Lewis ch 42 - lower GI problems Flashcards
difference between acute, chronic, and persistent diarrhea (# days)
acute: <14 days
chronic: >14 days
persistent: >30 days
what symptom is associated with E Coli
bloody diarrhea
what organism causing infectious diarrhea is hospital acquired
C diff
increased risk for diarrhea from infectious organisms (4)
- older adults
- use of PPIs
- use of antibiotics
- immunocompromised
noninfectious causes of diarrhea (4)
- drugs (laxatives)
- food intolerances (lactose, undigested carbs)
- osmotic (rapid GI transit)
- malabsorption (celiac disease, short bowel syndrome)
S+S upper GI diarrhea (4)
- large volume watery stools
- periumbilical pain
- cramping
- low grade/no fever
S+S lower GI diarrhea (2)
- small volume bloody diarrhea
- fever
what ABG imbalance can severe diarrhea lead to
metabolic acidosis
2 possible antibiotics for diarrhea
floroquinolone
azithromycin
patients at risk for cdiff infection (4)
- antimicrobial agents
- chemotherapy
- gastric acid suppressing agents
- immunosuppressive agents
Involuntary passage of stool related to motor and/or
sensory dysfunction
fecal incontinence
common causes fecal incontinence (6)
- anal sphincter weakness
- functional
- inflammatory
- neurologic disease
- pelvic floor dysfunction
- other (diarrhea, fecal impaction)
irritating diarrhea-producing foods (4)
- caffeine
- artificial sweeteners
- dairy products
- vegetables with insoluble fiber
◦Difficult or infrequent bowel movements
◦May require excessive exertion to defecate
◦Feeling of incomplete evacuation
◦Symptom, not a disease
constipation
difference between acute and chronic constipation (# days)
acute: <1 week
chronic: >3 months
risk factors constipation (7)
- low fiber diet
- decreased physical activity
- ignoring urge to defecate
- anxiety, depression
- diseases that slow GI transit
- drug induced (opioids)
- cathartic colon syndrome
4 causes abdominal pain
inflammation
peritonitis
obstruction
internal bleeding
2 complications abdominal pain
septic shock
hypovolemic shock
S+S abdominal pain (4)
- N/V/D
- rebound tenderness
- fever
- bloating
3 complications abdominal trauma
- shock
- peritonitis
- abdominal compartment syndrome
S+S abdominal trauma (4)
- hard distended abdomen
- decreased or absent bowel sounds
- cullens or grey turners sign (bruising)
- signs hypovolemic shock
Chronic abdominal pain or discomfort and alteration
of bowel patterns
irritable bowel syndrome
4 categories IBS
- IBS w/ constipation (IBS-C)
- IBS w/ diarrhea (IBS-D)
- IBS mixed
- IBS unsubtyped
which type IBS more likely for men v women
men: IBS-D
women: IBS-C
S+S IBS (5)
- mucus in stool
- abdominal pain
- fatigue
- headache
- sleep problems
S+S appendicitis (4)
- persistent pain RLQ
- rebound tenderness
- pain
- N/V
primary cause peritonitis
blood-borne organisms
secondary cause peritonitis
perforation of organs that spill contents into
peritoneal cavity
S+S peritonitis (5)
- abdominal pain
- rebound tenderness
- fever
- tachycardia
- N/V
complications peritonitis (5)
- hypovolemic shock
- sepsis
- intraabdominal abscess
- paralytic ileus
- acute respiratory distress syndrome
common foodborne cause of gastroenteritis
norovirus
S+S gastroenteritis (3)
- sudden N/V/D
- fever
- abdominal cramping
Chronic, inflammation of GI tract characterized by
periods of remission are interspersed with periods of
exacerbation
inflammatory bowel disease
2 classifications IBD
ulcerative colitis
crohns
risk factors IBD (5)
- autoimmune diseases
- diet (high intake sugar and fat, low intake fiber, fruits and veggies)
- smoking
- NSAIDs, oral contraceptives, antibiotics
- genetic links
S+S crohns disease (3)
- diarrhea, cramping
- weight loss
- rectal bleeding
S+S ulcerative colitis (3)
- protein loss in stool
- pseudopolyp formation
- bloody diarrhea
2 options drug therapy for IBD
Sulfasalazine (folic acid)
corticosteroids (calcium and potassium)
4 types intestinal obstruction
- partial
- complete
- simple (intact blood supply)
- strangulated (no blood supply)
what ABG imbalance can result from high intestinal obstruction
metabolic alkalosis
4 hallmark S+S intestinal obstruction
- abdominal pain
- N/V
- distention
- constipation
2 types polyps
- hyperplastic: non-cancerous, <5 mm, asymptomatic
- adenomatous: neoplastic
saccular dilations or outpouchings of the mucosa in the colon
diverticula
multiple, noninflamed diverticula
diverticulosis
one or more inflamed diverticula
diverticulitis
complications diverticulitis (4)
- perforation
- abscess
- fistula
- bleeding
risk factors diverticulitis (5)
- constipation/lack of dietary fiber
- obesity/lack of activity
- smoking
- excess alcohol use
- excess NSAID use
S+S diverticulosis (4)
(most asymptomatic)
- abdominal pain
- bloating
- changes in bowel habits
- serious: bleeding
S+S diverticulitis (4)
- pain LLQ
- distention
- decreased/absent bowel sounds
- N/V
Abnormal tract between two hollow organs or a hollow
organ and the skin
fistula
difference between simple and complex fistula
simple: 1 short direct tract
complex: multiple organs, abscesses, opens into base of wound
low, moderate, and high outputs for fistula (mL)
low: <200 mL/day
moderate: 200-500 mL/day
high: >500 mL/day
early signs fistula (2)
fever
abdominal pain
Protrusion of intestine through an opening or weakened area in the cavity wall
hernia
hernia that cannot be placed back into abdominal cavity; abdominal contents are trapped
irreducible/incarcerated
complications of irreducible hernia
strangulated - blood supply compromised
intestinal obstruction
gangrene and necrosis
4 types hernias
◦Inguinal
◦Umbilical
◦Femoral
◦Incisional
S+S strangulated hernia (4)
- severe pain
- vomiting
- cramping and abdominal pain
- distention
Impaired absorption of fats, carbohydrates, proteins,
minerals, and vitamins
malabsorption syndrome
5 common causes malabsorption syndrome
- IBD
- celiac disease
- tropical sprue
- cystic fibrosis
- lactose intolerance
most common cause malabsorption syndrome
lactose intolerance
most common signs malabsorption syndorme (3)
- weight loss
- diarrhea
- steatorrhea (fat in feces)
Autoimmune disease that damages small intestine
mucosa; triggered by gluten
celiac disease
classic S+S celiac disease (5)
- foul-smelling diarrhea
- abdominal pain
- abdominal distention
- flatulence
- malnutrition
risk factors hemorrhoids (6)
- pregnancy
- constipation
- straining
- diarrhea
- obesity
- heavy lifting
S+S hemorrhoids (4)
- bleeding with defecation
- prolapse
- itching, burning, edema
- thrombosis
Skin ulcer or crack in lining of anal wall
anal fissure
causes of anal fissures (4)
- trauma from hard stool
- anal trauma
- local infection (STDs)
- inflammation
S+S anal fissure (2)
- pain with defecation and pressure
- bleeding
Perianal collection of pus due to obstruction of anal
glands results in infection
anorectal abscess
S+S anorectal abscess (5)
- local severe pain and swelling
- foul-smelling drainage
- tenderness
- fever
- possible: sepsis
Abnormal tunnel from anus or rectum to skin, vagina,
or buttocks
anal fistula
