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Med Surg 1 > Disorders of the Lower GI Tract > Flashcards

Disorders of the Lower GI Tract Flashcards

1
Q

for occult blood tests this will create a false positive if

A

red meat, horseradish, or hemroids

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2
Q

two types of ostomies

A

ileostomy
colostomy

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3
Q

with any ostomie what area is at risk for break down

A

surrounding area

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4
Q

illeostomy

A

liquid
- should start putting out with in 2 hours

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5
Q

colostomy

A

formed

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6
Q

stoma

A

beefy red and moist

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7
Q

constipation

A

less than 3 per week

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8
Q

meds that cause constipation

A

opioids
iron
some antacids

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9
Q

what are some disorders that can cause constipation

A

rectal fistula
significant hemroids
obstruction

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10
Q

neurogenic disorders that can cause constipation

A

MS
parkinsons
hypothyroidism

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11
Q

what are some acute processes that can cause constipation

A

peritonitis
appendicitis

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12
Q

constipation can lead to straining which is what, who do we not want doing this

A

vasovagal/valsalva manöver
- vagus nerve stimulation = decrease HR
* avoid in elderly and cardiac patients

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13
Q

how do we prevent reoccurrence of constipation

A

exercise
diet
- increase fiber
fluid and fiber
- remind elderly about fluid
judicious use of laxitives
- do not want to become dependent

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14
Q

what is key in treating diarrhea

A

NEED TO RULE OUT AN INFECTION BEFORE TREATMENT

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15
Q

why do we need to rule out an infection before treatment of diarrhea

A

because if there is an infection and you are giving a med to slow the bowels then the bacteria is sitting in bowel reproducing

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16
Q

diarrhea causes what acid base disturbance

A

metabolic acidosis

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17
Q

vomitting causes what acid base disturbances

A

metabolic alkalosis

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18
Q

complications of diarrhea

A

fluid volume deficit
electrolyte disorders
metabolic acidosis
skin breakdown

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19
Q

management of diarrhea

A

controlling symptoms and preventing complications

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20
Q

fecal incontinence

A

involuntary passage of stool from the rectum

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21
Q

what can cause fecal incontinence

A

some meds
- diabetic meds
- blood pressire

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22
Q

feccal incontinence
- management
- improve quality of life

A

bowel training program
frequent toileting
elimination of causative factors

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23
Q

how do we diagnose irritable bowel syndrome

A

last ditch diagnosis
everything else is ruled out

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24
Q

irritable bowel syndrome
- diet

A

restrictions followed by gradual reintroduction able to find trigger foods
ultimately want a high fiber diet

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25
Q

nursing role for irritable bowel syndrome
- patient family education

A

diet habits
food diary
limit fluids with meals
avoid smoking and alcohol

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26
Q

appendicitis
- pain location

A

right lower quadrant/periumbilical

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27
Q

appendicitis
common age

A

10-30

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28
Q

if appendicitis ruptures it would cause

A

peritonitis

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29
Q

who has an atypical presentation of appendicitis

A

elderly

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30
Q

who are more likely to come in with a ruptured appendix

A

elderly
- it is missed the first time and then ruptures

31
Q

why do we do a pregnancy test when we think of appendicitis

A

rule out ectopic pregnancy

32
Q

perforation of appendicitis occurs how long after onset of pain

A

24 hours

33
Q

perforation of appendicitis manifestations

A

fever
toxic apperence
increased pain

34
Q

management for appendicitis

A

surgery

35
Q

appendicitis
- IV fluids

A

isotonic

36
Q

appendicitis
- postion

A

high fowlers
- reduce tension
- help with N/V

37
Q

appendicitis
- pain management and relating adverse effects

A

morphine
- respiratory depression
- constipation

38
Q

appendicitis
incision care

A

redness/swelling/ drainage

39
Q

divertuculitis

A

food and bacteria retention in diverticulum producing infection and inflammation

40
Q

complications of divertuculitis

A

perforation
abscess formation
peritonitis
bleeding

41
Q

divertuculitis
- pain location

A

left lower quadrant

42
Q

divertuculitis
- other clinical manifestations

A

nausea
vomitting
weakness
fever
chills
leukocytosis

43
Q

main management of divertuculitis

A

gut rest

44
Q

do we do a colonoscopy with patients with divertuculitis

A

no
we do not want to perforate

45
Q

complications of divertuculitis

A

peritonitis
abscess
fistual
bleeding

46
Q

divertuculitis management
diet

A

gut rest= complete NPO
clear liquid and then advance to high fiber and low fat diet

47
Q

divertuculitis management pharm

A

analgesics
antispasmodic
antibiotics (7-10 days)

48
Q

divertuculitis
assess/monitor for complications

A

increase abdominal pain
tenderness
rigidity
elevated WBC
ESR
temp
increase HR
decrease BP

49
Q

if a patient is going for bowel surgery what profilaxis are they going to be on

A

antibiotics
- prevent infection and decrease bacterial load to reduce cause of peritonitis

50
Q

complications of peritonitis

A

sepsis
shock

51
Q

do we treat pain like peritonitis right away

A

we need to identify the source of pain and this gives us clues about what is wrong with the patient

52
Q

early manifestations of peritonitis

A

s/s of causative disorder
- appendicitis/diverticulitus

53
Q

what happens after early manifestations of peritonitis

A

diffuse abdominal pain more localized
aggravated by movement
tender
distended
rigid

54
Q

bowel sounds with peritonitis

A

decreased sounds

55
Q

peritonitis other manifesations

A

N/V
increase temp
increase pulse
increase WBC

56
Q

peritonitis
medical management

A

fluids, colloids, electrolytes (N/V)
pain management
antiemetic
bowel decompression with NG tube
respiratory management
antibiotics
surgery

57
Q

peritonitis
positioning

A

high fowlers

58
Q

bowel obstruction

A

blockage of intestines preventing the flow of intestinal contents

59
Q

bowel obstruction
- mechanical

A

bowel twists/adhesions

60
Q

bowel obstruction
functional

A

post op anesthesia

61
Q

bowel obstruction most common site

A

small intestine

62
Q

bowel obstruction major complaint

A

pain

63
Q

bowel obstruction large bowel symptoms develop

A

slowly

64
Q

bowel obstruction large bowel complaint

A

constipation

65
Q

bowel obstruction small bowel complaint

A

extreme pain (crampy/wavelike/colicly)

66
Q

if you have a complete bowel obstruction what is the resolution

A

surgery

67
Q

if you have a partial bowel obstruction what is the resolution

A

we will medically manage to see if the issue resolves on its own

68
Q

bowel obstruction
- how do we decompress the stomach

A

NG tube on low intermittent suction

69
Q

bowel obstruction
NG tube what do we need to monitor and replace

A

monitor drainage
replace fluides/lytes

70
Q

bowel obstruction
careful management of pain

A

opioids

71
Q

colon cancer
screening changes based on

A

risk factors

72
Q

colon cancer clinical manifestations

A

change in bowel habits
- constipation
blood in stools

73
Q

colon cancer
- gerontological considerations

A

change in bowel habits

74
Q

treatment for colon cancer

A

surgery
chemo
radiation

Med Surg 1 (47 decks)

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