Appendicitis - ANS RLQ Pain
Appendix obstructed causing infection
Young adults/children
Don't apply Heat, Don't push on belly
Psoas - fetal position with R leg held up - can't straighten it without pain
What organ is diverticulosis affecting? - ANS Colon - large intes...
Cha 2 Exam 2 GI Questions With Complete
Solutions
Appendicitis - ANS RLQ Pain
Appendix obstructed causing infection
Young adults/children
Don't apply Heat, Don't push on belly
Psoas - fetal position with R leg held up - can't straighten it without pain
What organ is diverticulosis affecting? - ANS Colon - large intestine
Diverticulosis/litis - ANS Pockets in colon, when become inflammed then itis,
Intermittent pain LLQ.
When/if pain becomes constant - could indicate it became infected -- then
rupture/perforation/hemorrhage risk. So Emerg surgery needed in this case.
Increase fiber. Decrease straining during acute. Fiber 25-30g daily. If litis/acute then no fiber b/c
can irritate inflammation.
Ulcerative Colitis - Malabsorption - ANS Inflammation of rectum and rectosigmoid colon
(bottom on colon). Continuous inflammation.
Causes protein loss, diarrhea, blood/mucus in stool, tenesesmus, Anemia, excessive BM's a
day.
*Barium enema shows difference between this and Crohns.
**HEMOMMORHAGE/PERFERATION**
-Dehydration
-Hypokalemia and Hypovolemia which can cause cardiac symptoms!
-Skin breakdown
Tenesesmus - ANS Urgent need to defecate
Chohn's - Malabsorption - ANS Inflammation that skips around in the intestines. Mostly
small intestine but can be everywhere.
Causes Fat Malabsorption.
, Risks: unknown
5-6 loose stools a day
Steatorrhea!
Weight loss, abdominal pain
Supplement with electrolytes, watch for skin breakdown, cancer, obstruction, anemia,
abscesses.
Teach: Avoid dairy, gluten, stimulants. Low residue, high cal diet. Stress management. Rest.
Lactose Intolerance - Malabsorption - ANS Deficiency of the intestinal enzyme lactase, so
lactose accumulates in sm intestine b/c it doesn't get digested. It draws water into the color
whcih acts like an osmotic laxative = watery diarrhea and they still have bacteria in their gut
which creates hydrogen and therefor produces gas.
Short Bowel - Malabsorption - ANS
Celiac/Tropical Sprue - Malabsorption - ANS Celiac Disease/Gluten intolerance
Tropical is a bacterial problem
GERD - ANS Sphincter doesn't prevent stomach contents from backflowing into the
esophagus.
H. Pylori infection can be seen.
Risks: High Pressure on the stomach, acidic foods, large meals.
Assess: Dyspepsia, regurgitation, cough/hoarseness, pain.
Dx: No definitive diagnosis. pH monitoring is most accurate.
Complications: Can develop Barrette's - columnar cells to protect - but are premalignant.
Stricture - of the esophagus can cause difficulty swallowing. - Aspiration pneumonia.
PUD - ANS Overproduction of pepsin & H. Pylori which eats the mucus out of the
stomach, exposing its protective barrier, leading to ulcers in the stomach.
Cause is often H. Pylori infection. NSAIDS, caffiene, radiation. Abdominal pressure, acid reflux.
Assess: Dull pain, ab pain, vomiting. If bleeding= emergency. Xray to see if perferation.
"Triple therapy" = PPI + 2 antibiotics.
*RISK FOR BLEEDING r/t vomiting = hypovolemia - rehydrate with IV fluids.
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