Gastrointestinal Disorders

Question 1

What is constipation

Answer 1

small, infrequent, or difficult BM

Fewer than 3 BMs/week

Question 2

What is the causes of constipation

Answer 2

Diet (low in fiber)
Lack of exercise
Slowed peristalsis
Pathologic conditions
Obstruction or diverticulitis

Question 3

What is an impaction

Answer 3

unrelieved constipation

Question 4

what can an iimapaction lead to

Answer 4

an obstruction

Question 5

what is an obstruction

Answer 5

a firm, immovable mass of stool obstructs lower GI tract

Question 6

S/S of an impaction (5)

Answer 6

May have continuous oozing or diarrhea

Loss of appetite

N/V

Abdominal distention

Cramping and pain

Question 7

What is diarrhea

Answer 7

increase in frequency and fluidity of bowel movements

Question 8

what can cause ACUTE diarrhea

Answer 8

Infection,
emotional stress,
some medications,
liquid stool around an impaction

Question 9

what can cause CHRONIC diarrhea

Answer 9

lasting more than 4 weeks
Chronic GI infection
Alterations in motility or integrity
Malabsorption
Endocrine disorders

Question 10

What is causes EPISODIC diarrhea

Answer 10

Food allergy or irritant

Question 11

What are the 4 pathophysiologic mechanisms of diarrhea

Answer 11

Osmotic diarrhea

Secretory diarrhea

Exudative diarrhea

Related to motility disturbances

Question 12

what is osmotic diarrhea

Answer 12

increase in solutes

sodium and water rush into colon

common with mag sulfate
and tube feeding

Question 13

what is secretory diarrea

Answer 13

caused by bacteria or toxin causing increase secretion and inhibit reabsorbtion.

Question 14

2 common bacteria in secretory diarrhea

Answer 14

Vibrio cholerae & Staphylococcus aureus

Question 15

what is exudative diarrhea

Answer 15

active inflammation in bowel lumen resulting in exudate of mucus, blood and proteins in a open wound pulling water into intestines .
common in crohn disease and ulcerative colitits

Question 16

what is Related to motility disturbances

Answer 16

decrease absoprtion in small intestines with large amounts of fluid delivered to colon.

examples include Dumping syndrome & IBS

Question 17

problems with diarrhea

Answer 17

Skin breakdown

Fluid/Electrolyte imbalance

Nutritional concerns

Question 18

Drugs used to treat Diarrhea

Answer 18

Anti-diarrheals

Question 19

Different groups of diarrheals

Answer 19

Adsorbants

Antimotility (anticholinergics and opiates)

Probiotics

Question 20

route of antidiarrheals

Answer 20

oral

Question 21

Drug name for adsorbent drug

Answer 21

bismuth subsalicylate (Pepto-Bismol)

Question 22

MOA of bismuth subsalicylate

Answer 22

coats the walls of the GI tract

Bind the causative agent for elimination

Question 23

Adverse Effects (Bismuth subsalicylate)

Answer 23

Increased bleeding time

Constipation

Dark stools and darkening of tongue

Question 24

characteristics of bismuth subsalicylate (Pepto-Bismol)

Answer 24

form of asprin

contains activated charcoal

Question 25

What is the antimotility drugs

Answer 25

loperamide (Imodium) diphenoxylate [atropine] (Lomotil)

Question 26

MOA of antimotility drugs

Answer 26

Slow peristalsis Drying effect\*

Question 27

adverse effects of antimotility drugs

Answer 27

Urinary retention Headache dizziness anxiety drowsiness Bradycardia hypotension Dry skin Flushing

Question 28

T/F Antimotility drugs can be Used alone or in combination with adsorbants and opiates

Answer 28

TRUE

Question 29

MOA of probiotics

Answer 29

Replenish these bacteria and restore normal flora

Question 30

These bacteria make up the majority of normal flora of gut

Answer 30

Lactobacillius organisms (Bacid, Culturelle)

Question 31

Medication used in the treatment of C-Diff

Answer 31

Saccharomyces boulardii (Florastor)

Question 32

What are laxatives used for

Answer 32

treatment of constipation

Question 33

Different groups of laxatives

Answer 33

Bulk-forming Emollient Hyperosmotic Saline Stimulant

Question 34

How laxative treatment is prioritized

Answer 34

Individualized by: Age Severity Contributing factors

Question 35

Bulk-forming medication

Answer 35

psyllium (Metamucil)

Question 36

MOA of psullium

Answer 36

Act similar to dietary fiber Absorb water into the intestine, increasing bulk Distends bowel to initiate reflex bowel activity and bowel movement

Question 37

T/F psullium is OK for long term use

Answer 37

TRUE

Question 38

Adverse effects of psullium

Answer 38

Impaction above strictures Fluid/electrolyte imbalance Gas formation Esophageal blockage

Question 39

Emollient medications

Answer 39

docusate sodium (Colace) mineral oil

Question 40

MOA of docusate sodium

Answer 40

lubricates fecal material and walls, promotes fat absorption into fecal mass

Question 41

uses of docusate sodium

Answer 41

prevent opioid-induced constipation

Question 42

route of docusate sodium

Answer 42

PO

Question 43

MOA of mineral oil

Answer 43

lubricate intestines

Question 44

uses of mineral oil

Answer 44

fecal impactions

Question 45

route of mineral oil

Answer 45

PO PR

Question 46

Adverse effects of emollients

Answer 46

skin rashes, decreased absorption of vitamins

Question 47

what do emollients prevent

Answer 47

water from moving out of intestines

Question 48

Hyperosomtic drugs

Answer 48

glycerin lactulose polyethylene glycol

Question 49

MOA of hyperosomtic drugs

Answer 49

Increasing water content in feces Promotes distention, peristalsis, and evacuation

Question 50

uses of hyperosomtic drugs

Answer 50

Evacuate bowels before diagnostics and surgical procedures

Question 51

adverse effects of hyperosomtic drugs

Answer 51

Abdominal bloating Rectal irritation Electrolyte imbalance

Question 52

MOA of saline laxatives

Answer 52

increase osmotic pressure and draw water into colon

Question 53

Adverse effects of saline laxatives

Answer 53

Magnesium toxicity Electrolyte imbalance Cramping, diarrhea

Question 54

2 Types of Saline salts

Answer 54

Magnesium salts sodium salts

Question 55

3 types of magnesium salts

Answer 55

magnesium citrate (Citroma) magnesium hydroxide (Phillips Milk of Magnesia) magnesium sulfate (epsom salts)

Question 56

type of sodium salt

Answer 56

fleet enema

Question 57

2 Type of stimulant laxative

Answer 57

bisacodyl (Ducolax) senna (Senokot)

Question 58

route of bisacodyl

Answer 58

PO PR

Question 59

route of senna

Answer 59

PO

Question 60

Uses of stimulant laxatives

Answer 60

OTC for constipation or whole bowel evacuation

Question 61

Adverse Effects of stimulant laxatives

Answer 61

Nutrient malabsorption Gastric irritation Electrolyte imbalance