Week 2 Pre-Learning: GI Tract - Lower Disorders - Obstruction, Malabsorption, Cancer

Question 1

What is an intestinal obstruction? (2)

Answer 1

• Any time there is impaired movement of the intestinal contents
• Most commonly occurs in the the small intestine, but can occur in large intestine, where symptoms develop slowly

Question 2

What is the mechanical cause of intestinal obstruction? (2)

Answer 2

• Occurs when there is a physical obstruction in the intestine
  Ex. Adhesions from surgery (small intestine), tumour (large intestine), inguinal hernia, volvulus, intussusception

Question 3

What is the nonmechanical (functional) cause of intestinal obstruction?

Answer 3

• neurological impairment or failure of propulsion of the intestine, often called paralytic ileus

Question 4

What are examples of nonmechanical intestinal obstruction? (6)

Answer 4

• Peritonitis
• Pancreatitis
• Crohn’s
• Ulcerative colitis
• spinal cord injuries
• electrolyte imbalances

Question 5

What should nurses look for in a patient with a possible intestinal obstruction in the small intestine? (2)

Answer 5

• bowel symptoms onset will be rapid and include frequent vomiting with colicky, cramp-like abdominal pain
• may continue to have bowel movements for a period of time

Question 6

What should nurses look for in a patient with a possible intestinal obstruction in the large intestine? (4)

Answer 6

• symptom onset will be gradual
• include low-grade cramping, abd. pain
• abd. distention
• absolute constipation (no BMs)

Question 7

Intestinal obstruction diagram

Answer 7

Question 8

What is malabsorption syndrome?

Answer 8

• results from impaired absorption of fats, carbohydrates, proteins, minerals and vitamins

Question 9

What are possible causes of malabsorption syndrome? (5)

Answer 9

• Enzyme deficiencies
• Bacterial proliferation
• Disruption of small intestine mucosa
• Disturbed lymphatic and vascular circulation
• surface area loss

Question 10

What is the most common malabsorption disorder?

Answer 10

lactase deficiency

Question 11

What is lactase deficiency?

Answer 11

• lactase enzyme is deficient or absent (enters large intestine undigested)

Question 12

What are the clinical manifestations of malabsorption syndrome (lactase deficiency)? (7)

Answer 12

• abdominal bloating
• cramps
• flatulence
• diarrhea
• nausea
• borborygmi
• vomiting

Question 13

How does one manage lactase deficiency?

Answer 13

• lactase avoidance and/or lactase supplementation

Question 14

What is the second most common cause of cancer death in Canada? (2)

Answer 14

• colorectal cancer
• 20% of tumours are within the reach of examining finger, and 50% are within reach of sigmoidoscope

Question 15

What are the risk factors of colorectal cancer? (6)

Answer 15

• diet high in red/processed meat
• Obesity
• Physical inactivity
• alcohol
• smoking
• low intake of fruit and vegetables

Question 16

What are the clinical manifestations of colorectal cancer? (8)

Answer 16

Nonspecific if early
- Rectal bleeding (occult)
- changing bowel patterns
- abdominal cramps
- gas
- bloating
- narrow, ribbon-like stool
- Loss of appetite
- weight loss