Adult Health Chapter 57 Flashcards Preview

Nursing 2016 > Adult Health Chapter 57 > Flashcards

Flashcards in Adult Health Chapter 57 Deck (71)
Loading flashcards...
1

What are 3 acute inflammatory disorders?

Appendicitis, peritonitis, and gastroenteritis

2

What are the 4 chronic inflammatory disorders?

Ulcerative colitis
Crohn’s disease
Diverticular disease
Celiac disease

3

What are some anal disorders?

Anal abscess, fissure & fistula

4

What are the main topics in inflammatory intestinal disorders?

Acute inflammatory disorders, chronic inflammatory disorders, anal disorders, parasitic infection

5

What is appendicitis?

Inflammation of the appendix, characterized by a sudden and constant pain at the navel and shifts to RLQ with N/V- McBurney's rebound pain, elevated WBC

6

What is McBurney's rebound pain?

Pain during palpation or during release
Do this last because it may be painful for patient

7

What are some problems being a female with appendicitis?

appendicitis can be confused with ovarian cysts- may take longer to diagnose due to this

8

What is some non-surgical management for appendicitis?

administer fluids, ensure comfort and prepare for surgery

9

Describe the surgical management for appendicitis.

Appendectomy open or laparoscopic (better for the patient because they can go home after 24 hours or so- recover quicker)

10

What are some nursing interventions to focus on after an appendectomy?

Pain management
Bleeding
Signs of infection
Drains assessment

11

What is important to know about teaching pre surgery for an appendectomy?

Pre surgery teaching is limited due to urgency

12

What is peritonitis?

Life threatening inflammation of visceral peritoneum and endothelial lining of abdominal cavity

13

What can peritonitis lead to?

Hypovolemic shock
Slower peristalsis
Respiratory problems

14

What is the classic sign for peritonitis?

Rigid, board like abdomen

15

What does the assessment include for peritonitis?

Rigid, board like abdomen (classic sign)
Abdominal pain (localized, poorly localized or referred to shoulder and chest)
Distended abdomen
Nausea, vomiting anorexia
Diminishing bowel sounds
Inability to pass flatus or feces
Rebound tenderness in the abdomen
High fever
Tachycardia
Dehydration
Decreased urine output

16

What are some non surgical interventions for peritonitis?

IV hypertonic fluids (5%dextrose in NS, 3%saline)
Antibiotics
Pain control
NG tube (to decompress stomach)

17

What are some surgical interventions for peritonitis?

Laparotomy
Infection
IV fluids
I+O
Fluid electrolyte balance
Drains- when they come out of surgery- looking for baseline then

18

Describe some patient education on peritonitis.

At discharge inform the patient to report:
-Foul smell from drain
-Swelling, redness, warmth, -bleeding from incision
-Increased temperature
-Abdominal pain
-Wound dehiscence
-no lifting 6 weeks post surgery (or for 2 weeks if laparoscopy)
-possible need to antibiotics

19

Who does the dressing change for peritonitis when the patient is discharged?

Dressing change by home care RN- not by patient

20

What is gastroenteritis?

Inflammation of stomach and intestinal tract (mainly small bowel)
Caused by viruses or bacteria (Norovirus)
Self limiting 1-3 days in healthy individuals

21

What is gastroenteritis most commonly caused by?

Caused by viruses or bacteria (Norovirus)

22

How long does gastroenteritis usually last in a health individual?

Self limiting 1-3 days in healthy individuals

23

What are some nursing interventions regarding gastroenteritis?

Hand washing !!!
Dehydration
Hypokalemia
Fluid replacement (Gatorade)
Antibiotics- only if it is bacterial
Skin damage from frequent stools & wiping (around anal area)
Warm washcloths and protective crème
Protect and contain- not allow it to spread

24

What is ulcerative colitis?

Inflammation of rectum and sigmoid colon
- unknown cause
-peak diagnosis at age 30-40 and 55-65
-has remissions and exacerbations

25

How are the stages of ulcerative colitis determined?

Mild, moderate, severe- depends on amount of stool and how often there are trips to the bathroom

26

What is fulminant?

most severe stage of ulcerative colitis- > 10 bloody stools a day- increasing symptoms, anemia may require a transfusion, colonic distention on X-Ray

27

Describe the mild stage of ulcerative colitis.

28

Describe the moderate stage of ulcerative colitis.

>4 stools/day with/without blood- minimal symptoms, mild abdominal pain, mild intermittent nausea, possible increased C-reactive protein or ESR

29

Describe the severe stage of ulcerative colitis.

>6 bloody stools/day, fever, tachycardia, anemia, abdominal pain, elevated C-reactive protein and/or ESR

30

Describe an acute onset of ulcerative colitis

many don’t want to go out because they are worried about not making it to the bathroom( patient "tied to the toilet"- diarrhea, low grade fever,