IBD Flashcards
what is ibd
a group of chronic disorders that result in inflammation and/or ulceration of the bowel
where does crohn’s disease occur
anywhere from mouth to anus
common in right illium
what is the patho of crohns
inflammatory process begins w/ crypt inflammation and abscesses that develop into small focal ulcers
cobblestone appearance
diseased bowel segments have defined borders separate from normal bowel tissue (skip lesions)
what are localized manifestations of crohns
diarrhea
steatorrhea
rlq abd pain (crampy)
anorxeia, wt loss, malnutrition, secondary aneamia, pain after eating
abd tenderness and spasm
what are the systemic manifestations of crohns
joint disorders
skin lesions
ocular disorders
oral ulcers
diagnostics tests for crohns
wbc
elevated esr and crp
hgb and hct
albumin and protein
ct abd scan
MRI
colonoscopy
what complication is common w/ crohns
fistula
what is the patho for ulcerative colitis
affects superficial mucosa of colon
bleeding occurs d/t ulceration
ulceration is CONTINUOUS
what are the localized manifestations for ulcerative colitis
diarrhea (mucous, pus, or blood)
pallor, anemia, and fatigue
anorexia, wt loss, fever, vomiting, dehydration, hypoalbuminemia, electrolyte imbalances
llq abd pain
what are the systemic manifestations for ulcerative colitis
skin lesions
eye lesions
joint abnormalitites
liver disease
diagnostic tests for ulcerative colitis
colonoscopy
abd xray
positive hemoccult testing
low hgb and hct
elevated wbc
elevated crp and esr
low albumin and protein levels
electrolyte imbalances
what is a complications of ulcerative colitis
toxic megacolon
what the prototype for aminosalicylates
sulfasalazine
what is the first line agent used for IBD
sulfasalazine
what is the prototype for immunomodulators
azathioprine
pt educations for azathioprine
high risk for infection
what do you monitor for azathioprine
neutropenia and thrombocytopenia
what drugs are used to treat ibd
aminosalicylates
corticosteroids
immunomodulators
TNF
antibiotics
nutritional management for ibd
oral fluids
low fiber (10-15 g)
high protein
high cal
avoid triggers
2 or less servings of dairy per day
what is tpn
method of providing nutrients to the body by an IV route (central line)
goal of tpn
improve nutrition status
establish positive nitrogen balance
maintain muscle mass
promote wt maintenance/gain
enhance healing process
what are some cvads
percutaneous (non-tunneled central caths)
peripherally inserted central caths (PICC)
surgically placed (tunneled) central caths
implanted vascular access ports
nursing considerations for tpn
maintain optimal nutrition
prevent infection
maintain fluid balance
encourage activity
monitor
daily wt
sugar check q6
infection
change tubing every 24 hrs
what is the surgical management for ibd
used as last resort
may need surgery to relieve strictures
small bowel resection
