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Nursing of Adults I > Chapter 47: Lower Gastrointestinal Problems > Flashcards

Chapter 47: Lower Gastrointestinal Problems Flashcards

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1
Q

care of patient after hemorrhoidectomy: encourage patient to __________________________ frequently

A

change positions

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2
Q

organism that causes infectious gastroenteritis: manifestations include abdominal pain, nausea, vomiting, secretory diarrhea

A

Salmonella

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3
Q

patient teaching for ostomies: describe ostomy’s potential effects on _______________, _______________, ________, and __________ and ways to manage these changes

A

sexual activity, social life, work, recreation

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4
Q

type of stoma that is made by bringing a loop of bowel to the abdominal surface and then opening the anterior wall of the bowel to provide fecal diversion

A

loop stoma

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5
Q

those who have a first-degree relative who developed colorectal cancer before age 60 or have 2 first-degree relatives with colorectal cancer should have a colonoscopy every ___ years beginning at age ____ or ______ years earlier than when the youngest relative developed cancer

A

5, 40, 10

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6
Q

if a pilonidal sinus forms an abscess, __________ and ____________ are needed. Nursing care includes __________ and _________ heat applications, positioning on ___________ or _______ for comfort, and teaching to avoid ________________ dressing when urinating or defecating and to avoid ____________ when possible

A

incision, drainage, warm, moist, abdomen, side, contaminating, straining

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7
Q

four neurologic manifestations of malabsorption

A

altered mental status, night blindness, paresthesias, peripheral neuropathy

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8
Q

OLD CARTS pain assessment stands for

A

Onset, Location/radiation, Duration, Character, Aggravating factors, Relieving Factors, Timing, Severity

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9
Q

two extraintestinal manifestations of IBD of the liver/gallbladder

A

gallstones, liver disease

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10
Q

organism that causes infectious gastroenteritis: treatment is vancomycin

A

Clostridium difficile

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11
Q

nursing management of diarrhea: ensure the patient maintains adequate _________ intake containing ___________ and _____________

A

fluid, glucose, electrolytes

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12
Q

two extraintestinal manifestations of IBD of skin

A

erythema nodosum, pyoderma gangrenosum

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13
Q

ulcerative colitis and/or Chron’s disease: common strictures

A

Chron’s disease

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14
Q

organism that causes infectious gastroenteritis: common in winter months

A

rotavirus

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15
Q

most common cause of small bowel obstruction

A

surgical adhesions

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16
Q

organism that causes infectious gastroenteritis: parasitic diarrhea in which ova and parasite are found in stool

A

Giardia lamblia

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17
Q

treatment of acute abdominal trauma: establish IV access with ____________________ and infuse _____________ or __________________

A

2 large-bore catheters, normal saline, lactated Ringer’s

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18
Q

ulcerative colitis and/or Crohn’s disease: common incidence of malabsorption and nutrition deficiences

A

Crohn’s disease

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19
Q

position common with visceral pain

A

supine with outstretched legs

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20
Q

treatment of peritonitis: monitor ____________ and ____________; monitor ____________ status to determine replacement therapy

A

intake, output, electrolyte

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21
Q

position common with peritoneal irritation (such as appendicitis)

A

fetal position

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22
Q

type of intestinal obstruction that occurs with reduced or absent peristalsis due to altered neuromuscular transmission of the parasympathetic innervation to the bowel

A

nonmechanical obstruction

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23
Q

extraintestinal manifestation of IBD of bones

A

osteoporosis

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24
Q

ulcerative colitis and/or Chron’s disease: tenesmus rare (feeling of need to pass stools)

A

Crohn’s disease

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25
Q

nursing management of diarrhea: encourage patient to increase ____________ foods unless contraindicated

A

high fiber

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26
Q

patient teaching for ostomies: explain _________________ and __________________ of ostomy

A

description, function

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27
Q

organism that causes infectious gastroenteritis: treatment may include TMP-SMX (trimethoprim/sulfamethoxazole) (2)

A

Shigella, E. coli

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28
Q

nine vegetables high in fiber

A

asparagus, beans, broccoli, carrots (raw), corn, peas (canned), potatoes (baked and sweet), squash (acorn), tomato (raw)

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29
Q

type of diarrhea caused by undigested carbohydrates, lactose intolerance, and certain laxatives

A

osmotic diarrhea

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30
Q

four skin manifestations of malabsorption

A

brittle nails, bruising, dermatitis, hair thinning/loss

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31
Q

patient teaching for ostomies: demonstrate and allow patient/caregiver to practice following:
1. remove the old ______________, ___________ the skin, and correctly apply new _____________
2. _________, _________, __________, and ________ pouch
3. empty pouch before it is _________ full to prevent leakage

A
  1. skin barrier, cleanse, skin barriers
  2. apply, empty, clean, remove
  3. 1/3
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32
Q

ulcerative colitis and/or Chron’s disease: tenesmus common (feeling of need to pass stools)

A

ulcerative colitis

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33
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: gradual constipation

A

distal small intestine

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34
Q

care of patient after hemorrhoidectomy: assess for rectal ____________, especially in those taking ________________

A

bleeding, anticoagulants

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35
Q

treatment of acute abdominal trauma: stabilize impaled objects with __________________; do not remove

A

bulky dressing

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36
Q

seven fruits high in fiber

A

apple, blackberries, orange, peach, pear, raspberries, strawberries

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37
Q

HNPCC/Lynch syndrome: if colon polyps present, occur at (earlier, later) age than general population and are (less, more) prone to become cancerous

A

earlier, more

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38
Q

organism that causes infectious gastroenteritis: characterized by afebrile abdominal distention, cramping, and flatulence

A

Giardia lamblia

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39
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: obstipation (inability to pass the accumulation of dry hard feces)

A

large intestine

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40
Q

type of intestinal obstruction that results from an interference with the blood supply to a part of the intestines (rare)

A

vascular obstruction

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41
Q

type of polyps that are flat, broad-based, and attached directly to the intestinal wall

A

sessile

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42
Q

organism that causes infectious gastroenteritis: treatment is supportive care ONLY (2)

A

rotavirus, Norwalk

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43
Q

treatment of acute abdominal trauma: obtain blood for ______ and ________ and _________________

A

CBC, type, crossmatch

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44
Q

organism that causes infectious gastroenteritis: spread via food borne (3)

A

Salmonella, E. coli, Rotavirus

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45
Q

ulcerative colitis and/or Crohn’s disease: depth of involvement is entire thickness of bowel well (transmural)

A

Crohn’s disease

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46
Q

ulcerative colitis and/or Crohn’s disease: small bowel involvement minimal

A

ulcerative colitis

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47
Q

organism that causes infectious gastroenteritis: can be fatal for immunocompromised

A

Cryptosporidium

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48
Q

type of hernia that protrudes through the posterior wall of the inguinal canal

A

direct inguinal

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49
Q

two vascular problems that may cause acute abdominal pain

A

mesenteric vascular occlusion, ruptured aortic aneurysm

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50
Q

constipation patient teaching: do not delay _____________; respond to ________

A

defecation, urges

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51
Q

ulcerative colitis and/or Chron’s disease: perforation common because inflammation involves entire bowel wall

A

Chron’s disease

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52
Q

HNPCC/Lynch syndrome: increased risk of these eight cancers

A

stomach, brain, ovary, uterus, skin, urinary tract, small bowel, bile ducts

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53
Q

usual surgical procedure for diverticulosis/diverticulitis involves _____________ of colon with a primary ____________; if this is not possible, patient will need temporary _______________

A

resection, anastomosis, colostomy

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54
Q

patient teaching for ostomies: ________ food very well to reduce the chance of blockage

A

chew

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55
Q

three infectious disease organisms that may cause acute abdominal pain

A

E. coli O157:H7, Giardia, Salmonella

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56
Q

patient teaching for ostomies: fluid intake of at least ____________ mL/day to prevent dehydration unless contraindicated; increase in these three situations

A

3000
hot weather, excess perspiration, diarrhea

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57
Q

nursing management of diarrhea: implement proper _________________ and ____________ control precautions

A

isolation, infection

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58
Q

risk factors for colorectal cancer: family history of _______________ in first-degree relative; family or personal history of _____________ or _____________

A

colorectal cancer, FAP, HNPCC syndrome

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59
Q

PQRST pain assessment stands for

A

Provocation/Palliation: what brought pain on, what makes it better/worse
Quality/Quantity: what it feels like, use descriptive words
Region/Radiation
Severity Scale
Timing

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60
Q

HNPCC/Lynch syndrome: colonoscopy recommended every _____________

A

1-2 years

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61
Q

four other causes of acute abdominal pain (other than gynecologic, infectious disease, inflammation, and vascular problems)

A

obstruction/perforation of abdominal organ
GI bleeding or ischemia
myocardial infarction
trauma

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62
Q

organism that causes infectious gastroenteritis: manifestations include nausea, vomiting, headache, low-grade fever, aches, chills

A

Norwalk virus

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63
Q

organism that causes infectious gastroenteritis: treatment includes supportive care (4)

A

Salmonella, E. coli, Rotavirus, Norwalk

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64
Q

type of hernia that protrudes through the inguinal ring (most common)

A

indirect inguinal

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65
Q

this diagnostic test for colorectal cancer detects DNA in stool

A

Cologuard

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66
Q

organism that causes infectious gastroenteritis: manifestations include nausea, vomiting, diarrhea, low-grade fever

A

rotavirus

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67
Q

patient teaching for ostomies: describe community ___________ to assist with emotional and psychologic adjustment to ostomy

A

resources

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68
Q

(liquid EN, PN) is preferred for a patient with IBD during an acute exacerbation; two reasons why

A

liquid EN
atrophy of gut, bacterial overgrowth occur when GI tract not used

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69
Q

four goals of surgical therapy for colorectal cancer

A
  1. complete resection of tumor
  2. thorough exploration of abdomen to determine any spread
  3. removing all lymph nodes that drain area where cancer located
  4. restoring bowel continuity to promote normal bowel function
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70
Q

nursing management of diarrhea: provide ____________ for toileting and use a(n) ____________

A

privacy, deodorizer

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71
Q

care of patient after hemorrhoidectomy: provide as much ____________ as possible when providing wound care and performing assessments

A

privacy

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72
Q

diagnosis of diverticulitis is based on these three things

A

physical assessment, CBC, imaging

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73
Q

five musculoskeletal manifestations of malabsorption

A

bone pain, muscle wasting, tetany, weakness, muscle cramps

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74
Q

organism that causes infectious gastroenteritis: characterized by green watery diarrhea that could cause hemorrhagic colitis

A

E. coli

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75
Q

ulcerative colitis and/or Crohn’s disease: small bowel involvement common

A

Crohn’s disease

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76
Q

ulcerative colitis and/or Chron’s disease: usually starts in rectum and spreads in a continuous pattern up the colon

A

ulcerative colitis

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77
Q

four goals of diet management for IBD

A
  1. provide adequate nutrition without worsening symptoms
  2. correct and prevent malnutrition
  3. replace fluid and electrolyte losses
  4. prevent weight loss
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78
Q

care of patient after hemorrhoidectomy: apply ______ to the area several times a day for _______ at a time

A

ice, 10 minutes

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79
Q

four goals of treatment of peritonitis

A
  1. resolution of inflammation
  2. relief of abdominal pain
  3. freedom from complications
  4. normal nutrition status
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80
Q

type of polyps that are attached to the bowel wall by a thin stalk

A

pedunculated

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81
Q

ulcerative colitis and/or Chron’s disease: weight loss common, may be severe

A

Crohn’s disease

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82
Q

type of stoma that is made by dividing the bowel and bringing both the proximal and distal ends through the abdominal wall as 2 separate stomas

A

double-barreled stoma

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83
Q

supportive care for infectious gastroenteritis includes maintaining _______ and administering _____________ and _____________ drugs

A

fluids, antidiarrheal, antibiotic (if necessary)

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84
Q

treatment of acute abdominal pain: establish IV access with __________________ and infuse ________________ or ___________________; insert another if ________ present

A

large-bore catheter, warm normal saline, lactated Ringer’s, shock

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85
Q

constipation patient teaching: do not overuse ____________ and __________; can become dependent

A

laxatives, enemas

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86
Q

risk factors for colorectal cancer: obesity with BMI ______ or greater

A

30 kg/m2

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87
Q

organism that causes infectious gastroenteritis: characterized by PROFUSE watery diarrhea and abdominal cramping and pain

A

Clostridium difficile

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88
Q

patient teaching for IBD focuses on these six things

A
  1. rest and diet management
  2. perianal care
  3. drug action and side effects
  4. symptoms of recurrence of disease
  5. when to seek medical care
  6. ways to reduce stress
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89
Q

extraintestinal manifestation of IBD of the mouth

A

aphthous ulcers

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90
Q

treatment of acute abdominal trauma: cover protruding organs or tissue with ____________________

A

sterile saline dressing

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91
Q

nursing management of diarrhea: implement measures to make toileting easier for patients, such as ____________ in reach, easy-to-manage ___________, and ___________________ available

A

call light, clothing, assistive devices

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92
Q

treatment of acute abdominal trauma: apply appropriate ___________ therapy

A

oxygen

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93
Q

ulcerative colitis and/or Crohn’s disease: distribution: healthy tissue interspersed with areas of inflammation (skip lesions)

A

Crohn’s disease

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94
Q

eight hallmark signs of abdominal trauma

A

guarding/splinting
hard board-like abdomen
decreased/absent bowel sounds
bruising
hematemesis/hematuria
Cullen’s sign
Grey Turner’s sign
bruits

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95
Q

treatment of acute abdominal trauma: monitor __________, _______________, _____________ and _______________

A

vital signs, level of consciousness, O2 saturation, urine output

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96
Q

organism that causes infectious gastroenteritis: treatment is metronidazole

A

Giardia lamblia

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97
Q

risk factors for colorectal cancer: personal history of these three conditions

A

colorectal cancer, inflammatory bowel disease, diabetes

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98
Q

diverticula are most common in this part of the colon

A

left (descending, sigmoid)

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99
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: persistent, cramping pain

A

large intestine

100
Q

position common with kidney stones and gallstones

A

restlessness, inability to find comfortable position

101
Q

care after a hernia repair involves measuring _________ and _________, observing for _____________ bladder, and applying a(n) _________ support and ice to relieve pain/edema in the area

A

intake, output, distended, scrotal

102
Q

patient teaching for ostomies: describe how to obtain ostomy ________________

A

supplies

103
Q

nursing management of diarrhea: maintain accurate __________________ records and record _________ daily

A

intake and output, weight

104
Q

ulcerative colitis and/or Chron’s disease: distribution: continuous areas of inflammation

A

ulcerative colitis

105
Q

positioning for patient with peritonitis

A

lie still, shallow breaths (movement worsens pain)
knees flexed increases comfort

106
Q

treatment of acute abdominal pain: ensure patent ________

A

airway

107
Q

ulcerative colitis and/or Chron’s disease: age at onset teens to mid-30s; after 60

A

both

108
Q

three uses of chemotherapy in treating colorectal cancer

A
  1. shrink tumor before surgery
  2. adjuvant therapy after bowel resection
  3. palliative treatment for nonresectable cancer
109
Q

conservative care for diverticulosis/diverticulitis includes these four things

A

high-fiber diet, fiber supplements, weight loss, smoking cessation

110
Q

care of patient after hemorrhoidectomy: administer ______________ as ordered, especially before bowel movements; also administer ________________ and ________________ as ordered

A

analgesics, stool softeners, bulking agents

111
Q

risk factors for colorectal cancer: alcohol (___ or more drinks/week) and cigarette smoking

A

4

112
Q

two hematologic manifestations of malabsorption

A

anemia, hemorrhagic tendency

113
Q

patient teaching for ostomies: describe __________________________ that resulted in need for ostomy

A

underlying condition

114
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: minimal abdominal distention

A

proximal small intestine

115
Q

care of patient after hemorrhoidectomy: teach patient to use _________________________ cushion, not a ring or “doughnut” when sitting

A

pressure relief

116
Q

type of hernia that occurs due to weakness of the abdominal wall at the site of a previous incision

A

ventral or incisional

117
Q

seven GI manifestations of malabsorption

A

diarrhea, flatulence, glossitis, cheilosis, stomatitis, steatorrhea, weight loss

118
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: rapid onset

A

proximal and distal small intestine

119
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: less frequent vomiting

A

distal small intestine

120
Q

FAP is autosomal ______________ or _____________

A

dominant, recessive

121
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: gradual onset

A

large intestine

122
Q

four extraintestinal manifestations of IBD of the eye

A

conjunctivitis, episcleritis, iritis, uveitis

123
Q

three cardiovascular manifestations of malabsorption

A

hypotension, peripheral edema, tachycardia

124
Q

care of patient after hemorrhoidectomy: teach patient care of the ____________, symptoms of ________________, and ways to avoid _______________ and ______________

A

anal area, complications, constipation, straining

125
Q

organism that causes infectious gastroenteritis: common in schools and cruise ships

A

Norwalk virus

126
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: increased abdominal distention

A

distal small intestine, large intestine

127
Q

gold standard for colorectal cancer screening

A

colonoscopy

128
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: late or absent vomiting

A

large intestine

129
Q

constipation patient teaching: drink _____ fluids per day, and avoid ____________

A

2 L, caffeine

130
Q

organism that causes infectious gastroenteritis: characterized by watery diarrhea that progresses to bloody mucus

A

Shigella

131
Q

ulcerative colitis and/or Crohn’s disease: increased incidence and severity of CDiff infection

A

both

132
Q

ulcerative colitis and/or Crohn’s disease: intermittent fever common

A

Chron’s disease

133
Q

treatment of acute abdominal pain: insert _________ as needed and keep patient ______

A

NG tube, NPO

134
Q

ulcerative colitis and/or Chron’s disease: increased incidence of small intestinal cancer

A

Crohn’s disease

135
Q

nursing management of diarrhea: apply ________________________ cream as needed

A

moisturizing skin barrier

136
Q

two uses of radiation in treating colorectal cancer

A
  1. adjuvant to surgery
  2. palliative
137
Q

(right-sided, left-sided) colorectal cancers are more likely to cause bleeding and diarrhea

A

right-sided

138
Q

ulcerative colitis and/or Crohn’s disease: pseudopolyps rare

A

Crohn’s disease

139
Q

treatment of peritonitis: place on _______ status; may need __________ to decrease gastric distention and further leakage of bowel contents into peritoneum

A

NPO, NG tube

140
Q

HNPCC/Lynch syndrome is autosomal ____________

A

dominant

141
Q

treatment of acute abdominal trauma: insert indwelling _________________ if no blood at meatus, pelvic fracture, or boggy prostate; obtain ___________

A

urinary catheter, urinalysis

142
Q

treatment of acute abdominal pain: assess for _______ and amount/character of ___________

A

pain, emesis

143
Q

treatment of acute abdominal trauma: insert __________ if no evidence of facial trauma

A

NG tube

144
Q

most common form of nonmechanical obstruction characterized by lack of intestinal peristalsis and bowel sounds

A

paralytic ileus

145
Q

nursing management of diarrhea: have patient use ______________, _________________, or ______________ to reduce perianal irritation and pain

A

dibucaine, witch hazel, sitz baths

146
Q

type of diarrhea which involves oversecretion of water, sodium, and chloride into bowel

A

secretory diarrhea

147
Q

small tract under the skin between the buttocks in the sacrococcygeal area that may have congenital origin (assess for family history)

A

pilonidal sinus

148
Q

preferred diagnostic procedure for appendicitis (with two other options in parentheses)

A

CT scan (ultrasound, MRI)

149
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: colicky, cramping pain that occurs at frequent intervals

A

proximal small intestine

150
Q

hallmark sign for appendicitis

A

pain at McBurney point

151
Q

organism that causes infectious gastroenteritis: spread through fecal-oral route (4)

A

Clostridium difficile, Shigella, Cryptosporidium, Norwalk

152
Q

four hallmark manifestations of intestinal obstruction

A

abdominal pain, nausea/vomiting, distention, constipation

153
Q

ulcerative colitis and/or Crohn’s disease: intermittent fever occurs during acute attacks

A

ulcerative colitis

154
Q

preferred diagnostic test for diverticulitis

A

CT scan with oral contrast

155
Q

ulcerative colitis and/or Crohn’s disease: weight loss rare

A

ulcerative colitis

156
Q

ulcerative colitis and/or Chron’s disease: rectal bleeding sometimes

A

Crohn’s disease

157
Q

treatment of acute abdominal pain: monitor ____________, ________________, ________________, and ____________ and ____________

A

vital signs, level of consciousness, O2 saturation, intake, output

158
Q

type of hernia that occurs when there is a protrusion through the femoral ring into the femoral canal

A

femoral

159
Q

constipation patient teaching: eat _________ fiber per day

A

20-30 g

160
Q

most common causes of large bowel obstruction

A

colorectal cancer (malignant obstruction), then diverticular disease

161
Q

ulcerative colitis and/or Crohn’s disease: occasional strictures

A

ulcerative colitis

162
Q

type of polyps that are noncancerous

A

hyperplastic

163
Q

three gynecologic problems that may cause acute abdominal pain

A

pelvic inflammatory disease, ruptured ectopic pregnancy, ruptured ovarian cyst

164
Q

if the appendix has ruptured and there is evidence of peritonitis or abscess, giving these two things for (time period) before appendectomy prevents dehydration and sepsis

A

IV fluids, antibiotic therapy, 6-8 hours

165
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: feces bowel movement for a short time

A

proximal small intestine

166
Q

nursing management of diarrhea: teach patient to avoid ________ and ________ known to worsen diarrhea

A

foods, fluids

167
Q

eight risk factors for hemorrhoids

A

pregnancy, constipation, straining to defecate, diarrhea, heavy lifting, prolonged standing/sitting, obesity, ascites

168
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: colicky pain that occurs more intermittently

A

distal small intestine

169
Q

extraintestinal manifestation of IBD of kidneys

A

kidney stones

170
Q

treatment of acute abdominal trauma: remove ___________

A

clothing

171
Q

organism that causes infectious gastroenteritis: found in lakes

A

Giardia lamblia

172
Q

extraintestinal manifestation of IBD of vascular system

A

thromboembolism

173
Q

ulcerative colitis and/or Crohn’s disease: cobblestoning of mucosa is common

A

Crohn’s disease

174
Q

minimally invasive procedure that may be done to inspect the surface of abdominal organs, obtain biopsy specimens, perform ultrasounds, and remove organs (for diagnosis/treatment of abdominal pain)

A

laparoscopy

175
Q

two treatment goals for intestinal obstruction

A

regain intestinal patency, resolve obstruction

176
Q

ulcerative colitis and/or Crohn’s disease: depth of involvement is mucosa

A

ulcerative colitis

177
Q

type of polyps that are neoplastic and closely related to colorectal adenocarcinoma

A

adenomatous

178
Q

type of hernia that occurs when rectus muscle is weak or umbilical opening does not close after birth

A

umbilical

179
Q

in diagnosing appendicitis, this is done to rule out genitourinary conditions that mimic appendicitis

A

urinalysis

180
Q

organism that causes infectious gastroenteritis: virus is present in stool (2)

A

rotavirus, Norwalk virus

181
Q

treatment of acute abdominal pain: apply oxygen via _______________ or _______________

A

nasal cannula, nonrebreather mask

182
Q

ulcerative colitis and/or Chron’s disease: perianal abscess and fistulas rare

A

ulcerative colitis

183
Q

treatment of acute abdominal pain: insert indwelling ________________ and obtain ______________

A

urinary catheter, urinalysis

184
Q

care of patient after hemorrhoidectomy: have patient use ______________ or __________________ instead of toilet paper

A

baby wipes, medicated pads

185
Q

hallmark manifestation of malabsorption syndrome

A

steatorrhea

186
Q

nursing management of diarrhea: assist patient with keeping _____________ area clean

A

perianal

187
Q

organism that causes infectious gastroenteritis: cephalosporins can be given

A

Salmonella

188
Q

patient teaching for ostomies: describe symptoms of _______________________ imbalance and how to recognize problems such as these four

A

fluid and electrolyte
fever, diarrhea, skin irritation, stomal problems

189
Q

ulcerative colitis and/or Chron’s disease: cobblestoning of mucosa is rare

A

ulcerative colitis

190
Q

ulcerative colitis and/or Crohn’s disease: toxic megacolon rare

A

Crohn’s disease

191
Q

most appendicitis patients have a mildly to moderately elevated __________

A

WBC count

192
Q

seven inflammatory processes that may cause acute abdominal pain

A

appendicitis, cholecystitis, diverticulitis, gastritis, IBD, pancreatitis, pyelonephritis

193
Q

teach patients with hemorrhoids measures to prevent ____________, avoid ___________, __________ time sitting on the toilet, and seek medical care for ______________________

A

constipation, straining, limit, severe symptoms

194
Q

care of patient after hemorrhoidectomy: administer warm ____________ for 15-20 minutes, 2-3 times per day

A

sitz baths

195
Q

patient teaching for ostomies: to prevent nutrition problems, have a well-balanced ______ and _________

A

diet, supplements

196
Q

ulcerative colitis and/or Crohn’s disease: occurs anywhere along GI tract; most common site is distal ileum

A

Crohn’s disease

197
Q

ulcerative colitis and/or Chron’s disease: increased incidence of colorectal cancer after 10 years of disease

A

ulcerative colitis

198
Q

risk factors for colorectal cancer: eating red meat _____ or more servings per week

A

7

199
Q

HNPCC/Lynch syndrome: women should undergo screening for _________________ and ___________________ cancers

A

ovarian, endometrial

200
Q

three other signs of peritonitis (other than universal sign)

A

rebound tenderness, rigidity, spasm

201
Q

treatment of peritonitis: establish IV access to give ________ and ____________

A

fluids, antibiotics

202
Q

seven local/GI complications of IBD

A

hemorrhage, strictures, perforation, abscesses, fistulas, CDiff infection, toxic megacolon

203
Q

proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: frequent and copious vomiting

A

proximal small intestine

204
Q

patient teaching for ostomies: explain how to contact the _______________________ and _____________

A

wound ostomy continence nurse (WOCN), dietician

205
Q

treatment of acute abdominal trauma: control external bleeding with _______________ or _________________________

A

direct pressure, sterile pressure dressing

206
Q

term for fresh blood in stool

A

hematochezia

207
Q

acute care for diverticulosis/diverticulitis includes ______________ therapy, _______ status, IV _______, _________________, NG _______, and _________

A

antibiotic, NPO, fluids, analgesics, suction, surgery

208
Q

three grain products high in fiber

A

whole wheat bread, cereal, popcorn

209
Q

ulcerative colitis and/or Chron’s disease: toxic megacolon more common

A

ulcerative colitis

210
Q

constipation patient teaching: exercise regularly: walk, swim, or bike at least _____ times per week

A

3

211
Q

patient teaching for ostomies: explain importance of ______________ care

A

follow-up

212
Q

treatment of acute abdominal trauma: anticipate diagnostic _________________

A

peritoneal lavage

213
Q

ulcerative colitis and/or Chron’s disease: increased incidence of colorectal cancer but less than the other

A

Chron’s disease

214
Q

ulcerative colitis and/or Crohn’s disease: severe constant abdominal pain

A

ulcerative colitis

215
Q

ulcerative colitis and/or Crohn’s disease: rectal bleeding common

A

ulcerative colitis

216
Q

ulcerative colitis and/or Chron’s disease: pseudopolyps common

A

ulcerative colitis

217
Q

patient teaching for ostomies: ________________ colostomy to regulate bowel elimination (optional)

A

irrigate

218
Q

intestinal obstruction: bowel sounds are ___________ above the obstruction and __________________ below the obstruction

A

high-pitched, decreased/absent

219
Q

ulcerative colitis and/or Chron’s disease: perforation common because of toxic megacolon

A

ulcerative colitis

220
Q

GI motility disorder that mimics a mechanical obstruction

A

pseudo-obstruction

221
Q

hallmark manifestation of polyps/colorectal cancer

A

painless rectal bleeding or occult blood in stool

222
Q

ulcerative colitis and/or Chron’s disease: diarrhea is common

A

both

223
Q

two primary problems of Crohn’s disease

A

diarrhea, cramping abdominal pain

224
Q

treatment of acute abdominal pain: obtain blood for ________ and ____________ levels; for ___________ level, ___________ test, ____________ studies, and ________ and _____________ as appropriate

A

CBC, electrolyte; amylase, pregnancy, clotting, type, crossmatch

225
Q

organism that causes infectious gastroenteritis: causes swimming pool diarrhea (can close down pools for 48 hours)

A

Cryptosporidium

226
Q

treatment of acute abdominal trauma: maintain patient warmth using _____________, warm _________, or warm _______________

A

blankets, IV fluids, humidified O2

227
Q

type of stoma that is made by dividing the bowel and bringing out the proximal end as a single stoma, making a colostomy or ileostomy

A

end stoma

228
Q

presence of multiple noninflamed diverticula

A

diverticulosis

229
Q

three extraintestinal manifestations of IBD of the joints

A

ankylosing spondylitis, peripheral arthritis, sacroiliitis

230
Q

seven causes of chronic abdominal pain

A

IBS, PUD, chronic pancreatitis, hepatitis, pelvic inflammatory disease, adhesions, vascular insufficiency

231
Q

treatment of acute abdominal trauma: if unresponsive, assess these three things; if responsive, monitor these same three things

A

airway, breathing, circulation

232
Q

organism that causes infectious gastroenteritis: spores last on surfaces; must hand wash because hand sanitizer does not kill

A

Clostridium difficile

233
Q

those at average risk (general population) should screen (colonoscopy) for colorectal cancer in this age group and this often

A

45-75 years, every 10 years

234
Q

ulcerative colitis and/or Chron’s disease: cramping abdominal pain

A

Chron’s disease

235
Q

ulcerative colitis and/or Chron’s disease: perianal abscess and fistulas common

A

Chron’s disease

236
Q

organism that causes infectious gastroenteritis: treatment may include ampicillin

A

Shigella

237
Q

constipation patient teaching: establish and record a regular time/pattern to ____________

A

defecate

238
Q

organism that causes infectious gastroenteritis: neurotoxins cause neuro symptoms (headache, nuchal rigidity, convulsions)

A

Shigella

239
Q

two primary problems of ulcerative colitis

A

bloody diarrhea, abdominal pain

240
Q

procedure that may be done when laparoscopy is inadequate

A

laparotomy

241
Q

type of bowel obstruction in which there is a physical obstruction of the intestinal lumen

A

mechanical obstruction

242
Q

if the familial adenomatous polyposis (FAP) gene is present, colorectal screening begins at ________, and annual colonoscopy begins at _________

A

puberty, age 16 years

243
Q

ulcerative colitis and/or Crohn’s disease: minimal incidence of malabsorption and nutrition deficiencies

A

ulcerative colitis

244
Q

universal sign of peritonitis

A

tenderness over involved area

245
Q

during the acute phase of IBD, focus nursing care on these four aspects

A
  1. hemodynamic stability
  2. pain control
  3. fluid and electrolyte balance
  4. nutritional support
246
Q

inflammation of one or more diverticula, resulting in perforation into peritoneum

A

diverticulitis

Nursing of Adults I (21 decks)

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