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NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam (Latest 2024 / 2025) Rasmussen
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NUR 2063 / NUR2063: Essentials ofPathophysiology Final Exam (Latest 2024 /
2025) Rasmussen
What is Gastritis/Acute Gastritis?
Inflammation of the stomach lining. Causes include ingestion of alcohol, aspirin, NSAIDs; can also be caused by a virus, bacteria, an autoimmune disorder
Treatment: Remove the offending agent!
Chronic Gastritis
*H.Pylori is almost always a factor
Causes: Person-to-Person, Fecal/Oral, Reservoir in water sources
Complications: PUD, Atrophic Gastritis, Gastric Adenocarcinoma, Mucosal Lymphoma, Decreased Acid, and Intrinsic Factor
PUD - Peptic Ulcer Disease
Disorders of the upper GI Tract caused by the action of Acid and Pepsin.
Injury to the mucosa of the esophagus, stomach, and duodenum.
Causes: *H.Pylori (HIGHLY CONTAGIOUS), NSAIDs, Stress, Smoking, and Genetics
Clinical Manifestations: Epigastric burning pain (relieved by food intake or antacids)
Complications: GI Bleeding and Perforation
Tx: Sulcralfate, PPIs, Avoid caffeine and alcohol
PUD - Ulcer Types: MOST COMMON
Gastric Ulcer: Pain occurs on an empty stomach; may present soon after a meal
Duodenal Ulcer: Pain 2-3 hours after meal; relieved by food intake
Ulcerative Colitis (IBD - Inflammatory Bowel Disease)
Chronic inflammation of the mucosa - rectal and colon - leading to large ulcers
Complications: *Bloody Diarrhea, Lower abdominal pain; *Exacerbations and Remissions Treatment: Corticosteroids, Broad Spectrum Antibiotics
Chron's Disease
An immune-mediated disease that can affect any part of the digestive tract. There is NO CURE. Complications: Granulomas, Fistulas, Ulcerations, Strictures, and Fibrosis
Bowel Obstruction Manifestations - Types
Mechanical: Increased bowel sounds, abdominal pain, and N/V
Functional: Absent bowel sounds
Upper Jejunal: Vomiting, dehydration, and electrolyte depletion
Distal Small Bowel/Ilium: Constipation
What percentage of the pancreas is Endocrine function?
5% - Pancreas secretes hormones into the blood
*Exocrine function: Pancreas secretes digestive juice into the duodenum
Pancreatic Cancer
About 2% of all CA; Ranks 4th among malignant deaths.
Risks: Smoking, Obesity
Manifestations: Jaundice, Malabsorption, weight loss, abdominal pain, nausea
Tx: Surgery, Chemo
Gastroesophageal Varices Management
Varicies are a result of Portal Hypertension d/t Cirrhosis of the liver; Alcoholism and Viral Hepatitis
Dx: Endoscopy, Abdominal CT Scan, Upper GI Barrium
Tx: Fluids (NaCl), Administer Blood Products, Vasopressin IV, H2 Blockers, PPIs; Surgical Banding and Balloon Therapy
Diverticulosis
Syndrome of "Outpouchings"/Herniations through the muscular layer of the colon.
*HIGH FIBER DIET
Diverticulitis
Inflammation of the "Outpouchings"
*LOW FIBER DIET
Assessment of Kidney Disease Palpation of the CVA for pain/tenderness
*CVA = Costalvertebral Angle
Kidney Cancer S/S
Is typically asymptomatic until advanced. Most common is CVA tenderness, hematuria, palpable abdominal mass, dyspnea, cough, bone pain secondary to metastasis
Dialysis Benefits and Risks
Used for pts with ATN/CKD in stage 5 in order to remove metabolic waste and correct fluid and electrolyte imbalances. Pts are at risk for Hypotension after treatment because they Hypertensive prior to treatment.
TYPES of Acute Kidney Injury (AKI)
PRERENAL: Conditions that diminish perfusion of the kidney - Hypovolemia, Hypotension, Heart Failure, Renal Artery Obstruction, Fever, Burns, Edema, Ascites, ACE Inhibitors, NSAIDs
POSTRENAL: Obstruction of the normal outflow of urine from kidneys - Renal Pelvis, Ureters, Bladder Outlet, Urethra
Causes: BPH, Kinked Catheter, Intra-abdominal Tumors, Strictures, Calculi
INTRINSIC/INTRARENAL: Primary dysfunction of the nephrons and the kidney itself! The most common problem within the renal tubules results in *ATN(Acute Tubular Necrosis). Causes of ATN: Nephrotoxic insults: Contrast Media, Sepsis, Vancomycin, Chemo; Lack of O2, Alcohol, Drugs
PHASES of Acute Kidney Injury (AKI)
PRODROMAL: *Insult to the kidney has already occurred. Serum BUN and Creatinine is ELEVATED.
OLIGURIC: Normal urine output of 50-400mL daily. Oliguria, Uremia, decreased GFR, Hypervolemia.
S/S: Fluid excess, Hyperkalemia, Uremic Syndrome, Metabolic Acidosis
POSTOLIGURIC: Termination of the Oliguric phase represents recovery. Urine volume increases, tubular function improves fluid volume deficit until kidneys recover. Cystitis
Acute onset of frequency, Urgency and Dysuria, Suprapubic Pain, Hematuria, Cloudy Urine. LOC in elderly
could present as Dementia, as well as new-onset incontinence.
Toxic Causes of Intrarenal Kidney Injury
Prolonged postrenal failure, blood transfusion reaction, antibiotics/antifungal, antiviral, *CONTRAST MEDIA, chemo drugs, recreational drugs, snake venom, environmental factors
Renin Angiotensin-Aldosterone System (RAAS) and the relationship between the autoregulation and the kidneys
Kidneys attempt to: Regulate Perfusion and Maintain GFR
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