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Adults > intestinal/rectal disorders (final) > Flashcards

intestinal/rectal disorders (final) Flashcards

1
Q

what are causes of constipation

A
  • blockages
  • nerve
  • muscular involvement
  • hormonal imbalances
  • certain meds
  • ignoring the urge
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2
Q

what is happening with constipation?

A

-stool mpving too slowly
-stool unable to be evacuated

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3
Q

labs/tests for constipation

A
  • blood tests
  • colonoscopy/sigmoidoscopy
  • colonic transit study
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4
Q

what are meds that help with constipation

A

otc laxatives, stimulants, stool softeners, enemas
prescription lubiprostone, linaclotide

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5
Q

complications of constipation

A

hemorrhoids
anal fissure
impaction
rectal prolapse

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6
Q

how can nurses help constipation

A
  • diet and activity
  • monitor med risk
  • EDs
  • sit with legs supported
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7
Q

causes of diarrhea

A
  • virus/bacteria
  • meds
  • food intolerance
  • surgery
  • digestive disorders
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8
Q

what is the rapid transit of stool through the colon

A

diarrhea

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9
Q

labs/tests for diarrhea

A
  • CBC
  • stool test
  • sigmoidoscopy/colonoscopy
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10
Q

meds that can help diarrhea

A
  • antibiotics (parasitic)
  • liquids!!!
  • atropine/diphenoxylate
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11
Q

cuases of IBS

A
  • strong/weak contractions
  • nervous system
  • inflammation
  • infection
  • changes in gut bacteria
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12
Q

how does a client with IBS present?

A
  • abd pain/cramp
  • diarrhea/constipation
  • mucus shreds in stool
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13
Q

labs/tests for ibs

A
  • stool tests
  • lactose intolerance tests
  • colonoscopy/sigmoidoscopy
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14
Q

meds for ibs

A

lubiprostone
linaclotide

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15
Q

complications of ibs

A
  • colon cancer
  • social isolation
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16
Q

how can nurses help ibs

A
  • diet/lifestyle
  • counseling/relaxation
  • fluids/sleep
  • avoid triggers
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17
Q

what are causes of appendicitis

A
  • blockages in appendix
  • kinked, occluded, tumor
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18
Q

what is heppening in appendicitis

A
  • loss of blood supply
  • infalmmation, ischemia, necrosis
  • untreated = sepsis/death
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19
Q

what condition has symptoms of…
* periumbilical pain shifting to RLQ
* flu-like symptoms
* pain worse w/ movement
* bloating/flatulence
* aging population

A

appendicitis

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20
Q

labs/tests for appendicitis

A
  • mcburney’s point (rebound tenderness RLQ)
  • CBC
  • abd CT
  • HCG levels to r/o preg
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21
Q

what meds can help appendicitis

A
  • prophylactic antibiotics
  • narcotic pain meds/NSAIDs
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22
Q

what are causes of diverticulitis

A
  • diverticula (holes)
  • diverticulum (multiple holes)
  • diverticulosis
  • weak pockets in colon
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23
Q

what condition is…
* marble-sized protrusions
* tearing of diverticula

A

diverticulitis

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24
Q

diverticulitis has pain in the _____

A

LLQ

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25
Q

a client with _____ will present with persistent pain, LLQ pain, tenderness, n/v, constipation

A

diverticulitis

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26
Q

labs/tests for diverticulitis

A

* no colonoscopy while inflamed!!
* UA
* CBC
* HBG
* liver enzymes
* stool studies

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27
Q

what are complications of diverticulitis

A
  • abscess
  • blockage by scarring
  • fistula
  • peritonitis
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28
Q

surgical interventions for diverticulitis

A
  • drain
  • bowel resection
  • temporary/permanent colostomy
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29
Q

meds that can help diverticulitis without complication

A
  • oral antibiotics
  • liquids to solids
  • acetaminophen and OTC
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30
Q

meds that can help diverticulitis with complication

A

IV antibiotics (hospitalization)

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31
Q

how can nurses help diverticulitis

A
  • educate on liquid nutrition
  • pain control
  • fluid promotion
  • educate on bulk laxatives
  • stool softeners
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32
Q

what are causes of chron’s

A
  • immune system
  • heredity
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33
Q

what condition has…
* inflammation of small/large intestine
* affects all layers (transmural)
* inflammation = lack of absorption
* inflammation = perforation/infection

A

chron’s

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34
Q

what quadrant is chron’s pain

A
  • RLQ and distal ileum
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35
Q

what condition has…
* exacerbation/remission
* pain unrelieved by defecation
* chronic diarrhea
* anorexia/weight loss
* pain after meals
* blood/fat in stool
* extraintestinal manifestations (eyes, joints, skin)

A

chron’s

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36
Q

labs/tests for chron’s

A
  • CT (cobblestone)
  • CBC
  • stool studies
  • EGD with biopsy
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37
Q

acute interventions for chron’s

A
  • bowel rest/NG
  • bowel resection
  • possible temporary colostomy
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38
Q

complications of chron’s

A
  • bowel obstruction
  • ulcers
  • fistula/anal fissures
  • malnutrition
  • colon cancer
  • extraintestinal issues
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39
Q

what meds can help chron’s

A
  • anti-inflammatory (corticosteroids)
  • immunosuppressants (methotrexate)
  • aminosalicates
  • TNF inhibitors (adalimumab)
  • antibiotics
  • pain reliever
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40
Q

what are causes of ulcerative colitis

A
  • heredity
  • autoimmune
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41
Q

what condition has…
* long-lasting inflamamtion
* multiple ulcerations
* desquamation
* ulcers to innermost colon

A

ulcerative colitis

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42
Q

what quadrant is ulcerative colitis pain

A

LLQ

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43
Q

what condition has a client presenting with…
* diarrhea
* abdominal pain
* rectal bleeding
* anorexia/weight loss/fatigue
* varies by person

A

ulcerative colitis

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44
Q

labs/tests for ulcerative colitis

A
  • CBC/BMP
  • stool tests
  • abd x-ray
  • sigmoid/colonoscopy
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45
Q

acute interventions for ulcerative colitis

A
  • bowel resection
  • temp. colostomy
  • antibiotics
  • pain control
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46
Q

complications of ulcerative colitis

A
  • bleeding (may be severe)
  • perforation
  • dehydration
  • extraintestinal
  • colon CA
  • megacolon
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47
Q

what meds can help ulcerative colitis

A

** no NSAIDs
** anti-inflamm (corticosteroids)
* TNF inhibitor
* aminosalicates
* antibiotc
* anti-diarrheal

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48
Q

how can nurses help ulcerative colitis

A
  • discuss CA screening
  • nutrition
  • bowel rest
  • pain control/ fluid intake
  • prevent breakdown
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49
Q

causes of intestinal obstruction

A
  • adhesions (after surgery)
  • chron’s
  • infected diverticula
  • hernia
  • colon CA
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50
Q

what is when…
* stool is unable to pass through GI
* content accumulates above onstruction = distention
* pressure leads to ischemia

A

intestinal obstruction

51
Q

labs/tests for intestinal obstruction

A
  • x-ray
  • CT
  • barium enema
52
Q

acute interventions for intestinal obstruction

A
  • bowel rest
  • surgery
53
Q

complications of intestinal obstruction

A
  • bowel necrosis / rupture
    * fecal emesis
  • infection -> sepsis
54
Q

where do most bowel obstructions happen

A

small bowel

55
Q

what kind of obstruction usually happens rapidly and resolves with NG rest and decompression

A

small bowel

56
Q

what kind of obstruction is usually caused by adhesions and pain is usually around umbilicus or eipgastric pain

A

small bowel

57
Q

what kind of obstructions usually happen over time

A

colon

58
Q

what kind of obstruction is usually adenocarcinoid tumors, only sx may be constipation, and has a change in stool shape

A

colon

59
Q

is there tenderness in colon obstruction

A

no

60
Q

can fecal mass be palpated in colon obstruction?

A

yeah

61
Q

describe the differences between ileostomy and colostomy

A

ileostomy
1. ileum cut and connected to opening made through abdominal wall
2. fluid is liquid/semi liquid
colsotomy
1. diseased/damaged aprt of colon removed, linked to opening made through abdominal wall
2. fluid is semisolid to solid

62
Q

describe the outputs of ileostomy/colsotomy

A

ileostomy = 500ml-1L
colostomy = 200-300 ml

63
Q

what makes up the common bile duct of the liver?

A

hepatic duct and cystic duct

64
Q

what organ has functions of…
* gluc/protein/fat/drug metabolism
* ammonia conversion
* vitamin and iron storage
* bile formation
* bilirubin excretion

A

liver

65
Q

which test…
* helps breakdown of protein
* process of turning food into energy
* in liver cells

A

ALT

66
Q

which test…
* found in many body tissues (mostly liver, heart, kidney, brain, RBC

A

AST

67
Q

which test…
* is a waste product of colon bacteria
* processed by liver into urea and glutamine
* can cross BBB if not disposed
* is toxic to the brain

A

ammonia

68
Q

which test…
* is made when hgb is broken down
* is from the gallbladder
* is turned into bile
* jaundice

A

serum bilirubin

69
Q

which test…
* is the msot abundant plasma protein
* holds fluid in bloostream
* carries hormones, vitamins, and enzymes

A

albumin

70
Q

what are causes of hep A

A
  • hepatitis A virus (HAV)
  • contaminated food/water
  • close contact with person/infected object
71
Q

what is the process of hep A

A
  • virus attacks liver cells
  • often self-limiting, rarely chronic
72
Q

is hep A symptomatic

A

no

73
Q

if hep a symptoms are present at all, what are they?

A
  • flu-like symptoms
  • abd pain
  • clay-colored stools
  • jaundice
  • pruritis
74
Q

labs/tests for hep a

A
  • LFTs (ALT/AST)
  • Ct/ultrasound
  • HAV antibodies
75
Q

acute interventions for hep a

A
  • rest
  • hydration
76
Q

what is the rare complication of hep a

A

acute liver failure

77
Q

what meds can help hep a

A

antiemetics

78
Q

how can nurses help hep a

A
  • self-limiting
  • rest/hydration/light diet
  • discuss transmission / handwashing
  • HAV vacc
  • avoid alcohol and watch OTC meds
79
Q

what are causes of hep b

A
  • hep b virus (HBV)
  • trasnmission from blood/semen/body fluid
  • can be acute/chronic
80
Q

what is heppening in hep b

A

virus attacks liver cells

81
Q

s/sx of hep b

A
  • takes 2 weeks - 1/4 months post transmission to manifest
  • flu-like sx
  • abd pain (RUQ)
  • dark urine
  • jaundice
  • joint pain
82
Q

labs/tests for hep b

A
  • (AST/ALT)
  • CT/ultrasound
  • HBV antibodies
  • liver biopsy
83
Q

acute interventions for hep b

A
  • rest
  • nutrition
  • antivirals
84
Q

what are complications of hep b

A
  • cirrhosis
  • liver failure / CA
  • kidney/vascular issues
  • portal HTN -> esophageal varices
85
Q

what meds can help hep b

A
  • entecavir, tenofovir, lamivudine, adefovir, telbivudine
  • interferon alfa-2b
86
Q

how can nurses help hep b?

A
  • vaccinate
  • can fully recover
  • discuss liver transplant options
  • avoid alc/meds
  • wear gloves
  • discuss transmission orevention
87
Q

what causes cirrhosis

A
  • liver disases
  • chronic obesity
  • certain meds
88
Q

what is…
* later stage scarring of liver, liver can’t regenerate more
* scar tissue to portal areas
* biliary duct obstruction
* heoatocytes to fat to scarred

A

cirrhosis

89
Q

how will a cline with cirrhosis present?

A
  • fatigue
  • easy bleeding/ecchymosis
  • nausea/anorexia
  • edema to lower extremities
  • weight loss
  • jaundice
  • late finding = GI varices and caput medusa
90
Q

how can nurses help cirrhosis

A
  • vitamin replacement
  • assess for varices!!
  • pain control
  • educate of drinking cessation
  • falls/bleeding risk
91
Q

labs/tests for cirrhosis

A
  • (ALT/inAST)
  • INR, BMP
  • MRI, CT, US
  • biopsy
92
Q

acute interventions for cirrhosis

A
  • pain control
  • nutrition replacement
  • complication control
93
Q

complications of cirrhosis

A
  • portal HTN
  • bleeding
  • splenomegaly
  • edema
  • malnutrition
  • hepatic encephalopathy
94
Q

what are causes of esophageal varices

A
  • serious liver diseases
  • clot
  • scar tissue
95
Q

what results from…
* collateral circulation
* smaller vessels=too much work
* vessels enlarge = rupture
* life-threatening bleeding
* -portal HTN

A

esophageal varices

96
Q

how will a client present with esophageal varices

A
  • vomit large amnts of blood
  • melena/coffee ground emesis
  • anemia/weakness/dizziness
97
Q

labs/tests for esophageal varices

A
  • endoscopy
  • CT
  • doppler US
  • CBC
  • (ALT/AST)
98
Q

acute interventions for esophageal varices

A
  • blood transfusion/fluid replacmeent
  • emergent suregry
  • meds to slow bleeding/flow
  • balloon tamponade
99
Q

complications of esophageal varices

A
  • hypovolemic/hemorrhagic shock
  • death
100
Q

meds that can help esophageal varices

A
  • octreotide / vasopressin (constrict)
  • beta-blockers (propanolol, nadolol)
101
Q

how can nurses help esophageal varices

A
  • NG tube / NPO
  • blood transfusion
  • reduce anxiety/enhance coping
  • obesity management
  • no unprotected sex/sharing needles
102
Q

what stores bile

A

gallbladder

103
Q

how much bile does the gallbladder hold?

A

30-50 ml

104
Q

what emulsifies fats and contracts when food is in the duodenu,m

A

gallbladder

105
Q

what are causes of cholecystitis

A
  • gallstones
  • acalculous
  • bile duct problems
  • tumor/infection
106
Q

what is…
* inflammation of gallbladder
* blockage from excretion
* infection, perforation, rupture

A

cholecystitis

107
Q

what quadrant is cholecystitis

A

RUQ

108
Q

characteristics of _ are…
* pain to right shoulder
* pain afetr fatty meal
* n/v or anorexia
* fever
* dark urine / clay colored stool

A

cholecystitis

109
Q

labs/tests for cholecystitis

A

ERCP (scope)
HIDA scan
CT
gallbladder US
CBC BMP LFT

110
Q

acute interventions for cholecystitis

A

antibiotics
surgical removal

111
Q

complications of cholecystitis

A

infection
perforation
sepsis/death

112
Q

meds that can help cholecystitis

A

opioid pain relief
antibiotic

113
Q

how can nurses help cholecystitis

A
  • discuss danger of rapid weight loss
  • maintian healthy weight
  • monitor surgical site
114
Q

causes of pancreatitis

A
  • enzymes inactive while in pancreas
  • alcohol/gallstones
  • abd suregry/certain meds
  • trauma
115
Q

what is…
* pancreas inflammation
* unable to work properly
* eventual scarring
* acute/chronic

A

pancreatitis

116
Q

s/sx of acute pancreatitis

A
  • upper abd pain
  • radiates to back
  • pain worse after eating
  • n/v, anorexia
117
Q

s/sx of chronic pancreatitis

A
  • upper abd pain
  • losing weight
  • oily, smelling stools
118
Q

labs/tests for pancreatitis

A
  • amylase/lipase
  • stool tests
  • CT/MRI
  • abdominal US
  • ERCP
119
Q

acute interventions for pancreatitis

A
  • fasting -> clear liquid -> low fat
  • pain meds
  • NSAIDs
  • IV fluid
120
Q

surgical interventions forpancreatitis

A
  • ERCP
  • surgery to remove tissue, drian fluid
  • cholycystectomy (if stones)
121
Q

what are complications of pancreatitis

A
  • infection
  • kidney failure
  • breathing rpobs
  • diabetes
  • malnutrition
  • pancreatic CA
122
Q

meds that can help pancreatitis

A
  • opioids
  • pancreatic enzymes
123
Q

how can nurses help pancreatitis

A
  • pain control
  • alc/drug cessation
  • nutriotion
  • discuss enzyme replacmeennt
  • CA screening
  • hydrate!

Adults (35 decks)

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