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Med Surg 1 > Exam 2- Disorders of the Lower GI Tract > Flashcards

Exam 2- Disorders of the Lower GI Tract Flashcards

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1
Q

Abnormal infrequency or irregularity of defecation, abnormal hardening of stools making passage difficult and painful

A

Constipation

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2
Q

Meds that cause constipation

A

Opioids, antiemetics

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3
Q

Increase in frequency of bowel movements (more than 3 per day), and altered consistency

A

Diarrhea

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4
Q

ABG complication with diarrhea

A

Metabolic acidosis

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5
Q

Involuntary passage of stool from the rectum

A

Fecal incontinence

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6
Q

Most common GI condition

A

IBS

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7
Q

Diet for IBS

A

High fiber diet (soluble-psyllium)

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8
Q

Med for IBS

A

Metamucil (soluble-psyllium)

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9
Q

IBS med for diarrhea

A

Loperamide

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10
Q

IBS med that slows motility

A

Lotronex

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11
Q

IBS med probiotic

A

Lactobacillus

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12
Q

Anti-diarrheal

A

Imodium

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13
Q

Diagnostic stool tests for IBS

A
  • Fecal occult blood test
  • C-Diff
  • Culture
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14
Q

Basic labs for IBS

A
  • CBC
  • CMP
  • PT/PTT
  • INR
  • Liver test
  • Amylase
  • Lipase
  • Triglycerides
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15
Q

Endoscopy for IBS (2)

A
  • Sigmoidoscopy
  • Colonoscopy
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16
Q

LGI surgeries

A
  • Colectomy
  • Ostomies
    (Ileostomy and colostomy)
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17
Q

Signs for ileostomy

A

More watery, yellow/green, located R lower side typically

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18
Q

Signs for colostomy

A

More formed, brown typical color, stool more solid because water has been reabsorbed from colon
- Can be located in ascending colon, transverse, or descending

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19
Q

Acute abdomen disorders

A
  • Appendicitis
  • Diverticulitis
  • Peritonitis
  • Bowel obstruction
  • Colon cancer
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20
Q

Inflammation or edema as a result of becoming kinked or occluded by a fecalith (hardened mass of stool), tumor, lymphoid hyperplasia, or foreign body

A

Appendicitis

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21
Q

Appendicitis pathophysiology

A

Appendix fills with pus, becomes ischemic-bacterial overgrowth occurs which can lead to gangrene

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22
Q

Appendicitis pain location

A

Peri-umbilical pain localized to RLQ within a few hours

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23
Q

With appendicitis, relied of pain may indicate…

A

Rupture

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24
Q

Food and bacteria retention in a diverticulum producing infection and inflammation

A

Diverticulitis

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25
Foods that can cause diverticulitis
Nuts, seeds, popcorn, seeds on strawberries
26
Inflammation of diverticulum can lead to...
Perforation, abscess formation, peritonitis, and bleeding
27
Acute onset or mild to severe pain in the LLQ. What is this?
Diverticulitis
28
What diagnostic testing is contraindicated with diverticulitis?
Colonoscopy
29
Management for diverticulitis
Analgesics Antispasmodic agents Antibiotics 7-10 days Increase bulk laxatives (metamucil) (not stimulants) High fiber
30
Docusate
Stool softener, bulk forming
31
Derived from leaf that irritate GI structures and increase peristalsis
Senokot
32
Entrance of microorganisms into peritoneal cavity as a result of - Rupture of internal organs - Trauma - Surgical procedures
Peritonitis
33
Complications of peritonitis (2)
SEPSIS AND SHOCK
34
Pathophysiology of peritonitis
- Tissue edema - Development of exudate - Increased protein, WBCs, cellular debris, and blood in peritoneal fluid
35
Which disorder involves abdominal pain becoming more localized and aggravated by movement?
Peritonitis
36
Tender, distended, board like abdomen is a manifestation of...
Peritonitis
37
Clinical manifestations of peritonitis
- Decreased bowel sounds (paralytic ileus) - Hypotension - Tachycardia - Increased WBCs
38
Medical management for peritonitis
Antiemetics Antibiotics Bowel decompression (NG tube)
39
Peritonitis nursing management
- Ongoing assessment, serial exams - Pain management: multimodal (positioning) - Accurate I&O (CVP, UO, Drains)
40
Blockage of intestines preventing the flow of intestinal contents
Bowel obstruction
41
Signs of improvement with peritonitis
- Decreased temp and pulse rate - Softening of abdomen - Return of bowel sounds
42
Types of bowel obstructions
- Mechanical - Functional - Partial vs. complete
43
Mechanical bowel obstruction
Something in the way (tumor)
44
Functional bowel obstruction
Just not working
45
Partial vs. complete bowel obstruction
Partial: not fully obstructed
46
Vomiting and BM at the same time is r/t viral infection or severe issue with thyroid. What type of bowel obstruction is this?
Functional
47
Most common site for bowel obstruction
Small intestine
48
Three causes for bowel obstruction
- Adhesions - Hernias - Neoplasms
49
15% of bowel obstructions occur in...
Large intestine - most in sigmoid colon - Carcinoma - Diverticulitis - Inflammatory bowel disorders - Benign tumors
50
- Symptoms develop slowly - Constipation, lack of flatulence - May vomit feces - Crampy lower abdominal pain; distention; bloating
Large bowel obstruction
51
- GI contents above the obstruction increase - Extreme pain (crampy wavelike) - Vomiting; can have diarrhea followed by lack of stool/gas - Dehydration (Acidosis may results from loss of fluid and NA)
Small bowel obstruction
52
Hypovolemic shock can happen if this is untreated
Small bowel obstruction
53
WIth a bowel obstruction, we do a lab study for lactate. What does this mean?
It means not getting enough adequate perfusion (blood flow to the bowels), so it results in gangrene
54
Management for bowel obstructions
- NGT (decompression) - Monitoring drainage - Fluid/lytes replacement - Careful management of pain (SE of opioids)
55
Bowel obstruction teaching
- Bowel program: High fiber prevention - Avoidance of constipating substances - Increased activity - Medications that can impact
56
Gold standard diagnostic for bowel obstruction
Chest X-Ray to check placement (or KED)
57
Colon cancer risk factors
- Increasing age - Family hx of colon cancer or polyposis - Previous colon cancer/adenomatous polyps - Inflammatory bowel disease (Crohn's or UC) - High-fat, high protein, low fiber diet - Genital cancer or breast cancer - ETOH, smoking, obesity - History of Gastrectomy
58
When should you start screening for colon cancer?
45
59
Colon cancer screening options
- Stool test - Direct visualization test
60
How is colon cancer determined
Determined by location of tumor, stage of disease, and function of portion of bowel where tumor is located
61
Clinical manifestations of colon cancer
- Change in bowel habits - Blood in stool; anemia - Anorexia - Weight loss, "B-Symptoms" - Fatigue
62
Diagnosis of colon cancer
- Abdominal and rectal exam - FOBT, CEA, CA 19-9 (tumor markers) - CT A/P - Endoscopy with bx (colonoscopy)
63
Complications of colon cancer
- Bowel obstruction - Hemorrhage - Perforation - Abscess formation (a dead piece of tumor that causes gangrene and sepsis) - Peritonitis - Sepsis - Shock
64
Chemo treatment for colon cancer
FOLFOX, immunotherapy, neuroendocrine tumors
65
Can you live without your colon?
Yes

Med Surg 1 (13 decks)

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