Medicine Notes
Medicine Notes
Medicine Notes
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Digestive system.
Signs and symptoms of the disorders
of the digestive system
Pain
Nausea and vomiting
Intestinal gas
. Belching
flatulence
Dyspepsia
Change in bowel habits and stool
characteristics
Diarrhoea
constipation
Stomatitis
Diet modification
Promoting of rest
Avoiding alcohol and NSAIDs
Adherence on drugs
PEPTIC ULCERS
Peptic ulcers are open sores that develop on the inside lining
of the stomach and the upper portion of the small
intestine.
Less often, ulcers may cause severe signs or symptoms such as:
Vomiting or vomiting blood — which may appear red or black
Dark blood in stools, or stools that are black or tarry
Trouble breathing
Feeling faint
Nausea or vomiting
Unexplained weight loss
Appetite changes
CAUSES OF PEPTIC ULCERS.
A bacterium.
Helicobacter pylori bacteria in the mucous layer that
lining the stomach and small intestine can cause
inflammation of the stomach's inner layer, producing an
ulcer. It may be transmitted from person to person by close
contact, such as kissing and through food and water.
Drugs that protect the lining of the stomach and small intestine ;In some
cases, your doctor may prescribe medications called cyto-protective agents that
help protect the tissues that line your stomach and small intestine.
Nursing interventions
Relief of pain;
medications provided should provide relief of ulcer related pain. The
patient should avoid aspirin.
Reducing anxiety;
assess the patients level of anxiety explaining the tests and medications
as scheduled to reduce anxiety.
interact with the patient in a relaxed manner to identify stressors.
encourage the patients family toprovide emotional support.
Maintaining optimal nutritional status.
Assess the patient for malnutrition and weight loss.
Advise and explain the importance of adhering to medication and dietary
restrictions
Monitoring and managing potential complications
Hemorrhage; assess the patient for faintness, dizziness and nausea
which may precede or accompany bleeding from the ulcer
Perforation and penetration, watch for any back and epigastric pain not
relieved by medication and report immediately .
Gastric outlet obstruction
Pass an NG tube to aspirate gastric contents; a residual of
more than 400 ml suggests obstruction, report to doctor for
further intervention.
Promoting home , community based, and transitional
care
Teach the patient about the factors that relieve or aggravate
the condition.
Review information about the medication to be taken at
home including name, dosage, frequency , possible side
effects, stressing the importance of completing the dose even
when the symptoms have subsided.
Reinforce the importance of follow up and give follow up
date.
Remind the patient and family to participate in health
promotion activities like cessation of use of tobacco, stress
management
COMPLICATIONS
A hole (perforation) in your stomach wall. Peptic ulcers can eat a hole through
(perforate) the wall of your stomach or small intestine, putting you at risk of serious
infection of your abdominal cavity (peritonitis).
Obstruction. Peptic ulcers can block passage of food through the digestive tract,
causing you to become full easily, to vomit and to lose weight either through swelling
from inflammation or through scarring.
Gastric cancer. Studies have shown that people infected with H. pylori have an
increased risk of gastric cancer.
JAUNDICE
Jaundice is a condition in which the skin, sclera (whites of
the eyes) and mucous membranes turn yellow.
It is also known as icterus.
This yellow color is caused by a high level of bilirubin, a
yellow-orange bile pigment. Bile is fluid secreted by the
liver. Bilirubin is formed from the breakdown of red blood
cells.
CAUSES
gall stones.
Inflammation (swelling) of the gallbladder.
gall bladder cancer.
Pancreatic tumor.
TYPES OF JAUNDICE
Hemolytic jaundice
Is the result of an increased destruction of the red blood cells. The
plasma is rapidly flooded with bilirubin, though the liver is
functioning well, it cannot excrete the bilirubin as quickly as it is
being formed. It is commonly asymptomatic.
Hepato-cellular jaundice.
Is caused by the inability of damaged liver cells to clear normal
amounts of the bilirubin from the blood. The damage may be caused
by hepatitis viruses and other viruses like yellow fever or chemical
toxins.
Obstructive jaundice
May be due to occlusion of the bile duct by gall stone, an inflammatory
process or a tumor or pressure from an enlarged organ. it makes bile
unable to reach the intestine, it remains in the liver then it is
reabsorbed in the blood and Carried through out the body
stainnning the skin, mucous membranes and scelera. it is excreted in
urine making it deep orange.
SIGNS AND SYMPTOMS OF JAUNDICE.
fever
Chills.
abdominal pain
Flu-like symptoms.
Change in skin color.
Dark-colored urine and/or clay-colored stool.
If jaundice isn't caused by an infection, you may have symptoms such
as weight loss or itchy skin (pruritus). If the jaundice is caused by
pancreatic or biliary tract cancers, the most common symptom is
abdominal pain. Sometimes, you may have jaundice occurring with
liver disease if you have:
Chronic hepatitis or inflammation of the liver.
Pyoderma gangrenosum (a type of skin disease)..
Polyarthralgias (inflammation of the joints
MANAGEMENT OF JAUNDICE
Fatigue
flu-like symptoms
Dark urine
Pale stool
Abdominal pain
Loss of appetite
Unexplained weight loss
Yellowish skin and eyes as signs of jaundice
PREVENTION
Tumor. A tumor may prevent bile from draining out of your gallbladder
properly, causing bile buildup that can lead to cholecystitis.
Bile duct blockage. Kinking or scarring of the bile ducts can cause blockages
that lead to cholecystitis.
Blood vessel problems. A very severe illness can damage blood vessels and
decrease blood flow to the gallbladder, leading to cholecystitis.
SYMPTOMS
The body takes nutrients from food and converts them to energy. the body
has takes the food components that it needs, waste products are left behind.
The kidney and urinary systems help the body to eliminate liquid waste
called urea, and to keep chemicals, such as potassium and sodium, and water
in balance .
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Structure of the kidney
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PHYSIOLOGY
Two ureters. These narrow tubes carry urine from the kidneys to the bladder
Bladder. The bladder's walls relax and expand to store urine, and contract and
flatten to empty urine through the urethra.
Two sphincter muscles. These circular muscles help keep urine from leaking by closing tightly the opening of the bladder.
Nerves in the bladder. The nerves alert a person when it is time to urinate, or empty the bladder.
Abdominal cramping
Abdominal, pelvic or back pain that can be severe
Bloody or pink-colored urine ( hematuria)
cloudy urine
Fever and chills
Foul-smelling urine
frequent urination
General ill feeling
Leaking of urine
Pain during sexual intercourse
Pain or burning with urination ( dysuria)
unexplained weight loss
Urgent need to urinate
GENERAL CAUSES
Antibiotics
Azithromycin (Azuthromax) 1g single dose
Erythromycin 500mg 6 hourly for 7 days
Levofloxacin (Levaquine) 500mg once daily
for 7 days.
COMPLICATIONS
Women who;
Are sexually active.
Use certain types of birth control.
Are pregnant.
Have reached menopause.
Interference with the flow of urine. .
Changes in the immune system.
Prolonged use of bladder catheters.
CAUSES
Bacterial ;The most common bug or bacterium causing urinary tract infection is Escherichia coli (E.
coli).
Drug-induced cystitis.; particularly the chemotherapy drugs cyclophosphamide and ifosfamide, can
cause inflammation
Radiation cystitis. Radiation treatment of the pelvic area can cause inflammatory changes in bladder
tissue.
Foreign-body cystitis. Long-term use of a catheter can predispose you to bacterial infections and to
tissue damage, and cause inflammation.
Chemical cystitis. hypersensitivity to chemicals contained in certain products, such as bubble bath,
feminine sprays or spermicidal jellies, and may develop an allergic-type reaction within the bladder,
causing inflammation.
Cystitis associated with other conditions. Cystitis may sometimes occur as a complication of other
disorders, such as diabetes, kidney stones, an enlarged prostate or spinal cord injuries.
SIGNS AND SYMPTOMS
Go to the toilet to pass urine as soon as you feel the urge, rather than
holding on.
Drink plenty of water every day to flush your urinary system.
Wipe yourself from front to back (urethra to anus) after going to the toilet.
Wash your genitals before sex and encourage your partner to do the same.
Urinate after sex.
Wear cotton rather than nylon underwear.
Avoid wearing nylon pantyhose, tight pants or tight jeans.
Don’t use perfumed soaps, talcum powder or any type of deodorant around
your genitals.
Avoid bubble baths.
Treat vaginal infections such as thrush or trichonomiasis promptly, since
these organisms can encourage cystitis.
Pyelonephritis( kidney infection)
Inflammation of the kidney.
Causes
Due to a certain type of
Glomerulonephritis
Glomerulonephritis is inflammation of the tiny filters in the kidneys
(glomeruli).
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SIGNS AND SYMPTOMS
foamy urine.
Nephrotic syndrome is a kidney disorder that causes your body to pass too much
protein in your urine.
Blood clots. The inability of the glomeruli to filter blood properly can lead to loss of blood
proteins that help prevent clotting. This increases your risk of developing a blood clot in your
veins.
High blood cholesterol and elevated blood triglycerides. When the level of the protein albumin
in your blood falls, your liver makes more albumin. At the same time, your liver releases more
cholesterol and triglycerides.
Poor nutrition. Loss of too much blood protein can result in malnutrition. This can lead to weight
loss, which can be masked by edema. You may also have too few red blood cells (anemia), low
blood protein levels and low levels of vitamin D.
High blood pressure. Damage to your glomeruli and the resulting buildup of excess body fluid
can raise your blood pressure.
Acute kidney injury. If your kidneys lose their ability to filter blood due to damage to the
glomeruli, waste products can build up quickly in your blood. If this happens, you might need
emergency dialysis — an artificial means of removing extra fluids and waste from your blood —
typically with an artificial kidney machine (dialyzer).
Chronic kidney disease. Nephrotic syndrome can cause your kidneys to lose their function over
time. If kidney function falls low enough, you might need dialysis or a kidney transplant.
Infections. People with nephrotic syndrome have an increased risk of infections.
Renal failure
MANAGEMENT FOR ACUTE RENAL FAILURE