Exam 2 chapter 24 Flashcards
condition characterized by intermittent and recurrent abdominal pain and stool pattern irregularities?
Irritable Bowel Syndrome (IBS)
symptoms of IBS
constipation diarrhea alternating diarrhea/constipation abdominal distention Excessive flatulence
The Rome III criteria
abd pain and discomfort lasting 3 months starting at least 6 months ago The pain has relieved by defecation onset assoc with change in fx of stool onset assoc with change in stool appearance
Problems not associated with IBS
Anemia fever persistent diarrhea rectal bleeding severe constipation weight loss
Nutritional therapy for patient with IBS
eliminate gas producing foods brown beans Brussels sprouts cabbage cauliflower raw onions Grapes plums raisins
what should patient with IBS add to their diet
yogurt
fiber
probiotics
what medication may be given to a patient with IBS to control diarrhea and fecal urgency
Loperamide (Imodium)
why may anticholinergic be prescribe for a patient with IBS
Pantheline (Pro Banthine)
to decrease smooth muscle spasm decreasing cramping and constipation
what medication may be prescribed to treat women with IBS whose chief complaint is chronic constipation
Tegaserod (Zelnorm)
it increases the effects of serotonin in the intestines, thereby increasing motility.
SE: diarrhea
Teach pts to report severe diarrhea accompanied by dizziness or orthostatic hypotension.
Patient teaching for IBS
avoid alcohol and cigarettes
eat at regular times
chew food slowly and thoroughly
fluids should not be taken with meals = abd distention.
inflammatory Bowel Disease
characterized by recurrent inflammation of the intestinal tract.
periods of remission interspersed with periods of exacerbation
cause is unknown
no cure
Tx relies on medications to treat inflammation and maintain remission.
Types of inflammatory bowel diease
Ulcerative colitis
Crohn’s disease
Ulcerative colitis
diffuse inflammation
beginning in the rectum and spreading up the colon in a continuous pattern.
inflammation and ulcerations occur in mucosa and submucosa.
bowel occluded
multiple abscesses develop, break through into submucosa, leaving ulceration.
bleeding and perforation
clinical manifestations of ulcerative colitis
anorexia diarrhea (blood common) fatigue/malaise abd tenderness/cramping weight loss fever dehydration and electrolyte imbalances anemia Vitamin K deficiency
what are some complications for ulcerative colitis
toxic megacolon perforation bleeding vascular engorgement highly vascular granulation tissue
symptoms of toxic megacolon in patient with ulcerative colitis
fever
abd pain and distention
vomiting
fatigue
what type of surgery will be indicated for a patient with toxic megacolon who does not respond within 24 to 72 hours to medical management?
Total colectomy
why do patient with IBD have significantly increase risk for osteoporotic fractures
decreased bone mineral density
corticosteroid therapy
what are some labs to monitor for in patient with ulcerative colitis
WBC
H and H
albumin
electrolyte
adverse sequelae to the use of corticosteroids are
hypertension fluid retention cataracts hirsutism (abnormal hair growth) adrenal suppression steroid induced diabetes mellitus poor wound healing loss of bone density
what is a common procedure performed for strictures of the small intestines?
Laparoscope guided strictureplasty
the blocked or narrowed sections of the intestines are widened, leaving the intestines intact.
surgical removal of colon
colectomies
complete excision of colon, rectum and anus
proctocolectomy with ileostomy
recommended when the rectum is severely diseased
what is the procedure of choice when a rectum can be preserved for a patient with ulcerative colitis
restorative proctocolectomy with ileal pouch
chronic, nonspecific inflammatory bowel disorder of unknown origin that can affect any part of the GI
Crohn’s disease
