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PRNU 234 Med Surg 2 > Lecture 3 Intestinal Disorders > Flashcards

Lecture 3 Intestinal Disorders Flashcards

1
Q

what are the components of the small intestine?

A

duodenum
jejunum
ileum

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2
Q

what is the function of the small intestine?

A

absorb nutrients

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3
Q

what are the components of the large intestine?

A

cecum
ascending colon
transverse colon
descending colon
sigmoid colon
rectum
anus

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4
Q

what is the function of the large intestine?

A

absorb water and electrolytes

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5
Q

what is IBS?

A

chronic changes in bowel function without evidence of tissue changes or inflammation

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6
Q

risk factors for IBS

A

female sex
stress
diet - alcohol and caffeine

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7
Q

clinical manifestations of IBS

A

constipation
diarrhea
abdominal pain, bloating, distention

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8
Q

management of IBS

A

stress reduction
adequate sleep
exercise
restrict irritating foods

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9
Q

medications for IBS

A

psyllium for fiber and dicyclomine for both types
loperamide and alosetron for IBS D
lubiprostone for IBS C

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10
Q

dietary management of IBS

A

30-40 grams of fiber per day
food and bowel habit diary
avoid trigger foods
adequate fluid intake
avoid alcohol and smoking
probiotics

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11
Q

what is primary peritonitis?

A

spontaneous bacterial peritonitis
usually see in people with liver disease and ascites

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12
Q

what is secondary peritonitis?

A

related to perforation of abdominal organs and spillage of contents into abdominal caviity

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13
Q

clinical presentation of peritonitis

A

diffuse abdominal pain or intense localized pain
pain worse with movement
rebound tenderness
rigid, distended abdomen
anorexia, N/V
paralytic ileus

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14
Q

how is peritonitis diagnosed?

A

aspiration and culture of fluid
X ray
CT scan

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15
Q

medications for peritonitis

A

analgesia
anti emetics
IV antibiotics

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16
Q

treating peritonitis

A

drainage - pericentesis
surgery

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17
Q

diverticulum

A

sac like herniation of bowel lining

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18
Q

diverticulosis

A

existence of diverticula, asymptomatic

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19
Q

diverticulitis

A

inflammation and infection of diverticula

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20
Q

risk factors for diverticulitis

A

older age
low fiber diet
NSAIDs
family history

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21
Q

complications of diverticulitis

A

fistulas
abscesses
perforation
hemorrhage
obstruction
peritonitis

22
Q

clinical manifestations of diverticulosis

A

chronic constipation

23
Q

clinical manifestations of diverticulitis

A

LLQ cramping, acute onset
constipation
bloating
nausea
fever
bleeding

24
Q

diagnosing diverticulitis

A

CBC for leukocytosis, decreased H&H
abd CT scan with contrast

25
Q

provider orders to anticipate for diverticulitis

A

electrolyte test
NPO - bowel rest and potential surgery
IV medications and fluid if NPO
H&H
pain meds, antiemetics if N/V

26
Q

nursing priorities for diverticulitis

A

s/s of electrolyte imbalances
pain control
s/s of infection

27
Q

uncomplicated diverticulitis management at home

A

clear liquid diet
rest
advance slowly to high fiber low fat diet
maybe pain meds and antibiotics

28
Q

Hospital management of complicated diverticulitis

A

NPO
IV fluids
NG suction if vomiting and distention present
antibiotics
potentially opioid analgesia

29
Q

surgical interventions for diverticulitis

A

one-stage resection - anastomosis of intestine

hartmann’s procedure

30
Q

hartmann’s procedure

A

proctosigmoidectomy - colon and rectum separated
colostomy is created
colostomy may be reversed at later time

31
Q

what is IBD?

A

inflammatory bowel disease
inflammation or ulceration of bowel
Crohn’s or UC

32
Q

risk factor’s for IBD

A

age
race/ethnicity
family history
smoking
use of NSAIDs
viral illness

33
Q

what causes IBD?

A

immune response that causes inflammatory changes

34
Q

where does crohn’s disease occur?

A

can affect all the layers of the bowel and can occur anywhere in GI tract

most common is distal ileum and ascending colon

35
Q

long term bowel change from crohn’s disease

A

bowel thickening and fibrosis can cause narrowing of intestinal lumen

36
Q

complications of Crohn’s disease

A

intestinal obstruction
malnutrition/malabsorption
fistulas
abscesses
increased risk of colon cancer

37
Q

clinical manifestations of Crohn’s

A

crampy abdominal pain worse after eating
diarrhea and steatorrhea
anorexia
weight loss, anemia
fever, leukocytosis

38
Q

how does diseased tissue of Crohn’s differ from diseased tissue of UC?

A

crohn’s - ulcers and edematous patches

UC - desquamation, shedding of epithelium causes bleeding and diffuse lesions

39
Q

where does UC occur?

A

superficial - mucosal and submucosal layers
affects rectum and colon

40
Q

long term bowel changes from UC

A

bowel shortens, narrows, and thickens

41
Q

clinical manifestations of UC

A

diarrhea with mucus, pus, blood
LLQ pain
cramping
anorexia
vomiting

42
Q

diagnosing UC

A

colonoscopy
fecal occult blood test
CBC
stool studies to rule out other causes
barium enema
CT scan or MRI

43
Q

complications of UC

A

perforation
bleeding
toxic megacolon

44
Q

signs and symptoms of toxic megacolon

A

fever
vomiting
abdominal pain and distention

45
Q

treatment for toxic megacolon

A

NG suction
IV fluids, electrolytes, antibiotics, corticosteroids
surgery

46
Q

course of Crohn’s vs UC

A

crohn’s - prolonged and variable, may have exacerbations and remissions

UC - exacerbations and remissions

47
Q

frecquence of bleeding Crohn’s vs UC

A

Crohn’s - bleeding is rare

UC - bleeding is common

48
Q

skin and pouch care for ostomy

A

pouch should be worn at all times, with proper fit of wafter to avoid skin contact with stool

inspect skin and check for seal

empty regularly to avoid leaking or bursting

48
Q
A
48
Q
A
49
Q

diet after ostomy placement

A
50
Q
A

PRNU 234 Med Surg 2 (7 decks)

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