OUR LADY OF FATIMA UNIVERSITY

College of Nursing
Cabanatuan City

POINTERS TO REVIEW
Competency Appraisal

GERD _ Gastro Esophageal Reflux Disease.

_is a common condition in which the stomach contents move up into the esophagus.
Reflux becomes a disease when it causes frequent or severe symptoms or injury. Reflux may
damage the esophagus, pharynx or respiratory tract.

S/S

1. fiery feeling in one's chest

2. regurgitating sour or bitter liquid to the throat or mouth.
3. The combination of heartburn and regurgitation is such a common characteristic of
GERD that formal testing may be unnecessary.
 Medications

1.Antacids- neutralize stomach acid _Maalox

2. H2 receptor blocker- gastric acid _Ranitidine (Zantac)

3.Proton pump inhibitor(PPI) _Nexium (Esomeprazole)

EMPHYSEMA

_is one of the diseases that comprises COPD (chronic obstructive pulmonary
disease). Emphysema develops over time and involves the gradual damage of lung tissue,
specifically the destruction of the alveoli (tiny air sacs).

_Emphysema is generally caused by cigarette smoking or long-term exposure to

certain industrial pollutants or dusts. A small percentage of cases are caused by a familial or
genetic disorder, alpha-1-antitrypsin deficiency.

S/S _BARREL CHEST

Medications
 Bronchodilators. These drugs can help relieve coughing, shortness of breath and
breathing problems by relaxing constricted airways.
 Inhaled steroids. Corticosteroid drugs inhaled as aerosol sprays reduce inflammation and
may help relieve shortness of breath.
 Antibiotics.
ASTHMA

_ is a chronic disease that affects your lungs and your breathing. When asthma acts up, it
can be called an asthma attack or an asthma exacerbation. When you have an asthma attack, the
airways in the lungs become more inflamed and your air way muscles make the airways narrow.

_The most common asthma triggers include allergies, air pollution and other airborne
irritants

_You use a reliever inhaler to treat your symptoms when they occur. They should
relieve your symptoms within a few minutes.

BLEEDING ESOPHAGEAL VARICES

_Esophageal varices develop when regular blood flow to the liver is blocked by a clot or
scar tissue in the liver. To go around the blockages, blood flows into smaller blood vessels that
aren't designed to carry large volumes of blood. The vessels can leak blood or even burst,
causing life-threatening bleeding.

treatment for acute bleeding esophageal varices?

1. stop bleeding by applying pressure to the esophageal varices. One way to temporarily
stop bleeding is by inflating a balloon to put pressure on the varices for up to 24 hours, a
procedure called balloon tamponade.

HIATAL HERNIA

_occurs when part of the stomach protrudes up into the chest through the sheet of
muscle called the diaphragm. This may result from a weakening of the surrounding tissues and
may be aggravated by obesity and/or smoking. The esophagus runs through the diaphragm to the
stomach.

SIGNS Symptoms
 Abdominal/chest pain.
 Abdominal bleeding (which can be indicated by blood in vomit, red or black stool,
anemia, blood test indicating loss of blood)
 Change in voice.
 Early satiety (or becoming full after only eating a small amount of food)
 Occasional trouble swallowing (especially solid food)

Hiatal Hernia Treatments

1. Eating meals at least three to four hours before lying down.
2. Eating moderate to small portions of foods.
3. Limiting fatty foods, acidic foods (citrus fruits or juices), foods containing caffeine and
alcoholic beverages.
4. Losing weight or maintaining a healthy weight.
Ascites is a condition in which fluid collects in spaces within your abdomen.

ASCITES

_results from high pressure in certain veins of the liver (portal hypertension) and low
blood levels of a protein called albumin.

_Ascites can be life-threatening if you don't treat it and your liver fails. Then, you'll need
a liver transplant to replace your damaged organ. There's no cure for ascites, but treatments
and diet changes can relieve symptoms, prevent complications, and help you feel better.

PEPTIC ULCER DSE (PUD)

_A peptic ulcer is an open sore or raw area in the lining of the stomach or intestine.
There are two types of peptic ulcers:

1. Gastric ulcer -- occurs in the stomach.

2. Duodenal ulcer -- occurs in the first part of the small intestine.

Zollinger-Ellison syndrome

_is a rare digestive disorder that results in too much gastric acid. This excess gastric
acid can cause peptic ulcers in your stomach and intestine. Symptoms include abdominal pain,
nausea, vomiting, weight loss, and diarrhea.

_Zollinger-Ellison syndrome (ZES) is a group of symptoms comprised of severe peptic

ulcer disease, gastroesophageal reflux disease (GERD), and chronic diarrhea caused by a
gastrin-secreting tumor of the duodenum or pancreas (gastrinoma triangle)
Symptoms of Zollinger-Ellison syndrome
 Stomach pain.
 Diarrhea.

 Burning, aching or discomfort in your upper abdomen.

 Acid reflux and heartburn.
 Burping.
 Nausea and vomiting.
 Bleeding in your digestive tract.
 Losing weight without trying.

Stress ulcers
are multiple, superficial erosions which occur mainly in the fundus and body of the
stomach.
Types of Stress Ulcers
 Curling ulcers are a type of stress ulcer that is caused by systemic burns, or burns that
impact 30% of the body or more.
 Cushing ulcers are a type of stress ulcer that is caused by acute traumatic brain injury.
Cushing ulcers are gastrointestinal ulcers that develop following injury or infection to the
central nervous system

Curling's ulcer is an acute gastric erosion resulting as a complication from severe burns
when reduced plasma volume leads to ischemia and cell necrosis (sloughing) of the gastric
mucosa.

Cushing's ulcers develop following central nervous system injury. Morphologically,

Cushing's ulcers tend to be single and deep and may involve the esophagus, stomach, or
duodenum . Curling's ulcers occur following burns involving greater than 30 percent total
body surface area.

APPENDICITIS

_is when the appendix gets blocked and becomes infected. The appendix is a small
organ attached to the large intestine in the lower right side of the belly. Appendicitis is an
emergency. It's important to know what to look for and get medical care right away.

Appendicitis typically starts with a pain in the middle of your tummy (abdomen) that
may come and go. Within hours, the pain travels to your lower right-hand side, where the
appendix is usually located, and becomes constant and severe. Pressing on this area, coughing or
walking may make the pain worse.

S/S REBOUND TENDERNESS, RIGHT LOWER QUADRANT PAIN

Inflammatory bowel disease (IBD)

_ is a term for two conditions (Crohn's disease and ulcerative colitis) that are
characterized by chronic inflammation of the gastrointestinal (GI) tract. Prolonged
inflammation results in damage to the GI tract.

Both ulcerative colitis and Crohn's disease usually are characterized by diarrhea, rectal
bleeding, abdominal pain, fatigue and weight loss.

Hepatobiliary System.

_The liver, gall bladder and bile ducts. The liver produces and secretes bile which is
stored in the gallbladder. The bile is released through passageways called bile ducts into the
bowel to help digest fat and carry away waste.

The biliary system refers to bile production, storage, and secretion via the liver,
gallbladder, and bile ducts. Bile ducts are categorized into intrahepatic and extrahepatic bile
ducts.

Liver Cirrhosis

_Means is scarring (fibrosis) of the liver caused by long-term liver damage. The scar
tissue prevents the liver working properly. Cirrhosis is sometimes called end-stage liver disease
because it happens after other stages of damage from conditions that affect the liver, such as
hepatitis.

_Cirrhosis is a type of liver damage where healthy cells are replaced by scar tissue.
Common causes include excessive drinking of alcohol, hepatitis B and C virus infections,
and fatty liver that's caused by obesity and diabetes.

What is post hepatic liver disease?

_Defined PHLF as “a post-operatively acquired deterioration. in the ability of the liver to
maintain its synthetic, excretory, and detoxifying functions, which are characterized by an.
increased INR and concomitant hyperbilirubinemia on or. after postoperative day 5”

_The pathological process of postnecrotic cirrhosis consists of necrosis of liver cells,

regeneration of hepatic tissue, and the formation of large bands of connective tissue which
course irregularly through the liver.