[Exam 1/Final] Chapter 47 - IBD

Question 1

IBD: What is this

Answer 1

Group of disorders causing inflammation or ulceration of the bowels

Question 2

IBD: What are some types?

Answer 2

Chrogns Disease

Ulcerative Colitis

Question 3

Crohns Disease: How does this appear?

Answer 3

Cobblestone appearance

Question 4

Crohns Disease: What is this?

Answer 4

Chronic inflammation of the GI tract that extends through all of the layers. Is a edema and thickening of the mucosa. Ulcers appear spread out giving the cobblestone appearance

Question 5

Crohns Disease: CMs?

Answer 5

RLQ pain, where ilieum and ascending colony are at. Not relieved by defecation

Diarrhea

Weight Loss/Nutritional Deficit

Abscesses or Fistulas due to inflammation

Question 6

Crohns Disease: This is diagnosed how?

Answer 6

CT or MRI showing wall thickening/Edema

Question 7

Crohns Disease: What age does this affect?

Answer 7

Teens to Mid 30s and then peaks after 60

Question 8

Crohns Disease: What pain will they have?

Answer 8

Abdominal pain and tenderness in RLQ

Question 9

Crohns Disease: What signs will they have?

Answer 9

Severe diarrhea, low grade fever, rectal bleeding, weight loss and severe malabsorption

Question 10

Crohns Disease: What complications may you see?

Answer 10

Perineal Abscesses
Intestinal Fistulas
Peritonitis

Question 11

Crohns Disease: Later signs of this as it progresses?

Answer 11

Dehydration
Electrolyte Imbalance
Anemia

Question 12

Ulcerative Colitis: What is this?

Answer 12

Inflamation of the mucosa and submucosa of the colon and rectum. Begins in rectum and then leads up leading to ulcerations and bleeding

Question 13

Ulcerative Colitis: How often do they go to bathroom

Answer 13

6x per day

Question 14

Ulcerative Colitis: CMs of this?

Answer 14

Diarrhea with mucus, pus, blood

LLQ Pain

Abdominal distention

Intermittent Tenesmus (Feeing of being unable to empty bowel)

Question 15

Ulcerative Colitis: How will this be diagnosed?

Answer 15

Abdomianl X-Ray or colonoscopy or biopsy of the tissue.

Question 16

Ulcerative Colitis: Complciations of this?

Answer 16

Toxic Mega Colon

Question 17

Ulcerative Colitis: What is Toxic Mega Colon

Answer 17

COlon is not able to contract

Question 18

Ulcerative Colitis - Mx: What is included here??

Answer 18

Nutritional Therapy
Medications
Surgery

Question 19

Ulcerative Colitis - Mx: Nutritional Therapy is geared toward what?

Answer 19

Decreasing inflammation and resting bowel

Question 20

Ulcerative Colitis - Mx: What nutrition changes will occur?

Answer 20

High fluid since they have frequent diarrhea. Also soft diet.

Question 21

Ulcerative Colitis - Mx: Wht meds can be given?

Answer 21

Anti-diarrheal, corticosteroids, aminosuppressant, aminimodulators like methotrexate.

Anticholingerics to help slow peristalsis down for GI tract.

Question 22

Ulcerative Colitis - Mx: What surgeries can be done?

Answer 22

Strictureplasty
Colectomy
Total Colectomy with Ileostomy

Question 23

Ulcerative Colitis - Mx: What is Strictureplasty

Answer 23

There are narrow sections within the bowel and they go in and remove the narrow sections and reconnect the bowel

Question 24

Ulcerative Colitis - Mx: What is Colectomy

Answer 24

Surgrically removing part of the colon. Maybe to go in and taken out descending portion and leave a stoma at end to drain bowel

Question 25

Ulcerative Colitis - Mx: What is Total Colectomy with Ileostomy

Answer 25

THey have taking out large intestine and all that is left is ileostomy with a outpouching.

Question 26

Ulcerative Colitis - Mx: What is a Continent Ileostomy?

Answer 26

For badly diseased rectums. They take out large intestine and make a pouch for reservoir. Fecal mater will stay here and catheter will be used to drain it.

Question 27

Ulcerative Colitis - Mx: What is a Restorative Proctocolectomy wiht Ileal Pouch Anal Anastomosis

Answer 27

Portion of ileum turned into pouch and connected to anus.

Question 28

IBD - Nursing Process: Diagnosis include what

Answer 28

Diarrhea (Goes with Deficient Fluid)
Acute Pain
Deficient Fluid
Imbalanced Nutrition
Ineffective Therapeutic Regimen Mx
Knowledge Deficit of Disease Process

Question 29

IBD - Nursing Process: What is an appropriate goal for patient?

Answer 29

Look for SMART format. Need to have them all.

Question 30

IBD - Nursing Process: Intervetions for diarrhea?

Answer 30

Treat with nutritonal intervention like low residual diet and giving them anti-diarrheal. Give high protein high calorie diet

Question 31

IBD - Nursing Process: How do you know if patients dehydrated?

Answer 31

If HR going up and BP is decreasing. Heart rhythm may also tell about electrolytes

Question 32

IBD - Nursing Process: Complications?

Answer 32

Electrolyte Imbalance
Cardiac Dysrhythmias
GI Bleeding with Fluid Loss
Perforation of Bowel

Question 33

IBD - Nursing Process: Why does BP go up with Peritonitis?

Answer 33

Because of the pain. When septic, HR will go up but BP will actually decrease.

Question 34

IBD - Nursing Process: How is Peritonitis diagnosed?

Answer 34

Perioneal Aspiration
Ultrasound
CBC

Question 35

IBD - Nursing Process: How to treat Peritonitis?

Answer 35

Identify cause, give LR, replace electrolytes, checking for peristalsis, and surgery to close perforation

Question 36

Nursing Mx of Ileostomy - PreOp Care: What is done?

Answer 36

Education on what stoma is that they will have outpouch. Stool will come out of stoma

Question 37

Nursing Mx of Ileostomy - PostOp Care: This will focus on what?

Answer 37

What stoma looks like. Is it pink, red and shiny?

Drainage will be seen 24-48 hours after.

Monitor fluids / electrolytes. Have NG in place.

Question 38

Nursing Mx of Ileostomy - PostOp Care: Skin care around stoma includes what?

Answer 38

Don’t want a lot of skin showing. Don’t want leaking.

Question 39

Nursing Mx of Ileostomy - PostOp Care: How often are bags emptied

Answer 39

Every 2-4 hours or when they are 2/3 full.