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AHI > Care of Patient with Inflammatory Intestinal Disorders > Flashcards

Care of Patient with Inflammatory Intestinal Disorders Flashcards

1
Q

Inflammation of the mucous membranes of the stomach and intestinal tract - primarily small bowel
Causes diarrhea and/or vomiting
Affects mainly the small bowel
Usually self limiting - not do anything about it; do something if severely dehydrated
Types

A

Gastroenteritis

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2
Q

Viral (most common)
Bacterial - antibiotics

A

Types - Gastroenteritis

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3
Q

Norovirus is the leading foodborne disease: cruise ship
Transmitted via the fecal-oral route from person to person and from contaminated food and water

A

Viral (most common)

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4
Q

Campylobacter enteritis, Escherichia coli, Shigellosis

A

Bacterial - antibiotics

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5
Q

Recent travel out of the country or has eaten at any restaurant in the past 24 to 36 hours

A

Gastroenteritis assessment: History

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6
Q

N/V
Some Abdominal cramping
Diarrhea
Immunosuppressed or older adults can become dehydrated easily - at risk pats; monitor for signs of dehydration

A

Gastroenteritis assessment: Clinical Manifestations

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7
Q

Poor skin turgor
Dry mucous membranes
Orthostatic blood pressure changes and hypotension
Oliguria
Acute confusion in the older adult may be the only clinical manifestation present

A

Gastroenteritis assessment: Symptoms of dehydration:

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8
Q

Oral rehydration or IV fluids - replace fluids lost
Monitor VS, I/O, weight - fluids
Monitor electrolytes - esp if v&d
Drugs that suppress intestinal motility are usually not administered
Antibiotics to treat bacterial gastroenteritis and anti-infective to treat shigellosis may be needed (depends on type and severity of illness)- if identify bacteria
Prevent transmission to others

A

Gastroenteritis treatment

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9
Q

Potassium may be needed for patients with excessive diarrhea

A

Monitor electrolytes - esp if v&d

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10
Q

These drugs can prevent the infecting organisms from being eliminated from the body
Not give anti-diarrheals because v&d getting rid of organism - let run its course; sometimes give ammodium
If determined they are necessary, loperamide (Imodium) is the drug of choice

A

Drugs that suppress intestinal motility are usually not administered

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11
Q

Hand hygiene
Sanitize environmental items
Proper food preparation
Not share food

A

Prevent transmission to others

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12
Q

Begins in rectum and proceeds toward the cecum - only colon

A

Location - Chronic inflammatory bowel disease - Ulcerative colitis

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13
Q

Unknown

A

Etiology - Chronic inflammatory bowel disease - Ulcerative colitis

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14
Q

15-25 and 55-65

A

Age of incident - Chronic inflammatory bowel disease - Ulcerative colitis

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15
Q

10-20 liquid, bloody

A

stools per day - Chronic inflammatory bowel disease - Ulcerative colitis

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16
Q

Hemorrhage
Nutritional deficiencies

A

Complications - Chronic inflammatory bowel disease - Ulcerative colitis

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17
Q

Infrequent

A

Need for surgery - Chronic inflammatory bowel disease - Ulcerative colitis

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18
Q

Most often in terminal ileumm can also involve colon with patchy involvement through all layers of bowel - all areas bowel

A

Location - Chronic inflammatory bowel disease - Crohn’s disease

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19
Q

Unknown

A

Etiology - Chronic inflammatory bowel disease - Crohn’s disease

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20
Q

15-40

A

Age of incident - Chronic inflammatory bowel disease - Crohn’s disease

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21
Q

5-6 soft, loose nonbloody

A

stools per day - Chronic inflammatory bowel disease - Crohn’s disease

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22
Q

Fistualas (more common)
Malabsorption and nutritional deficiencies - not absorping nutrient properly
Obstructions due to inflammation and scaring

A

Complicatins - Chronic inflammatory bowel disease - Crohn’s disease

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23
Q

Frequent

A

Need for surgery - Chronic inflammatory bowel disease - Crohn’s disease

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24
Q

Chronic inflammatory disease of the small intestine (most often), the colon, or both
Presents as inflammation that causes a thickened bowel wall
Etiology: unknown, but may include genetic, immune, and environmental factors
Clinical Manifestations:
Lab findings: nutritional labs
Diagnostic testing:

A

Crohn’s disease

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25
Q

5-6 soft, loose stools per day, non-bloody
Abdominal pain
Low-grade fever
Weight loss - nutritional deficits

A

Clinical Manifestations: - Crohn’s disease

26
Q

Anemia - not as much
Decreased folic acid and Vitamin B12
Decreased albumin levels
Elevated C-reactive protein and ESR - indicators of inflammation

A

Lab findings: nutritional labs - Crohn’s disease

27
Q

X-ray/CT: shows narrowing, ulcerations and strictures
Magnetic resonance enterography (MRE): determine bowel activity/motility
Abdominal ultrasound
Abdominal computerized tomography
Colonoscopy
GI bleeding scan - look for a bleed

A

Diagnostic testing:- Crohn’s disease

28
Q

Immunomodulators are given to suppress the immune system - autoimmune and inflammatory thing
Glucocorticoids are used during exacerbation to decrease inflammation
Aminosalicylates are used to decrease inflammation - on all the time
Antidiarrheals are given cautiously - not all time

A

Crohn’s disease treatment - Drug therapy:

29
Q

NPO
TPN - until bowel calmed down
Nutritional supplements

A

Crohn’s disease treatment - Nutrition therapy

30
Q

If do: Treatment includes nutrition and electrolyte therapy, skin care, and prevention of infection - fistula: high risk for infection and skin issues; NPO and TPN so fix fistula and not have comps

A

Crohn’s disease treatment - Fistulas (abnormal tracts between two or more body areas) are common

31
Q

Not as successful because inflammation occurs along all areas of the bowel
Not cure
For obstruction

A

Crohn’s disease treatment - Surgery may be needed

32
Q

Creates widespread inflammation of mainly the rectum and rectosigmoid colon but can extend to the entire colon when the disease is extensive
Etiology: unknown; but genetic, immunologic (treat with immunomodulators), and environmental factors likely contribute to disease
Clinical manifestations:
Lab findings:
Diagnostic testing:

A

Ulcerative colitis

33
Q

10-20 liquid, bloody stools per day
Stool may contain mucus
Tenesmus (an unpleasant and urgent sensation to defecate)
Lower abdominal colicky pain relieved with defecation
Malaise
Anorexia
Anemia
Dehydration
Fever
Weight loss

A

Clinical manifestations: - Ulcerative colitis

34
Q

Anemia - H&H if low
Increased WBC - inflammation
Elevated C-reactive protein and ESR - inflammation
Decreased electrolytes - more issues with these

A

Lab findings: - Ulcerative colitis

35
Q

Magnetic resonance enterography (MRE) - check motility
Colonoscopy - inside bowel
Abdominal computerized tomography
Barium enema

A

Diagnostic testing: - Ulcerative colitis

36
Q

Immunomoduators are given to suppress the immune system
Glucocorticoids are used during exacerbation to decrease inflammation
Aminosalicylates are used to decrease inflammation
Antidiarrheals are given cautiously

A

Ulcerative colitis treatment - Drug therapy:

37
Q

NPO - exacerbation
TPN
Avoid caffeine, alcohol, raw vegetables, high fiber foods, lactose containing foods

A

Ulcerative colitis treatment - Nutrition therapy:

38
Q

Can reduce intestinal activity, provide comfort, and promote healing
Not want increase activity

A

Ulcerative colitis treatment - Restrict activity

39
Q

Hbg and Hct
Electrolyte values
VS

A

Ulcerative colitis treatment - Monitor for GI bleeding

40
Q

Removal of colon - pouch internally/ostomy

A

Ulcerative colitis treatment - Surgery may be required if medical therapies alone are not effective

41
Q

Hemorrhage
Perforation
Abscess formation
Toxic megacolon
Malabsorption - HUGE; not absorbing nutrients
Bowel obstruction
Fistulas
Colorectal cancer
Extraintestinal complications
Osteoporosis

A

Comps of chronic IBS

42
Q

Most common in Crohn’s

43
Q

Higher risk in patients with ulcerative colitis greater than 10 years

A

Colorectal cancer

44
Q

Diverticulosis
Diverticulitis
Etiology: unknown
Clinical manifestations of diverticulosis:
Clinical manifestations diverticulitis:
Lab findings for diverticulitis:
Diagnostic testing:

A

Diverticular disease

45
Q

Presence of many abnormal pouchlike herniations (diverticula) in the wall of the intestine; wall of intestines

A

Diverticulosis

46
Q

Inflammation of diverticula
Outpouchings of intestines inflammed

A

Diverticulitis

47
Q

Usually has no symptoms
May go undiagnosed

A

Clinical manifestations of diverticulosis:

48
Q

Abdominal pain (LLQ)
Temperature > 101 F
Lower GI bleeding
May develop peritonitis if ruptures - CONCERN; med emergency

A

Clinical manifestations diverticulitis:

49
Q

Elevated WBC - infection
Decreased Hbg and Hct - esp if having bleeding

A

Lab findings for diverticulitis:

50
Q

Abdominal x-rays - tells if have diverticulosis/diverticulitis
Abdominal computerized tomography (CT)
Abdominal ultrasound (US)

A

Diagnostic testing: - Diverticular disease

51
Q

IV fluids
Drug therapy:
Avoid laxatives or enemas as they increase intestinal motility - not want stimulate bowels; rest bowels: NPO and NGT - not severe go to clear liquids; move way up once inflammation down
Assess electrolyte imbalance
Avoid increasing intra abdominal pressure - not want rupture
Diet modification
NGT
Surgery

A

Diverticulitis treatment

52
Q

Antimicrobial such as metronidazole (Flagyl) , Bactrim or Septra, and Cipro - GI infections
Mild analgesic for pain or opioid analgesic - abdominal pain

A

Drug therapy: - Diverticulitis treatment

53
Q

lifting, straining, coughing, or bending

A

Avoid increasing intra abdominal pressure - not want rupture - Diverticulitis treatment

54
Q

NPO, clear liquids, or low fiber diet
Fiber containing diet is gradually introduced when inflammation has resolved and bowel function returns to normal

A

Diet modification - Diverticulitis treatment

55
Q

If N/V or abdominal distention is severe

A

NGT - Diverticulitis treatment

56
Q

Indicated if peritonitis, bowel obstruction or pelvic abscess is present
Colon resection, with or without colostomy
Or perferates
Often not permanent
If have diverticulosis - low residual diet: no nuts - could cause diverticulitis

A

Surgery - Diverticulitis treatment

57
Q

Chronic inflammation of the small intestinal mucosa that can cause bowel wall atrophy and malabsorption
Causes:
Varying clinical manifestations with cycles of remission and exacerbation
Classic symptoms:
Treatment: Dietary management of gluten-free diet - common

A

Celiac disease

58
Q

Combination of genetic, immunologic, and environmental factors

A

Causes: - Celiac disease

59
Q

Some patients have no symptoms, some have classic symptoms, some have atypical symptoms that affect every body system; some vary

A

Varying clinical manifestations with cycles of remission and exacerbation - Celiac disease

60
Q

anorexia
diarrhea and/or constipation
steatorrhea (fatty stools)
abdominal pain
abdominal bloating (LOTS) and distention
weight loss

A

Classic symptoms: - Celiac disease

AHI (77 decks)

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