Exam 3 Study Guide - NonInflammatory Disorders Flashcards
1
Q
Irritable Bowel Syndrome (IBS)
define
etiology
A
- Functional GI disorder tht causes chronic or recurrent diarrhea, constipation, and/or abdominal pain & bloating
- Most common digestive disorder
- Etiology
> research suggests tht a combination of factors
> certain food & fluids; carbonated or caffeinated bevs, dairy products
> immunologic
> genetic
> hormonal; 2x more likely in women
> stress; anxiety & depression can play a role
2
Q
IBS - Assessment
basic
A
-
Hx
> weight change; usually have a stable weight
> malaise & fatigue
> abdominal pain; most common in left lower quadrant
> changes in bowel pattern & consistency of stools; can have diarrhea or constripation of alternate w/ both
> passage of mucus
> nutrition; caffeine, sorbitol or fructose can cuase bloating & diarrhea
> factors causing exacerbations such as diet, stress, anxiety, food intolerance
3
Q
IBS - Assessment
lab testing
manis
A
-
Lab Testing
> CBC (normal)
> Serum albumin (normal)
> ESR (normal)
> Stools for occult blood (normal)
> Hydrogen breath test; will exhale a higher lvl of hydrogen secondary to bacterial overgrowth & malabsorp in small intestines -
CMs
> LLQ abd pain
> diarrhea and/or constipation
> cramping
> belching or gas
> anorexia
> bloating
> nausea w/ meals
4
Q
IBS - Interventions
teaching
drug therapy
A
-
Health Teaching
> dietary fiber (30-40g of fiber each day)
> eating regular meals
> 8-10 cups of liquid a day
> chewing slowly -
Drug Therapy depends on symps:
> constipation predominant: bulk-forming laxative (Metamucil), Lubiprostone (Amitiza) to incr fluid in intestine, Linaclotide (Linzess) to incr fluid in testines & incr intestinal motility
> diarrhea predominant: antidiarrheal agents like loperamide (Immodium)
> pain predominant: tricyclic antidepressants (Elavil)
5
Q
IBS - Interventions
complimentary & alternative
A
- Probiotics to reduce bacteria
- Peppermint oil capsules
- Stress management: relaxation techniques, meditation and/or yoga
- Exercise
6
Q
Hernias
causes
types
A
-
Causes
> congenital or acquired muscle weakness
> incrd intra-abd pressure (obesity, pregnancy, lifting heavy objects) -
Most Common Types
> indirect inguinal (occur mostly in men)
> direct inguinal (occur more often in older adults)
> femoral (common in obese or pregnant women)
> umbilical (congenital or common in obese or pregnancy)
> incisional or ventral (occurs in ppl who have undergone abd surgery)
7
Q
Reductible Hernias
A
Contents of the hernial sac can be placed back into abd cavity by gentle pressure
8
Q
Irreducible (incarcerated) Hernias
A
- Hernia cannot be reduced or placed back into abd cavity
- Requires immediate surgical evaluation
9
Q
Strangulated Hernias
A
- Blood supply to the herniated segment of bowel is cut off by pressure from hernial ring
- Can lead to necrosis of bowel & possible bowel perforation
- Symprtoms:
> abd distension
> N/V
> pain
> fever
> tachycardia
10
Q
Hernias - Assessment
A
- Observe for bulging or protrusion ove rinvolved area
- Inspect when lying & standing
> if reducible it may disappear when lying flat - Assess for bowel sounds
> absent bowel soubds may indicate obstruction or strangulation
11
Q
Hernia - Nonsurgical Intervention
A
- Treatment of an inguinal hernia
- Truss (pad made w/ firm material); held in place over hernia w/ a belt
- Applied after hernia has been reduced
12
Q
Hernias - Surgical Interventions
A
- Surgical option for inguinal hernia repairs:
-
Minimally Invasive Inguinal Hernia Repair (MIIHR)
> laproscopic herniorrhaphy
> recover more quickly, have less pain, fewer postop complications -
Open Herniorrhaphy (open incision)
> follow general postop care of pts
> assess for difficulty in voiding
13
Q
Hernias - PostOp Teaching
A
- Avoid coughing
- Elevation of scrotum w/ a soft pillow to prevent & control swelling
- Ice bags to prevent & control swelling
- Follow surgeon’s recommendation for returning to usual activities
- Avoid straining & lifting for several weeks
- Observe for fever, chills, wound drainage, redness or separation of incision & incring incisional pain
- Keep wound clena & dry w/ antibacterial soap & water
14
Q
Colorectal Cancer - Etiology/Risk Factors
A
- Older than 50yrs
- Genetic predisposition
- Personal or family hx of cx
- Diseases tht predispose the pt to cx
> familial adenomatous polyposis
> Crohn’s disease
> Ulcerative colitis - Infectious agents
> H. pylori
> Human papilloma virus (HPV) - Long term smoking
- Obesity
- Physical inactivity
- Heavy alcohol consumption
- HIgh-fat diet
15
Q
Colorectal Cancer - Assessment
basic
A
- Hx
-
Physical Assessment/CMs
> rectal bleeding
> anemia
> change in stool consistency or shape
> possible abd pain
> possible abd distention or visible mass