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2024DM Med Surg > digestive tract disorders part 4 > Flashcards

digestive tract disorders part 4 Flashcards

1
Q

Weakness in the abdominal wall that allows a portion of the large intestine to push through
Classified as reducible or irreducible

A

Abdominal Hernia

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2
Q

s/s of Abdominal Hernia

A

A smooth lump on the abdomen
With incarceration, the patient has severe abdominal pain and distention, vomiting, and cramps
Weak locations include the umbilicus and the lower inguinal areas of the abdomen; may also develop at the site of a surgical incision

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3
Q

medical management of Abdominal Hernia

A

Surgical repair
Herniorrhaphy
Hernioplasty

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4
Q

Nursing Assessment of Abdominal Hernia

A

Chief complaint (ask about mesh use in previous surgeries)
Ask about pain and vomiting
Inspect for abnormalities, and listen for bowel sounds in

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5
Q

Preoperative interventions of Abdominal Hernia

A

Risk for Injury

Impaired Skin Integrity

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6
Q

Postoperative interventions of Abdominal Hernia

A

Impaired Urinary Elimination
Constipation
Acute Pain
Risk for Injury

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7
Q

Ulcerative colitis and Crohn’s disease
Inflammation and ulceration of intestinal tract lining
Exact cause is unknown
Possible causes: infectious agents, autoimmune reactions, allergies, heredity, and foreign substances

A

Inflammatory Bowel Disease

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8
Q

Diarrhea with frequent bloody stools, abdominal cramping

s/s of inflammatory^

A

Ulcerative colitis

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9
Q

If the stomach and duodenum are involved, symptoms include nausea, vomiting, and epigastric pain
Involvement of the small intestine produces pain and abdominal tenderness and cramping
An inflamed colon typically causes abdominal pain, cramping, rectal bleeding, and diarrhea
Systemic signs and symptoms include fever, night sweats, malaise, and joint pain

A

Crohn’s disease

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10
Q

complications of Inflammatory Bowel Disease

A

Hemorrhage, obstruction, perforation (rupture), abscesses in the anus or rectum, fistulas, and megacolon

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11
Q

Assessment of inflammatory Bowel Disease

A

Onset, location, severity, and duration of pain
Note factors that contribute to the onset of pain
Onset and duration of diarrhea; presence of blood
Vital signs, height and weight, measures of hydration
Inspect perianal area for irritation or ulceration
Maintain accurate intake and output records
Measure diarrhea stools if possible and count as output

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12
Q

Small saclike pouches in intestinal wall: diverticula

Weak areas of the intestinal wall allow segments of the mucous membrane to herniate outward

A

Diverticulosis

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13
Q

risk factors Diverticulosis

A

Lack of dietary residue

Age, constipation, obesity, emotional tension

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14
Q

s/s Diverticulosis

A

Often asymptomatic, but many people report constipation, diarrhea, or periodic bouts of each
Rectal bleeding, pain in left lower abdomen, nausea and vomiting, and urinary problems

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15
Q

Bleeding, obstruction, perforation (rupture), peritonitis, and fistula formation

A

Diverticulitis

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16
Q

medical treatment of diverticulosis

A

High-residue diet without spicy foods No seeds
Stool softeners or bulk-forming laxatives; antidiarrheals; broad-spectrum antibiotics; anticholinergics
Surgical intervention may be necessary

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17
Q

Assessment of Diverticulosis

A

Assess patient’s comfort and stool characteristics; note nausea and vomiting
Monitor patient’s temperature
Assess abdomen for distention and tenderness

18
Q

Interventions of Diverticulosis

A

Fluids as permitted; monitor intake and output
Antiemetics, analgesics, anticholinergics as ordered
Be alert for signs of perforation
Teach patient about diverticulosis, including the pathophysiology, treatment, and symptoms of inflammation

19
Q

Cancer of the large intestine
People at greater risk for colorectal cancer are those with histories of inflammatory bowel disease, or family histories of colorectal cancer or multiple intestinal polyps
High-fat, low-fiber diet and inadequate intake of fruits and vegetables also contribute to development
Can develop anywhere in the large intestine
Three fourths of all colorectal cancers are located in the rectum or lower sigmoid colon

A

Colorectal Cancer

20
Q

Signs and symptoms Colorectal Cancer

Right side of the abdomen

Left side or in the rectum

A

Right side of the abdomen
Vague cramping until the disease is advanced
Unexplained anemia, weakness, and fatigue related to blood loss may be the only early symptoms
Left side or in the rectum
Diarrhea or constipation and may notice blood in the stool
Stools may become very narrow, causing them to be described as pencil-like
Feeling of fullness or pressure in the abdomen or rectum

21
Q

Medical and surgical treatment Colorectal Cancer

A

Usually treated surgically
Combination chemotherapy postoperatively if tumor extends through the bowel wall or if lymph nodes involved
Early stage rectal cancer sometimes treated with radiation and surgery

22
Q

Assessment

Colorectal Cancer

A

Vital signs, intake and output, breath sounds, bowel sounds, and pain
Appearance of wounds and wound drainage
If there is a colostomy, measure and describe the fecal drainage

23
Q

Small growths in the intestine
Most benign but can become malignant
Inherited syndromes: familial polyposis and Gardner’s syndrome
Usually asymptomatic; found on routine testing
Complications are bleeding and obstruction
Diagnosed by barium enema or endoscopic exam
Colectomy for familial polyposis or Gardner’s syndrome because of the high risk of malignancy

A

Polyps

24
Q

Internal or external dilated veins in the rectum
Thrombosed
Blood clots form in external hemorrhoids; become inflamed and very painful

A

Hemorrhoids

25
Q

Risk factors of Hemorrhoids

A

Constipation, pregnancy, prolonged sitting or standing

26
Q

Signs and symptoms of Hemorrhoids

A

Rectal pain and itching
Bleeding with defecation
External hemorrhoids easy to see; appear red/bluish

27
Q

Medical diagnosis and treatment Hemorrhoids

A

Nonsurgical treatment
Topical creams, lotions, or suppositories soothe and shrink inflamed tissue
Sitz baths often comforting
The physician may order heat or cold applications
Outpatient procedures: ligation, sclerotherapy. Thermocoagulation/electrocoagulation, laser surgery
Hemorrhoidectomy
The surgical excision (removal) of hemorrhoids

28
Q

Assessment

Hemorrhoids

A

After hemorrhoidectomy, monitor vital signs, intake and output, and breath sounds. Assess the perianal area for bleeding and drainage

29
Q

An infection in the tissue around the rectum

A

Anorectal Abscess

30
Q

Signs and symptoms of Anorectal Abscess

A

are rectal pain, swelling, redness, and tenderness

31
Q

treatment of Anorectal Abscess

A

Treated with antibiotics followed by incision and drainage

32
Q

Preoperatively of Anorectal Abscess

A

Preoperatively, pain is treated with ice packs, sitz baths, and topical agents as ordered

33
Q

Postoperatively of Anorectal Abscess

A

Postoperatively, pain treated with opioid analgesics
Patient teaching emphasizes importance of thorough cleansing after each bowel movement
Advise patient to consume adequate fluids and a high-fiber diet to promote soft stools

34
Q

Laceration between the anal canal and the perianal skin (small, oval shaped tear in skin that lines the opening of the anus

A

Anal Fissure

35
Q

cause Anal Fissure

A

May be related to constipation, diarrhea, Crohn’s disease, tuberculosis, leukemia, trauma, or childbirth

36
Q

Signs and symptoms Anal Fissure

A

include pain before and after defecation and bleeding on the stool or tissue

37
Q

medical management Anal Fissure

A

If fissure chronic, the patient may experience pruritus, urinary frequency or retention, and dysuria
Usually heal spontaneously, but can become chronic
Conservative treatment: sitz baths, stool softeners, and analgesics
Surgical excision may be necessary

38
Q

Abnormal opening between anal canal and perianal skin
Develops from anorectal abscesses or related to inflammatory bowel disease or tuberculosis
Patient typically complains of pruritus and discharge
Sitz baths provide some comfort

A

Anal Fistula

39
Q

surgical management Anal Fistula

A

Surgical treatment is excision of fistula and surrounding tissue
Sometimes a temporary colostomy to allow the surgical site to heal

40
Q

Postoperative care:Anal Fistula

A

analgesics and sitz baths for pain

41
Q

Located in the sacrococcygeal area
Results from an infolding of skin, causing a sinus that is easily infected because of its closeness to the anus
Once infected, it is painful and swollen and may form an abscess

A

Pilonidal Cyst

42
Q

medical management Pilonidal Cyst

A

Surgical excision usually recommended

Care is similar to that for the patient having a hemorrhoidectomy

2024DM Med Surg (35 decks)

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