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Med Surg > Chapter 29 lower gi disorders > Flashcards

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
Q

tx of ulcerative colitis

A

anit-inflammatory drugs, immunosuppressants, surgery

25
Q

s/s of inflammatory bowel syndrome (IBD)

A

-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
Q

IBD treatment/ interventions

A

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
Q

some age related concerns with appendicitis?

A

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
Q

what is appendicitis? caused by?

A

acute inflammation of the appendix
- caused by bacteria from feces that accumulate in the appendix

28
Q

s/s of appendicitis

A

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
Q

tx of appendicitis

A
  • 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
Q

what is peritonitis? caused by?

A

acute inflammation of the peritoneum
- caused by rupture of abdominal organ with spilling of bacteria and contents into peritoneum
- infectious agents

31
Q

s/s of peritonitis?

A
  • 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
Q

explain three different types of perionitis

A

primary: spontaneous bacterial infection (liver failure)
secondary: perforation of abdominal organs
tertiary: suprainfection in immunocompromised patient

33
Q

tx of peritonitis

A
  • 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
Q

nursing interventions for peritonitis

A
  • 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
Q

what is malabsorption

A

irritation of intestinal mucosa and consequent diarrhea
- adult celiac disease (sprue)
- lactose intolerance

36
Q

s/s of malabsorption

A
  • 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
Q

treatment of malabsorption

A
  • limiting intake of lactose
  • lactase enzyme preparations
  • omit gluten from diet
38
Q

what are hemorrhoids(internal/external)? caused by?

A

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
Q

s/s of hemorrhoids

A

anal pain and discomfort
- itching in the anus
- inflammation of anal canal
- visible blood in stool
- visible dilated vein

40
Q

tx of hemorrhoids

A

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
Q

what are pilonidal cyst

A

lesions located in the cleft of the buttocks at the sacrococcygeal region

42
Q

s/s of pilonidal cyst

A

no symptoms until it becomes infected then pain, swelling and purulent drainage

43
Q

tx of pilonidal cysts

A

surgical incision and drainage

44
Q

what is anorectal abscess and fistula

A

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
Q

s/s and tx of anorectal abscess and fistula

A

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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