Nutrition & Elimination part 2 (GAS#11 & Gas#12) Flashcards Preview

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Flashcards in Nutrition & Elimination part 2 (GAS#11 & Gas#12) Deck (65)
1

Irritable Bowel Syndrome is associated with..

Stress

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s/s of Irritable Bowel Syndrome

constipation, diarrhea, feeling urge to defecate, abdominal pain, cramping, improves with defecation

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Irritable Bowel Syndrome treatment

elimination diet, 6-8 glasses, Exercise, antispasmodics, soluble fiber

4

Diverticulosis occurs in which part of intestine

it can occur anywhere but most common in sigmoid colon

5

Diverticulosis

food gets caught in sac like herniation of the lining of the bowel usually in the sigmoid colon (or anywhere in small intestine or colon) and then gets infected which turns into diverticulitis; ppl can have this for years and not know it

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Diverticulitis

infection from food or bacteria being retained

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s/s of Diverticulitis

fever, N/V, chills, cramping, constipation, bleeding (usually stops)

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Diverticulitis can result in

abscess, fistulas, obstruction, perforation, peritonitis, hemorrhage

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Management of Diverticulosis

High fiber Diet!

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Management of Diverticulitis

bowel rest by liquids only then once inflammation subsides, high fiber, low fat diet and rest, antibiotics and pain meds

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What should be avoided with Diverticular disease?

morphine should be avoided because it can increase pressure on colon & NSAIDS because they increase risk of perforation

12

Peritonitis

inflammation of the peritoneum ( can be caused by diverticulitis

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s/s of Peritonitis

pain, tender, distention, rigid muscles, n,v, decreased perstalsis, increased WBC, altered electrolytes, hypovolemia

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management of Peritonitis

increase fluids! because hypovolemia occurs & electrolytes go from intestines to peritonial cavity

15

Crohns Disease

WBC accumulate in intestine which create ulcers, can be located anywhere in the GI tract

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two main s/s of Crohns disease

diarrhea, abdominal pain in Right lower quadrant

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During an acute phase of crohns disease what is important for patient to be?

NPO

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Crohns disease management

steroids, antibiotics, amodium, surgery, TPN then clear liquids as tolerated

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Inflammatory Bowel Diseases

Crohns Disease & Ulcerative Colitis

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Ulcerative Colitis

continual inflammation, effects mucosa & submucosa. Mucosa becomes inflammed & sluffs off, bleeding is common which usually goes away

21

what is a common side effect of ulcerative colitis?

Diarrhea

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What can severe attacks of ulcerative colitis lead to?

hemmorrage

23

Only cure for ulcerative colitis?

surgery where they remove the colon & rectum (which also decreases their risk for cancer)

24

Surgery for ulcerative colitis is only for which people?

people with precancerous cells and the very severe

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With ulcerative colitis, during the acute phase, what happens to their calorie & protein levels? & whats important to teach them about it

they go down so make sure they have a diet high in calories & protein

26

Celiac Disease

inflammation of the small intestine triggered by gluten

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Is celiac disease genetic?

yes

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what can celiac disease lead to

osteoporosis, infertility, cancer

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s/s of celiac disease

abdominal pain, fatigue, HA, foggy, tingling in extremities, depression//anxiety, missed menstrual periods, bone/jt pain, dermatitis Herpetiformis, pale foul smelling stool (children)

30

What diseases cause the villi to be destroyed in the small intestine & what happens with the patients nutrition

Celiac disease;they become malnourished

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what foods should patients with celiac disease avoid?

pasta, baked goods, cereal

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Celiac Disease treatment

avoid gluten! kids start with rice cerel

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Celiac Disease parent teaching

teach there is "hidden" gluten such as "hydrolyzed vegetable protein" in food

34

Polyp formation

disruption of normal cell proliferation to replace epithelial cells, may be benign, malignant

35

s/s of Polyps

RECTAL BLEEDING, change in bowel habits, feeling of incomplete emptying, weakness/fatigue, wt loss

36

what is found in the blood when polyps lead to cancer

tumor markers

37

with a small bowel obstruction patient will have which electrolyte imbalance?

they will be hypokalemia & will have a decrease in HCL

38

Small bowel obstruction treatment

Decompression of the bowel through an NG tube, vs

39

Large Bowel obstructions are usually seen where?

sigmoid colon

40

what is a major cause of a large bowel obstruction?

cancer

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what can a large bowel obstruction lead to?

gangrene & perforation

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s/s of bowel obstruction

constipation, colicky pain, distended abdomen above site, high pitched tinkling bowel sounds, localized tenderness, vomiting (late sign)

43

Irritable bowel syndrome teaching to patient

Eat at regular times, chew food slowly and throughly, fluid shouldn't be taken with meals to avoid abdominal distention

44

Predisposing factor of diverticulosis

A low intake of dietary fiber

45

A Small bowel obstruction can cause which acid base imbalance?

Metabolic alkalosis

46

Difference between small bowel and large bowel obstruction

Small bowel=small intestine large bowel=large intestine; large bowel obstruction progress relatively slowly compared to small bowel obstruction

47

Stomach cancer complications post op

volvulus (twisting of the bowels), wound dehiscence, peritontitis

48

Necrotizing Entercolitis

immature GI motility

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Necrotizing Entercolitis s/s

not emptying completely, xray shows air in abdomen, distended abdomen, blood in stool, apnea

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3 things needed for necrotizing entercolitis

inadequate 02, invassive bactria, enternal feeding

51

Necrotizing Entercolitis management

NPO, may have NG tube, antibiotics, ventilator, 02

52

What do you have to do as a nurse for an infant with Necrotizing Entercolitis?

measue abdominal circumference, check to make sure they are going to the bathroom

53

Atresia

congenital absence or closure of a normal body opening

54

anal atresia

lack of passage of meconium stool

55

Intussusception

integration of one portion of the intestine into another

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s/s of intussusception

"currant jelly" stools; parents think baby is just colicky

57

Hirschsprung's (megacolon)

ansence of innervation to the muscle of a section of the bowel

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s/s of Hirschsprung's (megacolon)

no peristalsis (so it becomes enlarged), chronic constipation, RIBBON like stools, dilation of the bowel

59

Hirschsprung's(megacolon): failure to pass meconium(1st stool) within how many hours after birth?

24-48

60

Why are diagnostic tests done with caution with Hirschsprung's (megacolon)?

because they don't want to rupture bowel

61

What will the diagnostic tests show with Hirschsprung's (megacolon)

will show a lack of stool

62

Hirschsprung's (megacolon) treatment

may have temporary or permanent colostomy (depends how bad it is)

63

what do you teach parents about Hirschsprung's (megacolon) before they leave?

teach colostomy care!

64

Pre surgery for Hirschsprung's (megacolon)

edemas, NPO, TPN, decrease fiber with vitamin supplements

65

Post op surgery for Hirschsprung's (megacolon)

foley cath, NG tube, asses bowel sounds, liquids after 24 hrs, teach care & management