Flashcards in Diverticulitis and Bowel Obstruction FE Deck (18):
What is Diverticulitis?
An inflammation of one or more diverticula
What is Diverticulosis?
A condition where patients develop out-pouches in the colon. "Diverticula" as a result of weakness in bowel wall or increased intraluminal pressure.
What can cause Diverticulitis?
Diverticula tears or gets inflamed as a result of increased pressure.
What are 3 risk factors for Diverticulitis?
1. Increased age (weakened colon wall)
2. Previous incident (25-30% recur without surgery)
3. Decreased fiber intake (decreased transit time)
Is Diverticulitis common in vegetarians?
No, because usually they have a high-fiber diet
Where does diverticulitis commonly occur?
Where blood vessels penetrate the colon wall
What are three s/sx of Diverticulitis?
1. May be asymptomatic (80-85%) or have a change in bowel habits
2. Severe pain (LLQ) or fever
3. Alternating diarrhea/constipation, bloating, flatulance
What are 6 dx tests for Diverticulitis?
4. Sigmoidoscopy or colonoscopy
6. Stool for obstructive bowel
What is the conservative course of tx?
1. Bowel rest--NPO with IV hydration
2. PT education, esp dietary modifications
3. Medications (ABX, IV, pain med, bulk-forming, lax after dx)
4. NG to low-intermittent wall suction
What are two surgery options for diverticulitis?
1. Colon resection
2. Temporary colostomy
What is Bowel Obstruction?
Partial or complete inability of contents to pass through GI Tract
What are 6 types of bowel obstruction?
1. Mechanical (physical)
2. Non-mechanical (paralytic ileus)
3. Simple (adequate blood flow)
4. Strangulated (inadequate blood flow)
5. Located in Small bowels
6. Located in large bowels (10-15%)
What are four causes of mechanical bowel obstruction?
1. Adhesion or stricture
2. Intussusception (part of bowel folds into another and nothing can pass)
3. Volvulus (twisted bowels)
What are three possible complications of bowel obstruction?
1. Paralytic ileus
3. Necrotic bowel
What are 4 dx studies for bowel obstruction?
1. CT scan
2. XR abdomen
3. Possible endoscopy
What are s/sx of Bowel obstruction?
1. Severe abdominal pain
3. Sweating, anxiety, restlessness
4. Abdominal distention
6. Lack of flatus
7. High-pitched, hyperactive, hypoactive or absent bowel sounds
What are 9 typical orders for tx of bowel obstruction?
1. NPO status, strict I and O
2. NG tube to decompress and rest bowel
3. IV fluid resuscitation/electrolyte replacement
5. Pain control
6. Prophylactic ABX
7. Possible TPN
8. Monitor closely for worsening condition (what will a worsening pt look like?)
9. Surgery consult (surgery will be required for mechanical obstruction)