Digestive system

Question 1

Stool Assessment

Answer 1

Frequency
Odour
Volume
Colour
Blood present
Pain
Effort
Abdominal tenderness/distension
Nausea/vomiting

Question 2

Causes of contsipation

Answer 2

Being an older adult
Being a woman
Being dehydrated
Eating a low fibre diet
Getting little or no physical activity
Certain medications
Mental health conditions - depression, eating disorder
Pyrexia
Injury
Immobility

Question 3

Side effects of constipation

Answer 3

Haemorrhoids
Anal Fissure
Rectal Prolapse
Faecal impaction

Question 4

Presentation of constipation

Answer 4

Abdominal bloating
BO less than 3 per week
BO more than 3 per day of type 1 or 2
Pain on defaecation
Rectal bleeding
Spurious diarrhoea - overflow
Lower back pain
Headaches

Question 5

Preventing recurrence of constipation

Answer 5

Consider damage to the rectum and the time required for ful recovery
Encourage and educate a high fibre diet
Reduce processed foods
Encourage fluids
Encourage activity and regular exercise
Assess and manage stressors
Do not ignore the urge to pass stool
Encourage a regular schedule for bowel movements
Manage medications
Stool assessment
Administer laxatives

Question 6

Diarrhoea

Answer 6

At least 3 loose, liquid or watery bowel movements each day

Question 7

Secretory diarrhoea

Answer 7

Sodium is prevented from being absorbed into the blood stream
Draws water into the bowel
May be caused by bacterial infection

Question 8

Osmotic diarrhoea

Answer 8

Unabsorbed nutrients draw water into the bowel

Question 9

Causes of diarrhoea

Answer 9

Viruses
Bacteria and parasites
Medications
Lactose intolerance
Digestive disorders
Artificial sweeteners/foods
Surgery

Question 10

Patient presentation of diarrhoea

Answer 10

Abdominal cramps or pain
Bloating
Nausea
Vomiting
Fever
Blood in stool
Mucus in stool
Urgent need to have a bowel movement

Question 11

Irritable bowel syndrome (IBS)

Answer 11

Disorder of bowel motility
No pathologic process of the GI tract has been identified
Presents with alternating diarrhoea and constipation accompanied by abdominal cramping pain
Slow wave of activity of the colon is increased in IBS
Sensory response to distension and simulation is heightened
Could be caused by genetic or environmental factors (episodic infection, psychological stressors, or dietary patterns)

Question 12

Causes of obstruction

Answer 12

Most common in adults is cancer
More common in infants is intussusception

Question 13

Tumours of the large bowel

Answer 13

Most are adenocarcinomas
Tend to grow slowly and remain asymptomatic for long periods
Tumours in the rectum, sigmoid and descending colon grow circumferentially and constrict the intestinal lumen
Tumours in the ascending colon are usually large and palpable

Question 14

Inflammatory bowel disease

Answer 14

Crohn’s disease
Ulcerative colitis

Question 15

Crohn’s disease

Answer 15

Deep inflammation that can affect all of the GI tract
Abdominal pain
Diarrhoea
Fistulae

Question 16

Ulcerative colitis

Answer 16

Only affects colon
Superficial ulceration
Diarrhoea often with blood and mucus

Question 17

Causes of crohn’s disease

Answer 17

Cause remains unknown although a genetic link has been established - most sufferers have at least 1 family member affected
Results from chronic type 1 T helper cell activation (leading to immune overstimulation, though to be an autoimmune process)

Question 18

Signs and symptoms of crohn’s disease

Answer 18

Inflammation and tissue injury
Focal inflammation lesions in the crypts of the intestinal mucosa expand and develop into noncaseating granulomas (without a necrotic centre)
Subsequent engorgement and inflammation of surrounding tissue lead to the development of deep linear ulcers in the bowel wall
Eventually all layers of the GI tract wall may become involved and the portion of the intestine that is affected may become thickened by fibrous scar tissue
Deep fissures may develop into fistulas which may e expand into adjacent tissue of other organs such as the bladder wall or even the skin

Question 19

Inflammatory response

Answer 19

Occurs when cells are injured, regardless of the cause of the injury
Protective mechanism that also begins the healing process

Question 20

Inflammatory response purposes

Answer 20

To neutralise and destroy invading and harmful agents
To limit the spread of harmful agents to other tissue
To prepare any damaged tissue for repair

Question 21

Signs of inflammation

Answer 21

Redness
Swelling
Heat
Pain
Loss of function