GI Disorders Study Guide

Pathophysiolo Surgical Nursing

Disorder Key Features Mnemonic Diagnostics Medications
gy Intervention Priorities
High-protein,
Transmural Corticosteroids,
low-residue
inflammation → Aminosalicylates, Partial/total colectomy
Colonoscopy (skip diet, monitor
Crohn’s cobblestone RLQ pain, diarrhea, “Cobblestone Immunomodulato with
lesions), Barium study, fluids/electrolyt
Disease lesions, weight loss CROHN” rs, Monoclonal ileostomy/anastomosis
CBC es, pain relief,
granulomas, antibodies (recurrence common)
skin care, stress
fistulas (Natalizumab)
reduction
Monitor
Corticosteroids,
Superficial bleeding,
Aminosalicylates
mucosal “ULCER” → Uniform, fluid/electrolyte
LLQ pain, bloody Sigmoidoscopy/colonosco (Sulfasalazine), Total colectomy with
Ulcerative inflammation → Lots of blood, balance,
diarrhea, rectal py, Stool test (blood), Immunomodulato ileostomy or ileoanal
Colitis continuous Continuous, End in promote rest,
involvement CBC rs, Monoclonal anastomosis (curative)
ulcerations, rectum, Risk cancer reduce anxiety,
antibodies
crypt abscesses patient
(Infliximab)
education
Pre-op
stabilization,
Obstruction “APPENDIX” →
RLQ pain IV fluids, post-op pain
(fecalith/tumor) Abdominal pain CBC (↑WBC), Appendectomy
(McBurney’s point), antibiotics, relief, high
Appendicitis → inflammation, RLQ, Point CT/ultrasound, (laparotomy/laparosco
rebound analgesics (avoid Fowler’s,
pus formation, tenderness, Pregnancy test py)
tenderness, fever laxatives/enemas) incision care,
risk of rupture Peritonitis risk
early
ambulation
Diverticulitis Herniation of LLQ pain, fever, “DIVERT” → CT with contrast, CBC Antibiotics, Resection with Clear liquid diet,
 Pathophysiolo Surgical Nursing
Disorder Key Features Mnemonic Diagnostics Medications
gy Intervention Priorities
mucosa → leukocytosis, Diarrhea/constipati (↑WBC, ↑ESR), analgesics anastomosis or avoid
infection, constipation/diarrh on, Infection, Colonoscopy (Meperidine), Hartmann’s procedure nuts/popcorn,
inflammation, ea Vomiting, Elevated (contraindicated in antispasmodics, if perforated monitor for
perforation risk WBC, Risk acute) bulk-forming perforation,
perforation, Tender laxatives pain relief, fluid
LLQ balance
Diet
modification
Functional Alternating
Antispasmodics, (high fiber),
motility disorder constipation/diarrh Diagnosis of exclusion,
“IBS = I Be Antidiarrheals, None (functional stress
IBS → altered ea, bloating, pain stool studies,
Stressed” Antidepressants, disorder) reduction,
peristalsis, relieved by colonoscopy
Probiotics patient
stress-related defecation
education,
exercise
Prevent
Impaired dehydration,
Vitamin/mineral
absorption of “FAT MAL” → Fatty monitor
Stool fat analysis, D- supplements, Surgery only if
nutrients (celiac, Steatorrhea, stools, Anemia, nutrition,
Malabsorpti xylose test, Endoscopy antibiotics structural cause (e.g.,
pancreatic weight loss, Thin, Malnutrition, supplement
on with biopsy, Hydrogen (tropical sprue), resection for short
insufficiency, anemia, bloating Abdominal pain, vitamins/minera
breath test gluten-free diet bowel)
lactose Loss of vitamins ls, treat
(celiac)
intolerance) underlying
cause
Small Bowel Adhesions/herni Colicky pain, fecal IV fluids, NG NG tube care,
“SBO = Stop Bowel Abdominal x-ray/CT (air- Adhesiolysis, hernia
Obstruction a → vomiting, decompression, monitor
Output” fluid levels) repair, bowel resection
(SBO) accumulation of distention analgesics fluids/electrolyt
 Pathophysiolo Surgical Nursing
Disorder Key Features Mnemonic Diagnostics Medications
gy Intervention Priorities
fluid/gas → es, pain relief,
distention, assess bowel
ischemia sounds
Monitor bowel
Tumor/stricture sounds, I&O,
Large Bowel → accumulation Constipation, pain relief,
“LBO = Large Abdominal x-ray/CT/MRI, IV fluids, rectal Resection, colostomy,
Obstruction of contents → distention, crampy prepare for
Blocked Output” Colonoscopy tube cecostomy
(LBO) distention, pain, fecal vomiting surgery,
perforation risk prevent
perforation
Monitor
bleeding,
Mucosal “POLYP =
educate on
overgrowth → Rectal bleeding, Protruding Colonoscopy, biopsy, None (removed Polypectomy
Polyps colonoscopy
neoplastic or obstruction if large Outgrowth Leads to barium enema surgically) (endoscopic removal)
screening, post-
non-neoplastic Yucky Problems”
polypectomy
care

Endocrine & Hepatic Disorders Study Guide

Pathophysiolog Nursing
Disorder Key Features Mnemonic Diagnostics Medications Surgical Intervention
y Priorities
Fibrosis replaces Ascites, “CIRRHOSIS” ↑AST, ALT, GGT, Diuretics Rest, low-
Paracentesis, liver
Hepatic Cirrhosis normal liver tissue jaundice, → C: Clotting ↓, bilirubin; (spironolactone), sodium diet,
transplant
→ portal HTN, varices, I: Itchy skin, R: ↓albumin; vitamins, lactulose monitor
 impaired edema, Red palms, R: prolonged PT; (encephalopathy), ascites, skin
metabolism encephalopath Renal issues, biopsy H2 blockers, care,
y O: Overgrowth albumin infusion bleeding
of tissue, S: precautions
Spider
angiomas, I:
Increased
bilirubin, S:
Splenomegaly
“HAV = Bed rest,
Antigen/antibod
Viral infection → Jaundice, Handwashing, Interferon, Ribavirin nutrition,
y tests (HBsAg,
hepatocyte anorexia, HBV = Blood, (HCV), Liver transplant avoid
Hepatitis (A–E) Anti-HBs, HAV
necrosis, malaise, dark HCV = Lamivudine/Adefovi (fulminant failure) alcohol,
stool antigen),
inflammation urine Contaminated r (HBV) infection
↑bilirubin
needles” prevention
“ASCITES =
Accumulation Daily
Percussion
Fluid shifts into of Sodium, weights,
Abdominal (shifting
peritoneum due to Cirrhosis, Spironolactone, I&O, low-
Ascites (Portal HTN) distention, dullness), girth Paracentesis
↑portal pressure, Increased furosemide sodium diet,
SOB, striae measurement,
↓albumin Tension, monitor
ultrasound
Enlarged electrolytes
Stomach”
“VARICES = Monitor
Vasopressin,
Collateral veins Very Acute bleeding,
Hematemesis, Octreotide, Beta- Band ligation,
Esophageal Varices rupture due to Rupture In Endoscopy, LFTs airway, IV
melena, shock blockers sclerotherapy, TIPS
portal HTN Cirrhosis fluids,
(propranolol)
Emergency Vitamin K,
 Situation” transfusions
Neuro
checks,
Confusion, “HE = High
↑serum protein
↑Ammonia → CNS asterixis, Encephalopath Lactulose, rifaximin,
Hepatic Encephalopathy ammonia, EEG None restriction
depression altered sleep, y from neomycin
changes (short-term),
coma Ammonia”
monitor
electrolytes
“PANCREAS =
NPO, NG
Severe Pain, Amylase
Autodigestion by suction, pain
epigastric pain,↑, Nausea, Opioids, H2
trypsin → ↑Amylase/lipase, relief, semi-
Acute Pancreatitis Cullen’s sign, Cullen’s, Rigid blockers, PPIs, Necrosectomy, drainage
necrosis, CT, ultrasound Fowler’s,
Grey-Turner abdomen, antiemetics
hemorrhage monitor
sign Enzymes ↑,
electrolytes
Alcohol, Shock”
“CHRONIC =
Constant pain,
High alcohol,
Avoid
Recurrent
Fibrosis → duct Recurrent pain, ERCP, MRI, Pancreatic alcohol,
attacks, Pancreaticojejunostomy
Chronic Pancreatitis obstruction, steatorrhea, glucose enzymes, non- enzyme
Obstruction, , Whipple
malabsorption weight loss tolerance test opioid analgesics replacement,
Nutrition poor,
low-fat diet
Insulin
deficiency,
Calcification”
RUQ pain “FAT, FORTY, Antibiotics, Pain relief,
Cholecystitis/Cholelithiasi Gallstones → bile Ultrasound, Laparoscopic
radiating to FEMALE, UDCA/CDCA low-fat diet,
s stasis, infection ERCP cholecystectomy
shoulder, FERTILE” (cholesterol monitor bile
 nausea, stones), analgesics drainage
jaundice
“DIABETES =
D: Diuresis, I:
Infections, A: Insulin (rapid,
SMBG,
Abdominal pain short, intermediate,
3 Ps: Polyuria, diet/exercise,
(DKA), B: FPG ≥126 long-acting), oral
Deficient insulin Polydipsia, foot care,
Diabetes Mellitus (Type 1 Blurred vision, mg/dL, HbA1c agents (metformin, Pancreas transplant
secretion/action Polyphagia; hypoglycemi
& 2) E: Electrolyte ≥7%, OGTT sulfonylureas, (rare)
→ hyperglycemia fatigue, a prevention,
imbalance, T: ≥200 mg/dL TZDs, alpha-
infections patient
Tingling, E: glucosidase
education
Excess thirst, inhibitors)
S: Slow
healing”

Neuro-Endocrine Disorders Study Guide

Medical/Surgical
Disorder Pathophysiology Key Features Mnemonic Diagnostics Nursing Priorities
Management
Monitor
Excess ADH → water Concentrated ↑Urine SG, ↓serum Fluid restriction,
“SIADH = Soaked electrolytes, daily
SIADH retention, dilutional urine, weight gain, Na, ↓serum furosemide, hypertonic
Inside” weights, seizure
hyponatremia edema, confusion osmolality saline
precautions
Dilute urine, Fluid deprivation
Diabetes Insipidus ↓ADH → polyuria, Desmopressin, Hydration, monitor
polydipsia, “DI = Dry Inside” test, ↓Urine SG,
(DI) dehydration vasopressin I&O, skin care
hypotension ↑serum osmolality
Hyperthyroidism Excess T3/T4 → Heat intolerance, “HOT THYROID” ↓TSH, ↑T3/T4, PTU, methimazole, Calm environment,
(Graves’) ↑metabolism weight loss, mnemonic thyroid scan radioactive iodine, monitor HR, eye
tremor, thyroidectomy care
exophthalmos
Cold intolerance,
Warm environment,
Hypothyroidism weight gain, Levothyroxine,
↓T3/T4 → ↓metabolism “SLOW” mnemonic ↑TSH, ↓T3/T4 monitor airway,
(Myxedema) bradycardia, supportive care
avoid sedatives
myxedema coma
Bone pain, Monitor Ca, strain
↑PTH → ↑Ca, bone “Bones, Stones, Hydration, diuretics,
Hyperparathyroidism fractures, renal ↑Ca, ↑PTH urine, fall
resorption Groans, Moans” parathyroidectomy
stones precautions
“CATS” →
Seizure
Tetany, Chvostek’s, Convulsions,
Hypoparathyroidism ↓PTH → ↓Ca, ↑Phos ↓Ca, ↑Phos Ca gluconate IV, Vit D precautions, airway
Trousseau’s Arrhythmias,
support
Tetany, Spasms
Moon face, buffalo ↑Cortisol,
↑Cortisol → “CUSHING” Taper steroids, Monitor glucose,
Cushing’s Syndrome hump, truncal dexamethasone
hypermetabolism mnemonic adrenalectomy infection prevention
obesity, striae suppression test
Bronze skin,
“ADDISON = Added
hypotension, Hydrocortisone, IV Crisis prevention,
Addison’s Disease ↓Cortisol/aldosterone pigmentation, ↓Cortisol, ↑K, ↓Na
hyponatremia, fluids, salt stress management
Sodium low”
hyperkalemia
Early: LOC change,
Brain swelling/bleeding → “ICP = Increased Mannitol, steroids, CSF HOB ↑30°, airway,
↑ICP headache; Late: CT/MRI, avoid LP
↑pressure Cranial Pressure” drainage neuro checks
Cushing’s triad
“SAFE” → Safety, Seizure
Aura, tonic-clonic,
Seizure Disorders Abnormal neuronal firing Airway, Fluids, EEG, CT/MRI Antiepileptics, surgery precautions,
postictal confusion
Education airway, meds
 FAST: Face droop, tPA (ischemic), Neuro checks,
Ischemia/hemorrhage → “BE FAST”
CVA (Stroke) Arm weakness, CT/MRI, carotid US anticoagulants, carotid mobility, speech
brain damage mnemonic
Speech, Time endarterectomy therapy
LOC change, Airway, neuro
Trauma → primary +
Head Injury/TBI Battle’s sign, CSF “HEAD” mnemonic CT/MRI, X-ray ICP control, surgery checks, prevent
secondary injury
leak complications
Paralysis, loss of
Immobilization,
Spinal Cord Injury Trauma → cord sensation, “SPINAL” Steroids, traction,
X-ray, MRI, ECG airway, prevent
(SCI) compression/transection bladder/bowel mnemonic surgery
complications
dysfunction
Fever, headache,
LP (↓glucose, Neuro checks,
Infection → meningeal nuchal rigidity, “Meningitis = Neck IV antibiotics,
Meningitis ↑protein, ↑WBC), seizure precautions,
inflammation Kernig’s, stiff, Fever, Rash” dexamethasone
CT/MRI isolation
Brudzinski’s
Fever, confusion, “ENCEPHALITIS = Comfort, seizure
Viral/fungal → brain
Encephalitis seizures, focal Encephalon MRI, PCR, CSF Acyclovir, antifungals precautions, renal
inflammation
deficits inflamed” monitoring
Fatigue, weakness, Mobility, bladder
Multiple Sclerosis MRI (plaques), CSF Glatiramer, steroids,
Autoimmune demyelination vision loss, “MS = Many Scars” training, emotional
(MS) oligoclonal bands baclofen
spasticity support
Energy
Myasthenia Gravis Autoimmune → ↓ACh Ptosis, diplopia, “MG = Muscle Tensilon test, AChR Pyridostigmine, conservation, meds
(MG) receptors bulbar weakness Gone” antibodies steroids, thymectomy on time, aspiration
prevention
Respiratory
Guillain-Barré Autoimmune → Ascending “GBS = Ground → LP (↑protein,
IVIG, plasmapheresis support, mobility,
Syndrome (GBS) demyelination of PNS paralysis, areflexia Brain Syndrome” normal WBC), EMG
prevent
 complications

Neuro–Musculoskeletal Disorders Study Guide

Medical/Surgical Nursing
Disorder Pathophysiology Key Features Mnemonic Diagnostics
Management Priorities
Carbamazepine, Pain prevention,
Sudden unilateral
Trigeminal Irritation/compression of “TRIGEMINAL = gabapentin, soft foods, hygiene
stabbing facial pain, tic MRI, clinical exam
Neuralgia CN V Triggered Pain” microvascular during pain-free
douloureux
decompression intervals
Eye protection,
Facial paralysis, tearing, “BELL = Blink, Eye, Prednisone, analgesics,
Bell’s Palsy Inflammation of CN VII Clinical exam facial massage,
pain behind ear Lacrimation, Lips” electrical stimulation
reassurance
Neurofibrillary tangles, Safe environment,
Memory loss, personality “AD = Always MMSE, CT/MRI, Cholinesterase
Alzheimer’s Disease amyloid plaques → routine, support
changes, disorientation Declining” labs inhibitors, memantine
cortical degeneration ADLs, nutrition
Mobility, fall
Tremor, rigidity,
↓Dopamine in substantia Clinical diagnosis, Levodopa, dopamine prevention,
Parkinson’s Disease bradykinesia, postural “TRAP” mnemonic
nigra PET/SPECT agonists, DBS nutrition, speech
instability
therapy
Motor neuron Respiratory
Progressive weakness, “ALS = Always Losing Riluzole, supportive
ALS degeneration → muscle EMG, clinical support, mobility,
fasciculations, dysphagia Strength” care
atrophy nutrition
Eye Disorders ↑IOP (glaucoma), lens Glaucoma: halos, vision Glaucoma = “HALO”, Tonometry, slit- Drops, trabeculectomy, Medication
(Glaucoma, opacity (cataract), retinal loss; Cataract: blurry Cataract = “CLOUDY”, lamp, phacoemulsification, adherence, eye
Cataract, Retinal separation vision; RD: curtain vision RD = “CURTAIN” ophthalmoscopy scleral buckle protection, postop
 Medical/Surgical Nursing
Disorder Pathophysiology Key Features Mnemonic Diagnostics
Management Priorities
Detachment) care
Otitis: pain, discharge;
Ear Disorders Communication
Infection, fluid Meniere’s: vertigo, Audiometry, Antibiotics, diuretics,
(Otitis, Meniere’s, Meniere’s = strategies, safety,
imbalance, nerve tinnitus, hearing loss; Weber/Rinne, vestibular rehab,
Vertigo, Hearing “VERTIGO TRIAD” infection
damage Vertigo: positional ENG surgery
Loss) prevention
dizziness
OA: stiffness, nodes;
Bone Disorders Gout: big toe pain; OA = “Wear & Tear”,
(OA, Gout, Osteoporosis: fractures; Gout = “TOPHI TOE”, NSAIDs,
Degeneration, uric acid Pain relief,
Osteoporosis, Osteomalacia: bowed Osteoporosis = X-ray, DXA, labs, bisphosphonates, Vit
deposition, bone mobility, diet,
Osteomalacia, legs; Paget’s: “POROUS”, Paget’s = biopsy D/Ca, antibiotics,
resorption/weakening infection control
Paget’s, deformities; “MOSAIC”, Osteomyelitis surgery
Osteomyelitis) Osteomyelitis: bone = “HOT BONE”
infection
Orthopedic Care
Cast syndrome, “5 P’s” → Pain, Pallor, Elevation, exercise,
(Casts, Splints, Immobilization for Neurovascular Cast care, traction
compartment syndrome, Pulselessness, skin care, infection
Braces, Traction, healing checks alignment, pin site care
disuse atrophy Paresthesia, Paralysis prevention
External Fixators)