Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medical Surgical Nusing > Lower Gastrointestinal Problems > Flashcards

Lower Gastrointestinal Problems Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

What are 8 common lower GI problems?

A

Appendicitis, Peritonitis, Inflammatory Bowel Disease (Crohn’s disease, ulcerative colitis), Irritable bowel syndrome, diverticulitis, intestinal obstruction (mechanical, neurological), colon cancer, hemorrhoids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 4 lower GI diagnostic tests?

A

colonoscopy, flex sigmoidoscopy (only look at rectum and sigmoid colon), barium enema, Labs (electrolytes, Hgb, Hct, WBC, BUN, FOB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Appendicitis?

A

Inflammation of the appendix; possible rupture, if not removed, can lead to peritonitis. It is the leading cause of emergency abdominal surgery; most common in people ages 10-30 yo.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Appendicitis: what are come causes of appendicitis?

A

obstruction of appendiceal (appendic and cecum) lumen, mucus backs up in lumen, bacteria multiply, appendix swells, infection, gangrene, perforation. Sources of obstruction: stool, parasites, growths, Crohn’s, UC, trauma, infection, enlarged lymph tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Appendicitis: what are 5 S/S or manifestations?

A

pain (1st symptom), tenderness (localized/rebound), loss of appetite, NV, fever (last symptom to appear; retrograde).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Appendicitis: what are 3 complications that may occur?

A

perforation, peritonitis, abscesses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Appendicitis: what are 4 diagnostic tests used to detect appendicitis?

A

Labs (CBC, UA, pregnancy test), X-ray/CT/Ultrasound, Peritoneal aspiration (look for things not common in abd cavity), Physical Exam (Rovsing sign: apply pressure in LLQ, when released feel pressure in RLQ).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Appendicitis: what are 6 nursing care options?

A

NPO, Ice RLQ (heat ma cause perforation), no laxatives/enemas, pain management (if pain suddenly goes away, means perforation), assess for complications/peritonitis, pre/post-op appendectomy care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Peritonitis?

A

inflammation of the peritoneum. Fluid shift into the abdominal cavity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Peritonitis: what are 6 causes for peritonitis?

A

Organisms, Cirrhosis with ascites, pancreatitis, GI obstruction, GI perforations d/t appendicitis/PUD/diverticulitis/abdominal trauma, post-op complications.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Peritonitis: what are some S/S or manifestations?

A

abdominal pain/rebound tenderness, muscular rigidity/distention/spasm, fever/tachycardia/tachypnea/ N/V.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Peritonitis: What are some complications of peritonitis?

A

Hypovolemic shock acute respiratory distress, sepsis, paralytic ileus, abscess formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Peritonitis: what are some diagnostic tests used to detect peritonitis?

A

Labs (CBC, electrolytes, ABG, BUN, creatinine, UA), ultrasound, CT scan, peritoneal lavage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Peritonitis: what are 7 nursing considerations?

A

airway, fluid/electrolyte replacement, continual assessment, prevent hypovolemic shock (NS/LR), NGT (decompress), Laparotomy (surgical repair), post-surgical care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is inflammatory bowel disease?

A

Intestinal disorders of unknown cause (other causes for inflammation need to be ruled out), periods of remission alternate with exacerbations, treatment with meds for acute inflammation/ maintain remission (UC, Crohn’s disease).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Ulcerative colitis (UC)?

A

Mucosal inflammation involving only the colon (begins in rectum and progresses proximally; usually limited to rectum and sigmoid), involves mucosa and submucosa, mucosa develops diffuse ulceration and hemorrhage (with congestion, edema, exudative inflammation), healing leaves scars that shorten/narrow colon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

UC: what are 3 S/S or manifestations?

A

Diarhea usually with blood/mucus (10-20 liquid stools/day), mild pain (LQ or rectal), fever/malaise/weight loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

UC: what are 5 potential complications?

A

toxic megacolon (colon becomes so dilated, it becomes permeable to bacteria and swells), hemorrhage, crypt abscesses (abscesses on wall of colon, causing shortening of colon), obstruction, perforation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

UC: what are some increased risks for UC?

A

colon cancer, extraintestinal symptoms (arthritis, uvelitis, hepatitis, pancreatitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

UC: what are 3 diagnostic tests used to detect UC?

A

Labs (CBC, stool cultures, FOB), Sigmoidoscopy/colonoscopy (Preferred), barium enema (is patient is at a flare up, procedure is aborted at risk for perforation).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Crohn’s Disease?

A

Effects all layers of the bowel wall, possible GI tract involvement from rectum to esophagus, common in terminal ileum (location of absorption of B12), segmental inflammation (asymptomatic, patchy distribution of ulceration), no cure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Crohn’s Disease: What are some causes for CD? (potential causes, possible contributing factors, highest risk factors)

A

Potential causes: infectious, immunologic, genetic.
Possible contributing factors: dietary, environmental, smoking, psychosocial.
Highest Risk factors: jewish descent, caucasian, urban setting, 2nd/3rd decade of life, familial association.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Crohn’s Disease: what are 5 S/S or manifestations?

A

Abdominal pain (intermittent/colicky), diarrhea (fewer bowel movements than UC), possible rectal bleeding, weight loss, fever.

24
Q

Crohn’s Disease: what are 7 complications of Crohn’s Disease?

A

Fistulas, localized abscesses, perforation, obstruction, toxic megacolon (not as big of a risk), extraintestinal symptoms (skin disorders), malabsorption of bile salts and vit B12.

25
Q

Crohn’s Disease: What are 6 diagnostic tests used to detect CD?

A

Labs (CBC, stool OB, albumin, folic acid), capsule endoscopy, colonoscopy with biopsy, double balloon with biopsy, barium swallow/enema, Upper GI series (string sign of terminal ileum), ultrasound.

26
Q

IBD: what are some collaborative care options?

A

Drug therapy: Anti-inflammatory (mesalamine, 5-ASA agents), corticosteroids (prednisone), anti-metabolite (methotrexate), immunosuppressants (6-mercaptopurine: wont see benefits till months later), immunomodulator (infliximab: interferes with DNA and RNA, pt at risk for lymphoma) antimicrobials/antidiarrheals.

27
Q

IBD: what 6 things would you teach the patient?

A

rest and diet, perianal care, medications (action, s/e), symptoms of recurrence, medical care (when to seek out), stress reduction techniques (r/t stress induced flare-ups).

28
Q

What is irritable bowel syndrome?

A

group of symptoms r/t functional disorder of large intestine (colon). Cause is unknown: increased sensitivity in nerves and muscles (theory)

29
Q

IBS: what are some S/S or manifestations?

A

abdominal pain, cramping, bloating, gas, diarrhea, constipation, rome III criteria (relief of pain with defecation, onset of pain with stool characteristics, onset of pain with stool frequency).

30
Q

IBS: what are some things to teach the patient to avoid possible recurrences?

A

avoid: fatty foods, milk products, alcohol, caffeine, carbonated drinks. Increase fiber/small meals, stress relief, medications (antispasmotics, laxative).

31
Q

What is Diverticular Disease?

A

characterized by herniation at weak points in the intestinal mucosa and submucosa. Most common in descending colon and sigmoid colon.

32
Q

Diverticular Disease: what are 5 contributing factors?

A

constipation, straining, obesity, low-fiber diet, hypertrophy of colonic muscle.

33
Q

What is Diverticulitis?

A

inflammation of the diverticulum.

34
Q

Diverticulitis: what are some S/S or manifestations?

A

fever, LLQ pain/tenderness, possible N/V, constipation

35
Q

Diverticulitis: what are 4 potential complications?

A

bleeding, rupture of inflamed diverticulum (peritonitis), abscess formation, vesicocolonic fistula formation

36
Q

Diverticulitis: what are 5 diagnositic tests?

A

Labs (CBC, FOB, Ua for stool), X-ray, barium enema, CT with contrast, colonoscopy/sigmoidoscopy.

37
Q

Diverticulitis: What are some collaborative care options

A

high-fiber diet, exercise, bulk-forming laxatives, wt loss, decreased straining/intraabdominal pressure, acute diverticulitis: red rest/bowel rest/antibiotics/analgesics, surgical intervention (obstruction, abscess, colon resection, temporary diverting colostomy).

38
Q

What is Intestinal Obstruction?

A

When GI content cannot pass through intestine. May occur in large or small intestine. May be mechanical, neurogenic, or vascular.

39
Q

What is mechanical obstruction?

A

detectable occlusion

40
Q

What is neurogenic obstruction?

A

pseudoobstruction, no mechanical blockage.

41
Q

What is vascular obstruction?

A

when blood supply to bowel is interrupted (patient can go ischemic in 5 minutes; caused by HTN)

42
Q

Intestinal Obstruction: what are some causes?

A

polyps, tumors, feces (intraluminal)
stricture or pyloric stenosis (intramural)
post-op adhesions or hernias (extrinsic)
paralytic ileus.

43
Q

Intestinal Obstruction: what are some S/S or manifestations of obstruction?

A

N/V, abdominal pain/cramping, high pitched or absent BS, distention, inability to pass flatus, constipation, signs of dehydration/fluid shifts.

44
Q

Intestinal Obstruction: what are 2 potential complications that may occur?

A

ischemia, peritonitis.

45
Q

Intestinal Obstruction: what are some collaborative care options?

A

regulate F/E imbalances, decompress GI tract, Meds (promotility-reglan, antibiotics), restoring bowel patency (endoscopically: dilation, polypectomy. Surgically: resection with anastomosis, colectomy, colostomy, ileostomy).

46
Q

Intestinal Obstruction: What are some nursing considerations?

A

NPO (ice chips), assess distention/BS/Pain/Shock, IV fluids with KCl, elevate HOB, Assist OOB and ambulate, oral/nasal care.

47
Q

Colorectal CA: what are some risk factors?

A

Increasing age, heredity (familial adenomatous polyposis: develop 100s of polyps; Lynch syndrome/hereditary nonpolyposis colorectal CA: suseptibility to all other CA), Hw of polyps, UC for more than 7 years, genital CA or breast CA

48
Q

Colorectal CA: what are some diagnostic test used to detect colon CA?

A

recommended screening starts at age 50, flex sigmoidoscopy and FOBT (done Q5 years), colonoscopy (gold standard, done Q10 years unless found something Q3-5 years), double contrast barium enema (done Q5 years), CT colongraphy (virtual colonoscopy).

49
Q

Colon CA: what are the S/S or manifestations of a right sided tumor?

A

Melenic stool, dull abdominal pain, anorexia, malaise/lethargy/weakness.

50
Q

Colon CA: what are some S/S or manifestations of a left sided tumor?

A

change in bowel habits, ribbon/pencil shaped stool, abdominal distention, constipation, cramping, rectal pressure, hematochezia (BRB of rectum).

51
Q

Colon CA: what are some complications of colon CA?

A

mets to liver/lungs/bones/brain, bowel obstruction, bleeding, perforation, peritonitis.

52
Q

Colon CA: what are some diagnostic tests used to detect colon CA?

A

stool: FOB, FIT, sDNA; sigmoidoscopy/colonoscopy with biopsy/cytology/polypectomy (gold standard), barium enema (double contrast), serum carcinoembryonic antigen test (CEA/CBC, LFT), MRI, CT scan

53
Q

What are hemorrhoids?

A

dilated veins in the anal canal. Internal: above internal sphincter. External: below external sphincter.

54
Q

What are some S/S or manifestations of internal hemorrhoids?

A

Hematochezia (most common), prolapsed hemorrhoids become irritated causing pain.

55
Q

What are some S/S or manifestations of external hemorrhoids?

A

painful swelling, itching, burning, bleeding

56
Q

Hemorrhoids: what are some nursing and collaborative care options?

A

diet high in fiber and fluids, OTC drugs/analgesic ointments/sitz bath/ice packs, internal surgical option (banding/ligation, infrared photocoagulation), external surgical option (hemorrhoidectomy, hemorrhoid stapling).

Medical Surgical Nusing (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions