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z_NUR411_Medsurge: UNIT 2 > Lower GI: Ulcerative Colitis and Crohn's Disease > Flashcards

Lower GI: Ulcerative Colitis and Crohn's Disease Flashcards

1
Q

What is Ulcerative Colitis?

A

• Chronic inflammatory disease of the colon, characterized by periods of remissions and exacerbations

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2
Q

What is the patho of UC?

A
  • Abnormal immune response causes inflammation in the mucosal layer of the colon, which leads to continuous ulcerations
  • Pseudopolyps may be present
  • Involves ONLY the colon
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3
Q

What are the risk factors for UC?

A
  • Autoimmune disorders
  • Genetics
  • Jewish descent
  • Stress
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4
Q

What are the s/s of UC?

A
  • Diarrhea with blood or pus (10-20 liquid stools/day)
  • Abdominal pain/cramping
  • Fecal urgency
  • Fatigue
  • Weight loss
  • Fever
  • Anemia
  • Dehydration
  • Tenesmus (always feeling like you need to shit)
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5
Q

What lab results indicate UC?

A
  • ↑ WBC, CRP, ESR

* ↓Hgb/Hct, albumin, potassium, magnesium

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6
Q

What is CRP?

A
  • C-reactive protein
  • Protein made by the liver
  • A high CRP test result is a sign of acute inflammation
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7
Q

What is ESR?

A
  • Erythrocyte sedimentation rate
  • Blood test that measures how quickly erythrocytes (red blood cells) settle at the bottom of a test tube that contains a blood sample.
  • A faster-than-normal rate may indicate inflammation in the body.
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8
Q

What dx tests are done for UC?

A
  • Guaiac test

* Colonoscopy w/ biopsy

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9
Q

What medications are used for tx of UC?

A
  • Sulfasalazine
  • Aminoacylates
  • Corticosteroids
  • Immunosuppressants
  • Antidiarrheals
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10
Q

What surgery tx is used for tx of UC?

A
  • Colectomy with appropriate ostomy

* Fecal microbiota transplant

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11
Q

What are we monitoring as part of our nursing care for UC pts?

A
  • I/Os
  • Electrolytes (risk of hypokalemia)
  • CBC levels
  • Complications (peritonitis, sepsis)
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12
Q

What is our pt teaching for UC?

A
  • NPO during exacerbations
  • Consume high calorie, low fiber diet (if ongoing UC)
  • Avoid caffeine, alcohol, lactose
  • Eat smaller, more freq meals
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13
Q

What are the complications associated with UC?

A
  • Toxic megacolon
  • Perforation
  • Hemorrhage
  • Arthritis
  • Colorectal
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14
Q

What is Crohn’s Disease?

A
  • Chronic inflammatory disease that can involve the entire GI tract and all layers of the bowel wall.
  • Most common in the distal small intestine or proximal colon
  • Characterized by periods of remissions and exacerbations
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15
Q

What is the patho for Crohn’s Disease?

A
  • Genetic, immune and environmental factors cause inflammation, which leads to the development of patchy ulcerations and granulomas in the GI tract
  • Causes scarring and narrowing of the intestinal lumen, and places the pt at risk for fistulas
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16
Q

What are the risk factors associated with Crohn’s Disease?

A
  • Autoimmune disorders
  • Genetics
  • Smoking
  • NSAID use
17
Q

What are the s/s of Crohn’s Disease?

A
  • Diarrhea (5-6 loose stools/day)
  • Steatorrhea
  • RLQ pain
  • Weight loss
  • Anemia
  • Fever
  • Fatigue
18
Q

What labs results are indicative of Crohn’s Disease?

A
  • ↓ Hct/Hgb and albumin

* ↑ ESR, CRP, WBC

19
Q

What dx tests are used for Crohn’s Disease

A
  • Colonoscopy
  • EGD (visual endoscopy)
  • CT/MRI
20
Q

What is the medication tx for Crohn’s?

A
  • 5-aminosalicylic acid (sulfasalazine)
  • Corticosteroids
  • Immunosuppressants
  • Antidiarrheals
21
Q

What is the surgical tx for Crohn’s?

A
  • Small bowel resection
  • Colectomy
  • w/ appropriate Ostomy
22
Q

What are we monitoring in our nursing care for a Crohn’s patient?

A
  • I/Os
  • Electrolytes
  • CBC levels
  • Complications
23
Q

What are the complications of Crohn’s to be aware of?

A
  • Peritonitis
  • Intestinal obstruction
  • Fistulas
  • Nephrolithiasis/Cholelithiasis
  • Arthritis
  • Retinitis
24
Q

What is our pt teaching for Crohn’s?

A
  • Bowel rest (NPO) with TPN during severe exacerbations
  • Consume a high calorie, low fiber diet
  • Eat small, freq meals
25
Q

Which is more dangerous, UC or Crohn’s?

A
  • Crohn’s

* Affects both colon and small intestines

26
Q

How does Crohn’s cause intestinal obstruction?

A

• Continual exacerbations at the same sites can cause compound scarring, shrinking the intestinal lumen at that area

27
Q

What is cobblestoning of the mucosa with Crohn’s?

A

• Longitudinal and circumferential fissures and ulcers separate islands of mucosa, giving it an appearance reminiscent of cobblestones

28
Q

True or False

Perianal skin tags are associated with UC.

A

• False, they are associated with Crohn’s

29
Q

As Crohn’s can effect ileum absorption, what deficits can result?

A
  • Vit B12
  • Iron def
  • Folate def
  • Vits A, D, E, K
30
Q

What are fistulas with Crohn’s?

A
  • Crohn’s disease may cause sores, or ulcers, that tunnel through the intestine and into the surrounding tissue, often around the anus and rectum and may get infected
  • These abnormal tunnels, called fistulas, are a common complication of Crohn’s disease
31
Q

What is an external enterocutaneous fistula?

A
  • Fistula between the intestine and the skin
  • If contents of the intestine leak out, the same enzymes in the gut that digest food will create the fistula and make contact the skin and cause it to become very red, painful and prone to infection
32
Q

What is an enteroenteric fistula?

A
  • Fistula between adjacent intestines

* These fistulas link parts of the intestines together, bypassing sections of the bowel

33
Q

What are some ways Crohn’s is different than UC?

A
  • CD has thickening of bowel walls, UC thins
  • CD has no obvious blood in stool, UC does
  • CD has asymmetrical inflammation, UC is symmetrical
  • CD location is different, can be esophageal, stomach, duodenal, jejunum or ileum. UC is colon only
  • CD inflammation affects all layers of bowel, UC is just mucosal
  • CD stooling is less freq (5-6) than with UC (10-20)

z_NUR411_Medsurge: UNIT 2 (25 decks)

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