gastrointestinal (class 8) Flashcards
diarrhea
acute or chronic. watery stools daily. can lead to dehydration. can lead to hypokalemia, hypomagnesemia, and metabolic acidosis.
constipation
fewer than three bowel movements per week. hard stools, incomplete evacuation, or manual evacuation. common in older adults. more common in women.
cdif
bacterial enterotoxins, loss of normal flora/overgrowth of pathogens. severe infection of the colon, antibiotic-associated infection, affects food digestion, causes diarrhea.
cdif incubation
1-2 weeks
cdif pathogenesis
antibiotic therapy interferes with normal protective bacteria in colon
cdif manifestations
diarrhea, abdominal cramps, malaise, fever, anorexia.
cdif management
cessation of causeative antibiotic; antibiotic therapy with metronidazole-possibly vancomycin for resistant strains.
irritable bowel syndrom IBS
motility disorder of lower GI tract. 10-15% adult population, young people most affected. higher in women than men, depression and anxiety linked to IBS.
IBS s/s
abdominal bloating, gas, nausea, vomiting, anorexia, fatigue, headache, depression, or anxiety colicky, spasms, or dull and continuous pan, change in frequency, hard or lumpy, loose or watery, straining urgency or a sensation of incomplete evacuation, tender near the sigmoid colon.
inflammatory bowel disease IBD
crohns
etiology unknown. chronic inflammatory disorder affecting the gastrointestinal tract. can affect any portion of the GI tract from the mouth to the anus but usually affects the terminal ileum and ascending colon.
age onset: 15-30/60-80. disease slowly progressive, relapsing. diarrhea: less severe than coloitis, no blood or mucus in stool. pain: cramping right lower quadrant. nutrition: anemia, weight loss, multiple vitamin and mineral deficiencies.
terminal ileum and ascending colon.
IBD
ulcerative coloitis
etiology unknown. chronic inflammatory disorder that affects the mucosa and submucosa of the colon and rectum, onset is usually insidious. attacks that last 1 to 3 months occuring at intervals of months to years
age 15-30/60-80. chronic and intermittent. 5-30 stools per day with blood and mucus. pain: cramping in left lower quadrant, relieved by defecation. nutrition: anemia, hypoalbuminemia, and weight loss.
rectum and sigmoid colon.
diverticular disease
diverticula are small (0.5-1.0 cm) outpouchings of the colon that occur in rows. inreases with age. diet plays a factor. lifestyle choices. men and women are equally affected
diverticulosis
presence of diverticula. asymptomatic
pain ( usually left-sided) constipation and diarrhea occur
complicaition is hemorrhage/diverticulitis
diverticulitis
inflammation in and around the diverticular sac causing pain. usually affects 1 diverticulum. sigmoid colon. undigested food/bacteria forms hard masses/ low grade temp/ abdomen tenderness
celiac disease
chronic t-cell mediated autoimmune genetic disorder of the small intestine in which the absorption of nutrients, particularly fats, is impaired.
lactose intolerance
lactase deficiency is usually genetic in origin, but also occurs secondarily to celiac disease, crohn disease, and other disorders affecting the mucosa of the small intestine.
short bower syndrome
resected small bowel due to tremors, infarction of bowel mucosa, incarcerated hernias, crohns disease, bariatric surgery, trauma, and enteropathy resulting from radiation therapy.
colorectal cancer
cancer of colon or rectum. cause unknown. 3rd most common cancer diagnosed in US. higher among african americans. occurs most frequently after age 50.
colorectal cancer complications
- bowel obstruction due to narrowing of bowel lumen by lesion. 2. perforation of the bowel wall by the tumor, allowing contamination of peritoneal cavity by bowel continent. 3. direct extension of the tumor to involve surrounding organs.
colorectal cancer screening
yearly fecal occult blood test. flexible sigmoidoscopy every 5 years or double contrast barium enema every 5 years.
colorectal cancer diagnosis
sigmoidoscopy or colonoscopy as the primary diagnostic test used to detect and visualize trmors.
colorectal cancer surgery
surgical resection of the tumor, adjacent colon, and regional lymph nodes in the treatment of hcoice for colorectal cancer.
caring for pt with colostomy
assess the stoma, monitoring output. provide stoma and dietary teaching. keep the stoma free from irritants. empty a drainable pouch or replace the colostomy bag as needed.
provide stomal and skin care.
no rectal suppositories, rectal temperatures, or enemas if had abdominoperineal resection.
radiation therapy for colorectal cancer
not primary treatment./used with resection. preoperatively to shrink large rectal tumors to surgically able to remove it.
colorectal cancer chemotherapy
used to reduce its spread to the liver and prevent recurrence. used postoperatively as adjunctive therapy.
both therapies
together radiation, chemotherapy reduce the rate of tumor recurrence and prolongs survival for patients with stage III rectal tumors.
