N351 final patho (summaries)
1. pathophysiology of Nausea/vomiting: · Vomiting occurs when there's stimula- tion of the
medulla oblongata
· Five neurotransmitters involved
o Muscarinic
o Dopamine
o Histamine
o NK1/substance P
o 5-Hydroxytryptamine/serotonin
· Stimuli are relayed to the vomiting center by afferent signals from chemoreceptor trigger
zone, cerebral cortex, sensory organs and the vestibular apparatus
· This stimulus and activation sends signals tot eh GI tract to relax the gastroe- sophageal
sphincter and reverse peristalsis causing the vomiting
2. general treatment of nausea and vomiting: · Antiemetics drugs work on those specific
neurotransmitters to prevent the transmission and response on the vomiting center, chemo
receptor trigger zones, cerebral cortex, vestibular apparatus and combination of these
3. complications with nausea and vomiting: · Dehydration
· Electrolyte depletion
· Metabolic alkalosis with loss of gastric contents
· Metabolic acidosis with dehydration/FVD
· Anxiety
· Increased ICP
· Pain
· Oral ulcers and tooth decay
4. GI ulcers: o Erosion of a mucous membrane forms an excavation in the stomach, pylorus,
duodenum, or esophagus. Most commonly occur in the duodenum
, N351 final patho (summaries)
o Associated with infection of H. Pylori
5. areas prone to GI ulcers: o Prone area
§ Duodenal mucosa is more prone (inability to handle HCl and pepsin)
6. symptoms of GI ulcers: § Pain in the midepigastrium
· Dull constant pain or a burning sensation
· Pain with gastric ulcers vs. duodenal ulcers
o Gastric ulcer
§ Pain immediately after eating
o Duodenal ulcer
§ Pain occurs 2-3 hours after meals; pain relief with food or antacid compared to patients with
gastric ulcers
§ Heart burn (pyrosis)
, N351 final patho (summaries)
§ GI discomfort/bloating
§ Nausea
7. complication with GI ulcers: § Hemorrhage
§ Perforation
8. treatment of GI ulcers: § Prescription medications
· PPIs, H2 blockers and antibiotics
§ Avoid NSAIDs
§ Surgery
§ Lifestyle and habits such as cigarette and alcohol use
§ Dietary modifications
§ education
9. assessment of the urological system: health history: § Presence of dysuria, hematuria, enuresis
and nocturia
§ Fever/chills
§ Stones
§ Incontinence
10.assessment of the urological system: physical assessment: § Labs
§ Urine character, color, consistency and odor
§ Pain
§ Palpation and percussion
11.assessment of the urological system: diagnostic studies: § Urinalysis
§ urine culture
§ Ultrasonography (bladder scan)
§ CT and MRI
§ Endoscopic procedures
§ Biopsies
§ IV urography
§ Cystography
12.urinalysis: · Components: color clarity, pH, specific gravity o Specific
, N351 final patho (summaries)
gravity
§ Expression of the degree of concentration of the urine which measure the density of a solution
to the density of water
§ Normal range of 1.010-1.025
§ Can be altered by the presence of blood, protein or casts
§ Largely depends on hydration status
· Decrease in fluid intake increases specific gravity
· Tests for protein, glucose and ketones
1. pathophysiology of Nausea/vomiting: · Vomiting occurs when there's stimula- tion of the
medulla oblongata
· Five neurotransmitters involved
o Muscarinic
o Dopamine
o Histamine
o NK1/substance P
o 5-Hydroxytryptamine/serotonin
· Stimuli are relayed to the vomiting center by afferent signals from chemoreceptor trigger
zone, cerebral cortex, sensory organs and the vestibular apparatus
· This stimulus and activation sends signals tot eh GI tract to relax the gastroe- sophageal
sphincter and reverse peristalsis causing the vomiting
2. general treatment of nausea and vomiting: · Antiemetics drugs work on those specific
neurotransmitters to prevent the transmission and response on the vomiting center, chemo
receptor trigger zones, cerebral cortex, vestibular apparatus and combination of these
3. complications with nausea and vomiting: · Dehydration
· Electrolyte depletion
· Metabolic alkalosis with loss of gastric contents
· Metabolic acidosis with dehydration/FVD
· Anxiety
· Increased ICP
· Pain
· Oral ulcers and tooth decay
4. GI ulcers: o Erosion of a mucous membrane forms an excavation in the stomach, pylorus,
duodenum, or esophagus. Most commonly occur in the duodenum
, N351 final patho (summaries)
o Associated with infection of H. Pylori
5. areas prone to GI ulcers: o Prone area
§ Duodenal mucosa is more prone (inability to handle HCl and pepsin)
6. symptoms of GI ulcers: § Pain in the midepigastrium
· Dull constant pain or a burning sensation
· Pain with gastric ulcers vs. duodenal ulcers
o Gastric ulcer
§ Pain immediately after eating
o Duodenal ulcer
§ Pain occurs 2-3 hours after meals; pain relief with food or antacid compared to patients with
gastric ulcers
§ Heart burn (pyrosis)
, N351 final patho (summaries)
§ GI discomfort/bloating
§ Nausea
7. complication with GI ulcers: § Hemorrhage
§ Perforation
8. treatment of GI ulcers: § Prescription medications
· PPIs, H2 blockers and antibiotics
§ Avoid NSAIDs
§ Surgery
§ Lifestyle and habits such as cigarette and alcohol use
§ Dietary modifications
§ education
9. assessment of the urological system: health history: § Presence of dysuria, hematuria, enuresis
and nocturia
§ Fever/chills
§ Stones
§ Incontinence
10.assessment of the urological system: physical assessment: § Labs
§ Urine character, color, consistency and odor
§ Pain
§ Palpation and percussion
11.assessment of the urological system: diagnostic studies: § Urinalysis
§ urine culture
§ Ultrasonography (bladder scan)
§ CT and MRI
§ Endoscopic procedures
§ Biopsies
§ IV urography
§ Cystography
12.urinalysis: · Components: color clarity, pH, specific gravity o Specific
, N351 final patho (summaries)
gravity
§ Expression of the degree of concentration of the urine which measure the density of a solution
to the density of water
§ Normal range of 1.010-1.025
§ Can be altered by the presence of blood, protein or casts
§ Largely depends on hydration status
· Decrease in fluid intake increases specific gravity
· Tests for protein, glucose and ketones
