Lower GI Flashcards
Complications of constipation
-Valsalva maneuver
-hemorrhoids/anal fissure
-fecal impaction
-megacolon
-diverticulosis
Tx of constipation
-increase activity, fluids, fiber
-laxatives, enemas (short term)
-stool softeners
-methylnaltrexone for opioid use
Sx of diarrhea
-cramp
-distention
-gas
-thirst
-tenesmus
-boyborygmus
Complications of diarrhea
-F/E imbalance (loss of Na and K)
-dehydration**
-metabolic acidosis
-skin breakdown
-lift threatening quick: elderly, very young, malnourished, immunocompromised
Diarrhea mgmt
-prevent F/E imbalance
-infection control
-diet: clear liquid, BRAT (banana, rice, applesauce, toast)
-preven skin breakdown
Acute abdomen
-requires quick surgical intervention
-risk of peritonitis, sepsis, septic shock
-rigidity, guarding, rebound tenderness
Appendicitis
-common cause of acute abd
-common in younger adults; higher mortality in elderly
-progress to gangrene and/or perforation within 6-24 hrs from pain onset
-ID and treat early
Diverticula disease
-cause: increased pressure and decrease muscle strength
-asymptomatic unless inflammation occurs
Diverticulosis
-no big deal
-many diverticula
Diverticulitis
-big deal
-inflammation of one or more diverticula
-access and fistula may form
-peritonitis can occur
Types of intestinal obstruction
-mechanical: you can see and remove it
-functional/paralytic: most common form is paralytic ileus
Small intentional obstruction
-cramp, wave like pain
-vomit: brown, orange, fecal smelling
-abd distention
-metabolic alkalosis
-lose fluids rapidly: dehydration and F/E imbalance
Large intestinal obstruction
-slower onset
-pain lower grade, cramp, abd
-absolute constipation
-dehydration and F/E imbalance more slowly
Bowel obstruction complications
-IVVD or hypovolemic shock
-electrolytes imbalance
-renal insufficiency
-peritonitis
-septic shock
-death
Pre op stoma care
-emotions
-site selection
