Gastrointestinal Disorder (Part 3) Flashcards
inflammation of the narrow tube attached to the base of the cecum.
Appendicitis
can cause
appendicitis
A blockage inside of the appendix
The main symptom____________________abdomen that gets worse over time
lower
right side
- The appendix is a small, thin pouch about
5 to 10cm (2 to 4
inches) long
It is typically cause d by direct (appendicitis) _________________________ and secondary to _________________
direct luminal obstruction; secondary to a faecolith or lymphoid hyperplasia,
Risk Factors
Appendicitis
Low-fiber diet
● High intake of refined carbohydrates
Abdominal pain that is most intense at (appendicitis)
McBurney’s
point
Patient’s guarding position (s/s)
Client in side-lying position, with abdominal guarding
and legs flexed
Pregnancy test. performed for women of
childbearing age to rule out
ectopic pregnancy and
before x-rays are obtained.
Protein produced by the liver
when bacterial infections occur and rapidly increases
within the first 12 hours.
What test/
C-reactive protein
Abdominal plain film showing radiopaque tubular
structure around the ileocecal junction in the right
lower quadrant
What test?
CT barium Scan
abdomen confirmed the
right psoas muscle abscess, which was caused by
perforated appendicitis into the retroperitoneum
What test?
Contrast-enhanced CT
test that palpates the lower left quadrant for appendicitis?
Rovsing’s signs
PHARMACOLOGIC INTERVENTION for appendicitis
Lactated Ringer’s solution 100–500 mL/hr of IV,
Antibiotics (broad-spectrum antibiotic coverage)
DOCUMENTATION
for appendicitis
PARL
Patient’s ability to ambulate and tolerate food
Appearance of abdominal incision (color, temperature,
intactness, drainage)
Response to pain medication, ice applications, and
position changes
Location, intensity, frequency, and duration of pain
● Response to pain medication, ice applications, an
Most important nursing responsibilities for patients with appendicities
DO NOT APPLY HEAT TO THE
ABDOMEN – could LEAD TO RUPTURE
Postoperative Nursing Diagnosis
appendectom
Risk for infection related to the surgical incision
If ruptured of appendix occurred, expect a
Penrose
drain to be inserted
Expect that drainage from the Penrose drain maybe
profuse for the first
2 hours.
COMPLICATIONS OF APPENDICITIS
APP
abscess
perforation of the appendix
● Peritonitis
chronic digestive and immune
disorder that damages the small intestine
Celiac disease
Gluten is a protein found naturally in wheat,
barley, and rye, and is common in foods such as
bread, pasta, cookies, and cakes.
The pathogenesis of disease involves interactions
between
environmental, genetic, and immunologic
factors.
DIAGNOSTICS
4 MARKERS FOR CELIAC DISEAS
CTED
- Celiac Disease Tests
- Tissue TransGlutaminase (tTG) immunoglobulin A
(IgA) and tTG immunoglobulin G (IgG) - EndoMysial Antibody (EMA) -IgA test.
- Deamidated Gliadin Peptide (DGP) -IgA and
DGP-IgG tests.
Facilitate tissue repair by ensuring food supplements
are high in
calories and vitamins A and C and iron.
runs in families about _____ in HIRSCHSPRUNG DISEASE
20% of the time.
HIRSCHSPRUNG DISEASE also known as
Congenital Aganglionic Megacolon
characterized by chronic
constipation caused by mechanical intestinal
obstruction.
Congenital Aganglionic Megacolon,
A surgical opening created on the surface of the
abdomen to allow stool (waste) to exit the body rather
than through the rectum.
COLOSTOMY AND ILEOSTOMY
Different types of Colostomy
DATS a Colostomy
Descending Colostomy
Ascending Colostomy
Transverse Colostomy
Sigmoid Colostomy
: type of transverse colostomy
where there is the creation of two stomas which
divide the bowel.
Double-barrel ostomy: t
a type of colectomy that removes part of the colon
HARTMANN’S PROCEDURE.
a type of colectomy that removes part of the colon
and sometimes rectum
(proctosigmoidectomy).
The
remaining rectum is sealed, creating what is known as
Hartmann’s pouch.
Position (Ileostomy vs Colostomy)
RLQ (Ileo)
LLQ (Colos)
Ileostomy: will always have
ave liquid stool. (RLQ)
Difference between different types of Colostomy
Ascending: liquid stool
Transverse: lose to partly formed stool
Descending/Sigmoid: similar to normal consistency
Post-op Nursing Care:Ostomies will SHOULD ALWAYS look
pink or red
and be moist/shiny.
Notify MD if stoma is: pale pink patient (may have a
low hgb and hct)
Ileostomy: drainage is dark green and then turns yellow when
patient starts to eat.
A _____________ will be over the stoma to keep the stoma
moist, and then a sterile dry dressing
until pouching system in place
A petroleum gauze
Colostomy: may pass mucous stool at first….stool will be
liquid at first and then progress to what it should look like
depending on its location. It can take up to
o 2 days before stool
is produced.
Be sure to measure the stoma and cut the
opening of the skin barrier to be
1/8” LARGER than the stoma.
Use caution and eat small amounts or completely avoid
foods that are not completely digestible:
Corn, celery, peas, coleslaw, popcorn, nuts and
seeds, raisins, skin of fruits, raw mushrooms and
pineapple etc,
COMMON CAUSES OF PERISTOMAL SKIN DAMAGE
LPPSSS
Leakage: Healthy skin exposed to fecal or urine output under
the skin barrier can breakdown fast.
Pressure: Belts and some clothing may cause pressure on the
stoma area.
COMMON CAUSES OF PERISTOMAL SKIN DAMAGE
LPPSSS
Leakage:
Pressure:
Pouching system:
Stoma size: E
Skin folds or creases,
Skin stripping or friction
NURSING CARE PLANS FOR COLOSTOMY AND ILEOSTOMY
Risk For Impaired Skin Integrity Care Plan
DISTURBED BODY IMAGE CARE PLAN
major physical change that can result
in psychological distress and affect the patient’s
self-confidence and relationships.
ostomy
