Exam 2 chapter 24

Question 1

condition characterized by intermittent and recurrent abdominal pain and stool pattern irregularities?

Answer 1

Irritable Bowel Syndrome (IBS)

Question 2

symptoms of IBS

Answer 2

constipation 
diarrhea
alternating diarrhea/constipation
abdominal distention
Excessive flatulence

Question 3

The Rome III criteria

Answer 3

abd pain and discomfort lasting 3 months
starting at least 6 months ago
The pain has
	relieved by defecation
	onset assoc with change in fx of stool
	onset assoc with change in stool appearance

Question 4

Problems not associated with IBS

Answer 4

Anemia
fever
persistent diarrhea
rectal bleeding
severe constipation
weight loss

Question 5

Nutritional therapy for patient with IBS

Answer 5

eliminate gas producing foods
	brown beans
	Brussels sprouts 
	cabbage
	cauliflower 
	raw onions
	Grapes
	plums
	raisins

Question 6

what should patient with IBS add to their diet

Answer 6

yogurt
fiber
probiotics

Question 7

what medication may be given to a patient with IBS to control diarrhea and fecal urgency

Answer 7

Loperamide (Imodium)

Question 8

why may anticholinergic be prescribe for a patient with IBS

Answer 8

Pantheline (Pro Banthine)

to decrease smooth muscle spasm decreasing cramping and constipation

Question 9

what medication may be prescribed to treat women with IBS whose chief complaint is chronic constipation

Answer 9

Tegaserod (Zelnorm)
it increases the effects of serotonin in the intestines, thereby increasing motility.
SE: diarrhea
Teach pts to report severe diarrhea accompanied by dizziness or orthostatic hypotension.

Question 10

Patient teaching for IBS

Answer 10

avoid alcohol and cigarettes
eat at regular times
chew food slowly and thoroughly
fluids should not be taken with meals = abd distention.

Question 11

inflammatory Bowel Disease

Answer 11

characterized by recurrent inflammation of the intestinal tract.
periods of remission interspersed with periods of exacerbation
cause is unknown
no cure
Tx relies on medications to treat inflammation and maintain remission.

Question 12

Types of inflammatory bowel diease

Answer 12

Ulcerative colitis

Crohn’s disease

Question 13

Ulcerative colitis

Answer 13

diffuse inflammation
beginning in the rectum and spreading up the colon in a continuous pattern.
inflammation and ulcerations occur in mucosa and submucosa.
bowel occluded
multiple abscesses develop, break through into submucosa, leaving ulceration.
bleeding and perforation

Question 14

clinical manifestations of ulcerative colitis

Answer 14

anorexia
diarrhea (blood common)
fatigue/malaise
abd tenderness/cramping
weight loss
fever
dehydration and electrolyte imbalances
anemia
Vitamin K deficiency

Question 15

what are some complications for ulcerative colitis

Answer 15

toxic megacolon
perforation
bleeding 
vascular engorgement 
highly vascular granulation tissue

Question 16

symptoms of toxic megacolon in patient with ulcerative colitis

Answer 16

fever
abd pain and distention
vomiting
fatigue

Question 17

what type of surgery will be indicated for a patient with toxic megacolon who does not respond within 24 to 72 hours to medical management?

Answer 17

Total colectomy

Question 18

why do patient with IBD have significantly increase risk for osteoporotic fractures

Answer 18

decreased bone mineral density

corticosteroid therapy

Question 19

what are some labs to monitor for in patient with ulcerative colitis

Answer 19

WBC
H and H
albumin
electrolyte

Question 20

adverse sequelae to the use of corticosteroids are

Answer 20

hypertension
fluid retention
cataracts
hirsutism (abnormal hair growth)
adrenal suppression
steroid induced diabetes mellitus
poor wound healing
loss of bone density

Question 21

what is a common procedure performed for strictures of the small intestines?

Answer 21

Laparoscope guided strictureplasty

the blocked or narrowed sections of the intestines are widened, leaving the intestines intact.

Question 22

surgical removal of colon

Answer 22

colectomies

Question 23

complete excision of colon, rectum and anus

Answer 23

proctocolectomy with ileostomy

recommended when the rectum is severely diseased

Question 24

what is the procedure of choice when a rectum can be preserved for a patient with ulcerative colitis

Answer 24

restorative proctocolectomy with ileal pouch

Question 25

chronic, nonspecific inflammatory bowel disorder of unknown origin that can affect any part of the GI

Answer 25

Crohn’s disease