GI Disorders

Question 1

Ulcerative Colitis S/S

Answer 1

Severe diarrhea (20+ stools per day) that may contain blood and mucus, abdominal pain in LLQ, rectal bleeding, anemia, dehydration, fatigue, anorexia, weight loss, malaise, malnutrition

Question 2

Ulcerative Colitis interventions

Answer 2

o During acute phase maintain NPO status and administer IV fluids and electrolytes as prescribed
o Monitor for bowel sounds and abdominal tenderness and cramping
o Monitor stools, noting color, consistency, and presence or absence of blood
o Monitor for bowel perforation, peritonitis, and hemorrhage. S/S: Guarding of the abdomen, increased fever and chills, pallor, restlessness, tachycardia, tachypnea, and progressive abdominal distention and abdominal pain

Question 3

Ulcerative Colitis complications

Answer 3

Toxic megacolon and colon perforation

Question 4

UC Diet/ teaching

Answer 4

Usually low-fiber, high-protein diet with vitamins and iron supplements
o Avoid gas-forming foods, milk products, and foods such as whole wheat grains, nuts, alcohol, and caffeine-containing products
o Avoid smoking

Question 5

UC medications

Answer 5

May include a combination of salicylate compounds, corticosteroids, immunosuppressants, and antidiarrheals

Question 6

Crohn’s Disease S/S

Answer 6

Abdominal pain and tenderness, diarrhea that may contain mucus – NO BLOOD, remissions and flare ups, cramp-like and colicky pain after meals, weight loss, malnutrition, dehydration, electrolyte imbalances

Question 7

Crohn’s Disease complications

Answer 7

Ulcers, abscesses, fistulas, and intestinal obstruction. Many patients undergo one or more surgical resections of the GI tract, causing disabilities and lifestyle changes.

Question 8

Crohn’s disease Meds

Answer 8

o Combination of sedatives, antidiarrheals, and antiperistaltic meds
o Crohn’s – metronidazole & ciprofloxacin
o Corticosteroids are used if these medications are ineffective
o Immunodulatory agents may be used (6 mercaptopurine or azathioprine)

Question 9

Crohn’s disease teaching

Answer 9

o	Stress management
o	YEARLY colonoscopy
o	Diet: 
Low residual, lower fiber, low fat,
NO spicy foods
Hydration
Loses fat soluble vitamins (A, D, E, & K) – supplements
NO stool softeners & no Golytely – Question order

Question 10

Diverticulitis S/S

Answer 10

LLQ cramp-like pain, elevated temperature, nausea, vomiting, bloating, change in bowel habits, generalized fatigue, IBS development

Question 11

Diverticulosis

Answer 11

Inflammation): Condition of having multiple diverticula in the colon. Diverticula are sac-like pouches of mucosa through the muscular layer of the bowel and may occur anywhere along the GI tract.

Question 12

Diverticulitis complications

Answer 12

More likelihood of perforation of a diverticulum

Question 13

Diverticulitis

Answer 13

Infection): Refers to inflamed diverticula. People with diverticulosis can develop diverticulitis

Question 14

Diverticulitis DX

Answer 14

CT of abdomen, CBC, hemoccult

Question 15

Diverticulitis intervention

Answer 15

o PO or broad spectrum IV

o Bowel rest in acute phase

Question 16

Diverticulitis Meds

Answer 16

Opioids, stool softeners (Colace), and bulk forming agents (Metamucil), antispasmodics (Pro-Banthine, Daricon)

Question 17

Diverticulitis teaching

Answer 17

o AVOID NSAIDS AND CORTICOSTEROIDS – INCREASE RISK OF PERFORATION

• NO BARIUM ENEMAS IN PATIENTS WITH DIVERTICULITIS

Question 18

Diverticulitis diet

Answer 18

During acute phase low fiber diet then increase fiber gradually
Increase fluids
NO SEEDS - Strawberries, cucumbers, tomatoes

Question 19

Appendicitis S/S

Answer 19

o Pain in the periumbilical area that descends to the RLQ
o Abdominal pain that is most intense at McBurney’s point
o Rebound tenderness and abdominal rigidity
o Low-grade fever
o Elevated WBCs
o Anorexia, nausea, vomiting

Question 20

Appendicitis intervention

Answer 20

o The goals are relieving the pain, reducing the anxiety and fears of the patient, preventing infection, decreasing the chances of dehydration, and preventing postoperative complications.
o Preop: IV fluids, prophylactic antibiotic therapy
o Surgery: Appendectomy (open or laparoscopic)
o Postop:
Ensuring good respiratory effort free of lung consolidation, taking frequent vital signs, maintaining IV fluids, assessing the wound, treating for pain, preventing infection.
The patient is placed in a semifowler’s position to reduce the tension and pulling of tissue on the wound area.
Diet is advanced as tolerated.

Question 21

Chronic Renal Failure S/S

Answer 21

Elevated urine specific gravity, oliguria, anemia, HTN, CHF, Anorexia, Ammonia odor to the breath, PUD, CNS depression, peripheral neuropathy, headache, electrolyte disturbances

Question 22

Chronic renal failure considerations

Answer 22

Patients with CRF has three options: (a) dialysis, (b) renal transplantation, or (c) do nothing

Question 23

CRF Meds

Answer 23

Antihypertensives, diuretics, erythropoietin for anemia