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Adult Health Nursing I > Lower GI > Flashcards

Lower GI Flashcards

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1
Q

Appendicitis

A

Inflammation of the appendix

Characterized by Rousing’s sign, pain

Treatment is surgical removal

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2
Q

Diverticulosis

A

Multiple diverticula without inflammation

Chronic constipation, bowel irregularities, nausea, anorexia, bloating, abdominal distention

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3
Q

Diverticulitis

A

Infection and inflammation of the diverticula

Symptoms include mild/severe pain in LLQ, nausea, vomiting, fever, chills, and leukocytosis

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4
Q

Diverticular Disease

A

May occur anywhere in the intestine but most common in the sigmoid colon

Diagnosis is usually by colonoscopy

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5
Q

Care of Patient with Diverticulitis

A

Encourage fluid intake of at leased 2 L/day

Soft foods with increased fiber, such as cooked vegetables

Exercise

Bulk laxatives (psyllium) and stool softeners

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6
Q

Peritonitis

A

Inflammation of the peritoneum

Rupture and contamination are complications

Characterized by diffuse pain, tenderness, elevated WBC

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7
Q

Inflammatory Bowel Disease

A

Crohn’s Disease and Ulcerative Colitis

More prevalent in Jewish people, characterized by exacerbations and remissions

Cause is unknown

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8
Q

Crohn’s Disease

A

Regional Enteritis

Most common in distal ileum or ascending colon

Extends to all layers of the bowel

Ulcers develop, lumen narrows

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9
Q

Signs and Symptoms of Crohn’s Disease

A

Gradual onset

Pain in RLQ

Cramping after meals

Diarrhea, steatorrhea, blood in the stool

Weight loss, nutritional deficiency

Abscesses or fistulas

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10
Q

Diagnostics of Crohn’s Disease

A

CBC, CMP, ESR, Fecal Occult Blood

Barium studies (“String sign”)

CT, MRI

Capsule endoscopy, balloon endoscopy

Proctosigmoidoscopy/Colonoscopy

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11
Q

Ulcerative Colitis

A

Usually begins in the rectum

Multiple ulcerations, contiguous

Bowel narrows, bleeding occurs

5% develop colon cancer

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12
Q

Signs and Symptoms of Ulcerative Colitis

A

Diarrhea, passage of mucus and pus

LLQ pain, spasms of the rectum, rectal bleeding

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13
Q

Diagnostics of Ulcerative Colitis

A

Stool analysis

CBC, CMP

X-Ray, CT, MRI

Sigmoidoscopy/Colonoscopy

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14
Q

Treatment of Inflammatory Bowel Disease

A

Reduce inflammation

Low residue, high protein, high calorie diets

Medications

Bowel rest

Surgery

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15
Q

Medications for Inflammatory Bowel Disease

A

Sedatives and antidiarrheals

Pain relievers

Iron/Calcium supplements

Aminosalicylates

5-ASA

Corticosteroids

Immune system suppressors

Antibiotics

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16
Q

Irritable Bowel Syndrome

A

Noninflammatory

Functional disorder

Abdominal pain, constipation, urgent bowel movements

Associated with stress, anxiety, depression

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17
Q

Colorectal Cancer

A

3rd most common cause of cancer deaths in the US

Manifestations include change in bowel habits: blood in the stool, tenesmus, symptoms of obstruction, pain

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18
Q

Early Detection of Colorectal Cancer

A

Beginning at age 50, both men and women should have:

Flexible sigmoidoscopy every 5 years, or colonoscopy every 10 years, or double-contrast barium enema every 5 years, or yearly fecal occult blood test

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19
Q

Diagnostic Evaluation of Colorectal Cancer

A

Abdominal and rectal exam

Stool for occult blood

Barium enema

Proctosigmoidoscopy/Colonoscopy with biopsy and cytology

CEA elevations

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20
Q

Liver Dysfunction

A

Glycogen is replaced with lipids

Inflammatory cell infiltration and growth of fibrous tissue

Possible regeneration of cells

End result is a fibrotic liver

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21
Q

Clinical Manifestations of Liver Dysfunction

A

Jaundice, portal hypertension and ascites, esophageal varices, hepatic encephalopathy or coma, nutritional deficiencies

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22
Q

Prehepatic Jaundice

A

Hemolytic

Result of increased destruction of RBCs

23
Q

Hepatic Jaundice

A

Hepatocellular

Results from injury or disease of parenchymal cells of the liver

24
Q

Posthepatic Jaundice

A

Caused by an obstruction of the bile duct

Bile is reabsorbed and stains the body

Urine is deep orange and frothy, stools are clay colored

Pruritus, fat intolerance, elevated bilirubin and alkaline phosphate

25
Q

Portal Hypertension

A

Obstructed blood flow through the liver results in increased pressure throughout the portal venous system

Results in ascites, esophageal varices

26
Q

Treatment of Ascites

A

Low-sodium diet

Diuretics

Bed rest

Paracentesis

Administration of salt-poor albumin

Transjugular intrahepatic portosystemic shunt

27
Q

Esophageal Varices

A

Complex tortuous veins at the lower end of the esophagus

Develop in areas where collateral and systemic circulations communicate

Contain little elastic tissue and are fragile

28
Q

Hepatic Encephalopathy

A

Changes in neurologic and mental responsiveness ranging from sleep disturbances to lethargy to coma

Result of liver being unable to convert ammonia to urea

Ammonia crosses the blood-brain barrier and causes neurologic toxic manifestations

Characteristic symptom is asterixis (flapping tremors involving arms and hands)

Fetor hepaticus (musty, sweet odor on patient’s breath)

29
Q

Medical Management of Hepatic Encephalopathy

A

Eliminate precipitating cause

Lactulose to reduce serum ammonia levels

IV glucose to minimize protein catabolism

Protein restriction

Reduction of ammonia from GI tract by gastric suction, enemas, oral antibiotics

Discontinue sedatives, analgesics, and tranquilizers

30
Q

Nutritional Therapy for Hepatic Encephalopathy

A

Dietary deficiencies of thiamine, folic acid, and vitamin B12

Diet high in calories (3000 kcal/day), increased carbohydrates, moderate to low fat, normal protein

31
Q

Hepatitis A

A

Spread by poor hand hygiene; fecal-oral

Incubation is 15-50 days, illness may last 4-8 weeks

Manifestations include mild flulike symptoms, low-grade fever, anorexia, later jaundice and dark urine, indigestion, enlargement of liver and spleen

32
Q

Management of Hepatitis A

A

Good handwashing, safe water, vaccine, immunoglobulin

Bedrest during acute stage

Nutritional support

33
Q

Hepatitis B

A

Transmitted through blood, saliva, semen, and vaginal secretions

Major worldwide cause of cirrhosis and liver cancer

Incubation of 1-6 months

Insidious and variable, similar symptoms to hepatitis A

34
Q

Management of Hepatitis B

A

Alpha interferon and antiviral agents (lamivudine, adefovir)

Best rest and nutritional support

Vaccinations

35
Q

Hepatitis C

A

Transmitted by blood and sexual contact

Most common bloodborne infection

A cause of 1/3 of cases of liver cancer and the most common reason for liver transplant

Variable incubation period

Symptoms usually mild, chronic carrier state frequently occurs

36
Q

Management of Hepatitis C

A

Antiviral medications (interferon, ribavirin)

Alcohol and medications that irritate the liver should be avoided

Screening of blood supply

37
Q

Hepatitis D

A

Only persons with hepatitis B are at risk

Blood and sexual contact transmission

Likely to develop fulminant liver failure or chronic active hepatitis and cirrhosis

38
Q

Hepatitis E

A

Transmitted by the fecal-oral route

Incubation period is 15-65 days

Resembles hepatitis A

39
Q

Clinical Course of Hepatitis

A

Asymptomatic and subclinical

Preicteric phase: flulike symptoms, hepatomegaly, lymphadenopathy

40
Q

Icteric Phase of Heptatitis

A

Jaundice, pruritus, RUQ pain, liver tenderness, increased bilirubin and AST and ALT and alkaline phosphatase, mild weight loss, respiratory difficulty

41
Q

Post Icteric Phase of Hepatitis

A

Usually full recovery in 6 months

Decline in symptoms

Resolution of abnormal lab results

Gradual increase in comfort

42
Q

Types of Cirrhosis

A

Laennec’s Cirrhosis (Alcoholic)

Postnecrotic cirrhosis

Biliary cirrhosis

43
Q

Clinical Manifestations of Cirrhosis

A

Intermittent mild fever

Vascular spiders, reddened palms, unexplained epistaxis

Ankle edema, flatulent dyspepsia, morning indigestion, abdominal pain

Firm, enlarged liver, splenomegaly

44
Q

Clinical Manifestations of Decompensated Cirrhosis

A

Jaundice, weakness, muscle wasting, weight loss, clubbing of fingers

Purpura, spontaneous bruising, epistaxis, sparse body hair, white nails, gonadal atrophy

Portal hypertension, ascites, esophageal varices, hepatic encephalopathy

45
Q

Cholecystitis

A

Inflammation of the gallbladder

46
Q

Cholelithiasis

A

Gallstones

Risk factors include fair, fat, forty, female, flatulent, fertile

47
Q

Signs and Symptoms of Gallbladder Problems

A

Pain, Murphy’s sign, changes in color of urine and stool, fever, N/V, jaundice

48
Q

Diagnosing Gallbladder Issues

A

X-Ray, ultrasonography, radionuclide imagine, cholecystography, endoscopic retrograde cholangiopancreatography

49
Q

Treatment of Gallbladder Issues

A

Diet, bowel rest, NG suction, IV fluids, analgesia

Extracorporeal or intracorporeal lithotripsy

Cholecystectomy

50
Q

Acute Pancreatitis

A

Pancreatic duct becomes obstructed and enzymes back up, causing autodigestion and inflammation of the pancreas

51
Q

Chronic Pancreatitis

A

Progressive inflammatory disorder with destruction of the pancreas

Cells are replaced by fibrous tissue

Pressure within the pancreas increases, obstructing the pancreatic and common bile ducts

52
Q

Causes of Acute Pancreatitis

A

Alcoholism, biliary tract disease, abdominal surgery, trauma, infections, metabolic problems, medications

53
Q

Signs and Symptoms of Acute Pancreatitis

A

Pain, nausea/vomiting, abdominal distention, fever, hypotension, respiratory distress, steatorrhea

Adult Health Nursing I (22 decks)

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