NR 293 Final Exam Concept Review Pathophysiology

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Chamberlain University

NR-293: Pharmacology for Nursing Practice

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Gastrointestinal Conditions: Causes, Signs, and Symptoms

Gastrointestinal conditions are common health problems that affect various parts of the digestive system, ranging from the esophagus to the intestines. They may result from infections, lifestyle factors, autoimmune responses, or anatomical abnormalities. Early identification of symptoms and understanding causes are crucial for effective management and treatment.

Hiatal Hernia

A hiatal hernia occurs when the upper portion of the stomach pushes through the diaphragm into the chest cavity. This condition may arise from a congenitally short esophagus, physical trauma, or weakening of diaphragm muscles due to aging. Individuals often report heartburn, belching, difficulty lying flat, and substernal pain. In severe cases, regurgitation and respiratory symptoms may also appear.

Chronic Gastritis

Chronic gastritis refers to long-term inflammation of the stomach lining. Common risk factors include infection by Helicobacter pylori, chronic alcohol use, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), and autoimmune conditions. The disorder presents with nausea, vomiting (sometimes with blood), abdominal pain, anorexia, and bloating. If untreated, it may lead to ulcers or gastric cancer.

Peptic Ulcer Disease

Peptic ulcer disease (PUD) involves open sores in the esophagus, stomach, or duodenum. The most frequent causes include H. pylori infection, prolonged NSAID therapy, and rare conditions such as Zollinger-Ellison Syndrome. Patients may experience burning abdominal pain, nausea, vomiting, bloating, and unintended weight loss. Complications include gastrointestinal bleeding and perforation.

Cholelithiasis

Cholelithiasis is the formation of gallstones within the gallbladder. Risk factors include obstruction of bile flow, high-fat diets, obesity, certain medications (e.g., estrogen therapy), age, and ethnicity. While gallstones can be asymptomatic, some patients develop upper abdominal pain, nausea, or jaundice when stones obstruct bile ducts.

Hepatitis

Hepatitis refers to liver inflammation, commonly categorized into types A, B, and C. Each type has distinct transmission routes: hepatitis A (fecal-oral route), hepatitis B (blood and body fluids), and hepatitis C (primarily bloodborne). Clinical progression typically includes three phases:

1. Prodromal stage – flu-like symptoms, fatigue, nausea.

2. Icteric stage – jaundice, dark urine, clay-colored stools.

3. Recovery stage – gradual improvement in symptoms.

Hepatic Encephalopathy

Hepatic encephalopathy develops due to advanced liver disease, where toxins (e.g., ammonia) accumulate in the bloodstream and impair brain function. Symptoms may include confusion, forgetfulness, personality changes, musty breath odor, hand tremors (asterixis), and slurred speech. Diagnosis typically requires blood tests measuring liver function and ammonia levels.

NR 293 Final Exam Concept Review Pathophysiology

Cirrhosis

Cirrhosis is a chronic, progressive liver condition characterized by irreversible scarring. Causes include long-term alcohol abuse, viral hepatitis, and fatty liver disease. Clinical features include fatigue, anorexia, jaundice, ascites, easy bruising, and esophageal varices. Patients are at risk for severe complications such as hepatic failure, portal hypertension, and increased susceptibility to infections.

Esophageal Varices

Esophageal varices are dilated veins in the lower esophagus resulting from obstructed blood flow due to portal hypertension. They may remain asymptomatic until rupture occurs, leading to life-threatening bleeding, hematemesis, and hypovolemic shock. Early diagnosis and preventive treatment (e.g., beta-blockers, endoscopic therapy) are essential.

Crohn’s Disease

Crohn’s disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract, from mouth to anus, though it most commonly involves the terminal ileum. It is associated with ulcer formation, strictures, and fistulas. Symptoms include abdominal pain, non-bloody diarrhea, malabsorption, fatigue, and weight loss. Unlike ulcerative colitis, Crohn’s may present with “skip lesions,” meaning areas of inflammation are separated by normal tissue.

Ulcerative Colitis

Ulcerative colitis (UC) is another form of inflammatory bowel disease, primarily affecting the colon and rectum. Unlike Crohn’s disease, it typically spreads in a continuous manner starting from the rectum. Key symptoms include bloody diarrhea, abdominal cramping, fever, fatigue, and tenesmus. Long-term complications include toxic megacolon and colorectal cancer.

Appendicitis

Appendicitis is inflammation of the appendix, most often caused by obstruction, infection, or decreased blood flow (ischemia). It commonly presents with sharp pain starting near the umbilicus and migrating to the right lower quadrant, fever, nausea, and localized tenderness. Prompt surgical removal (appendectomy) is typically required to prevent rupture and peritonitis.

Intestinal Obstruction

Intestinal obstruction refers to a blockage that prevents normal passage of intestinal contents. Causes include mechanical obstruction (tumors, adhesions, hernias) and functional obstruction (paralytic ileus). Clinical features include colicky abdominal pain, vomiting, constipation, and abdominal distension. Severe cases may require urgent surgery.

References

Huether, S. E., & McCance, K. L. (2019). Understanding pathophysiology (7th ed.). Elsevier.
Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (2021). Medical-surgical nursing: Concepts for interprofessional collaborative care (10th ed.). Elsevier.
McCance, K. L., & Huether, S. E. (2022). Pathophysiology: The biologic basis for disease in adults and children (9th ed.). Elsevier.