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Adult II > Exam 4- GI disorders > Flashcards

Exam 4- GI disorders Flashcards

1
Q

Inflammatory bowel disease includes

A

ulcerative colitis and Crohn’s

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2
Q

what causes IBD

A

diet, air pollution, stress, smoking, high dietary intake of total fats, genetic component, NOD2 associated with Crohn’s

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3
Q

both Crohn’s and UC are characterized by

A

remission and exacerbations of diarrhea, abdominal pain, fecal urgency, weight loss, fever, fatigue

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4
Q

what are some complications of IBD

A

hemorrhaging, malnutrition, perforation, colonic dilation, extra-intestinal complications (such as joint d/o, thromboemboli, liver disease, kidney stones, gallstones)

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5
Q

Crohn’s disease characteristics

A

recurrent and progressive inflammatory response
affects any area of the GI tract and all layers of the bowel
out common in the distal ileum and proximal colon
sharp demarcation lesions (skip lesions)
fistulas are common
has a lot diarrhea, cramping, weight loss, malabsorption and nutritional deficiencies, rectal bleeding is not as common

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6
Q

Ulcerative Colitis

A

nonspecific inflammatory conditions of the colon and rectum
begins in the rectum and spreads proximally and continuously
primarily affects the mucosal layer
bloody diarrhea
lesions may become necrotic and ulcerate, pseudo polyps develop
bowel wall thickens with repeated exacerbation
abdominal pain
increased stool output with moderate disease with systemic symptoms
mucuos and blood in stools with fever, wt loss, anemia, tachycardia, dehydration for severe

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7
Q

what are the diagnostic procedures for both

A

H&P, CBC, stool analysis, endoscopy, barium enema, sigmoidoscopy/colonoscopy with biopsy

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8
Q

what kind of pharmacologic therapy is available

A

aminoslicyclates (causes discoloration of the skin and urine/photosensitivity)
corticosteroids
immunosuppressant agents (Imuran, methotrexate, cyclosporine)
antimicrobials
biologic therapy (used the most)- TNF inhibitors (infliximab, adalimumab)
analgesics
anticholinergics
antidiarrheals
vitaminsm/inerals

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9
Q

25-40% of ___ patients will require surgery

A

UC

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10
Q

what kind of surgeries are available for UC

A

colectomy with variations on ileostomy or ileoanal anastomosis
colectomy is curative - they will have a stoma an dileostomy

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11
Q

___ of Crohn’s patients will requirer surgery

A

75%

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12
Q

what kind of surgeries are available for Crohn’s

A

repair stricture, colectomy with ileostomy if the colon is affected
surgery results in remission but recurrence is high

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13
Q

t/f patients right out of surgery will need lower amounts of fluids

A

false

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14
Q

after an ileostomy the patient may put out __ a day

A

2L

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15
Q

what kind of diet do you need for UC

A

high calorie, high protein, and low residue

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16
Q

what kind of diet do you need for Crohn’s

A

high fiber

17
Q

what qualifies as enteral therapy

A

NG tube, jejunostomy tube, and PEG tube

18
Q

what are some issues associated with enteral therapy

A

intestinal edema, decreased peristalsis, bacterial/fungal stasis, gut permeability

19
Q

t/f you need to wait for a BS reading before starting enteral feeding

A

F

20
Q

gut mass decreases by __% after 7 days of fasting even with TPN

A

50

21
Q

you cannot start tube feedings until

A

you get an x ray

22
Q

types of enteral feeding tubes:

A

nasogastric, esophogostomy, nasoduodenal, gastrostomy, jejunostomy

23
Q

Parenteral feeding

A

feeding through an IV, can even put Insulin in there

24
Q

what are the indications for parenteral nutrition

A
  • Chronic severe diarrhea and vomiting
  • Complicated surgery or trauma
  • GI obstruction
  • Intractable diarrhea
  • Severe anorexia nervosa
  • Severe malabsorption
  • Short Bowel Syndrome
  • GI tract anomalies and fistulae
25
Q

what are the complications of TPN

A

hyperglycemia, infection ,rebound hypoglycemia, fluid overload, altered renal function, electrolyte excess/deficiency, hyperlipidemia

26
Q

Central nutrition is also called

A

TPN

27
Q

what kind of nutrition is TPN

A

high calorie and high protein

28
Q

how is TPN given

A

through a CVC

29
Q

what is PPN

A

Peripheral parenteral nutrition, lower protein nd caloric needs

30
Q

__ parenteral nutrition is used for a short period of time

A

Peripheral

31
Q

how often do you change a filter and tubing for parenteral feedings

A

every 24 hours fo rTPn and every 72 hours for PPn

32
Q

when on parenteral feedings monitor glucose every

A

6hours

33
Q

what kind of dextrose is hung for each parenteral feeding

A

10% for TPN, 5% for PPN

Adult II (4 decks)

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