Lower GI Flashcards
What are the 3 major problems associated with severe or prolonged diarrhea?
- Dehydration
- Electrolyte imbalances
- Vitamin deficiencies
What is the expected appearance of a normal ileostomy stoma?
Bright red, moist, with continuous liquid stool output
What is the most common symptom of colorectal cancer?
Change in bowel habits
What is borborygmus?
A rumbling noise caused by the movement of gas through the intestines
What is a hallmark symptom of peritonitis?
A rigid, board-like abdomen
What foods should be avoided in patient with celiac disease?
Wheat, barley, rye, and other gluten-containing products
What is the primary treatment for severe ulcerative colitis?
Amniosalicylates, corticosteroids, and possible surgical intervention (colectomy)
What are common symptoms of irritable bowel syndrome (IBS)?
Abdominal pain, bloating, diarrhea, constipation, or a mix of both
What is the Rome criteria used for?
Diagnosing irritable bowel syndrome
What is the best intervention for a patient with fecal impaction?
Manual removal followed by stool softeners & increased fluids
What is the indication for Loperamide (Imodium)?
Used to treat diarrhea by slowing intestinal motility
What should a nurse monitor when a patient is on Loperamide?
Signs of toxic megacolon, especially in ulcerative colitis
What is the mechanism of action of Psyllium (Metamucil)?
A bulk-forming laxative that absorbs water to soften stool and promote bowel movements
What should a nurse educate a patient taking Psyllium about?
Take with plenty of water to prevent choking or bowel obstruction
What class of medication is Docusate (Colace)?
Stool softener used to prevent constipation
What are the indications for Sulfasalazine (Azulfidine)?
Used to treat inflammatory bowel diseases like ulcerative colitis and Crohn’s disease
What should be monitored in patients taking Sulfasalazine?
Liver function, renal function, and complete blood count
What is a major side effect of prednisone in IBD management?
Long-term use can cause osteoporosis, hyperglycemia, and immunosuppression
What is Adalimumab (Humira) used for?
A biological therapy for Crohn’s disease and ulcerative colitis
What should be monitored for patients on Adalimumab?
Signs of infection, tuberculosis screening before treatment
A nurse is caring for a patient with ulcerative colitis who reports 10-20 blood stools per day. What is the priority nursing action?
Monitor for signs of dehydration and electrolyte imbalances
A patient with diverticulitis reports severe lower left quadrant pain and a fever of 101. What is the nurse’s best action?
Notify the physician as this may indicate perforation
A patient with an ileostomy reports peristomal skin irritation. What should the nurse do first?
Assess for leakage and ensure the ostomy appliance fits correctly
A patient taking prednisone for Crohn’s disease should be monitored for which adverse effects?
Hyperglycemia, osteoporosis, and increased risk of infection
A nurse is education a patient on dietary management for IBS. What statement indicates further teaching is needed?
“I should drink fluids with meals to aid digestion.”
-Fluids should be taken between meals to reduce bloating.
Which patient is at highest risk for colorectal cancer?
Older (60) with a history of polyps and a diet high in red meat
A patient is receiving Metronidazole (Flagyl) for C. Diff. What instruction should the nurse provide?
Avoid alcohol due to severe disulfiram-like reactions
A nurse assesses a patient with a bowel obstruction who reports nausea and vomiting. What is the priority intervention?
Insert a nasogastric (NG) tube for decompression as prescribed
What dietary instruction is appropriate for a patient with celiac disease?
Avoid wheat, barley, and rye-containing foods
A patient reports taking bisacodyl (Dulcolax) daily for constipation. What should the nurse teach?
Chronic use can lead to laxative dependence and electrolyte imbalances
What is a common complication of diverticulitis?
Abscess formation and bowel perforation
What lifestyle changes help prevent constipation?
High-fiber diet, increased fluid intake, and regular exercise
What symptoms indicate a possible bowel obstruction?
Nausea, vomiting, abdominal distention, and absence of bowel movements
What are common symptoms of Crohn’s disease?
Chronic diarrhea, abdominal pain (right lower quadrant), weight loss, and fatigue
What is the major difference between Crohn’s disease and ulcerative colitis?
Crohn’s can affect any part of the GI tract and has patchy inflammation, while ulcerative colitis is limited to the colon and has continuous inflammation
What is a potential complication of prolonged diarrhea?
Metabolic acidosis due to loss of bicarbonate
What stool characteristics are seen in a patient with ulcerative colitis?
Frequent watery stools with blood and mucus
What is the primary cause of colorectal cancer?
Genetic and environmental factors, including a diet high in red meat and low in fiber
How is an intestinal obstruction diagnosed?
Abdominal X-ray, CT scan, & bowel sounds assessment
What dietary modifications are recommended for patients with diverticulitis?
High-fiber diet and adequate fluid intake
What are two major complications can peritonitis lead to?
- Septic shock
- Hypovolemic shock
How can septicemia lead to shock?
Septicemia (infection in the bloodstream) causes vasodilation, leading to low blood pressure (hypotension), organ failure, and shock
Cytokines & inflammatory mediators make blood vessels leaky, causing fluid loss, further worsening hypovolemic shock.
Name a few other conditions that might progress to peritonitis. What assessment findings are specific to peritonitis?
Assessments:
-Perforated appendicitis
-Perforated peptic ulcer
-Diverticulitis with perforation
-Bowel obstruction with ischemia
-Trauma (gunshot/stab wounds to the abdomen)
Findings:
Board-like abdominal rigidity, severe pain, fever, tachycardia, absent bowel sounds
What potential complication can a patient run into when diagnosed with appendicitis?
-Perforation leading to peritonitis
-Sepsis
-Abscess formation
What are common types of hernias?
-Inguinal
-Umbilical
-Femoral
-Incisional
What is a complication of an untreated strangulated hernia?
Necrosis of intestinal tissue requiring emergency surgery
What are the main causes of peritonitis?
Appendicitis rupture, perforated ulcers, bowel perforation
What are the primary treatment for peritonitis?
IV fluids, antibiotics, and surgery if perforation occurs
What are common complications of diverticulitis
Abscess formation, perforation, sepsis
What symptoms suggest a patient has diverticulitis?
LEFT lower quadrant pain, fever, altered bowl habits
What is the recommended diet for diverticulosis?
High-fiber diet with adequate fluid intake
What are the primary causes of intestinal obstruction?
Mechanical: tumors, adhesions, volvulus
Functional: Paralytic ileus
What are the symptoms of an intestinal obstruction?
Vomiting, abdominal distention, absence of bowel movements
How is an intestinal obstruction treated?
NG tube decompression, IV fluids, surgery, if needed
What is the major difference between Crohn’s disease and ulcerative colitis?
Crohn’s affects any part of the GI tract with patchy inflammation, while ulcerative colitis is limited to the colon with continuous inflammation
What are the common symptoms of colorectal cancer?
Alternating constipation/diarrhea, blood in stool, weight loss
How is colorectal cancer diagnosed?
Colonoscopy with biopsy
What are signs of a strangulated hernia?
Severe pain, vomiting, absence of bowel sounds, and discoloration over the hernia site
