Lower GI Disorders

Question 1

What is Diverticulosis? How does it occur?

Answer 1

is a condition characterized by small, saclike pouches in the intestinal wall called diverticula.

Question 2

What are some risk factors for Diverticulosis?

Answer 2

Low fiber diet, age, constipation, obesity, and emotional tension.

Question 3

What are the S&S for Diverticulosis? How can it be treated?

Answer 3

Often asymptomatic, may have constipation, diarrhea, and pain in left lower abdomen. Can be treated with a high fiber diet.

Question 4

What is Diverticulitis? How is it caused?

Answer 4

Inflammation of the diverticula. It is a complication of diverticulosis. Caused by stool being impacted in the diverticula.

Question 5

What are some complications for Diverticulitis?

Answer 5

Severe bleeding, Obstruction, Perforation, Peritonitis, Fistula Formation.

Question 6

What is the Medical/Surgical treatment for Diverticulitis?

Answer 6

Medical:
Bed rest, NPO and IV Fluids, GI decompression, Analgesics, Antibiotics
Surgical:
Colon resection, Colostomy, Hartmann procedure

Question 7

What is an abdominal hernia?

Answer 7

Muscle weakness resulting in large intestine protruding through the muscle.

Question 8

Explain an irreducible or incarcerated hernia and an strangulated hernia.

Answer 8

Irreducible or Incarcerated: The hernia can’t be manipulated back into place. May impair blood flow to the trapped loop of intestine, causing it to become gangrenous. Obstructed peristaltic flow.

Strangulated: Trapped and deprived of blood.

Question 9

What are the 4 types of hernias?

Answer 9

Inguinal
Femoral
Umbilical
Incisional

Question 10

What are the S&S for a hernia?

Answer 10

Some are asymptomatic. Usually not painful unless it is incarcerated. When incarcerated, the patient has severe abdominal pain and distinction, vomiting, and cramps.

Question 11

What is the Medical/Surgical treatment for a hernia?

Answer 11

Herniorrhaphy- the repair of the muscle defect by suturing
Hernioplasty- strong materials are used to cover and reinforce the defect
Truss- consists of a pad that is placed over the hernia and a belt that holds it in place.

Question 12

What is a volvulus?

Answer 12

A twisting of the intestine that causes a blockage, and may cut off blood flow and damage part of the intestine.

Question 13

What is an intestinal obstruction?

Answer 13

Is a partial or complete blockage of the bowel that prevents the contents of the intestine from passing through.

Question 14

What are S&S of Intestinal Obstruction?

Answer 14

Abdominal pain, N/V possibly projectile, Constipation, Bloating

Question 15

What is the Medical/Surgical treatment for Intestinal Obstruction?

Answer 15

NGT for decompression, IV hydration, and surgery may be needed if tube does not relieve symptoms or if there are signs of tissue death.

Question 16

What is Irritable Bowel Syndrome (IBS)?

Answer 16

is a disorder that leads to abdominal pain and cramping, changes in bowel movements, and other symptoms.

Question 17

What are some diagnostic tests for Irritable Bowel Syndrome?

Answer 17

Upper GI Series, Barium Enema, and Sigmoidoscopy.

Question 18

What are S&S of Irritable Bowel Syndrome?

Answer 18

Abdominal pain, Cramping, Flatulence, Constipation/Diarrhea.

Question 19

What is the treatment for Irritable Bowel Syndrome?

Answer 19

Reduce stress, Counseling, High fiber diet/Metamucil, Lifestyle changes, Adequate fluids & regular meal patterns.

Medications-
Sedatives: Xanax
Anti-spasmodic: Bentyl
Anti-diarrheal: Immodium

Question 20

What is constipation?

Answer 20

Is a condition in which a person has hard, dry, infrequent stools that are passed with difficulty.

Question 21

What are the causes for constipation?

Answer 21

• The frequent use of laxatives: these agents keep the lower digestive tract empty and eventually interferes with the normal pattern of elimination.
• Inactivity: physical activity promotes normal bowel elimination, people who are inactive are at risk for constipation.
• Adequate Fluids: Inadequate fluid intake can lead to constipation because more water will be reabsorbed from the stool.
• Low fiber

Question 22

What is the treatment for constipation?

Answer 22

Laxatives, Stool softeners, Fiber supplements.

Question 23

What is diarrhea?

Answer 23

The passage of loose, liquid stools with increased frequency.

Question 24

What are S&S of diarrhea?

Answer 24

Cramps, Abdominal pain, Urgency before bowel movements, Flatulence.

Question 25

What are the complications for diarrhea?

Answer 25

Dehydration, Electrolyte imbalances, Metabolic acidosis, Malabsorption leading to malnutrition and anemia.

Question 26

What are the nursing interventions for diarrhea?

Answer 26

NPO, IV, TPN if severe signs
I&O, daily weight
Record time, amount, color of stool
Motility reducers 
Monitor electrolytes

Question 27

What is Inflammatory Bowel Disease (IBD)?

Answer 27

Refers to both Ulcerative colitis and Crohn’s Disease. In both conditions, there is inflammation and ulceration of the lining of the intestinal tract. Ulcerative colitis begins from recriminations and Crohn’s begins anywhere.

Question 28

What is Crohn’s Disease?

Answer 28

Lesions affect the entire thickness of the bowel; can occur anywhere in the colon or small intestine. Lesions are patchy and positioned between areas of normal tissue.

Question 29

What are S&S of Crohn’s Disease?

Answer 29

Varies depending on areas affected.
Involving stomach and duodenum: N/V & Epigastric Pain
Involving Small intestine: Pain, Abdominal Cramping & Tenderness
An inflamed colon: Rectal bleeding and Diarrhea
Other: Steatorrhea, Weight Loss, Electrolyte Imbalance, Iron deficiency anemia, Amino acid mal-absorption.

Question 30

What are long term complications of Crohn’s Disease?

Answer 30

Hemorrhage, Bowel obstruction, Fistulas, Abscesses, Perforation.

Question 31

What is Ulcerative Colitis?

Answer 31

Is an inflammatory bowel disease (IBD) that causes long-lasting inflammation in part of your digestive tract. Usually affects only the innermost lining of your large intestine (colon) and rectum.

Question 32

What are S&S of Ulcerative Colitis?

Answer 32

Fever, anorexia, weight loss; Frequent, watery stools with mucous & blood.

Question 33

What are long term complications of Ulcerative Colitis?

Answer 33

Fissures, Abscesses, Increased risk of colon CA, Toxic megacolon.

Question 34

What is Appendicitis? What’s a fatal complication?

Answer 34

Inflammation of the appendix. If ruptured, peritonitis will develop which may be fatal.

Question 35

What are S&S of Appendicitis?

Answer 35

Pain at McBurney’s Point, N/V, Fever, Rebound tenderness, Pt can’t straighten right leg without pain.

Question 36

What is the treatment for Appendicitis?

Answer 36

An appendectomy.
Pre-op orders: NPO, IV fluids
Post-op orders: NPO until BS return then advance diet as tolerated. V.S, TC, & DB. Assess wound for S&S of infection. OOB as soon as possible.

Question 37

What is peritonitis?

Answer 37

Inflammation of the peritoneum caused by chemical or bacterial contamination of the peritoneal cavity.

Question 38

What are complications of peritonitis?

Answer 38

Abscesses, Adhesions, Septicemia, Hypovolemic shock, Paralytic ileus, and organ failure.

Question 39

What are S&S of peritonitis?

Answer 39

Pain over affected area, rebound tenderness, abdominal rigidity & distention, fever, tachycardia, tachypnea, N/V.

Question 40

What is the treatment for peritonitis?

Answer 40

NGT is inserted for gastrointestinal decompression. IV fluids, antibiotics, and analgesics are ordered. Surgery may be done to close a ruptured structure and to remove foreign material and fluid from peritoneal activity.