400 EXAM 2--Chapter 48 Flashcards

1
Q

ϖ An abnormal infrequency or irregularity of defecation, abnormal hardening of stools that makes their passage difficult and sometimes painful, a decrease in stool volume, or retention of stool in the rectum for a prolonged period often with a sense of incomplete evacuation after defecation

A

constipation

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2
Q

what qualifies a patient to have constipation

A

less than 3 BM per week

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3
Q

how to treat constipation

A

increase fiber and fluids

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4
Q

complications of constipation?

A

fecal impaction

hemorrhoids

fissures

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5
Q

o Test used to determine whether symptoms result from spasm or narrowing of the bowels:

♣ pressure studies such as balloon expulsion test

A

anorectal manometry

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6
Q

daily dietary intake of ____ to ____ g/day of fiber to prevent constipation

A

25-30 g/day

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7
Q

ϖ Increased frequency of bowel movements (more than 3 per day), and increased amount of stool (more than 200 g/day), and altered consistency (increased liquidity) of stool

A

diarrhea

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8
Q

diarrhea can be?

A

ϖ acute, chronic, inflammatory, noninflammatory, viral or bacterial or due to ATB therapy.

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9
Q

most often associated with infection and is usually self limiting, lasting up to 7 to 14 days

A

acute diarrhea

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10
Q

persist for more than 2 to 3 weeks and may return sporadically

A

chronic diarrhea

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11
Q

c. diff can be caused from?

A

long term IV ATB

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12
Q

sx of diarrhea

A

abdominal cramps
distention
anorexia
thirst

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13
Q

o Potential for _____ ______ d/t significant fluid and electrolyte loss (especially potassium) can lead to dehydration with diarrhea.

A

cardiac dysrhythmias

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14
Q

med of choice for diarrhea

A

loperamide (immodium)

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15
Q

ϖ Involuntary passage of stool from the rectum

A

fecal incontinence

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16
Q

cause of fecal incontinence

A

something impairing the neurological system

interference with motor or sensory control

out of control diarrhea

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17
Q

o Rectal examination and endoscopic examination such as a flexible signoidoscopy are performed to rule out ? with fecal incontinence

A

tumors, inflammation, or fissure

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18
Q

surgical procedures for fecal incontinence

A

surgical reconstruction, artificial sphincter implants, sphincter repair or fecal diversion with colostomy

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19
Q

nursing interventions for fecal incontinence?

A

bowel training

regular pattern of elimination

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20
Q

if there is a neurological fecal incontinence what may be required?

A

digital stimulation

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21
Q

if incontinence is r/t fecal impaction?

A

normal function will resume after impaction is removed and the rectum is cleansed

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22
Q

o If incontinence is d/t neurologic condition:

A

♣ Encourage high fiber diet and increased fluids

♣ Promote regular pattern of elimination

Do bowel training

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23
Q

o If incontinence is d/t diarrhea:

A

♣ Foods that thicken stool (applesauce) and fiber products (psyllium) help improve incontinence

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24
Q

new fecal and bowel management systems (fecal pouch)

A

o Flexi-Seal Management System—

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25
Q

♣ Consist of a tube with a low-pressure balloon that conforms to the internal rectal area, may be used for up to 29 consecutive days – do not inflate more than 30 ml Saline into baloon

A

Flexi-Seal

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26
Q

ϖ Most common GI condition (12% of population)—leading cause of workforce absenteeism

A

IRRITABLE BOWEL SYNDROME (AKA SPASTIC COLON)

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27
Q

ϖ Chronic disorder with no identifiable organic cause—more inconvenient than harmful

o No anatomic or biochemical abnormalities have been found that account for its common symptoms

A

IBS

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28
Q

dx of IBS

A

o Diagnosis is made only after test confirm the absence of structural or other disorders

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29
Q

o Main symptoms of IBS

A

alteration in bowel patterns: alternating constipation, diarrhea, or a combination of both
Pain (over sigmoid colon),

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30
Q

o With IBS: Abdominal pain sometimes precipitated by _____ and its frequently relieved by _____/

A

eating; defecation

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31
Q

Criteria for IBS include:

A

recurrent abdominal pain or discomfort for at least three days a month in the past 3 months

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32
Q

IBS also needs two or more of the following:

A

o Improvement with defecation

o Onset associated with change in frequency of stool

o Onset associated with change in appearance (form) of stool

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33
Q

medical management of IBS

A

Restriction and then gradual reintroduction of foods that are possible irritating may help determine what types of food are acting as irritants

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34
Q

changes for IBS patients

A

o High fiber diet, exercise, stress reduction or behavioral modification therapy programs

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35
Q

may be prescribed to decrease smooth muscle spasms decrease cramping & constipation for IBS patients

A

o Anticholinergics or antispasmodics (propantheline)

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36
Q

o Fluid should not be taken with meals because this results in abdominal distention with what patients?

A

IBS

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37
Q

o Can’t absorb fats very well

o Can’t tolerate food containing gluten

Usually identified in childhood

A

celiac disease

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38
Q

o Classic symptoms of celiac disease

A

Small stature person and steatorrhea(oily & fatty stools)

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39
Q

other sx of celiac disease

A

o Diarrhea, & frequently loose, foul smelling stools (pale, grey, or clay colored)

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40
Q

diet for celiac disease

A

gluten free

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41
Q

what is gluten in?

A

barley, rye, oats, wheat

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42
Q

celiac disease has an increased risk for ?

A

osteoporosis

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43
Q

ϖ Surgical emergency!—The most common cause of acute surgical abdomen in the United States

A

appendicitis

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44
Q

SX of appendicitis BEGIN like?

A

o Begins as vague epigastric or periumbilical pain (visceral, dull, and poorly localized) that is intermittent

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45
Q

pain migrates to _____ ____ (midway b/w umbillicus and anterior iliac crest in the RLQ)

A

McBurney’s point

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46
Q

♣ It is the usual site for localized pain and rebound tenderness (pain when pressure is released)

A

McBurney’s point

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47
Q

sx of appendicitis?

A

low grade fever, loss of appetite, N/V, elevated WBCs

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48
Q

appendicitis patients can not have _____ or ____.

A

laxatives or enemas

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49
Q

diagnosis of appendicitis

A

Elevated WBCs with elevated neutrophils

Abd. x-ray

ultrasound

CT scans

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50
Q

Perforation of the appendix can lead to

A

peritonitis

abscess formation

portal pylephlebitis

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51
Q

o , which is septic thrombosis or the portal vein caused by vegetative emboli that arise from septic intestine

A

portal pylephlebitis

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52
Q

a complication of appendicitis when the bowels go to sleep

A

paralytic ileus

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53
Q

a complication of appendicitis when something is twisting or obstructing

A

mechanical bowel obstruction

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54
Q

performed as soon as possible to decrease risk of perforation

A

o Appendectomy

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55
Q

safe and effective in the treatment of appendicitis with perforation

A

laparoscopy

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56
Q

o If abscess forms or appendix ruptures, then an _____ procedure is performed

A

open

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57
Q

if pt comes in with abdominal pain?!?!

A

place them NPO

draw CBC for WBC count

put on IV fluids and ATB

hold pain meds

ice pack RLQ

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58
Q

semipermeable membrane that allows water and electrolytes to flow between the peritoneal cavity and the blood stream

A

peritoneum

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59
Q

Inflammation of the peritoneum, the serous membrane lining the abdominal cavity and covering the viscera

A

ϖ Peritonitis

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60
Q

o Peritonitis fluid in response to inflammation can shift into the abdominal cavity instead of the blood stream at ____-____mL/hr

A

300-500

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61
Q

peritonitis patients have a high risk for?

A

F/E imbalances

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62
Q

causes of peritonitis

A

bacterial infection

inflammation

appendicitis

perforared ulcer

diverticulitis
bowel perforation
abd. surgery
peritoneal dialysis

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63
Q

sx of peritonitis

A

♣ Affected area of abdomen extremely tender and distended muscles become rigid; guarding may be present

rebound tenderness and paralytic ileus

hypoactive or absent bowel sound

anorexia N/V

diminished peristalsis

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64
Q

with peritonitis a temperature of ___-____ can be expected along with increased pulse.

A

100-101

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65
Q

o Hypotensive with progression of peritonitis If not corrected will lead to?

A

hypovolemic shock (oliguria, BP down, HR up, restless, pale)

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66
Q

assessment and diagnostic studies of peritonitis

A

CT scan of abd.
WBC count over 20,000
altered potassium, sodium, potassium, and chloride (low levels)
abd x-ray

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67
Q

what does the abd. X-ray show with peritonitis

A

shows air

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68
Q

medical management for peritonitis

A

IV fluids, colloid and electrolyte replacement (potassium especially)

bed rest

intestinal decompression –NG tube

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69
Q

when will surgery be recommended with peritonitis?

A

when bowel is perforated or gangrenous

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70
Q

if they had surgery for peritonitis they will likely have what after?

A

lavage

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71
Q

nursing management for peritonitis

A
NPO
I&Os
admin and monitor IV fluids
NG feedings
aseptic techniques
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72
Q

how to now if peritonitis patient is improving?

A
check vitals
stable HR and BP
balanced electrolytes
softening abdomen with bowel sounds returning
passing gas
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73
Q

ϖ herniatiation (out pouching) of the lining of the bowel that extends through a defect in the muscle layer
o May occur anywhere in the small intestine or colon

A

diverticulum

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74
Q

diverticulum is most common where?

A

sigmoid colon

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75
Q

single outputting of the bowel

A

diverticula

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76
Q

o Doesn’t present with any symptoms at all unless an infection occurs—usually harmless

A

diverticula

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77
Q

—(the condition) exists when multiple diverticula are present without inflammation, symptoms, or infection

A

diverticulosis

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78
Q

how is diverticulosis usually found?

A

colonoscopy

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79
Q

dietary risk factors for diverticulosis?

A

refined foods
high fat meats
low fiber

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80
Q

most patients with diverticulosis remain symptom free until ____ occurs

A

inflammation

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81
Q

sx of diverticulosis

A

abdominal cramping over LLQ over sigmoid colon

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82
Q

o results when food and bacteria retained in a diverticulum produce infection and inflammation that can impede drainage and can lead to perforation or abscess formation

A

diverticulitis

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83
Q

complications of diverticulitis

A
abscess
fistula formulation
bowel or urethra obstruction
perforation
peritonitis
rupture and hemorrhage
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84
Q

sx of diverticulitis

A

♣ Acute onset of mild to severe pain in the left lower quadrant relieved by bowel movement or farts.

♣ Accompanied by nausea, vomiting, fever, chills, leukocytosis

85
Q

inflammation from diverticulitis can cause inflammation around the bladder which will cause?

A

frequency of urine

86
Q

dx of diverticulitis

A

CT scan with contrast

colonscopy

abd. xray

CBC

occult blood test

UA

87
Q

outpatient treatment for diverticulitis

A

antispasmodics
analgesics
bulk forming laxatives

clear liquids
low residue foods

oral ATB 7-10 days

88
Q

inpatient acute diverticulitis treatment

A

NPO

NG tube (paralytic ileus or suctioning)

IV fluids

IV ATB 7-10 days

antispasmodics, analgesics bulk forming laxatives, fiber supplements, stool softeners, probiotics.

89
Q

high risk for ___ and ___ with diverticulitis

A

peritonitis and infection

90
Q

monitor for sx of perforation of diverticulitis such as???

A
o	increased abdominal pain and tenderness, 
abdominal rigidity, 
elevated WBCs and 
ESR, 
increased temp, 
tachycardia, and 
hypotension; 
perforation is a surgical emergency!
91
Q

how to tell patients with diverticulitis to maintain normal elimination pattern

A

o Fluid intake 2L per day unless contraindicated

o Soft foods with increased fiber (prepared cereals, soft-cooked vegetables) to increase bulk of stool

o Individualized exercise program encouraged

o Schedule meals and set time for defecation

o Admin bulk laxatives, stool softeners, oil retention enemas, etc. as ordered

o Avoid trigger foods if identified—such as nuts and popcorn, seeds

92
Q

Any condition that cause bowel inflammation

A

CHRONIC INFLAMMATORY BOWEL DISEASE (IBD)

93
Q

etiology is unknown for CHRONIC INFLAMMATORY BOWEL DISEASE (IBD) however there are some risk factors?

A
smoking
stress
diet
pesticides
food additives
tobacco
radiation

gene NOD2

NDSAIDs

age 15-30

94
Q

2 ex of IBD

o Both characterized by exacerbations and remissions

A

chron’s and ulcerative colitis

95
Q

ϖ Non-specific inflammatory bowel disorder that can occur anywhere in the GI tract (anywhere between rectum to esophagus) with unknown origin

A

chron’s disease

96
Q

chron’s disease is “____-sided”

A

RIGHT

often proximal colon and ileocecal junction

97
Q

chron’s occurs in age?

A

15-30

98
Q

____ have a 2-4x greater risk to develop chron’s disease

A

smokers

99
Q

sx of chron’s

A

RLQ pain
diarrhea unrelieved by defecation
pain occurs AFTER MEALS (ulcers)
edema and thickening of mucosa

100
Q

what are the ulcers like with chron’s?

A

cobblestone clusters

101
Q

chronic sx of chron’s

A
o	Diarrhea, 
Abdominal pain, 
Steatorrhea, 
Anorexia, 
weight loss, and 
nutritional deficiencies
102
Q

is there blood in the stool with chron’s dx?

A

NO

103
Q

complications with chron’s ?

A

strictures
fistulas
perforation
impaired absorption of nutrients

104
Q

hallmark sx of chron’s

A

perianal fistulas

105
Q

chron’s has an increased risk for ____ CA.

A

colon

106
Q

dx of chron’s

A

Proctosigmoidoscopy performed initially

stool examination

barium study of upper GI tract

colonoscopy

barium enema

CT sca

107
Q

o performed initially to determine whether the rectosigmoid area is inflamed

A

Proctosigmoidoscopy

108
Q

assessment of acute exacerbations with chron’s

A

CBC (anemia)
WBC
ESR
albumin (low)

109
Q

ϖ Recurrent ulcerative and inflammatory disease of the mucosal and submucosal layers of the colon and rectum

A

ULCERATIVE COLITIS

110
Q

ULCERATIVE COLITIS is “____-sided”

A

LEFT

111
Q

ϖ Thinning of mucosa becomes very fragile

Pseudo polyps

Diagnosed earlier in life

A

ULCERATIVE COLITIS

112
Q

predominant symptoms of ULCERATIVE COLITIS

A

bloody diarrhea and abdominal pain

113
Q

other sx of ULCERATIVE COLITIS

A

passage of 10-20 liquid stood per day

hypocalcemia and anemia

diarrhea

passage of mucous and pus

LLQ pain

rectal bleeding

intermittent tenesmus

114
Q

intestinal complications for ULCERATIVE COLITIS

A

risk of hemorrhage and strictures

toxic mega colon

115
Q

dx of ULCERATIVE COLITIS

A

CBD (low H and H and albumin, high WBC, electrolyte imbalances, elevated antineutrophil cytoplasmic antibody levels)

sigmoidoscopy

abd xray

barium enema study

CT scan, MRI, ultrasound

116
Q

complications of ULCERATIVE COLITIS

A

toxic megacolon

117
Q

♣ Inflammatory process extends into muscularis, inhibiting its ability to contract and resulting in colonic distention

A

toxic megacolon

118
Q

must respond within ___ -___ hours with ? for toxic megacolon?????

A

24-72 hours

NG tube, IV fluids, corticosteroids, ATB

119
Q

meds for ulcerative colitis

A

antimicrobials
aminosalicylates
corticosteroids
immunomodulators

120
Q

ulcerative colitis at risk for?

A

bone fractures

121
Q

what foods to be avoided?

A

fatty, cold foods and smoking avoided

122
Q

what injections giving monthly for ulcerative colitis??

A

B12

123
Q

♣ Not cured through surgery can reoccur in other places if tried to take it out
♣ Use surgery if obstruction, stricture, or abscess—otherwise last option

A

chron’s

124
Q

♣ Localized into left side of colon Better chance with surgery

A

ulcerative colitis

125
Q

o removes colon, rectum, and anus. (lack of improvement)

♣ Extensive ulcerative colitis may require total colectomy

A

Proctocolectomy (Total Colectomy) with Ileostomy

126
Q

(surgical opening into ileum or small intestine) allows drainage of fecal matter from ileum to outside the body

A

♣ Ileostomy

127
Q

creation of a continent ileal reservoir (Kock pouch) by diverting a portion of the distal ileum to the abdominal wall and creating a stoma.

• Eliminates the need for external fecal collection bag

A

continent ileostomy

128
Q

♣ Treatment of choice if rectum can be preserved
♣ Remove bad part of valve and put in temporary ileostomy. Let then body heal for certain amount of time and then go back in once healed and reconnect the bowel—Curative option if applicable in Ulcerative Colitis

A

o Restorative Proctocolectomy with Ileal Pouch Analanastomosis

129
Q

color of stoma should be?

A

brick red/pink

130
Q

o Colostomy Care

A

♣ Protect skin, assess stoma, select appropriate pouch, assisting patient to adapt to new device (psych care)

131
Q

pale stoma

A

anemia

132
Q

dusky or purple

A

strangulated low blood flow

ischemic

133
Q

black stoma

A

necrotic

134
Q

edametous stoma

A

allergic reaction to food

135
Q

how often to change bag ?

A

5-10 days unless leaking

136
Q

risk factors for colorectal cancer?

A
over 50
family history
IBD
genetics
high fat and protein diet
low fiber diets
smoking
137
Q

sx of colorectal cancer

A
change in bowel habits
blood in stool
rectal bleeding
anemia
weight loss
fatigue
138
Q

dx of colorectal answer

A

fecal occult blood

barium enema
Proctosigmoidoscopy

Colonoscopy:

139
Q

how often for colonoscopy

A

10 years if no probe

3 years if problems

140
Q

o May occur in a variety of spaces in and around rectum

o Foul smelling pus and is painful

A

ϖ Anorectal abscess

141
Q

o Tiny, tubular, fibrous tract that extends into the anal canal from an opening located beside the anus in the perianal skin
o Purulent drainage or stool may leak constantly from the cutaneous opening

A

anal fistula

142
Q

o A longitudinal tear or ulceration in the lining of the anal canal
o Caused by the trauma of passing a large, firm stool or from persistent tightening of the anal canal because of stress and anxiety, child birth, trauma, and overuse of laxatives

o Extremely painful defecation, burning, and bleeding characterize fissures

o Bright red blood may be seen on the toilet tissue after a bowel movement

A

ϖ Anal Fissure

143
Q

o Dilated portion of veins in the anal canal

A

ϖ Hemorrhoids

144
Q

ϖ Broad term for symptoms of stomach

symptom compounding lots of symptoms

A

dyspepsia

145
Q

sx of dyspepsia

A
o	Anorexia
o	Belching
o	Bloating
o	Pain
o	Nausea
o	Vomiting
146
Q

dyspepsia is commonly caused by

A

food intolerances

CA

lactose intolerxance

147
Q

tx of dyspepsia

A

protonix, prilosec, and pepsid (-zole)

148
Q

ϖ Inflammation of the stomach mucosa or gastric

A

gastritis

149
Q

acute gastritis

A

several hours to several days (ex: alcohol intoxication)

150
Q

chronic gastritis

A

repeated exposure to irritating agents or recurring episodes of acute gastritis

151
Q

gastritis is caused by:

A

excessive alcohol, drugs, radiation exposure, bacterial contamination of food

152
Q

ϖ Common causes of acute/diffuse gastritis

A

medications
drugs
chemo
alcohol

radiation exposure

bacterial contamination to food or water

aspirin and NSAIDs

153
Q

sx of acute/diffuse gastritis

A
N/V
epigastric pain
Hiccuping
Fever
HA
anorexia
154
Q

tx of acute/diffuse gastritis

A

NPO
antacids or PPI
H2 receptor antagonist
remove cause

155
Q

ϖ Involves muscle atrophy of stomach walls; not working quite as it should
ϖ Also involves decreased acid production
ϖ Prolonged inflammation of stomach, may be caused by benign or malignant ulcers of stomach

A

Chronic Gastritis (H. pylori gastritis)

156
Q

cause of

Chronic Gastritis

A

H. pylori

157
Q

how is Chronic Gastritis transmitted?

A

fecal-oral

oral-oral

158
Q

manifestations for chronic gastritis

A
anorexia
heartburn
belching
sour taste in the mouth
decreased intrinsic factor
159
Q

tx of chronic gastritis without ulcers

A

NO treatment

160
Q

tx of chronic gastritis with ulcers

A

tripple 1st line therapy:

PPI

ATB (chlarithmycin)

ATB (amoxicillin or metronidazole)

161
Q

Nursing Management for Chronic Gastritis

A
NPO
reduce acid in stomach and decrease pain
alcohol abuse counseling
avoid NSAIDs
small freq. meals
162
Q

what to monitor for with chronic gastritis?

A

hemorrhagic gastritis, bleeding in mucosa

163
Q

education for chronic gastritis

A

lifelong B12 injections

164
Q

PUD can be caused by ______.

A

H. Pylori

165
Q

PUD can cause ____.

A

gastritis

166
Q

how does H. pylori cause PUD

A

it drops the acid in your belly.

167
Q

other causes of PUD

A

chronic NSAID and aspirin use

stress
smoking
alcohol
milk
caffeine
hispanics

blood type O

168
Q

several peptic ulcers, extreme gastric hyperacidity, benign or malignant tumors of the pancreas

A

ϖ Zollinger-Ellison Syndrome (ZES)

169
Q

common in those with severe burns

A

ϖ Hurling ulcers –

170
Q

common in patient with head trauma

A

ϖ Cushing ulcers –

171
Q

sx of PUD

A

ϖ May last for a few days, weeks, or months and may disappear only to reappear, often without identifiable cause

ϖ Either a lot of pain or no pain – usually come in w/ GI bleed and never knew they had an ulcer

anorexia

vomiting

172
Q

PUDs most common sx

A

Dull, gnawing pain or a burning sensation in the mid-epigastrium

173
Q

complication of PUD

A

Peptic ulcer bleeding–main cause of upper GI bleeding

174
Q

hurts 1-3 hours after eating

A

gastric ulcer

175
Q

pain goes away when they eat and wake up at night

A

duodenal ulcer

176
Q

upper GI bleed

A

bright red

177
Q

lower GI bleed

A

coffee ground

178
Q

nursing management of PUD

A
lavage for suction
18G IV
NS or lactated ringer
aspiration risk
HOB high
side lying
179
Q

ulcers lead to _____ which leads to ____

A

perforation; peritonitis

180
Q

quadruple therapy for PUD

A

pepto, ATB, PPI

181
Q

why do PUD patient need 18 G IV?

A

might need blood

182
Q

perforation is common with PUD and can lead to?

most lethal complication of PUD

A

peritonitis

183
Q

sx of perforation of PUD

A

sudden severe upper abd. pain
absent bowel sounds
rapid shallow breaths
extremely tender and rigid boardlike abd.

184
Q

– fatty layer of stomach to cover up ulcer

A

o Momentum

185
Q

obstruction of the gastric outlet sxs

A
severe abd. pain
projectile vomiting
swelling in upper abd.
LOUD PERISTALSIS
weight loss
186
Q

dx of PUD

A

endoscopy

CBC

biopsy

stool antigen test

urea breath test

string test

ELISA test

187
Q

if pt with PUD has hypotension and tachycardia expect

A

GI bleed

188
Q

what meds for pain with PUD

A

tylenol NOT NSAIDs

189
Q

dietary education with PUD

A

no late night meals

avoid coke, coffee, stress, milk

eat at regular intervals, small meals

190
Q

potential complications with PUD

A

perforation
hemorrhage
gastric outlet obstruction

191
Q

nursing management of PUD

A
insert IV
NG tube lavage
insert foley
monitor O2
treat hemorrhagic shock
192
Q

normal BMI

A

18-24

193
Q

overweight

A

25-29

194
Q

obesity

A

greater than 30

195
Q

obese patients are at higher risk for ?

A
diabetes
HTN
stroke
sleep apnea
cancer
196
Q

how to treat obesity

A

lifestyle modifications
meds
surgery

197
Q

medications for obesity

A

loraserin (belviq)
meridia
orlistat
rimonabant

198
Q

lorcaserin is an

A

antidepressant

199
Q

orlistat works by ?

A

reducing caloric intake by binding to gastric and pancreatic lipase to prevent digestion of fats

200
Q

sx of orlistat?

A

incontinence, gas with oily discharge

201
Q

what is recommended with orlistat?

A

multivitamin

202
Q

rimonabant side effects

A

depression, anxiety, agitation, sleep disorders

taken off marker from suicidal tendencies

203
Q

surgical management of obesity

A

bariatric surgery

204
Q

prelim process for bariatric surgery

A

6-18 months of extensive counseling

205
Q

after bariatric surgery

A

patients require lifelong monitoring of weight loss, comorbidities

206
Q

women are advised to use contraceptives for ___ years after surgery until weight stabilizes

A

2

207
Q

complications of bariatric surgery

A
bleeding
blood clots
bowel obstruction
incisional or ventral hernias
infection
nausea
208
Q

monitor for side effects of bariatric surgery such as

A

nausea from overfilling

dumpling syndrome

changes in bowel function

nutritional deficiencies