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NURS 347 EXAM 5 UROLOGY > Lower Gastrointestinal Problems > Flashcards

Lower Gastrointestinal Problems Flashcards

1
Q

What is diarrhea?
What is acute (days)
What is persistent (days)
What is chronic (days)

A

The passage of 3 loose or liquid stools per day
14 days or less
More than 14 days
More than 30 days

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2
Q

Etiology and pathophysiology
The primary cause of diarrhea is ?
What is the most common?
E.coli caused what?
Giardia Lamblia causes what?
Clostridium difficult is ?

A

Infectious organisms
Viruses
Bloody diarrhea
Intestinal parasite
Hospital acquired

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3
Q

How is the transmission of diarrhea? (2)

A

Contaminated food or water
Fecal to oral route

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4
Q

Susceptibility of getting diarrhea?
(5)
Explain or example or each one

A

Age - older adults

Gastric acidicity
- proton pumps inhibitors decrease stomach acid and organisms survive

Intestinal micro flora
- microbial barrier altered by antibiotics
( c.diff infection - most serious )

Immune status
- immunocompromised due to disease or jenjuni enteral feedings

Laxatives, cealic disease, large amounts of carbohydrates

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5
Q

Clinical manifestations of diarrhea in upper gI tract (6)

A

Large volume
Watery stools
Cramping
Periumbical pain
Nausea/ vomiting
Low grade or no fever

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6
Q

Lower gi tract clninucal manifestations of diarrhea are (2)

A

Small volume
bloody diarrhea

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7
Q

Can the stool contain leukocytes blood and mucus ? True or false

A

True

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8
Q

Severe diarrhea manifestations are ? (3)

A

Dehydration ( life threatening )
Electrolyte imbalance ( K+)
Acid base imbalances ( metabolic acidosis )

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9
Q

Clostridium difficle infections causes (2)

A

Colitis and intestinal perforation

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10
Q

What are diagnostic studies we can for diarrhea? (7)

A

Stool cultures
- blood, muscus, wbc, infectious organisms

Blood cultures
- sepsis and immunocompromised

Wbc

Anemia
- iron and folate deficiency

Bun, creatinine, electrolytes, ph, osmolatoy

Stool fat, protein

Gi hormones

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11
Q

C.diff can live up to how many days?
What type of precautions?
Prophylaxis or adjunct therapy of what?

A

70 days
Contact

Lactobacillus

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12
Q

What’s the treatment of c.diff?
(2) and how long?
What’s the alternate?

A

Oral vancomycin or fidaxomicin for 10 days

Metronidazole

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13
Q

If it c.diff recurring what is it called that we can do for them?

Which is?
How can it be given? (3)

Concern when doing is?

A

Fecal microbitota transplantation
Donor feces administered
Enema, nasoenteral tube, colonoscopy

Infection

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14
Q

Nursing implentstion for diarrhea is? (6)

A

Consider all diarrhea infections until known
Meticulous hand hygiene
Flush vomit and stool in toilet
Teach and caregiver
- hygiene, PPE, proper food handling

Contact isolation
Disinfection 10% bleach or c.diff sporicidal

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15
Q

Fecal incontinece is what?

A

Involuntary passage of stool related to motor or sensory dysfunction

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16
Q

Diagnostic studies for fecal Incontience are? (3)

A

H&P( health & physical )
Rectal examination
Anorectal : manometry, ultrasound or electromyography

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17
Q

What does encopresis mean?

A

Constipation with leakage

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18
Q

Management of fecal incontience is? (8)
Examples of foods are (5)

A

Depends on the cause
- bowel movement program
- regular dedication high fiber
- increase fluids

  • fiber supplements
  • bulk forming laxatives
  • reduce irritating diarrhea producing foods

( coffee, sweets, diary producing, gas producing vegs ( beans ) & vegs with insoluble fiber )

Remove fecal impaction

Anti diarrheal angents

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19
Q

Nursing assessment for fecal Incontience is? (6)

A

Previous and current bowel patterns
Bristol’s stool scale
Sensation or urgency to Defecate
Interference with daily activities, diet, family
Perineal irritation or breakdown
( Incontience associated dermatitis )

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20
Q

Nursing implantation for fecal Incontience is that you are going to want to do these things
What program?
Maintain skin integrity how?

A

Bowel training program

Prompt cleaning, moisturizing; skin protecting

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21
Q

Patient education on fecal Incontience is?

A

Reduce episodes
Coping strategies
Identify triggers

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22
Q

What are characteristics of constipation? (3)

A

Difficulty or infrequent bowel movements

Excessive exertion

Feeling of incomplete evacuation

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23
Q

Constipation is a what and not a ??

A

Symptom not a disease

24
Q

Acute constipation?
Chronic constipation is?

A

Less than 1 week
More than 3 months

25
Q

Risk factors of constipation are? (6)

A

Low fiber diet
Decrease physical activity
Ignore urge to defecate
Emotions anxiety depression
Conditions that slow transit
Medications - opioids

26
Q

What are symptoms of constipation ? (5)

A

Discomfit
Hard, dry stools
Abdominal distention
Fecal impaction
Perforation

27
Q

Diagnostic studies for constipation are? (4)

A

Health and physical exams
Abdominal perianal and rectal areas

Bloody stools, anemia weight loss

Abdominal X rays, barium enema, colosnocpy

28
Q

What is diverticula?
Common mainly in?

A

Saccular dilations or outpouching of the mucosa in the colon

Older adults

29
Q

What is diverticulosis? (2)

A

Multiple
Noninflammated diverticula

30
Q

What is diverticulitis?

A

One or more inflamed diverticula

31
Q

Complications of diverticula is? (4)

A

Perforation
Abscess
Fistula
Bleeding

32
Q

Diverticula mainly happens where?
Develops at weak points like?
Main factors are (2)
Other factors are ? (4)

A

Left descending sigmoid colon
Blood vessels pass through muscle layer

Constipation & dietary fiber

Obesity; inactivity, smoking, ETOH, NSAID

33
Q

Diverticulosis is mainly asymptotic
But can show clinical manifestations of? (4)

Serious would be? (2)

A

Abdominal pain
Bloating
Flatulence
Changing in bowel habits

Bleeding & diverticulitis

34
Q

Diverticulitis manifestations are? (6)

Older adults will have? (3)

A

Acute pain in LLQ
Distention
Decreased/absent bowel sounds
Nausea
Vomiting
Systemic symptoms of infections

Afebrile
Normal WBC
Possible abdominal tenders

35
Q

Complications of diverticula are? (5)

A

Erosion of bowel wall
Perforation
Abscess
Peritonitis
Bleeding

36
Q

What are diagnostic studies of diverticula? (8)

A

Sigmoidoscopy/colonoscopy
CT scan
Occult blood
CBC
urinalysis
Barium enema
Blood culture
X ray

37
Q

Prevention of diverticula is ? (2)

A

High fiber diet ( no fat or red meat )
Physical activity

38
Q

Goal of acute diverticula is ?
By having ? (3)

A

Bowel rest to reduce inflammation
Clear liquid, bed rest and analgesic

39
Q

If severe symptoms, systemic infection or comorbities happen you are going to want to do what for diverticula patients? (6)

A

NPO
NGT
BED REST
IV FLUID& ANTIBIOTICS
OBSERVE SIGNS OF ABSCESS,BLEEDING, PERITONITIS
advance diet as tolerated

40
Q

If diverticulitis is reoccurring you are going to want to do what? (2)

A

Surgical resection with anastomos
Temporary colostomy

41
Q

Patient eduction on diverticula is? (4)

A

Explain condition
High fiber diet
Fluids : 2 L a day
Avoid increase intraabdominal pressure

42
Q

What is a fistula?

A

Abnormal tract between two hollow organs or hollow organ and the skin

43
Q

Fistula complication is?

A

Increase morbidity and mortality
Extended. Length of stay and increase cost

44
Q

Fistula simple is?
Fistula complex is ?

A

1 short direct tract
Multiple organs, abscess, opens into base of wound

45
Q

Output of a fistula is ?
Low
Moderate
Greater

A

200ml
200-500ml
500ml

46
Q

Early signs of fistula are? (2)

A

Fever and abdominal pain

47
Q

Nursing and Interprofessional & management of fistulas are? (7)
Explain the last one

Most heal sponganeoulsy but some require surgery ( notes )

A

Identify tract
Maintain fluid’s&electrolytes
Control infection
protect the skin
Manage I&O
Nutritional support
( high calorie, protein )

48
Q

What is a hernia ?

Most occur in the ___ and who?

A

Protrusion of intestine through an opening or weakened area in the cavity wall

Abdomen and men

49
Q

Hernia reducible means
Irreducible/incarcerated means?

A

Easily returns to abdominal cavity

Cannot be placed back into abdominal/ trapped

50
Q

When we have irreducible or incarcerated hernias, we can have 3 things happen

A

Strangulated - blood supply compromised
intestinal obstruction
- gangrene & necrosis

51
Q

What are the 4 types of hernias?

A

Inguinal
Umbilical
Femoral
Incisional

52
Q

What are manifestations of a hernia?
Can it be visible?

A

Pain
( increase with activities that increase intraabdominal pressure )

Yes

53
Q

Strangulated manifestations of hernia are? (5)

A

Severe pain
Vomiting
Cramping
Abdominal pain
Distention

54
Q

Diganosis of hernia is?
Treatment?

A

History and physical exam
Imagining - ct scan

Surgery

55
Q

Post operative care for hernia is? (6)

A

Monitor voiding & i&O

Scrotal edema - ice and elevation

Deep breathing
Splitting
Cough and sneeze mouth open

No heavy lifting (6-8 weeks)
No more than 10 pounds

NURS 347 EXAM 5 UROLOGY (16 decks)

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