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Adult Health Pt 2 > Intestinal/Rectal Disorders > Flashcards

Intestinal/Rectal Disorders Flashcards

1
Q

Constipation

A
  • infrequent/irregular stools
  • abnormal hardening of the stool
  • decrease in volume of stool
  • retention of stool for prolonged time
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2
Q

What are some causes of constipation?

A
  • meds
  • physical condition
  • endocrine disorders
  • poor diet
  • age/lifestyle
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3
Q

S/S of Constipation

A
  • < 3 bowel movements/week
  • abdominal pain/distention
  • anorexia
  • straining w/ BM
  • small, hard, dry stool
  • hemorrhoids
  • anal fissures
  • hypoactive bowel sounds
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4
Q

What can you do to help patient poop?

A
  • increase fiber/fluid
  • laxatives
  • discontinue meds causing prob
  • do not ignore urge
  • relieve anxiety
  • bowel training
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5
Q

What to do with Bowel Training?

A
  • improve consistency w/ stool
  • establish regular time for elimination
  • stimulate emptying on routine basis
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6
Q

Complications from Constipation

A
  • impaction
  • hemorrhoids
  • anal fissures
  • megacolon
  • straining
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7
Q

How to treat an impaction and what to watch for?

A
  • care w/ digital removal

- watch for Vagal Response

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8
Q

What does the vagal response cause?

A
  • bradycardia
  • hypotension
  • syncope
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9
Q

How can hemorrhoids be treated?

A

sitz bath
analgesic ointment
creams
good hygiene

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10
Q

What does straining cause?

A
  • initially lowers BP
  • secondary reaction is a rapid increase in BP above normal
  • if patient strains too long may ultimately lead to vasovagal response
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11
Q

Diarrhea

A
  • increased frequency of BM
  • increased amount of stool
  • liquid/watery stool
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12
Q

Acute Diarrhea

A
  • < 2 weeks

- usually infectious

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13
Q

Chronic Diarrhea

A
  • > 4 weeks

- physiological conditions

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14
Q

Risks for Diarrhea

A
  • meds
  • enteral feeding
  • physiologic disorder
  • infections
  • food intolerance/allergies
  • traveler’s diarrhea
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15
Q

S/S of Diarrhea

A
  • frequent, watery stool
  • abdominal distention
  • cramps
  • intestinal rumbling
  • hyperactive bowel sounds
  • excessive thirst
  • anorexia
  • incontinence
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16
Q

What can be done to treat diarrhea?

A
  • treat underlying process
  • control symptoms
  • hydration
  • low fiber/bulking diet
  • avoid caffeine/carbonated beverages
  • avoid milk, high fat foods, fresh fruits/veggies
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17
Q

What meds can be taken to reduce number of stools?

A

Lomotil or Imodium

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18
Q

What complications can occur from diarrhea?

A
  • dehydration
  • electrolyte imbalance-may cause Dig toxicity for those taking Digoxin
  • skin breakdown
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19
Q

What is the most common GI disorder?

A

irritable bowel syndrome

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20
Q

Irritable Bowel Syndrome (IBS)

A
  • colon becomes hypersensitive
  • overreacts to stimulation
  • instead of slow rhythmic muscle movements you have muscle spasms
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21
Q

S/S of IBS

A
  • diarrhea/constipation (separate or mixed)
  • pain brought on by eating and improved with defecation
  • abdominal distention
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22
Q

Treatment for IBS

A
  • relieve pain
  • control symptoms
  • learn triggers
  • high fiber/increase fluids
  • antidepressants/antispasmodics
  • smoking/alcohol cessation
  • small, frequent meals
  • reduce stress
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23
Q

Malabsorption

A

-inability to absorb major vitamins, minerals, and nutrients

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24
Q

What are some causes of malabsorption?

A
  • celiac sprue
  • Zollinger-Ellison Syndrome
  • gastric/intestinal surgeries
  • lactose intolerance
  • inhibited bacterial growth in bowel
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25
Q

S/S of Malabsorption

A
  • loose, bulky stools/diarrhea
  • gray color/yellow
  • fatty/oily stool, foul smelling stool
  • abdominal distention/pain
  • fatigue/malaise
  • weight loss/malnutrition
  • easy bruising
  • osteoporosis
  • vision probs
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26
Q

Treatment for Malabsorption

A
  • supplementation of vitamins, minerals, nutrients
  • management for primary disease state
  • anti-diarrheal
  • oral/IV fluid
  • monitor/treat complications
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27
Q

Appendicitis

A

inflammation of the appendix leading to increased pressure w/in the appendage

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28
Q

What is the most common reason for emergency abdominal surgery?

A

Appendicitis

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29
Q

S/S of Appendicitis

A
  • vague/dull pain in the periumbilical area that progresses to RLQ as sharp pain
  • low grade fever
  • nausea w/w/o vomiting
  • loss of appetite
  • rebound tenderness
  • constipation or diarrhea
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30
Q

How can appendicitis be diagnosed?

A
  • physical exam
  • symptoms
  • labs-CBC (elevated WBC’s)
  • diagnostic imaging- abdominal x-ray/CT scan
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31
Q

Treatment for Appendicitis

A
  • surgery usually immediate
  • prophylactic antibiotics
  • IV fluids
  • NPO
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32
Q

Perforation of Appendix

A

rupture of appendix

  • peritonitis
  • abscess
33
Q

What happens with pain and perforation of appendix?

A

Pain may be relieved initially w/ perforation but wide spread intense pain quickly returns

34
Q

Treatment for Perforation

A
  • abdominal cavity lavage
  • JP drain 5-7 days post op-drainage will be increased b/c of washout, clear to pus colored
  • NG tube until BS return
35
Q

What does A-P-P-E-N-D-I-X stand for?

A 
A-abdominal pain
P-point of McBurney's = most pain
P-poor appetite
E-elevated temp
N-nausea w/ or w/o vomiting 
I-increase WBC's, inability to pass gas or BM
X-experiences rebound tenderness
36
Q

Diverticulosis

A

weakening of intestinal muscle wall leads to herniation of the mucosa
-sac like pouch forms that collects bowel contents = diverticulitis

37
Q

S/S of Diverticulosis/Diverticulitis

A 
Losis
-vague GI symptoms 
Litis
-acute onset of pain
-constant, mild, severe, most often LLQ
-fever, increased WBC's
-N/V
38
Q

Colonoscopy Management

A
  • clears liquids day before
  • laxative prep afternoon/night before
  • patent IV
  • vital signs
  • monitor for severe, acute pain, N/V, fever/chills, abdominal distention
39
Q

Laxative Prep for Colonoscopy

A
  • mix w/ something flavored
  • keep chilled
  • follow w/ chaser
  • causes frequent forceful diarrhea
  • bloating, cramping
  • N/V
40
Q

Treatment for Diverticulitis Outpatient

A
  • clear liquid diet until symptoms are gone, then high fiber/low fat
  • antibiotics 7-10 days (cipro & flagyl)
  • OTC pain reliever (avoid NSAIDS)
  • antispasmodics (bentyl & levsin)
41
Q

Treatment for Diverticulosis Inpatient

A
  • IV fluids/NPO
  • NG tube to suction
  • IV antibiotics
  • Dilaudid for pain
42
Q

Surgical Treatment for Diverticulosis

A
  • Abscess-CT guided percutaneous drainage
  • Resection (colectomy) w/ anastomosis
  • Colectomy w/ double barreled colostomy
43
Q

CT Guided Percutaneous Drainage

A

imaging guidance used to place a needle or catheter through skin into the abscess to remove or drain infected fluid
-offers faster recovery

44
Q

Resection w/ Anastomosis

A

area of diverticulitis removed and two remaining ends are rejoined

45
Q

What are some complications from Diverticulosis Surgery?

A

DVT
pneumonia
infection
hemorrhage

46
Q

Complications of Diverticulitis

A
  • peritonitis
  • abscess
  • perforation
47
Q

Peritonitis (Hot Abdomen)

A

inflammation of the lining of abdominal cavity and lining of organs w/in (peritoneum)

48
Q

S/S of Acute Abdomen (Early) Peritonitis

A
  • generalized pain aggravated by movement
  • N/V
  • low grade fever
  • diminished BS
49
Q

S/S of Late Stage Peritonitis

A
  • constant, localized at site of infection
  • rigid abdomen/distention
  • rebound tenderness
  • tachypnea, tachycardia, hypotension, dyspnea
  • leukocytosis
50
Q

Treatment for Peritonitis

A
  • IV fluid Bolus-treat hypovolemia
  • pain meds/antiemetics
  • NG tube for decompression
  • respiratory assistance
  • high dose, broad spectrum antibiotics
  • surgery to treat cause
51
Q

Crohn’s Disease

A

inflammatory bowel disease that leads to chronic inflammation w/ development of scattered ulcerations on the mucosa

52
Q

S/S of Crohn’s Disease

A
  • comes on gradually
  • pain (RLQ) unrelieved by defecation
  • fatigue
  • diarrhea/intense cramping especially after eating
  • weight loss/malnutrition/anemia
  • electrolyte imbalances
53
Q

Complications from Crohn’s Disease

A
  • perforation
  • anal fissures
  • anal fistulas
54
Q

Anal Fissure

A

tear

55
Q

Anal fistula

A

tunnel that develops between the skin and anus

56
Q

Intestinal Symptoms of Crohn’s Disease

A
  • arthritis
  • tender, red nodules
  • eye disorders
  • oral ulcers
57
Q

Ulcerative Colitis

A

chronic disease of the colon in which the lining of the colon becomes inflamed and develops ulcerations that are continuous in nature

58
Q

S/S of Ulcerative Colitis

A
  • bloody mucous diarrhea/+ guaiac
  • abdominal pain
  • urgency/constant feeling of need to defecate
  • fever/fatigue
  • anorexia/weight loss/malnutrition
  • N/V, dehydration
59
Q

Complications of Ulcerative Colitis

A
  • hypovolemic shock
  • perforation
  • kidney stones
  • colon cancer
  • hemorrhage
  • toxic mega colon
60
Q

Toxic Megacolon

A
  • chronic distention of the colon
  • abdominal pain
  • distention
  • tachycardia
  • fever/diarrhea
  • if not responsive to treatment w/in 72 hrs surgery is necessary
61
Q

What part of the colon does Crohn’s disease effect?

A

Ascending, transverse, and descending

62
Q

What part of the colon does Ulcerative Colitis effect?

A

Descending into the anus

63
Q

Daily Treatment for Inflammatory Bowel Disease

A
  • increase oral fluids
  • low residue/high protein/ high calorie
  • vitamin supplements
  • avoid smoking, caffeine, alcohol, excessive dairy
  • NSAID’s will reduce likely bleeding
  • methotrexate/Imuran/remicade (immunosuppressants)
64
Q

Treatment for Flare-Ups of IBD

A
  • NPO/IV fluids
  • systemic corticosteroids
  • IV antibiotics
  • TPN for long term inability to tolerate PO
  • antidiarrheal/bulking agent
  • pain meds
  • surgery
65
Q

Polyps

A
  • usually no symptoms (maybe bleeding)
  • usually benign
  • removal during colonoscopy
66
Q

Colo-Rectal Cancer

A
  • 3rd most common site for cancer
  • 2nd common cause of death men 40-79
  • early diagnosis w/ prompt treatment is best cure
  • asymptomatic until late stages
67
Q

When do screenings for Colo-rectal cancer begin?

A

age 50

68
Q

How often are screens for Colo-rectal caner performed?

A
  • NO fam hx q 10 years

- Fam hx or findings q 5 yrs

69
Q

Intestinal Obstructions

A

a blockage prevents the normal flow of digestive contents through the intestines

70
Q

Small Bowel Obstructions

A

Most Common

  • intussusception (telescoping)
  • twisting of the bowel
  • tumors/hernias
  • adhesions
71
Q

Large Bowel Obstructions

A
  • tumors
  • diverticulitis
  • inflammatory bowel disease
72
Q

Small Bowel Obstruction S/S

A
  • acute symptoms
  • colicky, wavelike, cramping pain
  • blood/mucous may pass
  • no stool
  • vomiting of stomach contents, then bile, then feces
  • abdominal distention
  • diminished bowel sounds
73
Q

Large Bowel Obstruction S/S

A
  • progress slowly
  • constipation
  • melena
  • stool becomes smaller in size
  • abdominal distention
  • weight loss/anorexia
  • crampy lower abdominal pain
  • fecal vomiting
74
Q

Treatment for SBO

A
  • NG tube for decompression
  • NPO/IV fluids
  • surgery to correct cause
75
Q

Treatment for LBO

A
  • colonoscopy for decompression and correction
  • surgery to correct cause
  • rectal tube for decompression
76
Q

Pilonidal Cyst

A
  • thought to be the result of a hair that grows into the subQ tissue
  • may be congenital secondary to abnormal epithelial skin growth
77
Q

Where do pilonidal cysts usually develop?

A

lower sacral area

78
Q

S/S of Pilonidal Cyst

A
  • asymptomatic until inflammation/infection
  • redness
  • swelling
  • drainage at site
79
Q

Treatment fir Pilonidal Cyst

A
  • oral or IV antibiotics
  • incision and drainage
  • surgery if abscess forms

Adult Health Pt 2 (8 decks)

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