Understanding Pathophysiology, 6th Ed., Huether, McCance, Brashers, & Rote | Practical Nurse (LPN) School Study Aid
Anorexia Nervosa Assessment
- Adolescent Girls
- Fear of Gaining Weight
- Excessive Dieting
- Distorted Body Image
- Decreased Bone Density
- Stress Fractures
- Lanugo
- Amenorrhea
- Anemia
- BMI < 18.5
Bulimia Nervosa Assessment
- Normal Body Weight
- Binge and Purge
- Electrolyte Disturbances
- Alkalosis
- Hypokalemia
- Parotitis
- Enamel Erosion
- Russell's Sign
- Once Weekly For 3 Months
Anorexia Nervosa and Bulimia Nervosa Interventions
- Build Trust
- Plan Caloric Intake
- Supervise Meals
- Supervise Elimination
- Encourage Liquids
- Daily Weights
- Use Matter-of-Fact Statements
- Give Feelings of Control
- Tube Feedings If Further Weight Loss
Gastroesophageal Reflux Disease (GERD) Assessment
- Relaxed Lower Esophageal Sphincter
- Dyspepsia (Indigestion)
- Belching
- Nighttime Coughing
- Dysphagia
- Epigastric Pain
- Regurgitation
- Heartburn (Pyrosis)
- Globus
Types of Hernias
- Hiatal
- Gastroesophageal Reflux Disease (GERD)
- Inguinal
- Men
- Femoral
- Women
- Incisional
- Umbilical
- Strangulation
Hernia Interventions
- Reduce Intra Abdominal Pressure
- Avoid Straining and Lifting
- Open Mouth Sneezing
- Excision
- Herniorrhaphy
- Hernioplasty
- Scrotal Support
Types of Intestinal Obstruction
- Adhesions
- Hernia
- Volvulus
- Intussusception
- Tumor
- Mesenteric Artery Occlusion
- Spinal Injury
- Paralytic Ileus
Intestinal Obstruction
- Severe Abdominal Pain
- Vomiting
- High Pitched Bowel Sounds
- Abdominal Distention
- Increased Peristalsis
- Absent Bowel Sounds
- Paralytic Ileus
Acute Gastritis
- Erosive
- Disruption of Mucosal Barrier
- Caused by Stress
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
- Alcohol
- Uremia
- Burns
- Curling's Ulcer
- Brain Injury
- Cushing Ulcer
- Increase H+ Production
Chronic Gastritis
- Type A
- Fundus and Body
- Autoimmune
- Autoantibodies to Parietal Cells
- Pernicious Anemia
- Achlorhydria
- Type B
- Most Common Type
- Helicobacter pylori
- Antrum
- Increased Risk of MALT Lymphoma
- HIV/AIDS
- Crohn's Disease
Peptic Ulcer Disease Assessment
- Helicobacter Pylori
- Increased Stomach Acid
- Abdominal Pain
- Heartburn (Pyrosis)
- Melena
- Weight Changes
- GI Distress
- Most Commonly in Duodenum
- Duodenal: Pain Relieved by Eating
- Gastric: Pain Caused by Eating
Peptic Ulcer Disease Interventions
- Combination Drug Therapy
- Two Antibiotics
- Proton Pump Inhibitor (PPI)
- Decrease Acid Secretion
- Avoid NSAIDs
- Diet and Lifestyle Changes
Ulcerative Colitis Assessment
- Cramping Abdominal Pain
- Tenesmus
- Bloody Diarrhea
- Up to 10-20 / Day
- Fever
- Hemorrhage
Crohn's Disease Assessment
- Diarrhea
- 5-6 per day
- Cramping Abdominal Pain
- Fever
- Weight Loss
- Malabsorption
- Anemia
- Obstruction
- Fistulas
Irritable Bowel Syndrome (IBS) Assessment
- Abdominal Pain
- Relieved by Defecation
- Alternating Diarrhea and Constipation
- Fatigue
- Excessive Flatulence
- Sensation of Incomplete Evacuation
- Stressors
- Food Intolerances
- More Common in Women
- Rule Out Other Disorders
Irritable Bowel Syndrome (IBS) Interventions
- Identify Triggers
- Increase Fiber Intake
- Probiotics
- Anticholinergics
- Tricyclic Antidepressants (TCAs)
- Loperamide
- Linaclotide
- Tegaserod (Zelnorm)
- Lubiprostone (Amitiza)
- Alosetron (Lotronex)
Diverticulosis and Diverticulitis Assessment
- Outpouching
- Inflamed Diverticula
- Abdominal Pain
- Abdominal Distention
- Flatulence
- Fever
- Rectal Bleeding
- Alternating Constipation and Diarrhea
- Peritonitis
Diverticulosis and Diverticulitis Interventions
- High Fiber Diet
- Reduce Intra-abdominal Pressure
- Stool Softeners
- Exercise
- Anticholinergics
- Antibiotics
- Bowel Resection
Appendicitis Assessment
- Obstruction of Appendix
- Periumbilical Pain
- RLQ Pain
- Nausea/Vomiting/Anorexia
- Increased White Blood Cells
- Rebound Tenderness
- Fever
- Peritonitis
- Sepsis
Appendicitis Interventions
- Appendectomy
- Antibiotics
- IV Fluids
- No Enema or Laxative
- Semi-Fowler's Position
- Nasogastric Tube
- Diet as Tolerated
- Pain Management
- Early Ambulation
Cirrhosis Assessment
- Degeneration and Destruction of Liver Cells
- Jaundice
- Fatigue
- Palmar Erythema
- Spider Angiomas
- Hepatosplenomegaly
- Edema
- Gynecomastia
- Change in LOC
Cirrhosis Interventions
- Maintain Nutrition
- Paracentesis
- Drug Therapy
- Endoscopic Band Ligation or Sclerotherapy
- Balloon Tamponade
- Transjugular Intrahepatic Portosystemic Shunt (TIPS)
- Lactulose
- Antibiotics
Complications of Cirrhosis
- Portal Hypertension
- Ascites
- Esophageal Varices
- Coagulation Defects
- Portal-Systemic Encephalopathy
- Hepatorenal Syndrome
Bilirubin Lab Value
- 0.2-1.2 mg/dL
- Increased Bilirubin Causes Jaundice
Hyperbilirubinemia
- Increased Unconjugated Bilirubin
- Jaundice
- Kernicterus
- Early Feedings
- Heme Oxygenase Inhibitors
- Phototherapy
- Protect Eyes
- Monitor for Dehydration
- Monitor Bilirubin Levels
Hepatitis A
- Picornavirus
- 4 Week Incubation Period
- Fecal-oral
- Day Care Centers
- Travel to Developing Countries
- Usually Asymptomatic
- Acute Disease
- Jaundice
- Fever
- Vomiting
Hepatitis A (HAV) Assessment
- Fecal-Oral
- Ingestion of Contaminated Food or Water
- 4 Weeks
- Fever
- General Malaise
- Hepatomegaly
- Self-Limiting
- Proper Hand Washing
Hepatitis B Virus Disease
- Can turn chronic
- < 10% of adults become chronic carriers
- 90% of newborns become chronic carriers
- Cirrhosis
- Hepatocellular carcinoma
- Membranous Glomerulonephritis
- Polyarteritis nodosa
- Serum sickness like syndrome
Hepatitis B Virus Characteristics
- Hepadnavirus
- Enveloped
- Circular
- Partially Double-stranded DNA
- Has Reverse Transcriptase
- IV Drug Use
- Sex
- Maternal Fetal Routes
- 3 Month Incubation Period
Hepatitis B (HBV) Assessment
- Bodily Fluids
- Blood Transmission
- People Who Use IV Drugs
- Variable 1-6 Months
- Fever
- Nausea and Vomiting
- Hepatomegaly
- Cirrhosis
- Hepatocellular Carcinoma
- Vaccination
Hepatitis C
- Enveloped
- RNA Virus
- Flavivirus
- Icosahedral
- SS positive Linear
- Most Cases are Due to IV Drug Use
- Turns to Chronic Hepatitis in Over 70% of Cases
- Cirrhosis
- Hepatocellular Carcinoma
- Most Common Indication for Liver Transplantation
- Associated With Type I MPGN
- Porphyria Cutanea Tarda
Hepatitis C (HCV) Assessment
- Blood Transmission
- High Risk Sex (rare)
- IV Drug Users
- 7 Weeks
- Cirrhosis
- Barrier Protection
Cholecystitis Causes
- Gallbladder Inflammation
- Female
- Fair (Caucasian)
- Fat (Obese)
- Fertile (Pregnant)
- Forty (Advanced Age Over 40)
- Flatulence
Cholecystitis Assessment
- RUQ Pain
- Referred Shoulder Pain
- Clay Colored Stools
- Jaundice
- Nausea and Vomiting
- Dyspepsia (Indigestion)
- Fever
- Increased WBCs
- Fatty or Spicy Foods
- Ultrasound
Cholecystitis Interventions
- Supportive Therapy
- Antibiotics
- Low Fat Diet
- NG Tube
- Analgesics
- Lithotripsy
- Cholecystectomy
- T Tube
Acute Pancreatitis Causes
- "GET SMASHHED" Mnemonic
- Gallstones
- (Ethanol) Alcohol
- Trauma
- Steroids
- Mumps
- Autoimmune
- Scorpion Sting
- Hypercalcemia
- Hypertriglyceridemia > 1000
- ERCP
- Drugs
Acute Pancreatitis Assessment
- Heavy Alcohol Use and Gallstones
- Abdominal Pain
- Nausea/Vomiting/Anorexia
- Abdominal Rigidity/Guarding
- Decreased or Absent Bowel Sounds
- Hypotension and Tachycardia
- Jaundice
- Increased White Blood Cells
Acute Pancreatitis Interventions
- NPO with NG Tube to Suction
- Pain Management
- Albumin
- Lactated Ringers Solution
- Proton Pump Inhibitor (PPI)
- Antibiotics
- Surgery
- Nutrition
Barrett's Esophagus
- Metaplasia in Lower Esophagus
- Columnar Epithelium
- Gastroesophageal Reflux Disease (GERD)
- Esophagitis
- Esophageal Ulcers
- Increased Risk of Esophageal Adenocarcinoma