Lower GI Flashcards

1
Q

Complications of constipation

A

-Valsalva maneuver

-hemorrhoids/anal fissure

-fecal impaction

-megacolon

-diverticulosis

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2
Q

Tx of constipation

A

-increase activity, fluids, fiber

-laxatives, enemas (short term)

-stool softeners

-methylnaltrexone for opioid use

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3
Q

Sx of diarrhea

A

-cramp
-distention
-gas
-thirst
-tenesmus
-boyborygmus

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4
Q

Complications of diarrhea

A

-F/E imbalance (loss of Na and K)

-dehydration**

-metabolic acidosis

-skin breakdown

-lift threatening quick: elderly, very young, malnourished, immunocompromised

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5
Q

Diarrhea mgmt

A

-prevent F/E imbalance

-infection control

-diet: clear liquid, BRAT (banana, rice, applesauce, toast)

-preven skin breakdown

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6
Q

Acute abdomen

A

-requires quick surgical intervention

-risk of peritonitis, sepsis, septic shock

-rigidity, guarding, rebound tenderness

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7
Q

Appendicitis

A

-common cause of acute abd

-common in younger adults; higher mortality in elderly

-progress to gangrene and/or perforation within 6-24 hrs from pain onset

-ID and treat early

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8
Q

Diverticula disease

A

-cause: increased pressure and decrease muscle strength

-asymptomatic unless inflammation occurs

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9
Q

Diverticulosis

A

-no big deal

-many diverticula

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10
Q

Diverticulitis

A

-big deal

-inflammation of one or more diverticula

-access and fistula may form

-peritonitis can occur

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11
Q

Types of intestinal obstruction

A

-mechanical: you can see and remove it

-functional/paralytic: most common form is paralytic ileus

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12
Q

Small intentional obstruction

A

-cramp, wave like pain

-vomit: brown, orange, fecal smelling

-abd distention

-metabolic alkalosis

-lose fluids rapidly: dehydration and F/E imbalance

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13
Q

Large intestinal obstruction

A

-slower onset

-pain lower grade, cramp, abd

-absolute constipation

-dehydration and F/E imbalance more slowly

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14
Q

Bowel obstruction complications

A

-IVVD or hypovolemic shock
-electrolytes imbalance
-renal insufficiency
-peritonitis
-septic shock
-death

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15
Q

Pre op stoma care

A

-emotions
-site selection

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16
Q

Post op stoma care

A

-teach with first pouch change

-NGT, NPO

-bright red and moist is good

-dark leads to ischemia/necrosis

-stoma decreases after 5-7 days

-when peristalsis returns, fecal drainage starts

-skin care**

-limit odor foods

-change immediately if leaking

17
Q

IBS

A

-intermittent, recurrent, abd pain, stool pattern irregular

-abd distend, excessive gas, bloat, urgent

18
Q

Polyps

A

-cause rectal bleeding and bloody stool

-early removal decrease cancer

19
Q

Hemorrhoids

A

-dilated veins

-rectal bleeding, pruitis, pain

-high fiber with increase fluids

20
Q

Anal fissure

A

-skin ulcer or crack in lining of anal wall

-cause: trauma, infect or inflammation

-sx: anal pain and bleeding

-topical analgesics and stool softeners

-surgery last resort