Exam 2- Inflammatory Bowel Disorders Flashcards
Inflammatory bowel disorders
- ## Crohn’s & ulcerative colitis
Who is at higher risk for UC?
Men & ex-smoker/non
Who is at higher risk for Crohn’s?
Women & smokers
Crohn’s disease
Subacute and chronic inflammation of the GI tract extending through all layers
This disease can affect any part of the GI tract from the mouth to the anus, but most common in distal ileum and ascending colon
Crohn’s
This is slowly progressive, relentless, and often disabling
Crohn’s
Cobblestone bowel obstruction.. Narrowing of the lumen
Crohn’s
As this disease advances, bowel walls thicken and intestinal lumen narrows
Crohn’s
Crohn’s disease complications
- Colon cancer
- Fistula & abscess formation
- Intestinal obstruction
Crohn’s disease clinical manifestations
- Low grade fever
- Diarrhea
- Abdominal pain (Right Lower Quad) (crampy pain after eating)
- Weight loss (secondary to pain associated with eating)
- Steatorrhea (oily/fatty appearing stool)
- Abscess and fistulas
Crohn’s disease diagnostics
- Sigmoidoscopy/colonoscopy
- Stool examination
- CT scan or MRI
- CBC, Albumin, and protein levels
Crohn’s disease management
- Corticosteroids
- Salicylate compounds
- Immunosuppressants
- Antidiarrheal
- Surgery: colectomy
What surgery do you get for Crohn’s?
Colectomy
Inflammatory changes starts in the rectum and moves proximally through colon
Ulcerative colitis
Ulcerative colitis clinical manifestations
- Exacerbations and remissions
- Abdominal pain
- Crampy diarrhea
6 or more bloody stools per day, anemia, fluid and electrolyte imbalances - Abdominal distention
Ulcerative colitis complications
- Toxic megacolon
- Perforation and peritonitis
- Bleeding
- Osteoporosis
What contributes to osteoporosis associated with ulcerative colitis?
Corticosteroids
Ulcerative colitis diagnostics
Same as Crohn’s
Medical management for IBD
- Corticosteroids
- Salicylate compounds
- Antibiotics
- Immunodulators (Imuran, methotrexate)
- Antidiarrheal, antispasmodics
Surgery for IBD (2)
- Colectomy (complete removal)
- Ileostomy
What nutrition considerations for IBD?
- Low residue, high protein high calorie
- No nuts, seeds
- Fluid and electrolyte replacement (IV as needed)
Nursing management for IBD: what skin do we protect?
Peristomal skin
Nursing interventions: Preparing patient for surgery (IBD)
- Pre-surgery antibiotics
- WOC consult
- Bowel prep
- Emotional support
- Pain management
- Nutrition
Nursing interventions: Post-operative care (IBD)
- Optimize nutrition
- Mobilize C & DB, incentive spirometer
- Surgical site & abdominal assessment
- Ostomy assessment & care
- Supporting positive body image
What should a stoma look like?
Red, beefy, moist
What does a bad stoma look like?
Clay color if it is dying
