Download - Patho Diagram
B. Diagram of Pathophysiology
Ulcer induced by NSAIDs
Topical irritation of the gastric epithelial cells and
reduced protective prostaglandin synthesis
Pharmacologic properties
Increased concentration or activity of acid-pepsin
Altered mucosal gel layer
Tissue cannot withstand the digestive action of gastric acid HCL and
Pepsin
Normal antireflux barrier is impaired
Predisposing Factors:
- Genetics- Helicobacter pylori- Hypersecretory Condition
Precipitating Factors:
- Smoking
- Drinking Alcohol
- Taking NSAIDs
Signs and Symptoms:
- Loss of appetite
- Abdominal pain
- Pain after eating
- vomiting
- Weakness due to vomiting, loss of appetite and pain
- Heartburn or Bleeding perforation from the ulcer
- Gastric outlet obstruction
Helicobacter bacteria occur
Decrease Resistant to bacteria
Act as a barrier to HCLDamage mucosa cannot secrete enough mucous
Erosion to the mucosaDecrease resistance of
the Mucosa
Normal flora of mucosal layer which coats the lining of the human stomach and
doudenum
inflammation
Host immune system reponse
Damage mucosal defense system
Diminished blood flow
Good Prognosis
If not treatedIf treated
Nursing Management
- Advice to avoid spicy and acidic food and dairy products and caffeinated drinks; alcohol and smoking cigarettes.
- Advice to take small frequent meals
- Any bleeding from the rectum, blood in stools sudden acute
abdominal pain restlessness, falling of temperature should be reported at once to the physician or the patient should be brought at once to the hospital.
- Take vital signs and teach patient family member how to take and record same.
- Provide light clothing or linens.
- Modify the environment through cooling by turning on the air
conditioner or fan.
- Instruct to increase oral fluid intake
- Regulate IV fluid.
- Administer medications as ordered.
- Teach members of the family how to report all symptoms to the attending physician especially when patient is being cared for at home.
- Teach, guide and supervise members of the family on nursing
techniques which will contribute to the patient’s recovery.
- Interpret to family the nature of disease and need for practicing preventive and control measures.
Medical Management
- IV fluids and electrolytes- Bed rest- Avoid NSAIDs- Histamine-2 (H2) receptor antagonist
Surgical Movement- Vagotomy – may be performed to reduce
gastric acid secretion
The bacteria that does not re- infect the host is shed
into the stool
The bacteria that remained present in the system of the host pauses and continuous to multiply
which makes the host as “carrier” for a long time.
Bad Prognosis
Death
- internal bleeding in
the digestive system
- splitting (perforation)
of a section of the
digestive system or
bowel, which
spreads the infection
to nearby tissue
- High possibility of
getting Gastric
cancer