Lower GI Disorders

Question 1

What is an example of a laxative osmotic agent (draws water into stool to make it softer and easier to pass)?

Answer 1

• Polyethylene glycol and electrolytes (Colyte)

*Bisacodyl (Dulcolax) is a stimulant laxative
*Dioctyl sodium succinate (Colace) is a fecal softener
*Magnesium hydroxide (Milk of Magnesia) is a saline agent

Question 2

What is a hernia?

Answer 2

• Happens when part of an internal organ or tissue bulges through a weak area of muscle

Question 3

What are hernia types?

Answer 3

• Reducible (may use binder- Truss belt)
• Irreducible- surgery
• Strangulated (emergency- no blood flow!- absent bowel sounds)

Question 4

What is a hernioplasty?

Answer 4

Mesh patching over hernia

Question 5

What is IBS, what kind of disorder is it, and what are S/S?

Answer 5

• Functional Disorder
• Chronic or recurrent diarrhea, constipation, &/or pain & bloating, alternating both
• Etiology: environmental, immunologic, genetic, stress, hormonal, psychosocial
• Altered bowel patterns, pain, bloating, and abdominal distention

Question 5

What is IBS, what kind of disorder is it, and what are S/S?

Answer 5

• Functional Disorder
• Chronic or recurrent diarrhea, constipation, &/or pain & bloating, alternating both
• Etiology: environmental, immunologic, genetic, stress, hormonal, psychosocial
• Altered bowel patterns, pain, bloating, and abdominal distention

Question 6

What are IBS interventions?

Answer 6

Increase fiber (30-40 grams daily)
Promote normal bowel function
Regular meals 8-10 cups liquid qd

Question 7

Constipation dominant IBS intervention:

Answer 7

psyllium (Metamucil) or Linzess : need adequate fluid

Question 8

Diarrhea dominant IBS intervention:

Answer 8

• Imodium, psyllium (bulk)
• Alosetron (Lotronex): selective serotonin receptor antagonist—risky drug—can cause ischemic colitis—educate on symptoms

Question 9

What is celiac disease?

Answer 9

• Autoimmune response to gluten
• Chronic, non-curable disease
• No medicines to help
• Diet modifications only
• Quality of life

Question 10

What is dumping syndrome?

Answer 10

• Rapid emptying of food (especially high in sugar) into the small intestines. Vagal response.
• Common after gastric surgery.
• Fluids encourage motility.
• LOC + anxiety symptoms

Question 11

What is diverticulosis?

Answer 11

• pouch-like hernias
• Symptoms with inflammation
• RF: low fiber intake, slow gut, obesity, smoking, NSAIDs, family history, diets high in red meat, fat, refined sugars. Constant clog can lead to obstruction or perforation, scarring
• Inflamed= diverticulitis

Question 12

What should be avoided with diverticulitis?

Answer 12

fiber

Question 13

Is the following statement true or false?

The most common site for diverticulitis is the ileum

Answer 13

False; sigmoid is the most common place

Question 14

What foods/products would you tell the patient with Celiac Disease to avoid or check for gluten content?

Answer 14

• yeast rolls
• beer
• lipstick
• pizza
• toothpaste
• communion wafers

Question 15

What should be used in assessment for appendicitis?

Answer 15

McBurneys point

Question 16

What should you be concerned of if pain stops from appendicitis?

Answer 16

Rupture (peritonitis, gangrene, sepsis)

Question 17

What are the cardinal signs for peritonitis?

Answer 17

Abd. pain, tenderness, distention (board-like abdomen)- emergency!- sepsis risk

Question 18

What are the cardinal signs for peritonitis?

Answer 18

Abd. pain, tenderness, distention (board-like abdomen)- emergency!- sepsis risk

Question 19

Is the following statement true or false?

Abdominal pain and constipation are common clinical manifestations of Crohn’s disease.

Answer 19

False; diarrhea not constipation

Question 20

What is important to know with Crohn’s?

Answer 20

• ascending/transverse colon
• splotchy
• harder to treat
• autoimmune (risk for bushings, graves, etc.)
• fistulas! (bacterial infections)
• Symptom: N/V, weight loss, abd. pain, diarrhea

Question 21

What is important to know with UC?

Answer 21

• rectum up through descending colon
• fistulas are not common
  -symtpom: abd. pain, rectal bleeding, bloody diarrhea

Question 22

Is the following statement true or false?

Regular bowel habits can be established for a patient with an ileostomy.

Answer 22

False

Question 23

Is the following statement true or false?

Regular bowel habits can be established for a patient with an ileostomy.

Answer 23

False

Question 24

What is tenesmus?

Answer 24

Unable to produce results while straining to defecate

Question 25

What is paralytic ileus?

Answer 25

Paralyzed ileus; no peristalsis; unable to pass flatus; absent bowel sounds

Question 26

What in your assessment indicates perforation?

Answer 26

Rigid, board-like abdomen

Question 27

Where is B12 absorbed?

Answer 27

Small intestines/ileum

Question 28

How do you calculate ideal body weight?

Answer 28

Female: 100 + 5 lbs per inch
Male: 106 + 6 lbs per inch

Question 29

What color are stools with a stomach bleed?

Answer 29

Black and tarry

Question 30

What is TPN? How is it given? What is the base solution?

Answer 30

parenteral nutrition; IV; lipids

Question 31

What consistency of stool do you expect from an ileostomy? Why?

Answer 31

Thin or thick liquid; it bypasses the large intestine which is responsible for stool bulking