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MCAI-FINALS--3
Lower GI system
| Question | Answer |
|---|---|
| diarrhea bacteria in the hospital. | c-diff |
| reasons cause diarrhea | infectious organism, lactose intolerance, malabsorption in small bowel, bowel disease. |
| assessment | LBM, color |
| what happen to adult taking multiple meds | become dehydration, fluid loss issue |
| collaborative care to pt with diarrhea | rehydration, electrolyte replacement, antidiarrheal agents, and antibx for C.Diff.. |
| nursing consideration to pt with diarrhea | travel abroad, ausultate, palpation (tenderness, distention), good hand washing, proper prep of food. Hep A. designated own toilet. Bowel INC. |
| nursing dx for pt with diarrhea / fecal incontenence | isolation |
| what are the reason for fecal INC. | Physiologic: sensory receptor dysfunction, motor dysfunction, sphincter weakness, rectal tissue trauma. Secondary to fecal impaction. |
| Fecal incontinence dx test | rectal exam, CT scan, Sigmoidoscopy, colonoscopy |
| What is the gold standard dx test for pt with fecal INC.? | sigmoidoscopy and colonoscopy (scope for lower GI). |
| collaborative care to pt with pt with bowel INC. | high fiber (25 to 30gm/day), if traumatic even -surgery |
| pt loss sensation to have BM | bowel training |
| Constipation causes: | dehydration, not enough fiber, ignoring urge, sedentary, laxative not effective (reverse consequence) |
| nursing intervention for pt with fecal INC | bowel training, med / enemas, maintain skin integrity. |
| what are the manifestation of constipation? | absent stool, abd pain, abd distention, valsalva maneuver, perforation, and diverticulosis |
| constipation collaborative care and nursing | incrase fluid intake, dietary fiber, med, surgical intervention, using bathroom, privacy and exercise. |
| Intermittend GI upset (combination of diarrhea and constipation) | Irritable Bowel Syndrom (IBS) general dx |
| what are the signs of IBS? | abd distention, excessive flatulence, bloating, urge to defecate, urgency, sensation of incomple evacuation. Has to occur within in 12 weeks of abd pain w/I 6 mons. |
| Dx to rule out of IBM. | inability to breakdown glucouse, lactose intolerance |
| what are the S/S of appendicitis? | pain lower right quadrant, pushing cuase relief, letting go rebound tenderness, palpation of left lower quadrant and will pain in lower left quadrant. |
| what is the most comfortable position of the pt | lying on the side and curling up like a ball. |
| Why not to palpate the pt's appendix | it might cause perforation |
| what is peritonitis | inflammation of peritoneal cavity |
| what are contraindication of appendicitis | warm compress, do not eat, coumadin, no laxatives, no enemas |
| what is coumadin antagonist | Vit K |
| what is heparin antagonist | protamine |
| what are the s/s of gastroenteritis | microorganism, problems Vomiting, diarrhea, >= 24, NPO, risk dehydration, get electrolyte replacement, elederly at risk (no thirst response), |
| Who are most affected by Inflammatory Bowel Disease | more on younger people |
| two types of Inflammatory Bowel Disease | chron's disease and ulcerative colitis |
| S/S Chron's disease | anywhere in GI, irregular patern of spreading, cobblestoning, fistula formation, stricture formation, anal abscesses, colectomy |
| S/S Ulcerative colitis | starts in rectum towards cecum, cont. pattern of spreading, mucosal ulceration, diahrrhea, protein loss, pseudopolyps |
| IBD Manifestation | diahrrhea, abd pain, weigh loss with small bowel movement, rectal bleeding w. U.C., systemic symptoms, and dehydration |
| What are IBD's complications? | toxic megacolon, perforation, hemorrhage, abscess and fistula formation, nutritional deficits, bowel cancer, and inflammatory response elsewhere |
| What are the meds for IBD | 5-ASA suppress proinflammatory cytokines. Sulfasalazine (Azulfidine, sulfapyridine, olsalazine (Dipentum), mesalamine (Pentasa), and balsalazide (Colazal) |
| How can RN manage IBD pt? | bowel rest, inflame control, infection control, nutrition, stress relief, alleviate symptoms, improve Quality of Life. |
| What are the mechanical cause of Bowel obstruction? | adhesions, strangulated inguinal hernia, illeocecal intussusception, intussusception from polyps , mesenteric occlusion, neoplasm, volvulus of the sigmoid colon |
| what are the nonmechanical cause of bowel obstruction? | may result from neuromascular or neurovascular disorder. paralytic ileus: peritonitis, appendicitis and inflammatory response; pseudo -obstruction |
| What is diverticula? | outpouching of the mucosa |
| What is diverticulitis? | inflammation of diverticula resulting to perforation into the peritoneum |
| What is inguinal hernia? | veakness in the abdominal wall where spermatic cord or round ligament emerge |
| what is femoral hernia? | proturusion into the femoral canal |
| What is umbilical hernia | umbilical fails to close |
| what is ventral or incisional hernia | weakness of abdominal wall at the site of previous incision |
| what is s/s of celiac disease? | gluten intoleranc and diarrhea |
| what is s/s of lactose intolerance | abdominal distencion , flatus, crampy, pain, and diarrhea |
| what is anal fissure | a skin ulcer or a crach in the lining of the anal wall . |
| what is anorectal abscess | collection of perianal pus. |
| what is anal fistula | abnormal tunnel leading from the anus or rectum. Complication of chron's disease. |
| what is pilonidal sinus | small tract under the skin between the buttocks in the sacrococcygeal area. |
| What should RN do whenever pt has very painful GI disorder? | rest pt's bowel. |
Created by:
rt-study
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