Elimination

Question 1

diverticulitis

Answer 1

pockets in intestines (mostly left descending, sigmoid colon)
S/Sx
acute pain in LLQ
palpable abd mass,
systemic sx of infection (leukocytosis shift to left)

risk for perforation

Question 2

diverticulosis

Answer 2

no s/sx usually
if sx: abd pain, bloating, flatulence, change in bowel habits
eat high fiber diet, low fat/red meat and exercise

Question 3

tx for acute diverticulitis

Answer 3

rest colon so inflammation can subside
Home: oral antibiotics and clear liquids
Hospital: NPO, bed rest, fluids, antibiotics (IV)

Question 4

crohn’s

Answer 4

affects any part of the GI tract (mostly in terminal ileum)
all layers of bowel wall
cobblestone
risk for leaks (abscesses and peritonitis)
risk for fistulas
weight loss, diarrhea, crampy abd pain
osteoporosis from corticosteroids

Question 5

tx acute crohn’s

Answer 5

–

Question 6

ulcerative colitis

Answer 6

starts in rectum and goes up (mainly colon/rectum)
diarrhea with large F&E losses, protein in stool
forms pseudopolyps
bloody stools/diarrhea, abd pain
moderate:

Question 7

tx acute ulcerative colitis

Answer 7

–

Question 8

immunosuppressants

Answer 8

6-mercaptopurine, azathioprine, methotrexate, cyclosporine
maintainenance of remission
regular CBC monitoring bc they suppress bone marrow and can inflame pancreas or gallbladder

Question 9

corticosteroids

Answer 9

loss of potassium, sodium retention

Question 10

cause diarrhea in IBD

Answer 10

milk
high fat foods
cold foods
high fiber foods (brain cereal, fruit with peels)
smoking

Question 11

small bowel obstruction

Answer 11

rapid onset
frequent/copious vomiting
colicky, cramplike, intermittent pain
feces for a short time
increased lower abd distention
metabolic alkalosis

Question 12

large intestine obstruction

Answer 12

gradual onset
rare vomiting
low-grade, cramping, abd pain
absolute constipation
increased abd distention

Question 13

tx for obstruction

Answer 13

NPO
NG tube
IV fluids (NS or LR)
potassium
analgesic