Disease Risk Subjective Finding Objective Findings Diagnostics Treatment Education GI DISORDERS Appendicitis -Most common between 10-30yrs; but can occur at any age; rare in infants and olderadults -men more at risk - Diets low in fiber, high in fat, refined sugars, & other carbs at increasedrisk. - Obstruction of appendix is cause of majority of appendicitis - contributing factors: Intraabdominal tumors, positive familyhx - Recent roundworm infection or viral GI infection -Dx made clinically, based primarily onH&P exam - Classic presentation includes acute onset ofmild to severe colicky, epigastric, or periumbilical pain - Pain is vague at firstthen localizes within 24hrs to RLQ - Pain exacerbated by walking\coughing - Men may feel radiated pain in testes - Abd muscle rigidity,N\V, anorexia - Mildly elevated temp99-100F common - If RLQ accompaniedby shaking chills, perforation should besuspected - Older adults may present with weakness, anorexia, -May have HTN\tachy proportional to pain\symptoms -When lying flat, may flex R knee to relieve tension in abd muscle -Pain with palpation inabd, diffuse in early stages. Localized to RLQ later -Positive for reboundpain; ask pt to coughto localize pain location -Sudden cessation ofpain means perforation and is ER -Labs are not diagnostic and nonspecific -Women should haveurine human chorionic gonadotrophin to r\oectopic pregnancy - +Rovsing’s Signdeep palpation & release in LLQ causesrebound pain in RLQ - +Psoas Sign- lift R leg against gentle pressure causes pain - +Obturator Signflex R hip & knee andslowly rotate internally causes pain - +McBurney’s Sign- pain with pressure applied to point between umbilicus &ilium - x-ray\CT helpful when paired with positive H&P findings -Surgical; preoperative care, NPO, correction of fluid\electrolyte imbalances -Avoid narcotics -Atb with 3rd gen cephalosporin; Ex: ampicillin, gentamycin,flagyl -F\U with surgeon -Ambulation aftersurgery -Adv diet whenbowel sounds return -Return to hosp with s\s of infection -Avoid heavy liftingfor at least 2 wks NR 511 Completed Midterm study 511 Completed Midterm study guide (2020) Complete A+ Guide. 2020) Complete A+ Guide. (2020) Complete A+ Guide. NR 511 Completed Midterm study guide (2020) Complete A+ Guide. Midterm study NR 511 Completed Midterm study guide (2020) Complete A+ Guide. abd distention, mild pain leading to delayeddx and increased morbidity. Celiac disease ** (autoimmune disorder caused by an immunologic response to gluten) Mostly diagnosed in adulthood. A family member with celiac disease or dermatitis herpetiformis Type 1 diabetes Many asymptomatic. May complain of diarrhea, gas, dyspepsia, wt loss. Atypical symptoms: fatigue, bone or joint pain, arthritis, osteoporosis, or Muscle wasting (anemia), reduces subcutaneous fat, ataxia, & peripheral neuropathy (vitamin B12 deficiencies) osteoporosis or osteopenia (bone loss) Serologic testing for anti-tTG IgA antibody Total IgA (2% of pts have IgA deficiency and will falsely test negative) duodenal biopsies lifelong adherence to a strict gluten-free diet. Referral to a dietician to help. Some pts may need treatment with immunomodulating teaching related to gluten free diet. Some people with celiac disease have vitamin or nutrient deficienciesthat do not cause them to feel ill, such as anemia due to iron