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Lower GI disorders
Nursing
| Question | Answer |
|---|---|
| Inflamatory Bowel Disease (IBD) | 1. IBS 2. Crohn Dz 3. Ulcerative Colitis |
| Crhon Dz | non bloody mucus through out intestines Cobble stones appearance |
| Ulcerative Colitis | Bloody in colon |
| Fluid loss through GI via Vomiting and diarrhea is .... | 100 - 200 ml/day |
| nrsg dx | Fluid volume deficit |
| 1st priority | fluid replacement |
| diarrhea causes what acid/base imbalance? | metabolic acidocis |
| vomiting causes what acid/base imbalance? | metabolic alkalosis |
| what med and nursing intervention will require blood glucose checks often? and why? | steroids TPN they increase glucose |
| What VS will change fast w/ Peritonitis? | Temp spike = perforation |
| w/ UC what are the pts at risk for? | anemia |
| meds for IBD's: | steroids antidiarrheals Sulfasalazine (Azulfadine) |
| Azulfadine is a ..... that has ...... and ...... properties | antirheumatic Abx and anti-inflamatory |
| what education is needed w/ an ileostomy? | stoma care |
| what affect do narcotics have on the GI? | slowa mitility = constipation |
| if narcotics are needed what needs to be done and why? | monitor closely b/c of the risk of intestinal perforation |
| DIVERTICULAR DZ | 1. diverticulosis 2.diverticulitis |
| Diverticulosis | formation of a lot of pouches no pain |
| diverticulitis | inflamation of pouches pain |
| what potential problems can happen w/ diverticulitis | obstruction infection hemorrhage |
| Symptoms of diverticular dz | LLQ pain (location of sigmoid and descending colon) inc. flatus rectal bleeding |
| signs of obstruction | alternating constipation and diarrhea ABD distention Low-grade fever |
| to dx diverticulitis | Barium enema + colonoscopy |
| Intestinal obstructions | partial complete |
| cx of obstructions | mechanical neurogenic vascular |
| MECHANICAL (5) | 1. scarr tissue (adhesions) 2. strangulated hernia 3. volvulus (twisting of the gut) 4. Intussusception (telescoping of the gut within itself) 5. tumors (feces lodges against the tumor. stools will look like ribbons) |
| NEUROGENIC | 1. paralytic ileus 2. spinal cord lesion |
| paralytic ileus | gut is sleep |
| spinal cord lesion | sluggishe peristolsis r/t nerve blockage |
| VASCULAR | occluded mesenteric artery (leads to gut infarction) |
| Symptoms of obstructions | sudden abd pain/guarding / hx Abd surgery/ Abd distention / bowl sounds (high-picthed = early mechanical/ absent = neurogenic, late mechanical)/ N/V |
| ABG analysis | 1. Alkalotic = high sml intestines obstruction 2. Acidic = lower bowl obstruction |
| Nrsg interventions | 1. NPO, IV F&E 2. I&O, Foley cath 3. NGT (int/ doc q8h/irrigate NS 30-60 ml) |
| why do you want the NGT in low int. suction? | prevent damage to the lining and further electrolyte losses |
| what is a Cantor, Miller-Abbot, Harris tube? | tube from nose all the way to rectum (by MD) |
| monitor ABD for | 1. distention (measure abd girth) 2. rigidity 3. bowel sounds |
| CANCER OF THE COLON | usualy >60 |
| prevention | - cruficerous veggies (cabbage family) - increase fiber intake - wt management - decrease animal fat |
| EXAMS | - DRE (digital rectal ex)q year > 40 - Ocult blood q year > 50 - colonoscopy q 3-5 year > 50 (more freq depending on family Hx) |
| tx | surgery radiation antineoplastics |
| dx made by | DRE colonoscopy biopsy barium enema |
| how do you evaluate effectiveness of tx? | CEA (carcinoembryonic antigen) serum level |
| symptoms | early : rectal bleeding, changes in bowel habits, sense of imcomplete evacuation late: abd pain, N/V, wt loss (cachexia) |
| stoma |
Created by:
luwetherrbee
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