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Study Guid Flashcards

1
Q

where is the pancreas located?

A

only a small portion of the pancreas i s located in the right upper quadrent. the larger portion is located in the left upper quadrent

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2
Q

where is the pancrease in regards to the stomach?

A

it is positioned inferior to the stomach

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3
Q

what is positioned inferiror to the stomach?

A

the pancreas

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4
Q

what are the parts of the small intestine?

A

duodenum
jejunum
illium

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5
Q

what happend in the small intestine?

A

absorptio of
protien
carbohydrarted
fat digestion

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6
Q

what is villi?

A

finger like projections that increse absorption of nutrient

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7
Q

where are pancreatic enzimes and bile released?

A

in the duodenum

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8
Q

where does digestion occur?

A

in the jejunum

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9
Q

what has a rich blood supply and a muscular intestinal wall?

A

jejunum

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10
Q

what is the shortest segment of the small intestin?

A

duodenum

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11
Q

what is the first segment of the small intestin?

A

duodenum

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12
Q

where does digestion and absorption occure?

A

jejunum

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13
Q

what is the thickest portion f the small intestine?

A

jejunum

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14
Q

what has a rich blood supply and muscular intestinal wall?

A

jejunum

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15
Q

what is the lower portion of the small intestine?

A

illium

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16
Q

what connects to the large intestine at the ileocecal level?

A

illium

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17
Q

what inhibits the gastric motility and enzyme secreation?

A

the secreation of secretin and cholecystokinin

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18
Q

what pancreatic enzymes are stored in the duodenum and relased as chyme arrives?

A

cholecystokinin

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19
Q

what is released form the jejunum and duodenum when gastric, log fatty shains, and amino acids are present?

A

cholecystokinin

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20
Q

what stimulated the release of pancreatic enzymes that contract the gallbladder and relax the hepatopancreatic sphincter (sphincter of Oddi) for release of bile into the duodenum?

A

cholecystokinin

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21
Q

what is released from the small intestin in response to the presence of the acidic chyme in the small intestine?

A

secretin

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22
Q

what neutralizes the acidic chyme and protects the intestinal

A

sodium bicarbonate

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23
Q

what stimulates the liver and pancreas to release sodium bicarbonate

A

secretin

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24
Q

what is hematochezia?

A

the presence of blood in the stool can be described as bright blood in the stool

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25
what is melena?
black, tarry, stool
26
what is the sequence of an abdominal assesment?
inspection auscultation precussion palpation
27
what kind of bowels are caused by opiods anticholinergic medications constipation ileus (absence of normal gastrointestinal motility)
hypoactive bowel sounds
28
what kind of bowels are caused by cholinergic medications or infectious and inflammatory bowel disorders?
hyperactive bowel sounds
29
what do hypoactive sounds indicate?
obstruction
30
what do hyperactive bowel sounds indicate
obstruction diarrhea inflammatory bowel disorder
31
what do absent bowel sounds indicate
paralytic ileus casued by mechanical or neurological dysfunction
32
what do bruits indicate?
arterial obstruction whooshing sound of a bruit may indicate partial obstruct of the vessel
33
is a bruit in the abdomen a normal varient?
no
34
what questions do you ask to asses the GI system
``` do you smoke? do you use prescription or OTC medications? do you use herbals? do you drink alcohol? recent antibiotic use? any recent international travel ```
35
what questions can you ask to asses the health HX of the GI system? dietary practices
who prepaires your food at home? do you fast for cultural or religious reasons? do you have dietary restriction or cultural practices? how often do you eat? what do you consider to be healthy and unhealthy food? do you use food to treat ilnesses? any food intolerences? any food allergies?
36
what questions can you ask to asses the health HX of the GI system? preventitive health
what are your excersise habits? have you had hepatitis vaccines? have you had a colonoscopy or sigmoidoscopy? if so what were the results?
37
what is "cullen's sign"?
blue or purple coloring around the periumbilical area associated with intra-abdominal bleeding
38
what sound do you hear when you precuss over the liver or stomach?
flat dull sound
39
what can dulness also indicate?
precense of displaced fluid constipation ascites
40
what is dullness similer to in sound?
tapping on a ballon filled with water
41
what is the normal span of the liver?
6-12 cm
42
what is hepatomegaly?
term used to describe an enlarged liver
43
what is teqnique is used to asses the edge of the liver?
palpation, hooking technique
44
how do you perform a palpation, hooking technique?
1. stand to the left of the patient and place fingers under the 12th rib 2. when the patient inhales, the lives edge may come below the rib and be palpated by the providers fingers
45
what are the age related changes in bile synthesis??
1. decreased bile synthesis 2. widend common bile duct 3. increased cholecystokinin secreation
46
what is the subjective data and objective data for age related changesin bile synthesis?
subjective data: ask about right upper quadrent pain, early satiety, decreased appetite objective data: 1.inspection of the skin 2. palpation of the abdomen
47
what is the normal level of serum albumin?
3.4-5.1
48
what is a level of less than 3.5 g/dk of serum albumin indicate?
altered nutritional status associated with increased morbidity and mortality in older adults
49
what is the normal level of prealbumin?
12-42 mg/dl
50
what do decresed levels of prealbumin indicate?
increased morbidity and mortality in older adults
51
what is considered a more accurate indicator of plasma protiens? serum albumin or prealbumin
prealbumin
52
after an endoscopy what does the nurse monitor for before providing oral care? and why?
the return of swallow to decrease the risk of aspiration
53
after a lower endoscopy what is held teporarity due to the risk of bleeding?
anticoagulants and aspirin | ascetylsalic acid, or ASA
54
what is an Esophagogastroduodenoscopy
visualization of the esophaphagus, stomach, and duodenum
55
what is the rational of an Esophagogastroduodenoscopy
suspected upper gastrointestinal bleeding, dysphagia epigastric pain
56
what are the special considerations of Esophagogastroduodenoscopy
monitor return of gag reflex vital signs
57
what is the NPO status of Esophagogastroduodenoscopy
8-10 hr prior to study
58
what are the significance of findings of Esophagogastroduodenoscopy
peptic ulcers H pylori infection gastritis hiatal hernia esophageal * varices * strictures * cysts
59
describe stomatitis grade 1 functional symptoatic clinical examination
able to eat a normal diet redness of mucosa
60
describe stomatitis grade 2 functional symptoatic clinical examination
symptomatic but can eat a modified diet patchy oral ulcerations
61
describe stomatitis grade 3 functional symptoatic clinical examination
symptomatic and unable to eat or drink by mouth confluent oral ulcerations that bleed with minor trauma
62
describe stomatitis grade 4 functional symptoatic clinical examination
symptoms are life threatening tissue necrosis with significant bleeding; lifethreatening consequenses
63
describe stomatitis grade 5 functional symptoatic clinical examination
death death
64
when should mouth care be performed?
after each meal and as needed
65
what kind of a tooth brush do you use for proper mouth care?
soft-bristled
66
when doing mouth care what kind of rinse do you use?
warm saline or sodium bicarbonate (baking soda)
67
what kind of mouth wash should you not use to perform mouth care?
alchohol-containing mouth wash lemon-glycerine swabs
68
what kind of mouth care can irritate a sore or implame oral tissue?
lemon- glycerin swabs
69
what kind of motuh care can irritate the oral mucosa?
alcohol containing mouth wash
70
what disease is caused by acid reflux for the stomach or duodenum into the esophagus?
GERD
71
what kind of disease has a backward flow of gastroduodenal contents (refluxate) into the esophagus and/or adjacent organs, producing a variety of clinical manifestations that may or maynot cause tissue damage
GERD
72
what disease has factors that are associated with a decrease in LES presure that influence transient or chronic gastroesophageal reflux
GERD
73
what are these examples of? * Hiatal hernia * LES hypotension * Loss of esophageal motility * Increased compliance of the hiatal canal * Increased states of gastric secretion * Eating large meals * Delayed emptying of gastric contents * Obesity * Pregnancy * Ascites * Tight belts or girdles * Presence of a nasogastric tube
GERD
74
what disease has this pathophysiology/ clinical manifestation? retrograde flow of GI contents into the esophagus, resulting in inflammation
GERD
75
wich disease has this manifestation? hyperemia (increased blood flow) erosion (ulceration) possible minor bleeding to the esophagus?
GERD these are episods of acid reflux
76
what may be present during reflux?
pepsin and bile
77
what is the post-op care for laparoscopic nissen fundolipication?
1. follow a soft diet for 1 week, untill swallowing improves. avoid foods that arenot easy to swallow take small bites and eat slowly avoid activities that cause air to be swalloed. carbonated beverages, menoade, gum, stwas driving is allowed 1 week and after narcotic pain medications have been discontinued no heavy lifting
78
what kind of ristriction are these? * After surgery, the doctor usually changes the original surgical dressing after 2 days. Steri-Strips are left intact and usually fall off in about 10 days. Keep them clean and dry and do not peel them off. * Wash incisions with soap and water and pat them dry with a clean towel. * Observe incisions for redness or drainage, and report any of these symptoms to the healthcare provider. * Notify the healthcare provider for a fever greater than 101°F, or 38.3°C. Patients older than 65 years: report temperature above 100°F, or 37°C. Report nausea, vomiting, and severe bloating or unusual pain. * Bring a list of questions to the first postoperative appointment, usually within 4 weeks after surgery.  Walking is encouraged. Notify the healthcare provider for chest pain or difficulty breathing that gets worse with time. • Continue antireflux medication regimen unless notified otherwise by a healthcare provider.
Postoperative Patient Education After Laparoscopic Nissen Fundoplication
79
what procedurehas these emergency care Feeling very full, with inability to vomit or burp * Thick drainage that has a foul odor coming from incisions * Difficulty swallowing * Abdomen that feels hard and painful * Gauze that becomes soaked with blood * Stools that are black, bloody, or tarry * Vomiting up blood or “coffee grounds” emesis * Difficulty breathing and feeling light-headed * Coughing up blood, new chest pain when breathing in * An arm or leg that is painful, swollen, warm, and red
Emergency care after Laparoscopic Nissen Fundoplication
80
what disease has this assessment of respiratory symptoms aspiration pneumonia, chronic cough, morning hoarseness, night-time wheezing, adult-onset asthma, laryngitis, pharyngitis, bronchitis with long-term regurgitation
GERD
81
what is a is a causative factor in the development of adult-onset asthma.
GERD
82
when do GERD respiratory symptoms occur?
occur with aspiration of acid reflux into the tracheobronchial tree, larynx, pharynx, nose, and mouth (especially when supine).
83
what medications should be limited when a patient has GERD?
spicy/fatty foods caffeine chocolate carbonated beverages acidic foods pepermint alchohol
84
what kind of medications should be limited with a patient that has GERD?
calcium channel blockers anticholinergic medications smoothmuscle relaxers
85
what should be avoided because decreeses the presure in the LES
smoking alcohol
86
in a patient with GERD what should be avoided because it can irritate the lining of the esophagus
NSAID Aspirin
87
when should a patient with GERD have there last meal?
2 hrs before lying suspine
88
with a patient with GERD what should you educate them on?
wear nonrestrictive clothing maintain body weight
89
what bacteria causes gastritis?
Hpylori
90
what disease is caused by Crohns's disease teberculosis bile reflux alchocol NSAID
gastritis
91
what disease can lead to malapsoption of vit. b12. wich then leads to pernicious anemia?
gastritis
92
what test are used to dianose gastritis?
biopsy upper GI x-ray series or endoscopy stool testing urea breath testing histological examination of a tissue specimen
93
what diagnostic tests can rule out disorders that can siggest gastritis such as polyps and gastric neoplams
biopsy upper GI x-ray series or endoscopy histological examination of a tissue speciemn stool testing
94
what are other names for stool testing?
guaiac hematest hemoccult
95
what diagnostic test can detect active infection w/ hpylori. a patient drinks a solution that contains a special carbon atom
urea breath testing for gastritis
96
what disease has these manifestations? epigastric pain nausea and vomiting weight loss Pain with spicy food decreased appetite changes in color of the stool dehydration upper GI bleeding. Significant fluid or blood loss Hypovolemic Shock Pallor Tachycardia hypotension
acute gastritis
97
what kind of disease presents no symptoms?
atrophic gastritis
98
in what order should you rentroduce liquids after treatment?
1st- broth,tea,gelatin,carbonated beverages 2nd- ingestion of heavier liquids cream soups, pudding, milk 3rd, gradual reintroduction of solid food
99
what medications are associated with gastritis?
1. proton pump inhibitor 2. H2 receptor antagonis 3. esome/lanso/panto-prazole 4. antacids 5. sucralfate (carafate) 6. B12 7. H pylory
100
what medications relive pain and discomfort bloock and buffer gastric secreations for pain relief
PPIs & H2 receptor antagonist
101
what medication block enzyme in the gastric parietal cell?
PPI
102
what medication maintain the intragastric PH greater than 4?
Esome/lanso/panto-prazole
103
what medication decrese gastric acidiy by neutralizing the acid?
antacids aluminum or magnesium compounds maalox, mylanta
104
what has no effect on gastric PH but provides a physical barrier to prevent mucosal damage by gastric acid?
sucralfate (carafate)
105
what treatment is used for the eradication of H pylori
combination of PPI with to antibiotics for 7-14 days
106
what reduces the risk of antibiotic resistant H pylori strains?
using a combinations of antimicrobial agents
107
what therapies are recomended as the first-line treatmetn of H pylori?
PPI
108
what therapies are recomended as the second-line treatmetn of H pylori?
quadrupal therapy
109
what medications are in triple therapy?
PPI clarithromycin amoxicillin/metronidazole
110
what medications are in quadruple therapy?
bismuth metronidazole tetracycline PPi
111
what are nursing diagnosis associated with gastritis?
Acute pain related to irritated stomach mucosa * Anxiety related to treatment * Deficient knowledge about dietary management and the disease process * Risk for deficient fluid volume related to insufficient fluid intake and excessive fluid loss subsequent to vomiting
112
what is hematemesis?
vomiting of blood gastritis
113
what may lead to vometing of blood? (hematemesis)
hemorragic gastritis gastritis
114
when should you report hematemesis and why?
immidiatly to prevent shock gastritis
115
what does hematemesis look like?
bright red dark coffe ground appearance gastritis
116
what kind of bacteria causes gastroenteritis?
salmonella campylobactor shigella
117
what two bacterias come from ingesting raw or undercooked poultry?
salmonella and campylobacter
118
what kind of bacteria comes from ingesting raw or undercooked chicken and unpasturired milk? transmited by dogs or cats with diarreha?
campylobacter
119
what kind of backteria comes form undercooked eggs reptiles birds or amphibians?
salmonella
120
what kind of bacteria is transmitted person to person by fecal-oral rout or food born?
shigella
121
what can be a cause of gastereonteritis?
virus, bacteria, parasite -noravirus/ rotavirus acid suppresing medications - PPI (it reduces the acidis environment that provides an initial defense against gastrointestinal infections)
122
what kind of food should be avoided in someone who has gastroenteritis?
caffeine and milk products
123
how should foods be reintroduced with someone who has gastroenteritis
gradually reintroduce foods starting with bland easy to digest foods
124
what kind of liquids are initially prescribed as tolerated for a patient recovering with gastroenteritis?
clear liquids are prescribed as tolerated
125
name the clear liquids that are prescribed to a patient who has gastroenteritis
oral glucose- electrolyte solutions broth or bullon take frequent small sips
126
what are the risk factors for Peptic ulcers?
H pylori NSAID Asprin smoking alchohol sarcoidosis crohns disease rare infectious disease other mediations neoplasia acid hypersecretory disorders myeloproliferative disorder systemic mastocytosis ill patients (burns, head injury, physical trauma, organ failure)
127
what disease has this manifestation? burning epigastric pian aggravated by fasting? pain improved with food or antacids
duodenal ulcer
128
what kind of disease has this manifestation? pain awakens patient from sleep because of nocturnal gastric acid secretion
duodenal ulcer
129
what kind of disease is triggered or worsend by eating?
gastric ulcer
130
what kind of disease occurs after meals with little or no reliefs from antacids
gastric ulcer
131
what kind of pain radiates below the costal margins into the back or right shoulder?
peptic ulcer desiease pain duodenal/gastric ulcer
132
what kind of pain is located midline in the epigastrium near the xiphoid
Peptic Ulcer disease pain
133
what is a charecteristic of ulcer pain PUD?
exacerbations occurs daily for a period of several weeks and then remits intill the next recurrence
134
what is the perfered diagnostic test for PUD?
Upper GI endoscopy
135
what are some other diagnostic test for PUD?
barrium upper GI x-rays endoscopy esophagogastroduodenoscopy noninvasive testin -serum antibody testing - urease breath testing - stool antigen testing cbc fecal occult blood test
136
what medications are given to a patient who has PUD
1. antacids 2. H2-receptors 3. PPI 4. Prostaglandin E analog 5. sucrafate (carafate)
137
what medication neutralizes gastric acids contains aluminum hydroxide sodium bicarbonate calcium carbonate magnesium hydroxide simethicone
antacids
138
what medication decreases acid production?
H2-receptor anatgonist
139
name some H2 receptor antagonist
ranitidine nizatidine cimetidine formotidine
140
what should patients who must continue NSAID therapy use?
PPI
141
what medication blocks the final stage of hydrogen ion secretion by bloking the action of gastric parietal cell proton pump?
PPI
142
name some PPIs
omeprazole lansoprazol pantoprazole
143
what medication prevents mucosal damage in chronic users of NSAIDs
prostaglandin E analog
144
name a prostaglandin E analog
Misoprostol
145
what medication enhances mucosal defenses?
sucralfate (carafate)
146
what medication binds to necrotic ulcer tissue and serves as a barrier to acid, pepsin, bile, and can directly absorb bile salts
sucralfae (carafate)
147
what kind of diet should a patient with PUD follow?
no spices, alchohol, caffeine, smoking 6small meals a day or small hr meals intake of adequate fluids if bleeding=NPO
148
what complication of PUD has these charecteristics? sudden, severe, without warning symptoms of pain may not be present (common with NSAID use)
gastrointestinal bleeding
149
what complication of PUD has these characteristics? circulatory shock may develop depending on amount of blood loss acute hemorrage, sudden weakness, dizziness, cold, moist skin, passage of loose tarry stools and coffe-ground emesis
gastrointestinal bleed
150
what complication of PUD has these characteristics? ulcers on the anterior wall of stomach or duodenum perforation is a seriuous medical condition requiring immidiate attention
perforation
151
what complication of PUD has these characteristics? release of gastrointestinal contents into peritoneum abdominal distention and third spacing
perforation
152
what complication of PUD has these characteristics? peritonitis causes sudden intense epigastric pain abdomen is tender to palpation, abdominal muscles are rigid, HYPOACTIVE OR ABSENT BOWEL SOUNDS
perferation
153
what complication of PUD has these characteristics? caused by edema, spasm, contraction of scar tissue interference w/ free passage of gastric contents
obstruction
154
what complication of PUD has these characteristics? symptoms of early satiety, epigastric fullness and heaviness post meals, gastric reflux, weight loss, abdominal pain vomiting of undigested food
obstruction
155
what is hematemesis?
vometing of blood
156
in a patient with gastrointestinal bleeding what is the hallmark of upper gastrointestinal bleeding?
hematemesis- vometing of blood
157
in a patient with gastrointestinal bleeding what is bright red blood in the emesis indicative of?
active bleeding
158
in a patient with gastrointestinal bleeding what does coffe-ground emesis indicate?
older blood that has had time to be reduces by acid in the stomach
159
in a patient with gastrointestinal bleeding what is due to the degradation of blood in the small intestine and colon?
melena (black tarry stool with a foul odor)
160
what are the risk factors involved in Hiatal Hernia?
obesity pregnancy smoking barrets esophagitis 50 or older- increses with age as supportive structures weaken over time
161
what is the most specific diagnostic test of Hiatal hernia?
barium swallow w/ fluoroscopy
162
name some diagnostic test for Hiatal Hernia
barrium swallow with fluroscopy upper abdominal x-ray endoscopy esophagogastroduodenoscopy EDG
163
what are the clinical manefestations of hernias?
bulging or swelling at the site of the hernia ache that radiates in the are of the hernia feelings of fullness or presure in the area of the hernia
164
what disease has this clinical manifestation? bulge or visible swelling * associated when coughing or bering down
hernia
165
what disease has this clinical manifestation? Strangulation clinical manifestations include abdominal distention, nausea, vomiting, pain, fever, and tachycardia. *This is a medical emergency, and the patient must be prepared for surgery immediately to prevent the development of gangrene.
hernia
166
a patient with a stangulated hernia may present with what?
clinical manifestations of an intestinal obstruction
167
why must a patient with a strangulated hernia prepair for imidate surgery?
to prevent gangrene
168
what are the signs and symptomps for a patient with a strangulated hernia?
abdominal distention nausea vomiting pain fever tachycardia
169
what pain management techniques should you give to a patient with a hernia?
tell them to avoid driving ot operating machinery while taking medication
170
what medication provides temporary relief from burning, itching, and pain? for a patient with hemorrhoids?
local anesthetics benzocaine dibucaine lidocaine
171
what kind of medication forms a physical barrier on the skin to prevent irritation of the perianal regoin to a patient who has hemorrhoids?
protectants/ emollients cocoa butter lanolinen white petroleum zinc oxide mineral oil cod liver oil shark liver oil
172
what medication promotes skin dryness, wich helps relieve itching, irritation and inflamation to a patioen who has hemorrhoids?
astringents witch hazel zinc oxide calmaine
173
wich medication reduces inflammation in a patient who has hemorrhoids?
corticosteroids hydrocortisone
174
what can lead to constipation and should be avoided because it will futher increase pain and bleeding at surgical site for a patient who has a hiatal hernia?
avoiding having a bowel mobement due to painful defecation
175
when is a mild laxitive ordered for a patient who has a hernia?
after 3 days
176
what do bulk laxitives require the use of for a patient who has a hernia?
the use of increased fluids
177
what mesures to prevent constipation are taken in a patient who has a hernia?
good sources of fiber such as; whole grain raw vegetables fruit
178
what helps relive constipation in a patient who has a hernia?
increasing fluids & fiber OTC stool softners (docusate sodium
179
what increses the chances of constipation in a patient with hemrroids?
narcotic anagesics
180
what medications are sed to treat IBS?
antidiarreheals - loperamide (imodium) tricyclic antidepressants (TCAs) - ami-triptyline - nor-triptyline im-ipramine des-ipramine
181
name some tricyclic antidepressants (TCAs)
ami-TRIPTYLINE- elavil nor-TRIPTYLINE- pamelor im-IPRAMINE- tofranil des-IPRAMINE- norpramin
182
what medication block norepinephrine reiptake and are belived to slow transit time and improve pain tolerance?
Tricyclic antidepressants (TCAs) Amitriptyline (Elavil); imipramine (Tofranil); nortriptyline (Pamelor); desipramine (Norpramin)
183
what medication slow bowel transit, enhance water absoption and stenghten anal sphincter tone, resulting in fewer stools but does not relive pain?
antidiarreahls loperamide imodium
184
are herbal medicines classifies as diatary medicins in the united states?
no
185
what are some reputible online resources for herbal remidies?
* Natural Medicines Comprehensive Database * Natural Medicines Research Collaboration * ConsumerLab * Medline Plus Drugs and Supplement Directory * National Institutes of Health National Center for Complementary and Alternative Medicine Herb Fact Sheets * NIH Office of Dietary Supplements
186
what kind of ilness is a irritable bowl
its a psychological ilness
187
what is necessary for a patient with irritable bowl to have?
a therapeutic, trusting relashion ship establish a trusting relationship
188
what kind of teaching should you give to a patient with IBS
no smoking smoking cessation techniques
189
what increases GI motility, wich can increase pain/ diarrhea
smoking
190
what disease has 5-6 soft, loose, nonbloody stools a day?
crohns disease
191
what kind of disease has these charecteristics of stool? loose, semiformed
crohns disease
192
what kind of disease has these charecteristics of stool? frequent, watery, with blood and mucus
ulcerative colitis
193
what kind of disease has 10-20 liquid, bloody stools a day?
ulcerative colitis
194
what disease has elevated ESR is seen with inflamation? Erythrocyte Sedimentation Rate Test (ESR Test)
crohns disease iflamitory bowel
195
what levels are used to determine nutritional status?
Albumin levels are frequently used to determine nutritional status,
196
what is the primary goal of treatment in IBD?
rest the bowel and control the inflamation
197
in what disease are monthly B12 injections may be necessary because of the inability of the ileum to absorb this nutrient.
crohn's disease
198
how do you give vit to a patient who has cronh's IBD?
liquid vitamin
198
how do you give vit to a patient who has cronh's IBD?
liquid vitamin
199
what medication are given to a patient who has IBD?
biological therapies antidiarrheals
200
what medications provide symptom relief and bowel rest? these medications must be used with caution becuse they can cause colon dilation
antidiareahls
201
name some antidiarrheals
loperamide- imodium atropine sulfate- lomotil dipnoxylate hydrochloride
202
name some biologic therapies
centoLIZUMAB- cimzia nataLIZUMAB-humira adalimUMAB-tysabri
203
what kind of medication alter a persons immune response an inflammatory protien called TNF traditionally used as second line agents but are now prescribed as an earlier treatment
biologic therapies
204
what medications have many toxic side effects like blood dyscrasias, infection, pancreatitis digestive intolerence
biologic therapies
205
what are the 4 surgical options for ulcerative colitis?
1. proctocolectomy with permanent illiostomy 2. proctoclectomy with continent ileostomy (Kock pouch) 3. abdominal colectomy with ileoanal anastamosis 4. colectomy, mucosal protectomy and ileal pouch-anal canal anastomosis (IPPA)
206
what surgical option is it when the colon and rectum are removed, and the anus is closed the ileostomy is peminent
proctocolectomy with permanent ileostomy
207
what surgical option is it when the colon is removed the distal portion of the ileum is used to crete a pouch, wich serves for stool the patient must then insert a catheter into the pouch several times a day to eleminate the stool
proctocolectomy with continent ileostomy (Kock pouch)
208
what surgical option is it when the colon is removed and the ileum is sutured to the anal canal leakage of stool is a problem for these patients
abdominal colectomy with ileoanal anastomosis
209
what surgical option is it when a 2 step procedure is performed? 1st procedure- colon and rectal mucosa are removed ileoanal reservoir is created by using a portion of the ileum a temporary ileostomy is created 2nd surgery is performes 2-3 months after the pouch heals the ileostomy is reversed normal continence of bowel is restored
j pouch  Colectomy, mucosal proctectomy, and ileal pouch-anal canal anastomosis (IPAA)
210
what are some complications of IBD
* Enterocutaneous fistula (between skin and intestine) * Enteroenteral fistula (between intestine and intestine) * Enterovesicular fistula (between bowel and bladder) * Enterovaginal fistula (between bowel and vagina) Perineal abscesses fistulas strictures joint swelling & pain ankylosing spondylitid, osteoporosis, kidney stones, eye inflamation, mouth sores, skin lsesions fever anorexia malaise anal fissures intestinal obstruction inflammation edema fibrosis scarring malnutriton anemia from hemorrhage Surgical complications may include anal canal strictures, pelvic sepsis, pouch failure, fecal incontinence, pouch dysplasia/cancer, sexual dysfunction, and female infertility.
211
what skin care actions should you take when treating a patient with IBD?
use witch hazle compress to reduce anal irritation do not use soap
212
what kind of skinc care should you have with a patient who hs IBD?
meticulous skin care at all times
213
what kind of disease has these manifestations? diarrhea (often foul smelling, light in color and frothy), steatorrhea, flatulence, weight loss, and other signs of malabsorption. fatigue and weakness longstanding impaired absorption severe abdominal pain increased bleeding manifestations are similar to irritable bowel syndrome (IBS) and lactose intolerance, Atypical symptoms anemia, dental enamel defects, osteoporosis, arthritis, neurological symptoms, infertility, and increased transaminases.
celiac disease
214
what food choises should a patient with diverculitis have?
Fiber intake Do not eat Seeds, corn, nuts None Except for clear liquid diet for 2-3 days is common when there is an active outburst
215
what disease has these clinical manifestations? Abdominal pain over the sigmoid colon Fever or leukocytosis Palpable mass is felt over the involved area Flatulane Anorexia Bloting Distention Diarreah Constipation Stools will have mucus or blood Bleeding Change in mental status Confusion, falling, anorexia Sepsis Peritonitis Rebound tenderness
deverculitis
216
what disease has this kind of treatment? Broad spectrum antibiotics for 7-10 days consume a clear liquid diet untill symptoms subside antibiotics used to treat diverticulitis include: Ciprofloxacin and metronidazole, trimethoprim-sulfamethoxazole and metronidazole, amoxicillin-clavulanate, Augmentin or Moxifloxacin. IV fluids NPO Nasogastric tube Pain medications DO NOT GIVE LAXITIVES OR ENEMAS
devirculitis
217
what disease has these diatery recomendations? fiber from raw fruits and vegetables DO NOT increase your fiber during acute phases
diverculitis
218
what disease has this etiology? Without adequate fiber intake, more water is absorbed from the stool. This slows transit time and makes it more difficult for the stool to pass through the colon. This then causes increased intraluminal pressure from constipation and straining,
diverculitis

NUR 111 UNIT 4 (9 decks)

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