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Chapter 29 lower gi disorders Flashcards

1
Q

s/s of abdominal/inguinal hernia

A

abnormal pouching or lump
- swelling
- maybe pain or discomfort

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1
Q

what is an abdominal/inguinal hernia

A

defect in the muscular wall of the abdomen
- reducible and irreducible
- incarcerated or strangulated
- indirect or direct inguinal hernia

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2
Q

treatment/management of abdominal/inguinal hernia

A
  • herniorrhaphy
  • care after hernia repair directed at pain control and prevent reoccurrence of hernia
  • px cautioned not to do heavy lifting, pulling, or pushing that increases pressure
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3
Q

what is irritable bowel syndrome

A

hypersensitivity of the bowel wall that leads to disruption of the normal function of intestinal muscles
- abdominal pain or discomfort (relieved by bowel movement)

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4
Q

s/s of irritable bowel syndrome

A

alteration in bowel elimination (constipation or diarrhea or both)
- abdominal pain and bloating
- absence of detectable organic disease

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5
Q

IBS management/treatment

A
  • relieve abdominal pain, control diarrhea or constipation
  • High-fiber diet
  • alternative and complementary therapies
  • bulk-forming agents, antidiarrheals, antispasmodics, antidepressants, anti-sedatives
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6
Q

what is diverticula

A

a small blind pouch resulting from a protrusion of mucous membranes

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7
Q

s/s of diverticulosis

A

when infection or inflammation occurs
- rectal bleeding
- diarrhea or constipation
-left lower abdominal pain
- nausea/vomiting
- bloating

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8
Q

treatment of diverticulosis? what foods do you avoid?

A
  • high fiber diet
  • peanuts
  • seeds, berries with seeds
    -tomatoes
  • popcorn
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9
Q

what is an intestinal obstruction

A

exists when blockage prevents normal flow of intestinal contents through the intestinal tract

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10
Q

s/s of upper gi obstruction

A

-sharp pains in upper quadrants
- hyperactive, high-pitched bowel sounds above the point of obstruction
- absent bowel sounds below the point of obstruction
- vomiting
- rapid dehydration
- slight abdominal distention

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11
Q

s/s of lower gi obstruction

A
  • gradual onset
  • marked abdominal distention
  • pain lasts several minutes, comes in waves
  • vomiting (late sign)
  • fecal odor of emesis
  • fecal matter in emesis
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12
Q

interventions of obstructions?discharge teachings?

A

-closely monitor NGT output
- monitor i/o’s
- preop teaching if surgical intervention is necessary
- monitor for passing of latus and feces
discharge teaching: high fiber diet with raw fruit and veggies and whole grains, increased fluid intake, regular exercise

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13
Q

medical management of intestinal obstruction

A

abdominal decompression by using NGT
- iv fluid (replacement of fluid and electrolytes
- if px is tachycardic, hyperthermic, hypotensive, and has leukocytosis use surgical management

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14
Q

what are some complications of intenstinal obstruction

A

-peritonitis
-perforation
- shock
-death

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15
Q

what is bowel ischemia

A

occurs when the blood supply to bowel is insufficient to support metabolic needs

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16
Q

treatment of bowel ischemia

A
  • NPO and NG tube
    -iv hydration
  • smooth muscle relaxant or thrombolytic therapy if thrombus
  • surgical exploration may be indicated
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17
Q

What is IBD (inflammatory bowel disease)

A

inflammation of the mucosal lining of intestinal tract, causing ulceration, edema, bleeding, and fluid and electrolyte loss

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18
Q

what is Crohn’s disease

A

inflammation of any part of gi tract
- most commonly affects distal ileum and proximal colon
-inflamed tissue has granulomatous appearance

19
Q

what is ulcerative colitis

A

inflammation of colon with formation of ulcers in mucosal layer

20
Q

ulcerative colitis and crohns disease diagnostic tests

A

colonoscopy
- flexible sigmoidoscopy
-mucosal biopsy
- barium enema
- stool analysis

21
Q

s/s of crohns disease

A

abdominal pain, diarrhea, weight loss, fatigue

22
Q

s/s of ulcerative colitis

A

abdominal pain
- bloody diarrhea
- rectal pain

23
Q

tx of crohns disease

A

anti-inflammatory drugs, immunosuppressants, abx, surgery

24
tx of ulcerative colitis
anit-inflammatory drugs, immunosuppressants, surgery
25
s/s of inflammatory bowel syndrome (IBD)
-attacks precipitated by physical or emotional stress - frequent diarrhea that may contain blood and mucus - abdominal pain and cramping - malaise - fever - weight loss - bleeding that can lead to anemia
26
IBD treatment/ interventions
symptomatic tx: antidiarrheal agents, mild analgesics, dietary management, corticosteroids surgery for severe cases: colectomy, ileostomy, reservoir - monitor number and character of stools, bowel sounds, i/o's, daily weights, and lab values for anemia, electrolyte imbalance - fluid replacement prn - low fat, low fiber, high protein, high calorie die - provide small frequent meals
27
some age related concerns with appendicitis?
elderly may present with only vague s/s like malaise, fever, diffuse abdominal pain, confusion - difficulty diagnosing appendicitis make elderly more at risk for perforation
27
what is appendicitis? caused by?
acute inflammation of the appendix - caused by bacteria from feces that accumulate in the appendix
28
s/s of appendicitis
abdominal pain initially generalized but then localizes in RLQ - guarding of abdomen - rebound tenderness - inability to stretch abdomen - nausea/vomiting - low-grade fever - anorexia
29
tx of appendicitis
- appendectomy is tx of choice - iv fluids - pain control while px is waiting for surgery - administer antibiotics as ordered - NPO until after surgery PATIENT SHOULD NOT RECEIVE LAXATIVES OR ENEMAS DUE TO INCREASED RISK OF RUPTURE
30
what is peritonitis? caused by?
acute inflammation of the peritoneum - caused by rupture of abdominal organ with spilling of bacteria and contents into peritoneum - infectious agents
31
s/s of peritonitis?
- nausea/vomiting - severe abdominal pain - abdominal distention or rigidity - anorexia - hypoactive or absent bowel sounds - high fever - inability to pass flatus or feces - shock can occur rapidly
32
explain three different types of perionitis
primary: spontaneous bacterial infection (liver failure) secondary: perforation of abdominal organs tertiary: suprainfection in immunocompromised patient
33
tx of peritonitis
- fluid electrolyte replacement - analgesics for pain - antiemetics for nausea/vomiting -abx as ordered - surgical intervention to repair ruptured organ asap - NGT connected to low intermittent wall suction (relieves abdominal distention)
34
nursing interventions for peritonitis
- px remains NPO - oral and nasal care - preop teaching and preparation - post-op monitoring LOC, vital signs (temp, P, R, BP) - fluid electrolyte status (I/O) - maintain patient in semi-fowlers position to promote drainage
35
what is malabsorption
irritation of intestinal mucosa and consequent diarrhea - adult celiac disease (sprue) - lactose intolerance
36
s/s of malabsorption
- steatorrhea (passage of stool, that is bulk, frothy, and foul smelling and that usually floats in toilet -weight loss, weakness, and various signs of vitamin deficiency
37
treatment of malabsorption
- limiting intake of lactose - lactase enzyme preparations - omit gluten from diet
38
what are hemorrhoids(internal/external)? caused by?
dilated veins outside or inside the anal sphincter - increased intravenous pressure, obesity, pregnancy, constipation, prolonged stagnant position, straining with defecation internal: occurs above the internal sphincter external: occurs outside the external sphincter
39
s/s of hemorrhoids
anal pain and discomfort - itching in the anus - inflammation of anal canal - visible blood in stool - visible dilated vein
40
tx of hemorrhoids
local application of a cool or warm compress - sitz baths help cleanse area and soothe pain - high fiber diet and increased fluid intake avoidance of: straining during defecation, lifting heavy objects, prolonged sitting, laxatives
41
what are pilonidal cyst
lesions located in the cleft of the buttocks at the sacrococcygeal region
42
s/s of pilonidal cyst
no symptoms until it becomes infected then pain, swelling and purulent drainage
43
tx of pilonidal cysts
surgical incision and drainage
44
what is anorectal abscess and fistula
localized infection with collection of pus forms an anorectal abscess - fistula is chronic granulomatous tract that travels in a line from anal canal to skin
45
s/s and tx of anorectal abscess and fistula
s/s - discharge of pus from fistula, pain tx- pain meds, incision and drainage and/ or repair

Med Surg (12 decks)

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