IBD

Question 1

what is ibd

Answer 1

a group of chronic disorders that result in inflammation and/or ulceration of the bowel

Question 2

where does crohn’s disease occur

Answer 2

anywhere from mouth to anus
common in right illium

Question 3

what is the patho of crohns

Answer 3

inflammatory process begins w/ crypt inflammation and abscesses that develop into small focal ulcers
cobblestone appearance
diseased bowel segments have defined borders separate from normal bowel tissue (skip lesions)

Question 4

what are localized manifestations of crohns

Answer 4

diarrhea
steatorrhea
rlq abd pain (crampy)
anorxeia, wt loss, malnutrition, secondary aneamia, pain after eating
abd tenderness and spasm

Question 5

what are the systemic manifestations of crohns

Answer 5

joint disorders
skin lesions
ocular disorders
oral ulcers

Question 6

diagnostics tests for crohns

Answer 6

wbc
elevated esr and crp
hgb and hct
albumin and protein
ct abd scan
MRI
colonoscopy

Question 7

what complication is common w/ crohns

Answer 7

fistula

Question 8

what is the patho for ulcerative colitis

Answer 8

affects superficial mucosa of colon
bleeding occurs d/t ulceration
ulceration is CONTINUOUS

Question 9

what are the localized manifestations for ulcerative colitis

Answer 9

diarrhea (mucous, pus, or blood)
pallor, anemia, and fatigue
anorexia, wt loss, fever, vomiting, dehydration, hypoalbuminemia, electrolyte imbalances
llq abd pain

Question 10

what are the systemic manifestations for ulcerative colitis

Answer 10

skin lesions
eye lesions
joint abnormalitites
liver disease

Question 11

diagnostic tests for ulcerative colitis

Answer 11

colonoscopy
abd xray
positive hemoccult testing
low hgb and hct
elevated wbc
elevated crp and esr
low albumin and protein levels
electrolyte imbalances

Question 12

what is a complications of ulcerative colitis

Answer 12

toxic megacolon

Question 13

what the prototype for aminosalicylates

Answer 13

sulfasalazine

Question 14

what is the first line agent used for IBD

Answer 14

sulfasalazine

Question 15

what is the prototype for immunomodulators

Answer 15

azathioprine

Question 16

pt educations for azathioprine

Answer 16

high risk for infection

Question 17

what do you monitor for azathioprine

Answer 17

neutropenia and thrombocytopenia

Question 18

what drugs are used to treat ibd

Answer 18

aminosalicylates
corticosteroids
immunomodulators
TNF
antibiotics

Question 19

nutritional management for ibd

Answer 19

oral fluids
low fiber (10-15 g)
high protein
high cal
avoid triggers
2 or less servings of dairy per day

Question 20

what is tpn

Answer 20

method of providing nutrients to the body by an IV route (central line)

Question 21

goal of tpn

Answer 21

improve nutrition status
establish positive nitrogen balance
maintain muscle mass
promote wt maintenance/gain
enhance healing process

Question 22

what are some cvads

Answer 22

percutaneous (non-tunneled central caths)
peripherally inserted central caths (PICC)
surgically placed (tunneled) central caths
implanted vascular access ports

Question 23

nursing considerations for tpn

Answer 23

maintain optimal nutrition
prevent infection
maintain fluid balance
encourage activity
monitor
daily wt
sugar check q6
infection
change tubing every 24 hrs

Question 24

what is the surgical management for ibd

Answer 24

used as last resort
may need surgery to relieve strictures
small bowel resection