Git Disorders 2 Flashcards
Diverticular disease
Diverticula
Diverticulosis
Diverticulitis
Diverticula
Sac like out pouching in the wall of the bowel that extend through a defect in the muscle layer
Diverculosis
Multiple diverticula without inflammation
Diverticulitis
Infection and inflammation of diverticula caused by retained food and bacteria
Can lead to perforation of abscess of formation
Nursing goals
Goals - elimination patterns adequate pain relief and absence of complications
Dietary management
May involve surgical management
Disorders of faecal elimination
Diarrhoea
Faecal incontinence
Constipation
Intestinal obstruction
Diarrhoea
Increase stool volume and fluidity
Acute or chronic
Infectious
Faecal incontinence
Involuntary passage of stool
Maybe managed by a bowel training program
Constipation
Decrease on frequency of a bowel movement
Hardened stools, difficult to pass, retention of bowel movement
Intestinal obstruction
Intestinal contents not able to pass through gastrointestinal tract
Internal obstruction causes
Mechanical
No mechanical
Surgical adhesion Hernia Tumour Volvulus Intussusception
Neuromuscular
Vascular disorder
Intestinal obstruction signs
Nause and vomiting Hypotension Decrease oxygen Fluid and electrolyte imbalance Severe reduction of blood volume Pain Constipation
Symptoms of small intestine
Onset- Rapid Vomiting - Frequent and copious Pain- Colicky and cramp like Bowel movement -Faces for a short period Abdominal distension- Greatly increased
Symptoms of large intestine obstruction
Onset gradual Vomiting rare Pain - low grade abdominal pain Bowel movement- absolute constipation Abdominal distension -increased
Intestinal obstruction collaborative care
Decompression of the bowel with NG
Correcting fluid imbalance
Pain releif
Surgical management
Nursing management
Mil by mouth Iv therapy Provide care(assess, ng tube care, assess bowel sounds) Pain relief Management nausea and vomiting
Polyps of the colon and rectum
Symptoms
Treatment
Mass of tissue - protrudes into the lumen of the bowel
Symptoms: rectal bleeding, lower abdominal pain, symptoms of obstruction
Complications: perforation, bleeding
Treatment - removal (polypectomy)
Colorectal cance
Cancer of the rectum and colon
Most commonly diagnosed
2nd most cause
Colorectal cancer : risk factors
Age : over 50 Alcohol Diet Obesity Long term obesity Family history Previous history of colorectal cancer Long-term smoking
Colorectal signs:
Obstruction Weight loss Fatigue Iron-deficiency anaemia Rectal bleeding Cramping and abdominal pain
Colorectal cancer
Prognosis and treatment correlate with the staging of the disease
Surgical therapy
Chemotherapy/radiotherapy
Prognosis worsens with greater size and depth of tumour
L
Surgical therapy
Type of surgery (location, type of cancer) Right hemicolectomy Left hemicolectomy Low anterior resection Colectomy Abdoperineal resection
Bowel resection
Iv therapy Pain relief Indwelling urinary catheter Abdominal wound site May have - drain from wound, nasogastric, stoma bag
Nursing interventions
Required observation
Medication administration
Hygiene care
Avoiding complications
Colorectal cancer
Assessment Post op diagnosis Acute pain Imbalanced nutrition Risk of diarrhoea Risk of skin integrity Risk of sexual function Ineffective copping
Planning
Implementation
Evaluation
Types of stoma
Ileostomy
Colostomy
Stoma
The opening on the surface of the abdomen, is created when the intestine is brought through the abdominal wall sutured to the skin
Temp or permanent
Ileostomy
Opening from the ileum
Commonly used for ulcerative colitis and Crohn’s disease
Liquid to semi-liquid stool consistency
Colostomy
Opening between the caecum and the abdominal wall - proximal end of the colon is sutured to the skin
Depending on where the colostomy is
Stoma nursing care
Stoma nurse referral
Pre-op bowel prep
Pre-op bowel education
Post-op care: assessment of the stoma bag, skin protection
Emotional support
Patient teaching stoma care
Bowel cancer screening
Teaching about the signs and symptoms of bowel cancer
Bowel screening can help detect bowel cancer in its early stages
59- 74 yrs - every 2 years
Immunochemical faecal occult blood test- detects tiny amount of blood in faeces invisible to the naked eye
If positive screening
Colonoscopy
For people with high risk factors of regulat colons colonoscopy is the gold standard test
