Chapter 47: Lower Gastrointestinal Problems Flashcards
care of patient after hemorrhoidectomy: encourage patient to __________________________ frequently
change positions
organism that causes infectious gastroenteritis: manifestations include abdominal pain, nausea, vomiting, secretory diarrhea
Salmonella
patient teaching for ostomies: describe ostomy’s potential effects on _______________, _______________, ________, and __________ and ways to manage these changes
sexual activity, social life, work, recreation
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
loop stoma
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
5, 40, 10
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
incision, drainage, warm, moist, abdomen, side, contaminating, straining
four neurologic manifestations of malabsorption
altered mental status, night blindness, paresthesias, peripheral neuropathy
OLD CARTS pain assessment stands for
Onset, Location/radiation, Duration, Character, Aggravating factors, Relieving Factors, Timing, Severity
two extraintestinal manifestations of IBD of the liver/gallbladder
gallstones, liver disease
organism that causes infectious gastroenteritis: treatment is vancomycin
Clostridium difficile
nursing management of diarrhea: ensure the patient maintains adequate _________ intake containing ___________ and _____________
fluid, glucose, electrolytes
two extraintestinal manifestations of IBD of skin
erythema nodosum, pyoderma gangrenosum
ulcerative colitis and/or Chron’s disease: common strictures
Chron’s disease
organism that causes infectious gastroenteritis: common in winter months
rotavirus
most common cause of small bowel obstruction
surgical adhesions
organism that causes infectious gastroenteritis: parasitic diarrhea in which ova and parasite are found in stool
Giardia lamblia
treatment of acute abdominal trauma: establish IV access with ____________________ and infuse _____________ or __________________
2 large-bore catheters, normal saline, lactated Ringer’s
ulcerative colitis and/or Crohn’s disease: common incidence of malabsorption and nutrition deficiences
Crohn’s disease
position common with visceral pain
supine with outstretched legs
treatment of peritonitis: monitor ____________ and ____________; monitor ____________ status to determine replacement therapy
intake, output, electrolyte
position common with peritoneal irritation (such as appendicitis)
fetal position
type of intestinal obstruction that occurs with reduced or absent peristalsis due to altered neuromuscular transmission of the parasympathetic innervation to the bowel
nonmechanical obstruction
extraintestinal manifestation of IBD of bones
osteoporosis
ulcerative colitis and/or Chron’s disease: tenesmus rare (feeling of need to pass stools)
Crohn’s disease
nursing management of diarrhea: encourage patient to increase ____________ foods unless contraindicated
high fiber
patient teaching for ostomies: explain _________________ and __________________ of ostomy
description, function
organism that causes infectious gastroenteritis: treatment may include TMP-SMX (trimethoprim/sulfamethoxazole) (2)
Shigella, E. coli
nine vegetables high in fiber
asparagus, beans, broccoli, carrots (raw), corn, peas (canned), potatoes (baked and sweet), squash (acorn), tomato (raw)
type of diarrhea caused by undigested carbohydrates, lactose intolerance, and certain laxatives
osmotic diarrhea
four skin manifestations of malabsorption
brittle nails, bruising, dermatitis, hair thinning/loss
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
- skin barrier, cleanse, skin barriers
- apply, empty, clean, remove
- 1/3
ulcerative colitis and/or Chron’s disease: tenesmus common (feeling of need to pass stools)
ulcerative colitis
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: gradual constipation
distal small intestine
care of patient after hemorrhoidectomy: assess for rectal ____________, especially in those taking ________________
bleeding, anticoagulants
treatment of acute abdominal trauma: stabilize impaled objects with __________________; do not remove
bulky dressing
seven fruits high in fiber
apple, blackberries, orange, peach, pear, raspberries, strawberries
HNPCC/Lynch syndrome: if colon polyps present, occur at (earlier, later) age than general population and are (less, more) prone to become cancerous
earlier, more
organism that causes infectious gastroenteritis: characterized by afebrile abdominal distention, cramping, and flatulence
Giardia lamblia
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: obstipation (inability to pass the accumulation of dry hard feces)
large intestine
type of intestinal obstruction that results from an interference with the blood supply to a part of the intestines (rare)
vascular obstruction
type of polyps that are flat, broad-based, and attached directly to the intestinal wall
sessile
organism that causes infectious gastroenteritis: treatment is supportive care ONLY (2)
rotavirus, Norwalk
treatment of acute abdominal trauma: obtain blood for ______ and ________ and _________________
CBC, type, crossmatch
organism that causes infectious gastroenteritis: spread via food borne (3)
Salmonella, E. coli, Rotavirus
ulcerative colitis and/or Crohn’s disease: depth of involvement is entire thickness of bowel well (transmural)
Crohn’s disease
ulcerative colitis and/or Crohn’s disease: small bowel involvement minimal
ulcerative colitis
organism that causes infectious gastroenteritis: can be fatal for immunocompromised
Cryptosporidium
type of hernia that protrudes through the posterior wall of the inguinal canal
direct inguinal
two vascular problems that may cause acute abdominal pain
mesenteric vascular occlusion, ruptured aortic aneurysm
constipation patient teaching: do not delay _____________; respond to ________
defecation, urges
ulcerative colitis and/or Chron’s disease: perforation common because inflammation involves entire bowel wall
Chron’s disease
HNPCC/Lynch syndrome: increased risk of these eight cancers
stomach, brain, ovary, uterus, skin, urinary tract, small bowel, bile ducts
usual surgical procedure for diverticulosis/diverticulitis involves _____________ of colon with a primary ____________; if this is not possible, patient will need temporary _______________
resection, anastomosis, colostomy
patient teaching for ostomies: ________ food very well to reduce the chance of blockage
chew
three infectious disease organisms that may cause acute abdominal pain
E. coli O157:H7, Giardia, Salmonella
patient teaching for ostomies: fluid intake of at least ____________ mL/day to prevent dehydration unless contraindicated; increase in these three situations
3000
hot weather, excess perspiration, diarrhea
nursing management of diarrhea: implement proper _________________ and ____________ control precautions
isolation, infection
risk factors for colorectal cancer: family history of _______________ in first-degree relative; family or personal history of _____________ or _____________
colorectal cancer, FAP, HNPCC syndrome
PQRST pain assessment stands for
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
HNPCC/Lynch syndrome: colonoscopy recommended every _____________
1-2 years
four other causes of acute abdominal pain (other than gynecologic, infectious disease, inflammation, and vascular problems)
obstruction/perforation of abdominal organ
GI bleeding or ischemia
myocardial infarction
trauma
organism that causes infectious gastroenteritis: manifestations include nausea, vomiting, headache, low-grade fever, aches, chills
Norwalk virus
organism that causes infectious gastroenteritis: treatment includes supportive care (4)
Salmonella, E. coli, Rotavirus, Norwalk
type of hernia that protrudes through the inguinal ring (most common)
indirect inguinal
this diagnostic test for colorectal cancer detects DNA in stool
Cologuard
organism that causes infectious gastroenteritis: manifestations include nausea, vomiting, diarrhea, low-grade fever
rotavirus
patient teaching for ostomies: describe community ___________ to assist with emotional and psychologic adjustment to ostomy
resources
(liquid EN, PN) is preferred for a patient with IBD during an acute exacerbation; two reasons why
liquid EN
atrophy of gut, bacterial overgrowth occur when GI tract not used
four goals of surgical therapy for colorectal cancer
- complete resection of tumor
- thorough exploration of abdomen to determine any spread
- removing all lymph nodes that drain area where cancer located
- restoring bowel continuity to promote normal bowel function
nursing management of diarrhea: provide ____________ for toileting and use a(n) ____________
privacy, deodorizer
care of patient after hemorrhoidectomy: provide as much ____________ as possible when providing wound care and performing assessments
privacy
diagnosis of diverticulitis is based on these three things
physical assessment, CBC, imaging
five musculoskeletal manifestations of malabsorption
bone pain, muscle wasting, tetany, weakness, muscle cramps
organism that causes infectious gastroenteritis: characterized by green watery diarrhea that could cause hemorrhagic colitis
E. coli
ulcerative colitis and/or Crohn’s disease: small bowel involvement common
Crohn’s disease
ulcerative colitis and/or Chron’s disease: usually starts in rectum and spreads in a continuous pattern up the colon
ulcerative colitis
four goals of diet management for IBD
- provide adequate nutrition without worsening symptoms
- correct and prevent malnutrition
- replace fluid and electrolyte losses
- prevent weight loss
care of patient after hemorrhoidectomy: apply ______ to the area several times a day for _______ at a time
ice, 10 minutes
four goals of treatment of peritonitis
- resolution of inflammation
- relief of abdominal pain
- freedom from complications
- normal nutrition status
type of polyps that are attached to the bowel wall by a thin stalk
pedunculated
ulcerative colitis and/or Chron’s disease: weight loss common, may be severe
Crohn’s disease
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
double-barreled stoma
supportive care for infectious gastroenteritis includes maintaining _______ and administering _____________ and _____________ drugs
fluids, antidiarrheal, antibiotic (if necessary)
treatment of acute abdominal pain: establish IV access with __________________ and infuse ________________ or ___________________; insert another if ________ present
large-bore catheter, warm normal saline, lactated Ringer’s, shock
constipation patient teaching: do not overuse ____________ and __________; can become dependent
laxatives, enemas
risk factors for colorectal cancer: obesity with BMI ______ or greater
30 kg/m2
organism that causes infectious gastroenteritis: characterized by PROFUSE watery diarrhea and abdominal cramping and pain
Clostridium difficile
patient teaching for IBD focuses on these six things
- rest and diet management
- perianal care
- drug action and side effects
- symptoms of recurrence of disease
- when to seek medical care
- ways to reduce stress
extraintestinal manifestation of IBD of the mouth
aphthous ulcers
treatment of acute abdominal trauma: cover protruding organs or tissue with ____________________
sterile saline dressing
nursing management of diarrhea: implement measures to make toileting easier for patients, such as ____________ in reach, easy-to-manage ___________, and ___________________ available
call light, clothing, assistive devices
treatment of acute abdominal trauma: apply appropriate ___________ therapy
oxygen
ulcerative colitis and/or Crohn’s disease: distribution: healthy tissue interspersed with areas of inflammation (skip lesions)
Crohn’s disease
eight hallmark signs of abdominal trauma
guarding/splinting
hard board-like abdomen
decreased/absent bowel sounds
bruising
hematemesis/hematuria
Cullen’s sign
Grey Turner’s sign
bruits
treatment of acute abdominal trauma: monitor __________, _______________, _____________ and _______________
vital signs, level of consciousness, O2 saturation, urine output
organism that causes infectious gastroenteritis: treatment is metronidazole
Giardia lamblia
risk factors for colorectal cancer: personal history of these three conditions
colorectal cancer, inflammatory bowel disease, diabetes
diverticula are most common in this part of the colon
left (descending, sigmoid)
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: persistent, cramping pain
large intestine
position common with kidney stones and gallstones
restlessness, inability to find comfortable position
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
intake, output, distended, scrotal
patient teaching for ostomies: describe how to obtain ostomy ________________
supplies
nursing management of diarrhea: maintain accurate __________________ records and record _________ daily
intake and output, weight
ulcerative colitis and/or Chron’s disease: distribution: continuous areas of inflammation
ulcerative colitis
positioning for patient with peritonitis
lie still, shallow breaths (movement worsens pain)
knees flexed increases comfort
treatment of acute abdominal pain: ensure patent ________
airway
ulcerative colitis and/or Chron’s disease: age at onset teens to mid-30s; after 60
both
three uses of chemotherapy in treating colorectal cancer
- shrink tumor before surgery
- adjuvant therapy after bowel resection
- palliative treatment for nonresectable cancer
conservative care for diverticulosis/diverticulitis includes these four things
high-fiber diet, fiber supplements, weight loss, smoking cessation
care of patient after hemorrhoidectomy: administer ______________ as ordered, especially before bowel movements; also administer ________________ and ________________ as ordered
analgesics, stool softeners, bulking agents
risk factors for colorectal cancer: alcohol (___ or more drinks/week) and cigarette smoking
4
two hematologic manifestations of malabsorption
anemia, hemorrhagic tendency
patient teaching for ostomies: describe __________________________ that resulted in need for ostomy
underlying condition
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: minimal abdominal distention
proximal small intestine
care of patient after hemorrhoidectomy: teach patient to use _________________________ cushion, not a ring or “doughnut” when sitting
pressure relief
type of hernia that occurs due to weakness of the abdominal wall at the site of a previous incision
ventral or incisional
seven GI manifestations of malabsorption
diarrhea, flatulence, glossitis, cheilosis, stomatitis, steatorrhea, weight loss
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: rapid onset
proximal and distal small intestine
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: less frequent vomiting
distal small intestine
FAP is autosomal ______________ or _____________
dominant, recessive
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: gradual onset
large intestine
four extraintestinal manifestations of IBD of the eye
conjunctivitis, episcleritis, iritis, uveitis
three cardiovascular manifestations of malabsorption
hypotension, peripheral edema, tachycardia
care of patient after hemorrhoidectomy: teach patient care of the ____________, symptoms of ________________, and ways to avoid _______________ and ______________
anal area, complications, constipation, straining
organism that causes infectious gastroenteritis: common in schools and cruise ships
Norwalk virus
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: increased abdominal distention
distal small intestine, large intestine
gold standard for colorectal cancer screening
colonoscopy
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: late or absent vomiting
large intestine
constipation patient teaching: drink _____ fluids per day, and avoid ____________
2 L, caffeine
organism that causes infectious gastroenteritis: characterized by watery diarrhea that progresses to bloody mucus
Shigella
ulcerative colitis and/or Crohn’s disease: increased incidence and severity of CDiff infection
both
ulcerative colitis and/or Crohn’s disease: intermittent fever common
Chron’s disease
treatment of acute abdominal pain: insert _________ as needed and keep patient ______
NG tube, NPO
ulcerative colitis and/or Chron’s disease: increased incidence of small intestinal cancer
Crohn’s disease
nursing management of diarrhea: apply ________________________ cream as needed
moisturizing skin barrier
two uses of radiation in treating colorectal cancer
- adjuvant to surgery
- palliative
(right-sided, left-sided) colorectal cancers are more likely to cause bleeding and diarrhea
right-sided
ulcerative colitis and/or Crohn’s disease: pseudopolyps rare
Crohn’s disease
treatment of peritonitis: place on _______ status; may need __________ to decrease gastric distention and further leakage of bowel contents into peritoneum
NPO, NG tube
HNPCC/Lynch syndrome is autosomal ____________
dominant
treatment of acute abdominal trauma: insert indwelling _________________ if no blood at meatus, pelvic fracture, or boggy prostate; obtain ___________
urinary catheter, urinalysis
treatment of acute abdominal pain: assess for _______ and amount/character of ___________
pain, emesis
treatment of acute abdominal trauma: insert __________ if no evidence of facial trauma
NG tube
most common form of nonmechanical obstruction characterized by lack of intestinal peristalsis and bowel sounds
paralytic ileus
nursing management of diarrhea: have patient use ______________, _________________, or ______________ to reduce perianal irritation and pain
dibucaine, witch hazel, sitz baths
type of diarrhea which involves oversecretion of water, sodium, and chloride into bowel
secretory diarrhea
small tract under the skin between the buttocks in the sacrococcygeal area that may have congenital origin (assess for family history)
pilonidal sinus
preferred diagnostic procedure for appendicitis (with two other options in parentheses)
CT scan (ultrasound, MRI)
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: colicky, cramping pain that occurs at frequent intervals
proximal small intestine
hallmark sign for appendicitis
pain at McBurney point
organism that causes infectious gastroenteritis: spread through fecal-oral route (4)
Clostridium difficile, Shigella, Cryptosporidium, Norwalk
four hallmark manifestations of intestinal obstruction
abdominal pain, nausea/vomiting, distention, constipation
ulcerative colitis and/or Crohn’s disease: intermittent fever occurs during acute attacks
ulcerative colitis
preferred diagnostic test for diverticulitis
CT scan with oral contrast
ulcerative colitis and/or Crohn’s disease: weight loss rare
ulcerative colitis
ulcerative colitis and/or Chron’s disease: rectal bleeding sometimes
Crohn’s disease
treatment of acute abdominal pain: monitor ____________, ________________, ________________, and ____________ and ____________
vital signs, level of consciousness, O2 saturation, intake, output
type of hernia that occurs when there is a protrusion through the femoral ring into the femoral canal
femoral
constipation patient teaching: eat _________ fiber per day
20-30 g
most common causes of large bowel obstruction
colorectal cancer (malignant obstruction), then diverticular disease
ulcerative colitis and/or Crohn’s disease: occasional strictures
ulcerative colitis
type of polyps that are noncancerous
hyperplastic
three gynecologic problems that may cause acute abdominal pain
pelvic inflammatory disease, ruptured ectopic pregnancy, ruptured ovarian cyst
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
IV fluids, antibiotic therapy, 6-8 hours
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: feces bowel movement for a short time
proximal small intestine
nursing management of diarrhea: teach patient to avoid ________ and ________ known to worsen diarrhea
foods, fluids
eight risk factors for hemorrhoids
pregnancy, constipation, straining to defecate, diarrhea, heavy lifting, prolonged standing/sitting, obesity, ascites
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: colicky pain that occurs more intermittently
distal small intestine
extraintestinal manifestation of IBD of kidneys
kidney stones
treatment of acute abdominal trauma: remove ___________
clothing
organism that causes infectious gastroenteritis: found in lakes
Giardia lamblia
extraintestinal manifestation of IBD of vascular system
thromboembolism
ulcerative colitis and/or Crohn’s disease: cobblestoning of mucosa is common
Crohn’s disease
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)
laparoscopy
two treatment goals for intestinal obstruction
regain intestinal patency, resolve obstruction
ulcerative colitis and/or Crohn’s disease: depth of involvement is mucosa
ulcerative colitis
type of polyps that are neoplastic and closely related to colorectal adenocarcinoma
adenomatous
type of hernia that occurs when rectus muscle is weak or umbilical opening does not close after birth
umbilical
in diagnosing appendicitis, this is done to rule out genitourinary conditions that mimic appendicitis
urinalysis
organism that causes infectious gastroenteritis: virus is present in stool (2)
rotavirus, Norwalk virus
treatment of acute abdominal pain: apply oxygen via _______________ or _______________
nasal cannula, nonrebreather mask
ulcerative colitis and/or Chron’s disease: perianal abscess and fistulas rare
ulcerative colitis
treatment of acute abdominal pain: insert indwelling ________________ and obtain ______________
urinary catheter, urinalysis
care of patient after hemorrhoidectomy: have patient use ______________ or __________________ instead of toilet paper
baby wipes, medicated pads
hallmark manifestation of malabsorption syndrome
steatorrhea
nursing management of diarrhea: assist patient with keeping _____________ area clean
perianal
organism that causes infectious gastroenteritis: cephalosporins can be given
Salmonella
patient teaching for ostomies: describe symptoms of _______________________ imbalance and how to recognize problems such as these four
fluid and electrolyte
fever, diarrhea, skin irritation, stomal problems
ulcerative colitis and/or Chron’s disease: cobblestoning of mucosa is rare
ulcerative colitis
ulcerative colitis and/or Crohn’s disease: toxic megacolon rare
Crohn’s disease
most appendicitis patients have a mildly to moderately elevated __________
WBC count
seven inflammatory processes that may cause acute abdominal pain
appendicitis, cholecystitis, diverticulitis, gastritis, IBD, pancreatitis, pyelonephritis
teach patients with hemorrhoids measures to prevent ____________, avoid ___________, __________ time sitting on the toilet, and seek medical care for ______________________
constipation, straining, limit, severe symptoms
care of patient after hemorrhoidectomy: administer warm ____________ for 15-20 minutes, 2-3 times per day
sitz baths
patient teaching for ostomies: to prevent nutrition problems, have a well-balanced ______ and _________
diet, supplements
ulcerative colitis and/or Crohn’s disease: occurs anywhere along GI tract; most common site is distal ileum
Crohn’s disease
ulcerative colitis and/or Chron’s disease: increased incidence of colorectal cancer after 10 years of disease
ulcerative colitis
risk factors for colorectal cancer: eating red meat _____ or more servings per week
7
HNPCC/Lynch syndrome: women should undergo screening for _________________ and ___________________ cancers
ovarian, endometrial
three other signs of peritonitis (other than universal sign)
rebound tenderness, rigidity, spasm
treatment of peritonitis: establish IV access to give ________ and ____________
fluids, antibiotics
seven local/GI complications of IBD
hemorrhage, strictures, perforation, abscesses, fistulas, CDiff infection, toxic megacolon
proximal small intestine, distal small intestine, and/or large intestine bowel obstruction: frequent and copious vomiting
proximal small intestine
patient teaching for ostomies: explain how to contact the _______________________ and _____________
wound ostomy continence nurse (WOCN), dietician
treatment of acute abdominal trauma: control external bleeding with _______________ or _________________________
direct pressure, sterile pressure dressing
term for fresh blood in stool
hematochezia
acute care for diverticulosis/diverticulitis includes ______________ therapy, _______ status, IV _______, _________________, NG _______, and _________
antibiotic, NPO, fluids, analgesics, suction, surgery
three grain products high in fiber
whole wheat bread, cereal, popcorn
ulcerative colitis and/or Chron’s disease: toxic megacolon more common
ulcerative colitis
constipation patient teaching: exercise regularly: walk, swim, or bike at least _____ times per week
3
patient teaching for ostomies: explain importance of ______________ care
follow-up
treatment of acute abdominal trauma: anticipate diagnostic _________________
peritoneal lavage
ulcerative colitis and/or Chron’s disease: increased incidence of colorectal cancer but less than the other
Chron’s disease
ulcerative colitis and/or Crohn’s disease: severe constant abdominal pain
ulcerative colitis
ulcerative colitis and/or Crohn’s disease: rectal bleeding common
ulcerative colitis
ulcerative colitis and/or Chron’s disease: pseudopolyps common
ulcerative colitis
patient teaching for ostomies: ________________ colostomy to regulate bowel elimination (optional)
irrigate
intestinal obstruction: bowel sounds are ___________ above the obstruction and __________________ below the obstruction
high-pitched, decreased/absent
ulcerative colitis and/or Chron’s disease: perforation common because of toxic megacolon
ulcerative colitis
GI motility disorder that mimics a mechanical obstruction
pseudo-obstruction
hallmark manifestation of polyps/colorectal cancer
painless rectal bleeding or occult blood in stool
ulcerative colitis and/or Chron’s disease: diarrhea is common
both
two primary problems of Crohn’s disease
diarrhea, cramping abdominal pain
treatment of acute abdominal pain: obtain blood for ________ and ____________ levels; for ___________ level, ___________ test, ____________ studies, and ________ and _____________ as appropriate
CBC, electrolyte; amylase, pregnancy, clotting, type, crossmatch
organism that causes infectious gastroenteritis: causes swimming pool diarrhea (can close down pools for 48 hours)
Cryptosporidium
treatment of acute abdominal trauma: maintain patient warmth using _____________, warm _________, or warm _______________
blankets, IV fluids, humidified O2
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
end stoma
presence of multiple noninflamed diverticula
diverticulosis
three extraintestinal manifestations of IBD of the joints
ankylosing spondylitis, peripheral arthritis, sacroiliitis
seven causes of chronic abdominal pain
IBS, PUD, chronic pancreatitis, hepatitis, pelvic inflammatory disease, adhesions, vascular insufficiency
treatment of acute abdominal trauma: if unresponsive, assess these three things; if responsive, monitor these same three things
airway, breathing, circulation
organism that causes infectious gastroenteritis: spores last on surfaces; must hand wash because hand sanitizer does not kill
Clostridium difficile
those at average risk (general population) should screen (colonoscopy) for colorectal cancer in this age group and this often
45-75 years, every 10 years
ulcerative colitis and/or Chron’s disease: cramping abdominal pain
Chron’s disease
ulcerative colitis and/or Chron’s disease: perianal abscess and fistulas common
Chron’s disease
organism that causes infectious gastroenteritis: treatment may include ampicillin
Shigella
constipation patient teaching: establish and record a regular time/pattern to ____________
defecate
organism that causes infectious gastroenteritis: neurotoxins cause neuro symptoms (headache, nuchal rigidity, convulsions)
Shigella
two primary problems of ulcerative colitis
bloody diarrhea, abdominal pain
procedure that may be done when laparoscopy is inadequate
laparotomy
type of bowel obstruction in which there is a physical obstruction of the intestinal lumen
mechanical obstruction
if the familial adenomatous polyposis (FAP) gene is present, colorectal screening begins at ________, and annual colonoscopy begins at _________
puberty, age 16 years
ulcerative colitis and/or Crohn’s disease: minimal incidence of malabsorption and nutrition deficiencies
ulcerative colitis
universal sign of peritonitis
tenderness over involved area
during the acute phase of IBD, focus nursing care on these four aspects
- hemodynamic stability
- pain control
- fluid and electrolyte balance
- nutritional support
inflammation of one or more diverticula, resulting in perforation into peritoneum
diverticulitis