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NURSING 2 > Lower GI > Flashcards

Lower GI Flashcards

1
Q

Bowel obstruction: patho

A

Passage of intestinal material is impaired

  • can be complete or partial
  • strangulated = no blood supply
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2
Q

Bowel obstruction: non-mechanical cause

A

paralytic
inflammatory
electrolyte
interrupted blood supply

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3
Q

bowel obstruction: priority labs/diagnostics

A

Abdominal x-rays CT scan
Scope
CBC- metabolic profile

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4
Q

bowel obstruction: priority interventions

A 
NPO
NG
IV fluids (LR)
I&O
Oral care
Pre-post surgery care (possibility of stoma)
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5
Q

bowel obstruction: complications

A 
Perforation
Strangulated necrotic bowel 
Septic shock 
Ostomy 
Fatality
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6
Q

bowel obstruction: meds

A

pain- GI (H2 blockers, PPIs)- vasopressors

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7
Q

bowel obstruction: education

A

Bowel movements- go when you get the urge – schedule
Know symptoms of obstruction
Ostomy care –
Weeks for recovery

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8
Q

Small bowel obstruction: cause

A

Adhesions
Intussusception (more in infants, bowel folds back on self)
Volvulus
Paralytic ileus

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9
Q

Small bowel obstruction: assess

A 
distention
bowel sounds
vomiting
dehydration
pain
last BM
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10
Q

Small bowel obstruction: management

A

Decompression (NG)
Fluid replacement
Surgery

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11
Q

What might you expect will start happening in a client with BO?

A

eventually start vomiting fecal contents

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12
Q

Constipation: what?

A

less than 3 stools / week

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13
Q

Constipation: assess

A

abdominal distention
pain
cramp
don’t feel like they have emptied

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14
Q

Constipation: complications

A

Hemorrhoids (d/t pressure)
Anal fissures (d/t pressure)
Increase arterial blood pressure
Vagal stimulation (drop HR and BP, syncope)
Megacolon (colon stretches to compensate)

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15
Q

Constipation: treatment

A 
Increase fluid intake
 Increase dietary fiber 
Exercise 
Laxatives- non stimulant first (softeners like colace) 
Enema last resort
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16
Q

What is considered diarhhea?

A

more than 3 stools per day or abnormally liquid stool

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17
Q

Diarrhea: cause

A

meds, metabolic disorders, infectious process, intestinal obstruction

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18
Q

Diarrhea: manifestations

A

Borborygmus, abdominal cramps, thirst, anorexia, tenesmus (ineffective straining)

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19
Q

Diarrhea: complications

A

Metabolic acidosis
Hypokalemia
Dehydrations

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20
Q

Diarrhea: elderly

A

Become dehydrated quick

Digoxin (watch for problems w digoxin because hypokalemia and dig toxicity and really common)

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21
Q

Appendicitis: assess

A

cough deep breathe sneeze- if no pain not appendicitis

  • rebound tenderness
  • BP. HR, RR- peritonitis with rupture
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22
Q

Appendicitis: complications

A

peritonitis

abcess

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23
Q

appendicitis: interventions

A 
Prep for surgery
NPO may need NG 
Bowel Sounds 
Post op care 
BP HR RR
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24
Q

Why are we not going to give someone who is constipated a laxative if they already have appendicitis?

A

may cause appendix to rupture

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25
Q

appendicitis: s/s

A 
Sudden pain RLQ
NV
Loss of appetite
Fever
Constipation or diarrhea
Abdominal bloating
26
Q

Appendicitis: meds

A

analgesics
antiemetics
antibiotics

27
Q

appendicitis: teaching

A

Discharge in 24 hours if no complications
Med teaching if on antibiotics
Signs of wound infection

28
Q

Diverticular disease: patho

A

Sac-like herniation of the lining of the bowel extending through a defect in the muscle layer

29
Q

What is diverticulitis vs diverticulosis?

A

Diverticulosis: outpouching
Diverticulitis: inflammation/infection of the outpouching

30
Q

Diverticular disease: cause

A 
Low fiber
Constipation
Obesity
ETOH
smoking
31
Q

Diverticular disease: assessment

A 
NV
Pain LLQ (worsens w strain, lifting or cough)
Flatulence
Blood in stool
signs of perforation
32
Q

Acute diverticular disease: s/s

A

fever, chills, increase in pain

33
Q

Diverticular disease: tests for acute phase

A

CT scan

34
Q

Diverticular disease: tests for chronic

A

scope

35
Q

Diverticular disease: tests

A

CBC

blood cultures

36
Q

Diverticular disease: complications

A 
perforation
peritonitis
sepsis
fatality
ostomy
37
Q

Diverticular disease: interventions

A 
NPO
IV fluids
I&O 
Post op care 
Advance diet
38
Q

Diverticular disease: meds

A

Antibiotics (primarily metronidiazole), stool softeners, laxatives (bulk over stimulant)

39
Q

Diverticular disease: education

A

prevention (don’t get constipated)
avoid fat and meats
increase fluids
avoid activity that increase intrabdominal pressure

40
Q

Crohn’s and Ulcerative colitis: location

A

Crohn’s: mouth to anus

Ulcerative colitis: Rectum to cecum

41
Q

Crohn’s and Ulcerative colitis: inflammation

A

Crohn’s: skilled pattern (cobblestone)

Ulcerative colitis: continuous

42
Q

Crohn’s and Ulcerative colitis: complications

A

Crohn’s: abscess peritonitis, narrowed lumen scarring, ulcerative fistulas, small intestine cancer

Ulcerative colitis: Inflamed mucosa prevents absorption of electrolytes and water, Toxic megacolon, colorectal cancer

43
Q

Crohn’s and ulcerative colitis: Diet

A

Crohn’s: high fruit, fiber

Ulcerative colitis: high intake vegetables

44
Q

Crohn’s and ulcerative colitis: tests

A 
C reactive protein 
WBC  
CBC  
stool  
metabolic profile 
CT 
MRI 
barium enema 
scopes
45
Q

Crohn’s and ulcerative colitis: interventions

A 
prep for testing 
weight assess fluid loss I & O 
NPO- acute phase
IV fluids/electrolytes   
Nutritional needs 
Monitor Stools for consistency 
bowel sounds   
Hygiene
46
Q

Crohn’s and ulcerative colitis: surgery

A

may eventually have all of colon removed

Ileostomy care –> initial output can be up to 1800 ml / 24 hours
Significant for maintaining hydration for client

47
Q

Crohn’s and ulcerative colitis: education

A 
hygiene  
high protein, calories, vitamins  
Stress reduction  
emotional needs 
Medication administration
48
Q

Ileostomy

A

Creation of opening into ileum

49
Q

Ileostomy: kock pouch

A

Continent ileal reservoir

50
Q

Ileostomy: ileoanal anastomosis

A

Voluntary defecation is maintained

51
Q

Ileostomy: nursing care

A 
Stoma should be pink or red and moist
Stoma will change sizes post op
Drainage should begin in 72 hours
Kock pouch will have a catheter for continuous drainage 1-3 weeks post op 
Fluid loss
Skin care
52
Q

Colorectal cancer: begins as what?

A

benign polyp

53
Q

colorectal cancer: risk factors

A

age and family

54
Q

colorectal cancer: monitor

A

monitor minor bowel changes

– blood in bowel / stools

55
Q

What is a late indicator of colorectal cancer?

A

abdominal pain

56
Q

What is an early indicator of colorectal cancer?

A

blood in stool

57
Q

Colorectal cancer: CEA levels (cancer antigen levels)

A

indicate prognosis and should return to normal post tumor resection – if elevated, you have cancer

58
Q

Colorectal cancer: complications

A

obstruction by the tumor

59
Q

Hemorrhoids

A

Dilated veins in the anal canal

Related to shearing of the mucosa

60
Q

Hemorrhoids: s/s

A

itching
pain
bright red bleeding with defication

61
Q

hemorrhoids: treatment

A

increase fiber
good hygiene
light exercise

all of these will help improve peristalsis and avoid constipation

NURSING 2 (12 decks)

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