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Nur 336 > GI - Unit 1 - Intestinal Disorders > Flashcards

GI - Unit 1 - Intestinal Disorders Flashcards

1
Q

What is gastroenteritis?

A

Inflammation in GI tract.

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2
Q

What are the symptoms of gastroenteritis? What is it in the acute phase?

A

Basically food poisoning! Symptoms include N/V, abd pain/cramping, low grade fever, headache, etc.

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3
Q

How do we treat gastroenteritis?

A

Antibiotics, anti-emetics (but we have to watch those because they can sometimes slow peristalsis which is bad because we want the bad organism/bug to get out of there!)

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4
Q

What are some examples of a protozoal infection?

A

Dysenteries, Amebiasis, Giardiasis, Parasitic infections, etc.

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5
Q

What are the symptoms of a protozoal infection?

A

Abd cramps, diarrhea, nausea, weight loss, weakness, etc.

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6
Q

How do we diagnose and treat a protozoal infection?

A

Stool for O&P and treat like gastroenteritis!

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7
Q

Appendicitis - what is it?

A

Inflammation of the appendix.

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8
Q

What are symptoms of appendicitis?

A

Vague abdominal pain –> RLQ pain. Also, McBurney’s Point (inbetween navel and hip), N/V - these come last.

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9
Q

If it’s N/V –> Abdominal Pain, that is ____.

If it’s ABD Pain then N/V, that is ____.

A

If it’s N/V –> Abdominal Pain, that is gastroenteritis.

If it’s ABD Pain then N/V, that is appendicitis.

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10
Q

How do we diagnose appendicitis?

A

WBC >10,000, Abdominal/Pelvic Xray & Ultrasound, Iv Fluids, Antibiotics, possibly surgery.

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11
Q

What is the Rovsing’s Sign?

A

When you push on the left abdomen, they feel pain in the right. It’s associated with appendicitis.

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12
Q

What is the psoas sign?

A

Pain when you flex hip. It’s associated with appendicitis.

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13
Q

What are some things we have to watch for in appendicitis (in regards to nursing diagnoses)?

A

Altered tissue perfusion, altered comfort, risk for infection, impaired skin integrity, fear of the unknown, etc.

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14
Q

What is peritonitis?

A

Acute inflammation of endothelial lining of the abdominal cavity or peritoneum.

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15
Q

What is Primary Peritonitis?

A

It’s rare - from infection in the blood.

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16
Q

What is secondary peritonitis?

A

Ruptured appendix, diverticulum, gallbladder, peritoneal dialysis, etc.

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17
Q

What are some symptoms of peritonitis?

A

Pain, abdominal distention, board-like abdomen, hypoactive bowel sounds, N/V, increased temp, shallow respirations, fear/anxiety, etc.

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18
Q

How do we diagnose peritonitis?

A

WBC, Blood cultures, paracentesis, exploratory surgery, abd. x-rays, etc.

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19
Q

Peritonitis - how do they treat it?

A

Meds (mycins, flagyl), surgery to remove damaged tissue or close perforation, etc. Sometimes they are so swollen they just leave the incision open!

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20
Q

What is a paralytic ileus/ileus?

A

Nerve impairment of bowel which decreases propulsion of bowel contents.

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21
Q

What cause an ileus?

A

Injuries to GI tract, abdominal surgery, c-section-, general anesthesia, IBD.

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22
Q

How do we prevent an ileus?

A

Avoid total bed-rest especially post-op, assess bowel sounds, etc.

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23
Q

What are symptoms of an ileus?

A

Slowed to NO bowel sounds, N/V, no stools, abdominal pain, increased abdominal girth, malaise, weakness, etc.

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24
Q

How do we treat an ileus?

A

Decompress bowel with NG, suction, NPO, IV, increase GI motility, etc. Reglan might work but it takes days to recover from!

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25
Q

What is ulcerative colitis?

A

Inflammation of intestinal mucosa that begins in rectum and progresses towards cecum. Leaves ulcerations. Causes perforation and fistula formation.

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26
Q

What are some symptoms of Ulcerative Colitis?

A

Bloody, mucousy diarrhea, rectal bleeding, anemia, nutritional impairment, fatigue, anorexia, weakness, abdominal cramps in the LLQ RELIEVED by defecation.

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27
Q

What is tenesmus?

A

When you feel like you constantly have to shit.

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28
Q

How do we diagnose UC?

A

Exam stool, H&H, WBC, proctosigmoidoscopy, etc.

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29
Q

What should we do as nurses for a patient with UC?

A

Relieve abdominal cramping & diarrhea, emotional support. etc.

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30
Q

What diet might help a patient with UC?

A

Lactose free, NO caffeine, no raw fruits or veggies, increase bulk forming (bran), hi cal drinks if NPO.

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31
Q

What are some complications of UC?

A

Electrolyte imbalance, mega colon.

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32
Q

What are some treatments of UC?

A

Medication or colon resection, temporary loop ileostomy, total proctolectomy with permanent ileostomy.

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33
Q

Where is an ileostomy usually located on the abdomen?

A

On the right side.

34
Q

How should a stoma appear?

A

Pink, moist - should produce stool.

35
Q

With an ileoanal reservoir, how many times a day do they poop? What is it like? How should we handle that?

A

6-8 times a day - liquid stool that’s irritating, so keep their butts clean!

36
Q

What is Crohn’s disease?

A

Chronic, relapsing - autoimmune. Small lesions of mucosa, submucosa, etc - deep lesions - they have the SKIP lesions - so some areas are fine and others are not. They can be seen anywhere from the mouth to the anus!

37
Q

What are some complications of Crohn’s?

A

Obstruction, abscesses, fistula’s, CA of small bowel and colon, malnutrition, anemia, bowel perforation, etc.

38
Q

Is hemorrhage more common in UC or Crohn’s?

A

UC

39
Q

What are some symptoms of crohn’s?

A

Diarrhea (usually no blood!), abd pain, tenderness in RLQ (UC is LLQ) relieved by defecation, fever, fatigue, malaise, weight loss, anemia, malnutrition.

40
Q

How do we treat crohn’s? How do we diagnose?

A 
Usually diagnosed by colonoscopy.
Well balanced diet - lactose free, etc.
Meds. 
Surgery if there's any complications, like from a fistula or obstruction. 
Support!
41
Q

What is a fistula?

A

Bad connection between organs - could be bowel to bowel, bowel to skin, bowel to bladder, it just depends!

42
Q

Where is Crohn’s most common?

A

Terminal ileum and jejenum.

43
Q

What is irritable bowel syndrome?

A

Aka spastic bowel, colon, functional colitis, etc. - this is a syndrome with periods of constipation & diarrhea. Could be caused by low fiber, lactose, etc.

44
Q

Is IBS more common in men or women?

A

Women!

45
Q

What are symptoms of IBS?

A

Intermittent abd pain relieved by shitting. Also includes bloating, flatulence, etc.

46
Q

How do we diagnose IBS?

A

We diagnose when we rule out every other possible disease.

47
Q

How do we treat IBS?

A

Eliminate upsetting foods & treat symptoms. Meds could include Imodium, Zelnorm (tegaserod for peristalsis stimulation), metamucil, etc.

48
Q

What is a herniation?

A

Abnormal protrusion of an organ through defect in muscular wall of abdomen.

49
Q

What is an indirect hernia?

A

Improper closure of tract that develops as the testes before birth.

50
Q

What is a direct hernia?

A

Weakness in inguinal wall.

51
Q

What is a reducible hernia?

A

When sac returns into abdominal cavity.

52
Q

What is an irreducible or incarcerated hernia?

A

One that can’t be moved - at risked for strangulation there!

53
Q

Do we forcefully push a hernia back in?

A

NO

54
Q

Post-op for hernia - should they lift 200 pounds?

A

Nope, shouldn’t lift over 20 lbs.

55
Q

What is an intestinal obstruction? Mechanical vs. non

A

Mechanical - Physical barrier such as IBS. Something physical is causing the obstruction!

Non-mechanical - paralytic ileus, etc.

56
Q

What are some symptoms of an intestinal obstruction in the small bowel?

A

Abd pain, cramping, N/V, constipation, distention, high pitched bowel sounds, etc. Vomit looks like bile.

57
Q

What are some symptoms of an intestinal obstruction in the large bowel?

A

Lower abdominal distention, diarrhea, constipation, abd pain/cramping, local tenderness, desire to shit, high-pitched bowel sounds. They’ll have fecal-like vomit.

58
Q

With a bowel obstruction with vomiting, what might the patient get into? Hint..it’s metabolic.

A

METABOLIC ALKALOSIS, because they’ve been vomiting and they’ve lost acid!

59
Q

What are some diagnostic tests for an intestinal obstruction?

A

WBC, H&H, electrolytes (BUN might be elevated due to dehydration), BA swallow, enema, endoscopy.

60
Q

How do we treat an intestinal obstruction?

A

Decompress bowel with NG (#2 things to do), NPO (#1 most important thing to do!!!), IV pain meds. Surgery might be possible! Don’t give meds to make them shit like go-litely!

61
Q

What is a diverticula?

A

Saclike projections of mucosa through muscle layer.

62
Q

What causes diverticula?

A

Diet, decreased activity, postponed defecation, etc.

63
Q

What is diverticulosis?

A

Presence of diverticula.

64
Q

What is diverticulitis?

A

Inflammation of diverticula.

65
Q

Is diverticulitis easy for the elderly?

A

NO, it is most severe for them.

66
Q

What are symptoms of diverticulitis?

A

Pain in the LLQ, constipation and/or diarrhea, narrow stools, N/V, low grade fever, distended abdomen, weakness, symptoms of bowel obstruction, etc.

67
Q

How do we diagnose diverticulitis?

A

WBC, occult blood, BA enema, sigmoidoscopy (because it usually happens in the sigmoid colon!!!), CT, etc.

68
Q

How do we treat diverticulitis?

A

Varies - meds, pain relief, stool softener, high fiber diet, NPO for bowel rest, bowel resection if needed, etc.

69
Q

What are polyps?

A

Mass of tissue from bowel wall that protrudes into the lumen.

70
Q

What does FAP mean?

A

familiar abnormal polyopsis? something with lots of polyps ha.

71
Q

What’s a sessile polyps versus a pendunculated polyp?

A 
Sessile = almost flat.
Pendunculated = like a pendulum.
72
Q

What are some treatments for colon cancer?

A

Laser treatment, colon resection, chemo, radiation - but usually isn’t caught until too late. :(

73
Q

Colostomy locations = Give the 4.

A

Ascending for right sided.
Transverse (double barreled) for emergencies.
Descending colon.
Sigmoid.

74
Q

Colostomy irrigation - how many ml inserted in the first 3 inches?

A

300-500 ml.

75
Q

Stoma car - should be pink, moist, etc - should we limit gas forming foods?

A

YES

76
Q

What are hemorrhoids?

A

Unnaturally swollen or distended veins in the anorectal region.

77
Q

Internal vs. external hemorrhoids —

A

Internal is inside the anal tract - external is out.

78
Q

How do we treat hemorrhoids?

A

Treat bleeding, pain, itching - maybe zap it off, band it off, etc.

79
Q

Should we avoid strong laxatives with hemarrhoids?

A

YES. Support them and help them poop.

80
Q

What are fissures?

A

Ulcers or tears in anus, chronic inflammation, etc.

81
Q

What are fistulas in the butt?

A

Tunnel or tube like tract between anal canal and perianal skin. Caused often by Crohn’s.

Nur 336 (26 decks)

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