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Acute and Chronic > Exam 2 Diverticular Disease > Flashcards

Exam 2 Diverticular Disease Flashcards

1
Q

Saclike herniation of the lining of the bowel that extends to muscle

A

Diverticulum

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2
Q

Diverticulum

A

Saclike herniation of the lining of the bowel that extends to muscle

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3
Q

occur ___________ small intestine or colon BUT most commonly ______ colon

A

occur anywhere small intestine or colon BUT most commonly sigmoid colon

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4
Q

Asian heritage develop Right colon

A

Exception

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5
Q

Multiple diverticula without inflammation or symptoms

A

Diverticulosis

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6
Q

Diverticulosis

A

Multiple diverticula without inflammation or symptoms

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7
Q

Predisposing factors

A

decreased intake of dietary fiber

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8
Q

when food and bacteria retained in the diverticulum produce infection and inflammation

A

Diverticulitis

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9
Q

Diverticulitis

A

when food and bacteria retained in the diverticulum produce infection and inflammation

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10
Q

Symptoms

A

Abscess, fistula formation, obstruction, perforation, peritonitis and hemorrhage

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11
Q

Abscess, fistula formation, obstruction, perforation, peritonitis and hemorrhage

A

Symptoms

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12
Q

developed countries; increases with age
lead to perforation or abscess
If occurs at less than 50 years of age – may be related to obesity

A

random

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13
Q

acute onset of mild to severe pain in left lower quadrant with nausea, vomiting, chills and leukocytosis

A

With diverticulitis

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14
Q

With diverticulitis

A

acute onset of mild to severe pain in left lower quadrant with nausea, vomiting, chills and leukocytosis

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15
Q

t/f diverticular is proceeded by chronic constipation

A

true

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16
Q

If left untreated

A

can result in peritonitis and septicemia

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17
Q

can result in peritonitis and septicemia

A

If left untreated

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18
Q

Generally mild
Bowel irregularity – intervals of diarrhea, nausea, anorexia, bloating, abdominal distention
If bowel is repeatedly inflamed, results in narrowing in bowel, cramps, narrow stools, increased constipation and increased risk for obstruction
Weakness, fatigue and anorexia

A

Signs and Symptoms:

19
Q

Signs and Symptoms:

A

Generally mild
Bowel irregularity – intervals of diarrhea, nausea, anorexia, bloating, abdominal distention
If bowel is repeatedly inflamed, results in narrowing in bowel, cramps, narrow stools, increased constipation and increased risk for obstruction
Weakness, fatigue and anorexia

20
Q

Diverticulosis is diagnosed with…

A

colonoscopy

21
Q

Diverticulitis is diagnosed with…

A

CT with contrast to reveal abscesses
Abdominal x-ray – reveals free air under the diaphragm if perforation is present
Labs: CBC – look at: increased WBC (infection), Increased ESR (inflammation)

22
Q

what is contraindicated acute diverticulitis

A

Colonscopy Contraindicated in acute diverticulitis because the risk of perforation in the presence of local infection may result in sepsis

23
Q

will have tenderness, palpable mass, fever, leukocytosis

A

Abscess

24
Q

Abscess

A

will have tenderness, palpable mass, fever, leukocytosis

25
Q

abdominal pain localized over involved segment; often will follow with peritonitis

A

Perforation

26
Q

Perforation

A

abdominal pain localized over involved segment; often will follow with peritonitis

27
Q

abdominal pain, board-like abdomen, loss of bowel sounds, shock

A

Peritonitis

28
Q

Peritonitis

A

abdominal pain, board-like abdomen, loss of bowel sounds, shock

29
Q

abnormal passageway between body structures like bladder and bowel

A

Fistula

30
Q

Fistula

A

abnormal passageway between body structures like bladder and bowel

31
Q

due to inflamed diverticula eroding areas adjacent to arterial branches

A

Massive rectal bleeding

32
Q

Massive rectal bleeding

A

due to inflamed diverticula eroding areas adjacent to arterial branches

33
Q

Symptoms are less pronounced in an older adult
May not have abdominal pain until infections occurs
Overlook blood in the stool because they cannot see it due to visual changes, physical inability to inspect stools, or fear of knowing what blood is from

A

Gerontological Considerations:

34
Q

Rest, analgesic meds, antispasmodic agents
Clear diet until inflammation subsides
High fiber, low fat diet: increases stool volume, decreases colonic transit time, increases intraluminal pressure
Antibiotics x 7-10 days
Bulk-forming laxative
NO seeds

A

Dietary and Pharmacologic Management:

35
Q

Dietary and Pharmacologic Management:

A

Rest, analgesic meds, antispasmodic agents
Clear diet until inflammation subsides
High fiber, low fat diet: increases stool volume, decreases colonic transit time, increases intraluminal pressure
Antibiotics x 7-10 days
Bulk-forming laxative
NO seeds

36
Q

For older adults, immunocompromised or taking corticosteroids

A

Acute diverticulitis:
Inpatient hospitalization: For

37
Q

NPO, IV fluids, NG suctioning if vomiting or distention, put on bowel rest
Broad spectrum antibiotics x 7-10 days
Opioids or other analgesics for pain
Oral intake increased as: symptoms subside
Probiotics: to restore normal flora

A

Acute diverticulitis:

38
Q

Propantheline bromide: antimuscarinic agent for cramps, stomach spasms and intestines
Oxyphencyclimine (Daricon) – antimuscarinic and anticholinergic

A

Acute diverticulitis:
Antispasmodic agents:

39
Q

Acute diverticulitis:
Antispasmodic agents:

A

Propantheline bromide: antimuscarinic agent for cramps, stomach spasms and intestines
Oxyphencyclimine (Daricon) – antimuscarinic and anticholinergic

40
Q

Needed immediately for: perforation, peritonitis, hemorrhage or obstruction
Use CT guided percutaneous drainage for abscess formation without peritonitis, hemorrhage or obstruction
IV Antibiotics

A

Surgical Management:

41
Q

Surgical Management:

A

Needed immediately for: perforation, peritonitis, hemorrhage or obstruction
Use CT guided percutaneous drainage for abscess formation without peritonitis, hemorrhage or obstruction
IV Antibiotics

42
Q

inflamed area is removed, then end to end anastomosis is completed

A

One stage resection surgery

43
Q

inflamed area is removed, then end to end anastomosis is completed

A

One stage resection surgery

44
Q

Multiple stage procedure surgery

A

More likely on diseased colon
Resection with anastomosis
Bowel is brought to abdominal wall and the distal end is closed over and left in the abdomen = colostomy
Re-anastomosed later if possible

Acute and Chronic (15 decks)

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