MDC2 MODULE 5 Flashcards
(105 cards)
1
Q
What is the role of the lower gastrointestinal (GI) tract?
A
Digestion, absorption, and waste elimination
2
Q
What are some common lower gastrointestinal disorders?
A
- Irritable bowel syndrome (IBS)
- Inflammatory bowel diseases (IBD)
- Constipation
- Diverticulitis
- Colorectal cancer
3
Q
What is Irritable Bowel Syndrome (IBS)?
A
A chronic functional GI disorder characterized by recurrent abdominal pain associated with changes in bowel habits—without identifiable structural abnormalities
4
Q
What are the subtypes of IBS?
A
- IBS-C: Constipation-predominant
- IBS-D: Diarrhea-predominant
- IBS-M: Mixed type
- IBS-U: Unclassified
5
Q
What are the Rome IV Diagnostic Criteria for IBS?
A
Pain occurring at least once per week in the last 3 months, plus ≥2 of the following:
* Related to defecation
* Change in stool frequency
* Change in stool form
6
Q
What distinguishes Inflammatory Bowel Disease (IBD) from IBS?
A
IBD includes chronic inflammation of the GI tract and often involves systemic symptoms and mucosal inflammation, unlike IBS
7
Q
What is Crohn’s disease?
A
A type of IBD that may occur anywhere in the GI tract, typically affecting the ileum and ascending colon, characterized by transmural inflammation with skip lesions
8
Q
What are common complications of Crohn’s disease?
A
- Strictures
- Fistulas
- Abscesses
- Malabsorption
- Increased risk of colorectal cancer
9
Q
What is Ulcerative Colitis?
A
A type of IBD that begins in the rectum and progresses proximally through the colon, characterized by continuous inflammation limited to the mucosa and submucosa
10
Q
What are the clinical features of Ulcerative Colitis?
A
- Bloody diarrhea
- Left lower quadrant pain
- Tenesmus
- Urgency
11
Q
What defines constipation?
A
Fewer than 3 bowel movements per week, hard or lumpy stools, or sensation of incomplete evacuation
12
Q
What are the pathophysiologic types of constipation?
A
- Functional constipation
- Slow-transit constipation
- Defecatory disorders
13
Q
What is Diverticulitis?
A
Inflammation of diverticula (herniated sacs in the colon wall) often caused by trapped stool and bacterial overgrowth
14
Q
What are common symptoms of Diverticulitis?
A
- Left lower quadrant pain
- Fever
- Leukocytosis
- Constipation or diarrhea
- Nausea
- Bloating
15
Q
What are the risk factors for Colorectal Cancer?
A
- Age > 50
- Family history
- High-fat/low-fiber diet
- Obesity
- Smoking
16
Q
What are the symptoms of right-sided colorectal tumors?
A
Vague pain and anemia
17
Q
What are the symptoms of left-sided colorectal tumors?
A
Obstruction, constipation, and narrow stools
18
Q
What are the symptoms of rectal lesions?
A
Tenesmus, bloody stool, and incomplete evacuation
19
Q
What is the gold standard for diagnosing colorectal cancer?
A
Colonoscopy with biopsy
20
Q
What key factors influence lower gastrointestinal disorders?
A
- Environment
- Lifestyle
- Genetics
- Immune responses
- Medication use
21
Q
What dietary patterns contribute to lower GI disorders?
A
- Low fiber intake
- High-fat diets
- Trigger foods (e.g., dairy, caffeine, FODMAPs)
22
Q
How does chronic stress affect lower GI disorders?
A
Activates the HPA axis and alters gut-brain signaling
23
Q
What are common medications that induce constipation?
A
- Opioids
- Anticholinergics
- Antidepressants
- Calcium channel blockers
- Iron supplements
- Aluminum-based antacids
24
Q
What are the goals of nursing care for functional GI disorders?
A
- Improve quality of life through symptom control
- Focus on behavioral, dietary, and pharmacologic care
25
What is the nursing priority for managing pain in lower GI disorders?
Assess type and timing of pain, administer analgesics, and consider non-pharmacologic strategies
26
What should be included in nutritional support for lower GI disorders?
* Monitor weight and labs
* Provide small, frequent, low-residue meals
* Refer to dietitian if needed
27
What is the importance of patient education in managing lower GI disorders?
Promotes bowel health, medication adherence, and symptom tracking
28
What are nursing priorities in postoperative care for ileostomy?
* Pain management
* Stoma care
* Infection monitoring
* GI function assessment
* Activity promotion
* Nutrition management
29
How does the absence of mucosal damage in IBS influence nursing priorities?
Focus on symptom management, dietary changes, stress reduction, and lifestyle coaching
30
What are the complications of ulcerative colitis?
* Bleeding
* Perforation
* Toxic megacolon
* Extraintestinal symptoms (e.g., joint pain)
31
What are the underlying causes of GI disorders?
Functional, inflammatory, or infectious.
32
What is the primary goal of managing Functional GI Disorders like IBS?
Improve quality of life through symptom control.
33
List three treatment goals for patients with IBS.
* Relieve abdominal pain
* Normalize bowel habits
* Reduce anxiety and stress
34
Which medication is used for IBS-C?
Lubiprostone.
35
Which medications are commonly used for IBS-D?
* Loperamide
* Eluxadoline
* Rifaximin
36
What type of therapy is beneficial for psychosocial management in IBS?
Cognitive behavioral therapy (CBT).
37
What dietary guidance is recommended for patients with IBS?
* Implement low-FODMAP diet
* Encourage food/symptom journal
* Tailor fiber intake to IBS subtype
38
What are the main goals in managing Inflammatory bowel diseases (IBD)?
* Regulate immune response
* Reduce inflammation
* Support nutrition
39
What is the primary treatment goal for patients with IBD?
Achieve and maintain remission.
40
What pharmacologic agents are used for induction therapy in IBD?
* 5-ASA (e.g., mesalamine)
* Corticosteroids (short term)
41
List two nutritional strategies during flares of IBD.
* High-protein, high-calorie
* Low-residue
42
What is the primary goal in managing acute enteric infections like C. difficile?
Eradicate pathogen, contain infection, manage symptoms, prevent transmission.
43
What nursing interventions are critical for managing patients with C. difficile?
* Use contact precautions
* Administer antibiotics
* Monitor for signs of toxic megacolon
* Encourage hydration
44
What is the dietary focus for a patient with IBS?
Identify/eliminate triggers and emphasize soluble fiber.
45
What type of diet is recommended for patients with IBD during exacerbations?
Low-residue, high-protein.
46
True or False: Antidiarrheals are safe for all patients with GI disorders.
False.
47
What laboratory test identifies anemia in patients with GI disorders?
Complete Blood Count (CBC).
48
What does an elevated ESR or CRP indicate in patients with GI disorders?
Active inflammation.
49
What imaging study is considered the gold standard for evaluating the colon?
Colonoscopy.
50
What is the purpose of stool studies in GI assessment?
Detect infectious causes and screen for hidden GI bleeding.
51
What role does a dietitian play in managing patients with malabsorption?
Creates plans for malabsorption, ostomies, and IBD.
52
Which healthcare professional assists with ostomy care and emotional support?
WOC Nurse (WOCN).
53
What should nurses ensure during discharge planning for patients with GI disorders?
* Accurate discharge summaries
* Updated medication lists
* Follow-up plans
54
Fill in the blank: IBS is characterized by symptoms including _______.
[abdominal pain, bloating, altered bowel habits]
55
What is a common clinical sign of malabsorption?
Weight loss.
56
What does the Rome IV criteria assess?
Functional GI disorders like IBS.
57
How can fiber and fluid intake support GI health?
* Fiber adds bulk to stool
* Fluids help soften stool
58
What is the role of probiotics in bowel health?
Restore healthy gut flora and support immunity.
59
Which tests are commonly used to evaluate constipation or IBS?
* Stool studies
* Colonoscopy
* Celiac serology (e.g., tTG)
60
What is the primary goal of interprofessional collaboration in managing lower GI disorders?
Address the medical, nutritional, psychosocial, and educational needs of patients.
61
What should nurses assess for to prevent readmission in patients with lower GI disorders?
* Limited support
* Health literacy
* Financial strain
62
What is the benefit of conducting thorough discharge assessments?
Anticipate and address barriers to care.
63
What client education is important for IBS, constipation, and diarrhea?
Diet modification, stress management, hydration, medication use, and symptom tracking.
64
What diagnostic tests are commonly used to evaluate constipation, IBS, or malabsorption syndromes?
Stool studies, colonoscopy, sigmoidoscopy, hydrogen breath test, celiac serology (e.g., tTG).
65
Which members of the interprofessional team are involved in managing dietary needs for clients with celiac disease or IBD?
Dietitian, gastroenterologist, primary care provider, nurse educator.
66
What assessment findings indicate complications of a stoma?
Skin irritation, stoma retraction or prolapse, bleeding, odor, or lack of output.
67
What are the signs and nursing priorities for bowel obstruction?
Signs: pain, vomiting, distention, no flatus/stool. Priorities: NPO status, NG decompression, IV fluids, pain control, monitor for perforation.
68
What are the causes of constipation?
Dehydration, low fiber, inactivity.
69
What are the signs and symptoms of diarrhea?
Loose stools, dehydration, cramps.
70
What is the management for IBS?
Diet changes, stress reduction, symptom diary.
71
What dietary management is required for celiac disease?
Gluten-free diet, nutritional supplements (iron, B12, folate, calcium).
72
What are the signs and symptoms of ulcerative colitis?
Bloody stools, cramps, urgency.
73
What is septic shock?
A result of a systemic infection leading to hypotension and organ dysfunction despite fluid resuscitation.
74
What are the early signs of sepsis?
Fever, increased HR and RR, confusion, and hypotension.
75
What are the physiological changes during the compensatory stage of shock?
Increased HR/vasoconstriction.
76
What are the priorities in fluid resuscitation and oxygen delivery?
Administer isotonic fluids, oxygen therapy, monitor urine output, and maintain MAP >65 mmHg.
77
What laboratory results indicate early septic shock or MODS?
Elevated lactate, low MAP, metabolic acidosis, increased creatinine, abnormal LFTs.
78
What nursing interventions are required for septic shock?
IV fluids, antibiotics, oxygen.
79
What condition might severe abdominal pain and fever suggest in a patient with diverticulitis?
Peritonitis or perforated bowel.
80
What is the management for fecal incontinence?
Bowel training, incontinence products, skin care.
81
What is the pathophysiology of celiac disease?
Autoimmune response to gluten damages intestinal villi, leading to malabsorption.
82
What are the nursing management strategies for hemorrhoids?
Sitz baths, pain relief, hygiene, high-fiber diet, monitor for infection.
83
What are the key signs of hypovolemic shock?
Low BP, high HR, cool skin, decreased urine output.
84
What is the most common cause of MODS?
Sepsis.
85
Fill in the blank: Shock is defined as a condition where tissue perfusion is inadequate to deliver _______ and nutrients to support cellular function.
oxygen
86
What is the management for bowel obstruction?
NPO, NG tube, IV fluids, prepare for surgery.
87
What are the signs of GI-related sepsis?
Abdominal pain, distention, and decreased bowel sounds.
88
What is the purpose of parenteral nutrition (PN)?
Provide nutrition when GI tract is nonfunctional.
89
What are common lower GI disorders?
*Constipation
*Diarrhea
*IBS
*Celiac disease
*IBD (Crohn’s, UC)
*Diverticulitis
*Colorectal cancer
*Hemorrhoids
*Fistulas
90
What is hypovolemic shock?
Loss of blood or fluid volume → ↓ preload and CO
## Footnote
Key signs include low BP, high HR, cool skin, and ↓ urine output. Management involves fluid resuscitation (NS/LR) and controlling bleeding.
91
What is cardiogenic shock?
Pump failure → ↓ CO
## Footnote
Key signs include chest pain, crackles, hypotension, and JVD. Management includes inotropes (e.g., dobutamine), diuretics, oxygen, and possible PCI.
92
What characterizes distributive shock?
Vasodilation → maldistribution of blood
## Footnote
Types include septic, neurogenic, and anaphylactic shock. Key signs include warm skin (early septic), bradycardia (neurogenic), and wheezing (anaphylactic). Management includes vasopressors, fluids, antibiotics (septic), and epinephrine (anaphylactic).
93
What are the nursing priorities in the early/compensatory phase of shock?
Recognize early signs, monitor VS, assess LOC, administer fluids & oxygen
## Footnote
Medical priorities include identifying cause, ordering labs, and administering initial treatment (e.g., fluids, medications).
94
What are the medical priorities during the progressive phase of shock?
ICU transfer, continuous monitoring, prevent complications
## Footnote
Includes intubation, vasopressors, antibiotics, and organ support.
95
What defines septic shock?
Sepsis + hypotension despite fluid resuscitation
## Footnote
Recognition criteria include T ≥38°C or ≤36°C, HR >90, RR >20, WBC >12k or <4k.
96
What are the nursing actions for septic shock?
Monitor vitals, LOC, urine output, lactic acid levels; start oxygen, blood cultures before antibiotics, administer fluids (30 mL/kg)
## Footnote
Timely intervention is critical for patient outcomes.
97
What is the medical management for septic shock?
Broad-spectrum antibiotics (within 1 hour), vasopressors (norepinephrine), insulin, corticosteroids, mechanical ventilation if needed
## Footnote
Early administration of antibiotics is crucial.
98
What preventative measures can be taken to avoid sepsis?
Hand hygiene, aseptic technique, central line care, monitor for infection
## Footnote
These measures are essential in healthcare settings.
99
What is a key concept regarding psychological trauma in ICU patients?
Psychological trauma from ICU stays is common → screen for PTSD, anxiety, depression
## Footnote
Understanding this can help in providing better psychosocial support.
100
What is the nursing role during the transition phase from ICU to step-down/med-surg?
Ensure continuity of care, manage complex needs, reinforce patient education
## Footnote
This phase is critical for patient recovery.
101
What does discharge planning involve when transitioning from hospital to home/rehab?
Coordinate home health/PT/OT, medication reconciliation, monitor for long-term effects
## Footnote
Important long-term effects include fatigue, weakness, cognitive deficits.
102
What are some common labs/monitoring indicators in shock and sepsis?
Lactate >2 mmol/L, ABGs, BUN/Creatinine, liver enzymes, CBC, cultures, CVP/ScvO₂
## Footnote
These tests help assess tissue hypoxia, acidosis, renal perfusion, hepatic function, infection, and fluid responsiveness.
103
True or False: In septic shock, fluids should be administered before vasopressors.
True
## Footnote
This is a critical aspect of management in septic shock.
104
Fill in the blank: For distributive shock (especially anaphylaxis), _______ is first-line treatment.
epinephrine
## Footnote
Administering epinephrine promptly can save lives in cases of anaphylactic shock.
105
What should be avoided in cardiogenic shock?
Fluid overload
## Footnote
Instead, inotropes should be given to improve cardiac output.
