gi conditions (final sg)

Question 1

intestinal obstruction

Answer 1

➺ condition in which the flow of chyme through the intestinal lumen is obstructed
➺ SIMPLE: mechanical (physical) blockage of the lumen
➺ FUNCTIONAL: failure of intestinal motility

Question 2

signs of intestinal obstruction

Answer 2

➺ SMALL intestine: colicky pains, NV; vomit appears bile-stained or is fecal matter
➺ LARGE intestine: hypogastric pain and abdominal distention

Question 3

paralytic ileus

Answer 3

➺ a FUNCTIONAL obstruction
➺ often occurs after abdominal / intestinal surgery, pancreatitis, or hypokalemia
➺ symptoms may include abdominal distention / pain, constipation, inability to pass gas, NV

Question 4

paralytic ileus treatment

Answer 4

➺ NG tube to suction (bowel rest)
➺ NPO
➺ IV fluids / TPN
➺ medications

Question 5

crohn’s disease (chronic ibd) (symptoms)

Answer 5

➺ chronic inflammation of the SI, colon, or both (mouth to anus)
➺ inflammation causes a thickened bowel wall
➺ symptoms may include unintentional weight loss, change in stool characteristics, fever, abdominal pain in RLQ, abdominal distention, masses, visible peristalsis, tachycardia, dec. / absent bowel sounds
➺ anemia is common!!!

Question 6

complications r/t cd

Answer 6

➺ DIARRHEA due to inflammation of bowel mucosa
➺ acute / persistent pain due to inflammation and ulceration of bowel mucosa and skin irritation
➺ potential for lower GI bleeding (anemia)

Question 7

cd treatment

Answer 7

➺ manage diarrhea!
➺ diet low in animal fat / sugars and inc. vegetable / fruit intake
➺ no tobacco, alcohol, or caffeine
➺ monitor bowel movements and weight
➺ skin care
➺ MEDICATION: 5-aminosalicylates, glucocorticoids, immunosuppresants / modulators, antibiotics

Question 8

cd labs

Answer 8

➺ WBC
➺ c-reactive protein (inflammation)
➺ erythrocyte sedimentation rate
➺ sodium, potassium chloride
➺ albumin

Question 9

cd diagnostics

Answer 9

➺ MRE
➺ *endoscopy / colonoscopy / ileo (GOLD STANDARD)
➺ CT scan

Question 10

diverticular disease

Answer 10

➺ can occur in SI and colon, but mainly sigmoid colon (descending)
➺ muscle of the colon hypertrophies, causing herniations through mucosa and submucosa through colon wall
➺ diverticula occur in points of weakness in intestinal wall (where blood vessels interrupt muscle layer)
➺ weakening wall occurs as part of the aging process / poor diet

Question 11

what are the stages of diverticular disease?

Answer 11

➺ diverticuLOSIS: ASYMPTOMATIC stage
➺ diverticuLITIS: INFLMMATORY stage
➺ diverticula: herniations of mucosa through layers of colon wall

Question 12

diverticular disease symptoms

Answer 12

➺ this will OCCASIONALLY cause symptoms
➺ history of pain and constipation, low-grade fever, NV, abdominal pain, bleeding from rectum, bloody / mahogany / tarry stools

Question 13

diverticular disease labs

Answer 13

➺ CBC
➺ H+H
➺ occult blood

Question 15

diverticular disease treatments

Answer 15

➺ antibiotics: metronidazole with SMX/TMP or ciprofloxacin
➺ analgesics for pain
➺ NPO diet if symptoms are severe (NG tube), otherwise low fiber and clear liquids
➺ inc. dietary intake slowly; fiber is reintroduced once bowel function returns to normal
➺ COLON RESECTION with or without a colostomy is the most common surgical procedure
➺ may need emergency surgery if peritonitis, bowel obstruction, or pelvic abscess is present

Question 16

diverticular disease home treatment

Answer 16

➺ emphasis incision + colostomy care
➺ avoid fiber in diet initially, reintroduce once inflammation dec.
➺ avoid alcohol and foods containing seeds or ingestible material