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z_NUR411_Medsurge: UNIT 2 > Lower GI: Diverticulitis, Colon Cancer, PCA > Flashcards

Lower GI: Diverticulitis, Colon Cancer, PCA Flashcards

1
Q

What is diverticulitis?

A
  • Inflammation of diverticula (small pouches in the intestine)
  • Usually occurs in descending colon
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2
Q

What is the path of diverticulitis?

A
  • High intraluminal pressure causes diverticula to form in weak spots in the GI wall.
  • Undigested food and bacteria accumulate in the diverticula, leading to inflammation
  • If untreated, rupture can occur
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3
Q

What are the risk factors that can lead to diverticulitis?

A
  • Low fiber diet
  • Genetics
  • Obestity
  • Smoking/alcohol
  • NSAIDs
  • Corticosteroids
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4
Q

What are the s/s of diverticulitis?

A
  • LLQ abdominal pain (descending, sigmoid colon)
  • Bloating
  • Fever
  • N/V
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5
Q

What lab results would indicate diverticulitis?

A
  • ↑ WBCs, ESR

* ↓ Hgb/Hct with bleeding

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6
Q

What dx tests would be ordered for diverticulitis?

A
  • Barium enema
  • Colonoscopy
  • CT
  • Lower GI series
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7
Q

What is the medication treatment for diverticulitis?

A
  • Abx

* Analgesics

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8
Q

What complications need to be monitored for with diverticulitis?

A
  • Perforation
  • Peritonitis
  • Bleeding
  • Fistula
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9
Q

What is the pt teaching for diverticulitis?

A
  • NP or clear liquid diet during exacerbations, then progress to low-fiber diet
  • After immediate resolution, move to high-fiber diet
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10
Q

What surgical tx is available for diverticulitis if medication doesn’t work?

A

• Colectomy

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11
Q

True or False

The pt w/ diverticulitis is at increased risk for cancer.

A

• True

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12
Q

What lifestyle change can a patient do to help keep the bowel active?

A

• Exercise

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13
Q

What is used to help clean out the bowel with diverticulitis?

A
  • GoLytely, a common laxative

* Mixed in 3L water and pt needs to drink whole thing

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14
Q

In general, good bacteria like what kind of food?

A

• Vegetables

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15
Q

In general, bad bacteria like what kind of food?

A

• Sugars and fats

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16
Q

What screening needs to be done for colon cancer?

A
  • Guaiac test, annually
  • Colonoscopy, every 10 yrs
  • Sigmoidoscopy, every 5yrs
17
Q

What are the risk factors for colon cancer?

A
  • Older age
  • High-fat diet (especially red meat)
  • Genetics
  • Smoking/alcohol
  • Obesity
  • Sedentary lifestyle
18
Q

What labs and dx tests are done for colon cancer?

A
  • Colonoscopy w/ biopsy (definitive)
  • Positive Guaiac
  • CT/MRI
19
Q

What is the tx for colon cancer?

A
  • Chemotherapy/Radiation
  • Colon resection
  • Colectomy w/ colostomy/ileostomy
20
Q

Describe stage 1 of colon cancer.

A

• Cancer has grown through the mucosa layer of the colon/rectum but hasn’t spread beyond the colon/rectum wall

21
Q

Describe stage 2 of colon cancer.

A

• Cancer has grown into or through the wall of the colon/rectum, but hasn’t spread to nearby lyph nodes

22
Q

Describe stage 3 of colon cancer.

A

• Cancer has invaded nearby lymph nodes, but isn’t affective other parts of the body yet

23
Q

Describe stage 4 of colon cancer.

A

• Cancer has metastasized to distant parts of the body

24
Q

What occurs with a partial colectomy?

A
  • The disease section of the colon is removed

* The cut ends are then re-attached to repair colon

25
Q

What is a total colectomy?

A

• The entire colon is removed

26
Q

What is the Abdominal Perineal Resection procedure?

A
  • Done for distal colon cancer w/ large tumor
  • Colon is cut and non-cancerous portion is diverted to abdominal wall colostomy
  • Rest of colon and rectum is completely removed and anus is sealed
  • A perineal drain is inserted to drain exudate
  • No rectal temp may be taken again, as there is no rectum
27
Q

What is a PCA and what is it used for?

A
  • Patient Controlled Analgesia

* To control severe pain post-surgery

28
Q

The physician’s order reads…

PCA infusion to administer:
5% Dextrose 100ml w/ 100mg morphine sulfate to infuse as follows:
		Loading dose: 2mg
		Maintenance dose: 1mg/hr
		PCA dosage: 0.5mg
		Lockout interval: 15 min

This client pushed PCA button every 30mins for your shift after given the loading dose at 9am. Client pushed the first button at 9:30am. How much did the client receive morphine for your 8am – 3pm shift?

A

Ans: 14

29
Q

What must be done at setup of the PCA pump?

A

• Double check with another nurse

30
Q

What must be assessed hourly for those on a PCA pump?

A
  • Resp status
  • Pain
  • Mental status
  • Adverse effects of morphine (itching, n/v)

z_NUR411_Medsurge: UNIT 2 (25 decks)

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