NCLEX Deck

Gastrointestinal

NCLEX Clinical Study Booklet · 12 cards

Contents

GERD.

Upper GI
What is GERD?
  • Backflow of gastric contents into the esophagus.
  • Chronic reflux damages the esophageal lining.
What are the Causes / Risk Factors?
  • Weak lower esophageal sphincter
  • Obesity, hiatal hernia
  • Large/fatty meals, caffeine, alcohol
  • Smoking
  • Lying down after meals
What are the Symptoms?
  • Heartburn (pyrosis)
  • Regurgitation
  • Dysphagia
  • Chronic cough, hoarseness
  • Worse lying down / after meals
How is it Diagnosed?
  • Clinical history
  • Endoscopy
  • Esophageal pH monitoring
What is the Treatment?
  • PPIs (omeprazole), H2 blockers, antacids
  • Small frequent meals; avoid triggers
  • Stay upright 2–3h after eating; elevate HOB
  • Weight loss; no smoking
NCLEX TipElevate the head of the bed, avoid late/large meals and triggers, and stay upright after eating.
© NCLEX Deck1 / 12

Peptic Ulcer Disease.

Upper GI
What is Peptic Ulcer Disease?
  • Erosion of the stomach (gastric) or duodenal mucosa.
  • Gastric pain worse WITH food; duodenal BETTER with food.
What are the Causes / Risk Factors?
  • H. pylori infection
  • NSAIDs, aspirin
  • Excess acid
  • Smoking, alcohol, stress
What are the Symptoms?
  • Epigastric burning/gnawing pain
  • Gastric: worse with eating
  • Duodenal: relieved by eating
  • N/V
  • Hematemesis / melena (bleeding)
How is it Diagnosed?
  • Endoscopy
  • H. pylori testing (urea breath, stool)
  • Stool occult blood
What is the Treatment?
  • Triple therapy for H. pylori (2 antibiotics + PPI)
  • PPIs / H2 blockers
  • Avoid NSAIDs, alcohol, smoking
  • Monitor for bleeding/perforation
NCLEX TipGastric ulcer pain worsens WITH food; duodenal pain is relieved BY food. Treat H. pylori with antibiotics + PPI.
© NCLEX Deck2 / 12

Gastritis.

Upper GI
What is Gastritis?
  • Inflammation of the stomach lining.
  • Acute or chronic.
What are the Causes / Risk Factors?
  • H. pylori
  • NSAIDs, alcohol
  • Stress, spicy foods
  • Bile reflux
What are the Symptoms?
  • Epigastric pain / discomfort
  • N/V
  • Anorexia
  • Bloating, indigestion
  • Hematemesis (erosive)
How is it Diagnosed?
  • Endoscopy
  • H. pylori testing
  • CBC (anemia if bleeding)
What is the Treatment?
  • Remove the cause (stop NSAIDs/alcohol)
  • PPIs / H2 blockers, antacids
  • Treat H. pylori
  • Bland diet, small meals
NCLEX TipRemove the offending agent (NSAIDs, alcohol) and treat H. pylori. Watch for bleeding.
© NCLEX Deck3 / 12

Appendicitis.

Emergency
What is Appendicitis?
  • Inflammation of the appendix.
  • Can rupture → peritonitis. A surgical emergency.
What are the Causes / Risk Factors?
  • Obstruction (fecalith)
  • Lymphoid hyperplasia
  • Infection
What are the Symptoms?
  • Periumbilical pain → RLQ (McBurney's point)
  • Rebound tenderness
  • N/V, anorexia
  • Low-grade fever
  • Rovsing's sign
  • Sudden pain relief = rupture (danger)
How is it Diagnosed?
  • CT / ultrasound
  • ↑WBC
  • Clinical exam
What is the Treatment?
  • Appendectomy
  • NPO, IV fluids, antibiotics
  • NO heat or laxatives (rupture risk)
  • Post-op care
NCLEX TipRLQ pain at McBurney's point with rebound tenderness. Avoid heat/laxatives. Sudden pain relief may signal rupture.
© NCLEX Deck4 / 12

Cholecystitis.

Hepatic
What is Cholecystitis?
  • Inflammation of the gallbladder, usually from gallstones.
  • Obstructed bile flow.
What are the Causes / Risk Factors?
  • Gallstones (cholelithiasis)
  • Female, Fat, Forty, Fertile (risk)
  • High-fat diet
  • Rapid weight loss
What are the Symptoms?
  • RUQ pain (radiates to right shoulder)
  • Worse after fatty meals
  • +Murphy's sign
  • N/V
  • Fever
  • Jaundice (if duct blocked)
How is it Diagnosed?
  • Ultrasound (stones)
  • HIDA scan
  • ↑WBC, ↑bilirubin / alk phos
What is the Treatment?
  • Low-fat diet; NPO during acute phase
  • Pain control, antibiotics
  • Cholecystectomy (often laparoscopic)
  • Monitor for complications
NCLEX TipRUQ pain after fatty meals + positive Murphy's sign = cholecystitis. Low-fat diet and cholecystectomy.
© NCLEX Deck5 / 12

Pancreatitis.

Emergency
What is Pancreatitis?
  • Inflammation of the pancreas — autodigestion by its own enzymes.
  • Can be life-threatening.
What are the Causes / Risk Factors?
  • Gallstones
  • Chronic alcohol use
  • Hypertriglyceridemia
  • Certain medications, trauma
What are the Symptoms?
  • Severe epigastric pain radiating to the back
  • Worse after eating/alcohol
  • N/V
  • ↑amylase & lipase
  • Cullen's / Turner's sign (hemorrhagic)
  • Fever, hypotension
How is it Diagnosed?
  • ↑lipase (most specific) & amylase
  • CT / ultrasound
  • ↓calcium, ↑glucose
What is the Treatment?
  • NPO (rest the pancreas), IV fluids
  • Pain control
  • NG suction if vomiting
  • No alcohol; monitor for shock/hypocalcemia
NCLEX TipSevere epigastric pain radiating to the back + elevated lipase = pancreatitis. Keep NPO to rest the pancreas.
© NCLEX Deck6 / 12

Cirrhosis.

Hepatic
What is Cirrhosis?
  • Chronic, irreversible scarring of the liver.
  • Impaired function and portal hypertension.
What are the Causes / Risk Factors?
  • Chronic alcohol use
  • Hepatitis B/C
  • Non-alcoholic fatty liver
  • Biliary disease
What are the Symptoms?
  • Jaundice, pruritus
  • Ascites, edema
  • Esophageal varices (bleeding risk)
  • Hepatic encephalopathy (confusion, asterixis)
  • Easy bruising/bleeding
  • Spider angiomas, caput medusae
How is it Diagnosed?
  • ↑liver enzymes, ↑bilirubin
  • ↑ammonia
  • ↓albumin, prolonged PT/INR
  • Ultrasound / biopsy
What is the Treatment?
  • Stop alcohol; low-sodium diet
  • Diuretics / paracentesis (ascites)
  • Lactulose (lowers ammonia)
  • Beta blockers (varices); monitor bleeding
NCLEX TipLactulose lowers ammonia in hepatic encephalopathy. Bleeding esophageal varices are a life-threatening emergency.
© NCLEX Deck7 / 12

Hepatitis.

Hepatic
What is Hepatitis?
  • Inflammation of the liver, usually viral (A, B, C, D, E).
  • A/E = fecal-oral; B/C/D = blood/body fluids.
What are the Causes / Risk Factors?
  • Hep A/E: contaminated food/water (fecal-oral)
  • Hep B/C/D: blood, sexual, perinatal
  • Alcohol, toxins, autoimmune
What are the Symptoms?
  • Fatigue, malaise
  • Jaundice, dark urine, clay-colored stools
  • RUQ pain
  • Anorexia, nausea
  • Elevated liver enzymes
How is it Diagnosed?
  • Hepatitis panel (antigens/antibodies)
  • ↑ALT/AST, ↑bilirubin
  • Viral load
What is the Treatment?
  • Rest, hydration, nutrition
  • Antivirals (B/C)
  • Avoid alcohol / hepatotoxins
  • Prevention: vaccines (A, B); standard precautions
NCLEX TipHep A & E are fecal-oral; B, C, D are bloodborne. Vaccines exist for A and B. Avoid alcohol and hepatotoxic drugs.
© NCLEX Deck8 / 12

Inflammatory Bowel Disease.

Lower GI
What is Inflammatory Bowel Disease?
  • Chronic bowel inflammation: Crohn's (patchy, full-thickness, anywhere) vs Ulcerative Colitis (continuous, mucosal, colon).
  • Autoimmune, relapsing.
What are the Causes / Risk Factors?
  • Autoimmune
  • Genetic predisposition
  • Environmental triggers
What are the Symptoms?
  • Crohn's: RLQ pain, non-bloody diarrhea, fistulas, malabsorption
  • UC: bloody diarrhea, LLQ pain, tenesmus
  • Weight loss, fatigue
  • Fever during flares
How is it Diagnosed?
  • Colonoscopy with biopsy
  • ↑ESR/CRP
  • Stool studies
  • Imaging
What is the Treatment?
  • Aminosalicylates, corticosteroids, immunomodulators, biologics
  • Low-residue diet during flares
  • Monitor for obstruction / toxic megacolon
  • Surgery (colectomy cures UC)
NCLEX TipCrohn's = patchy, full-thickness, anywhere (non-bloody); UC = continuous colon, mucosal, bloody diarrhea.
© NCLEX Deck9 / 12

Bowel Obstruction.

Emergency
What is Bowel Obstruction?
  • Blockage preventing intestinal contents from passing.
  • Mechanical or paralytic (ileus).
What are the Causes / Risk Factors?
  • Adhesions (post-surgical)
  • Hernias, tumors
  • Volvulus, intussusception
  • Paralytic ileus (post-op, opioids)
What are the Symptoms?
  • Abdominal distension
  • Cramping pain
  • Vomiting (may be fecal)
  • No stool / flatus (obstipation)
  • High-pitched (early) or absent (late) bowel sounds
How is it Diagnosed?
  • Abdominal X-ray / CT
  • Electrolytes (imbalance)
  • ↑WBC
What is the Treatment?
  • NPO; NG tube decompression
  • IV fluids & electrolyte correction
  • Monitor for perforation / ischemia
  • Surgery if mechanical / strangulated
NCLEX TipBowel obstruction → NPO + NG decompression + IV fluids. Absent bowel sounds and rigidity suggest a worsening emergency.
© NCLEX Deck10 / 12

Diverticulitis.

Lower GI
What is Diverticulitis?
  • Inflammation/infection of diverticula (outpouchings) in the colon.
  • Usually the sigmoid colon.
What are the Causes / Risk Factors?
  • Low-fiber diet
  • Chronic constipation
  • Advancing age
  • Obesity
What are the Symptoms?
  • LLQ pain
  • Fever
  • Change in bowel habits
  • N/V
  • Palpable mass, bloating
  • Bleeding
How is it Diagnosed?
  • CT scan
  • ↑WBC
  • Avoid colonoscopy during acute phase (perforation risk)
What is the Treatment?
  • Acute: NPO / clear liquids, antibiotics, bowel rest
  • AVOID high-fiber & seeds during a flare
  • After healing: HIGH-fiber diet to prevent recurrence
  • Monitor for perforation / abscess
NCLEX TipAcute diverticulitis = bowel rest + antibiotics (low fiber now). After healing, switch to a HIGH-fiber diet to prevent recurrence.
© NCLEX Deck11 / 12

GI Bleed.

Emergency
What is GI Bleed?
  • Bleeding anywhere along the GI tract.
  • Upper (hematemesis, melena) vs lower (hematochezia).
What are the Causes / Risk Factors?
  • Peptic ulcers, varices (upper)
  • Diverticulosis, hemorrhoids, cancer (lower)
  • NSAIDs, anticoagulants
What are the Symptoms?
  • Hematemesis (coffee-ground or bright red)
  • Melena (black, tarry stool)
  • Hematochezia (bright red rectal bleeding)
  • Hypotension, tachycardia (shock)
  • Fatigue, pallor (anemia)
How is it Diagnosed?
  • Endoscopy / colonoscopy
  • CBC (↓H&H)
  • Stool occult blood
  • Type & crossmatch
What is the Treatment?
  • ABCs; IV fluids / blood
  • PPIs; endoscopic hemostasis
  • Octreotide / banding (varices)
  • Monitor vitals, H&H, output
NCLEX TipGI bleed priority is ABCs and volume replacement. Melena = upper GI bleed; bright red blood per rectum = lower.
© NCLEX Deck12 / 12
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