comorbidities like COPD, liver or kidney disease, smoking, corticosteroids, warfarin, caffeine intake
- Peptic ulcer disease clinical manifestations
Answer burning, gnawing, cramp-like pain; timing of pain (ex. Duodenal is most common 2-3 hours after eating)
- Peptic ulcer disease diagnostics
Answer gastroscopy/duodenoscopy and biopsy for H pylori, barium Xrays, labs (hgb and hct)
- Peptic ulcer disease treatments
Answer lifestyle modifications, eradication of microor- ganisms, cauterization
- Stress Ulcers pathophysiology
Answer acute mucosal damage after physiologically stressful events (ex. Sepsis, shock, burns); resolve with recovery
- Aluminum (Amphogel), Magnesium (Milk of Magnesia), and Calcium (Tums) use
Answer heartburn, GERD, GI bleed, gastritis, stress ulcer
- Aluminum (Amphogel), Magnesium (Milk of Magnesia), and Calcium (Tums) actions
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