1 /21NURS 5315 GI Module 9, exam 5
1.Upper GI organs
ANS mouth,pharynx, esophagus, stomach, and duodenum
2.Lower GI organs
ANS small intestine, large intestine, rectum and anus
3.Hepatoportal circulation
ANS hepatic artery receives oxygenated blood from the inferior mesenteric, gastric, and cystic veins. The hepatic portal vein receives de- oxygenated blood from the inferior and superior mesenteric vein and splenic vein and delivers nutrients that have been absorbed from the intestinal system
4.Osmotic diarrhea
ANS Caused by the presence of a nonabsorbable substance in the intestines. This pulls water by osmosis into the intestinal lumen and results in large volume diarrhea. This is how mag citrate, lactulose and miralax work. Causes include
excessive ingestion of nonabsorbable sugars, tube feedings, dumping 2 /21syndrome, malabsorption, pancreatic enzyme deficiency, bile salt deficiency, small intestine bacterial overgrowth or celiac disease
5.Secretory diarrhea
ANS Results in large volume losses secondary to infectious causes such as rotavirus, bacterial enterotoxins, or c-diff.
6.Motility diarrhea
ANS AKA short bowel syndrome. Results from resection of small intestine or surgical bypass of small intestine, IBS, diabetic neuropathy, hyperthy- roidism, and laxative abuse. Fatty stools and bloating are common in malabsorption syndrome. Complications include dehydration, electrolyte imbalance, metabolic acidosis, weight loss and malabsorption.
7.Upper GI bleed
ANS bleeding that occurs in the esophagus, stomach or duodenum commonly caused by bleeding varices, peptic ulcers or Mallory-Weiss tear(tearing of esophagus from stomach) Characterized by frank, bright
red or coffee ground emesis.
8.Lower GI bleed
ANS Bleeding in the jejunum, ileum, colon or rectum from inflam- 3 /21matory bowel disease, cancer, diverticula or hemorrhoids. Hematochezia, or the presence of bright red blood in the stools, suggest what kind of bleed
9.Peptic Ulcer Disease
ANS Is a break in the integrity of the mucosa of the esophagus, stomach
or duodenum resulting in exposure of the tissue to gastric acid. Risk factors include smoking, advanced age, NSAID use, ETOH, chronic disease, acute pancreatitis, COPD, obesity, socioeconomic status, gastrinoma, and infection with Helicobacter pylori. S&S Epigastric pain is worse with eating, melena or hemateme- sis
10.Duodenal ulcers
ANS most common and tend to develop in younger patients. S&S epigastric pain that is relieved by food. Patients may have melena(black
and tarry stool) or hematemesis
11.Ulcerative colitis (UC)
ANS Inflammatory disease of the large instestine in persons 20-40y/o. Less common in people who smoke. Has periods of remission and ex- acerbations. Characterized by inflammation and ulcerations that remain
superficial and in the small intestine.