NUR2063 Exam 2 Focused Review
Gallstones S/S
Biliary colic (pain that occurs from passing/blockage), related to intermittent obstruction of
cystic duct
Precipitated by a meal (infrequent schedule)
Persistent epigastric or RU abdominal pain, often radiates to back
Nausea, vomiting, sweating, flatus increases steadily for >15 minutes, lasts several hours, then
slowly decreases
Fatty food intolerance, belching, bloating, and epigastric burning
Peptic ulcer disease patho, causes and S/S
Disorders of upper GI tract caused by action of acid and pepsin
Injury to the mucosa of the esophagus, stomach, or duodenum
Causes: NSAIDs, stress (glucocorticoids), smoking, genetics, H. pylori
Gastric:
Caused by breakdown of protective mucous layer that normally prevents diffusion of acids into
gastric epithelia because of chronic irritations
Aspirin, NSAIDs, alcohol, and bile acids
Duodenal:
Inappropriate excess secretion of acid
Increased basal activity of vagus nerve (Stimulates pyloric antrum cells to release gastrin to act
on gastric parietal cells to release HCl, Results in high level of HCl)
S/S:
Epigastric burning pain that is usually relieved by the intake of food (especially dairy products)
or antacids
Pain of gastric ulcers typically occurs on an empty stomach but may present soon after a meal.
Pain of duodenal ulcer classically occurs 2 to 3 hours after a meal and is relieved by further food
ingestion.
Life-threatening complications, such as GI bleeding, may occur with no warning.
Appendicitis S/S
Periumbilical pain, RLQ pain (“McBurney’s point”) (classic, but may be anywhere), nausea,
vomiting, fever, diarrhea, RLQ tenderness, systemic signs of inflammation
, C Difficile causes and treatment
Bacteria causing inflammation in the colon
Proper hand washing
Avoid unnecessary use of antibiotics
Pseudomembranous colitis
Acute inflammation and necrosis of large intestine
Caused by Clostridium difficile (exposure to antibiotics)
Mediated by bacterial toxins
Diarrhea (often bloody), abdominal pain, fever, leukocytosis, sepsis, colonic perforation (rare)
Gastritis S/S
May be asymptomatic; anorexia, n/v, postprandial (after meal) discomfort, hematemesis
(vomiting blood)
Mechanical bowel obstructions
Causes of MBO: Adhesions, hernia, tumors, impacted feces, volvulus (intestine twisting),
intussusception(intestine slides into adjacent part)
Increased bowel sounds initially, accompanied by abdominal pain, n/v
Hirschsprung’s disease patho
Familial, congenital disorder of the large intestine in which the autonomic ganglia are reduced or
absent, common in male infant/children, missing nerves cell in the muscles of the infant’s colon,
unable to have a bowel movement
Complications of perforated gallbladder, bowel, etc.
Bleeding, sepsis, permanent damage, necrosis, abscesses, gallbladder rupture
Hepatitis S/S
A- Jaundice, RUQ pain, malaise, anorexia, nausea, low-grade fever, children may not
experience jaundice
B- Asymptomatic or rashes, arthralgia, arthritis, angioedema, serum sickness,
glomerulonephritis, jaundice (lasting 2 weeks on average)
C- Acute: usually asymptomatic, course is erratic with wide fluctuations on liver enzymes.
Chronic: Usually asymptomatic until advanced liver disease intervenes, most common
cause of end-stage liver disease with cirrhosis
D- Infection appears to accelerate and worsen HBV infection symptoms.
E- Prodromal and icteric illness. Usually last only 2 weeks. Similar to HAV infection