NR 283 Final Exam

NR 283 Final Exam

Student Name

Chamberlain University

NR-283: Pathophysiology

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Gastrointestinal Final Exam Concept Review

Pathophysiology, Causes, Signs, and Symptoms

Hiatal Hernia

A hiatal hernia occurs when a part of the stomach protrudes into the thoracic cavity through the diaphragm. This condition may be caused by a shortened esophagus, diaphragm muscle weakness, increased abdominal pressure (e.g., during pregnancy), trauma, or other underlying factors. Symptoms include heartburn (pyrosis), characterized by a burning sensation behind the sternum and a sour taste, frequent belching, discomfort when lying down or bending over, dysphagia (due to esophageal inflammation or compression), and persistent chest pain radiating to the shoulder or jaw. Complications include strangulation.

Acute and Chronic Gastritis

Acute gastritis is the inflammation of the gastric mucosa, which appears red and edematous. It can be triggered by bacterial or viral infections, food allergies, radiation or chemotherapy, ingestion of corrosive substances, excessive alcohol consumption, or ulcerogenic medications. Symptoms include anorexia, nausea, vomiting (potentially with hematemesis), epigastric pain or cramps, fever, headache, and diarrhea. Chronic gastritis involves atrophy of the stomach mucosa and loss of secretory glands, often caused by Helicobacter pylori infection, NSAIDs, alcohol abuse, or autoimmune conditions like pernicious anemia. Symptoms include mild epigastric discomfort, anorexia, and intolerance to spicy or fatty foods.

Peptic Ulcer Disease (PUD)

Peptic ulcer disease involves ulcerations in the mucosal lining of the lower esophagus, stomach, or duodenum. Common causes include Helicobacter pylori infection, NSAID use, and Zollinger-Ellison Syndrome. Duodenal ulcers often result from increased acid secretion, while gastric ulcers typically arise from impaired mucosal defenses. Symptoms include burning or aching epigastric pain (especially 2-3 hours after meals), localized pain after stomach emptying, weight loss, nausea, and vomiting. Complications include bleeding, perforation, and iron deficiency anemia.

Summary Table: Gastrointestinal Conditions

Endocrine Disorders

Conditions, Causes, Signs and Symptoms, and Complications

Endocrine disorders involve imbalances in hormone production or secretion, leading to significant health issues. Some common conditions include hypoparathyroidism, hyperparathyroidism, hypothyroidism, hyperthyroidism, Cushing’s syndrome, and Addison’s disease.

Hypoparathyroidism

Hypoparathyroidism can result from tumors, congenital absence of the parathyroid glands, surgery, or autoimmune diseases. It leads to hypocalcemia, weak cardiac contractions, and increased nerve excitability. Complications include a heightened risk of seizures and muscle spasms.

Hyperparathyroidism

Hyperparathyroidism arises from tumors, renal failure, or paraneoplastic syndromes. Symptoms include hypercalcemia, osteoporosis, and kidney stones, which may lead to complications such as heart issues, fractures, and renal complications.

Hypothyroidism

Hypothyroidism is often caused by iodine deficiency, Hashimoto’s thyroiditis, or tumors. Clinical manifestations include cold intolerance, weight gain, fatigue, and myxedema. It can result in complications such as cretinism in children and cardiovascular problems.

Hyperthyroidism

Hyperthyroidism may develop due to autoimmune disorders or excess iodine intake. Symptoms include increased body temperature, weight loss, anxiety, and exophthalmos. Complications include thyroid storm and severe metabolic disturbances.

Cushing’s Syndrome

Cushing’s syndrome results from excess glucocorticoids due to adenomas or iatrogenic conditions. It manifests with features such as a round face, truncal obesity, fragile skin, and high blood glucose levels. Complications include increased susceptibility to infections and emotional instability.

Addison’s Disease

Addison’s disease often stems from autoimmune reactions, infections, or hemorrhage. It presents with low blood pressure, fatigue, and bronze skin discoloration. Severe cases may lead to a crisis caused by acute adrenal insufficiency.

Neurological Assessment

Glasgow Coma Scale (GCS)

The Glasgow Coma Scale is a vital tool for assessing a patient’s consciousness level. A score of 15 indicates optimal responsiveness, while a score below 8 signifies severe impairment. A score of 3 indicates total unresponsiveness.

Types of Seizures and Their Implications

Seizures represent transient brain dysfunction due to erratic neuronal discharges. Tonic-clonic seizures, or grand mal seizures, may arise spontaneously or after simpler seizures. Status epilepticus, characterized by prolonged or recurring seizures exceeding 30 minutes, can lead to severe muscle spasms and confusion.

Increased Intracranial Pressure (ICP)

Increased ICP may first present as reduced consciousness, severe headaches, and other neurological symptoms. If untreated, it may lead to brain tissue herniation due to excessive pressure.

Chronic Neurological Disorders

Multiple Sclerosis (MS)

MS is a progressive disorder involving demyelination of neurons in the CNS. It typically begins between ages 20 and 40, peaking at 30 years, and is more common in women. Symptoms include vision issues, muscle weakness, coordination loss, and chronic fatigue. Although there is no cure, therapies like physical therapy and rehabilitation are crucial for management.

Parkinson’s Disease (PD)

PD is a degenerative disorder impacting motor function due to extrapyramidal activity loss. Symptoms include tremors, bradykinesia, rigidity, and stooped posture. Without treatment, it progresses to complications such as UTIs, RTIs, and dementia in later stages.

Amyotrophic Lateral Sclerosis (ALS)

ALS, or Lou Gehrig’s disease, is a neurodegenerative condition affecting motor neurons, leading to progressive muscle weakness and respiratory decline. It is typically fatal within 2–5 years, with respiratory failure being the most common cause of death.

Huntington’s Disease (HD)

HD is an inherited disorder linked to chromosome 4 mutations. It manifests after age 40 with symptoms such as choreiform movements, mood swings, and cognitive decline. The disease has no cure and progresses over 10–30 years, often leading to death due to infections or injuries.

Environmental Factors and Substance Abuse

Table of Environmental Factors and Substance Abuse

References

American Psychiatric Association. (2020). Diagnostic and statistical manual of mental disorders (5th ed.).

National Institute of Neurological Disorders and Stroke (NINDS). (2021). Neurological disorders overview.

NR 283 Final Exam

World Health Organization (WHO). (2021). Endocrine and metabolic diseases.

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.

Porth, C. M., & Matfin, G. (2020). Essentials of pathophysiology: Concepts of altered health states (5th ed.). Lippincott Williams & Wilkins.

Smith, L., & Morton, P. (2022). Clinical nursing skills and techniques (10th ed.). Elsevier.