Lower GI Disorders Flashcards
What is an example of a laxative osmotic agent (draws water into stool to make it softer and easier to pass)?
- 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
What is a hernia?
- Happens when part of an internal organ or tissue bulges through a weak area of muscle
What are hernia types?
- Reducible (may use binder- Truss belt)
- Irreducible- surgery
- Strangulated (emergency- no blood flow!- absent bowel sounds)
What is a hernioplasty?
Mesh patching over hernia
What is IBS, what kind of disorder is it, and what are S/S?
- 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
What is IBS, what kind of disorder is it, and what are S/S?
- 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
What are IBS interventions?
Increase fiber (30-40 grams daily)
Promote normal bowel function
Regular meals 8-10 cups liquid qd
Constipation dominant IBS intervention:
psyllium (Metamucil) or Linzess : need adequate fluid
Diarrhea dominant IBS intervention:
- Imodium, psyllium (bulk)
- Alosetron (Lotronex): selective serotonin receptor antagonist—risky drug—can cause ischemic colitis—educate on symptoms
What is celiac disease?
- Autoimmune response to gluten
- Chronic, non-curable disease
- No medicines to help
- Diet modifications only
- Quality of life
What is dumping syndrome?
- Rapid emptying of food (especially high in sugar) into the small intestines. Vagal response.
- Common after gastric surgery.
- Fluids encourage motility.
- LOC + anxiety symptoms
What is diverticulosis?
- 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
What should be avoided with diverticulitis?
fiber
Is the following statement true or false?
The most common site for diverticulitis is the ileum
False; sigmoid is the most common place
What foods/products would you tell the patient with Celiac Disease to avoid or check for gluten content?
- yeast rolls
- beer
- lipstick
- pizza
- toothpaste
- communion wafers
What should be used in assessment for appendicitis?
McBurneys point
What should you be concerned of if pain stops from appendicitis?
Rupture (peritonitis, gangrene, sepsis)
What are the cardinal signs for peritonitis?
Abd. pain, tenderness, distention (board-like abdomen)- emergency!- sepsis risk
What are the cardinal signs for peritonitis?
Abd. pain, tenderness, distention (board-like abdomen)- emergency!- sepsis risk
Is the following statement true or false?
Abdominal pain and constipation are common clinical manifestations of Crohn’s disease.
False; diarrhea not constipation
What is important to know with Crohn’s?
- ascending/transverse colon
- splotchy
- harder to treat
- autoimmune (risk for bushings, graves, etc.)
- fistulas! (bacterial infections)
- Symptom: N/V, weight loss, abd. pain, diarrhea
What is important to know with UC?
- rectum up through descending colon
- fistulas are not common
-symtpom: abd. pain, rectal bleeding, bloody diarrhea
Is the following statement true or false?
Regular bowel habits can be established for a patient with an ileostomy.
False
Is the following statement true or false?
Regular bowel habits can be established for a patient with an ileostomy.
False
What is tenesmus?
Unable to produce results while straining to defecate
What is paralytic ileus?
Paralyzed ileus; no peristalsis; unable to pass flatus; absent bowel sounds
What in your assessment indicates perforation?
Rigid, board-like abdomen
Where is B12 absorbed?
Small intestines/ileum
How do you calculate ideal body weight?
Female: 100 + 5 lbs per inch
Male: 106 + 6 lbs per inch
What color are stools with a stomach bleed?
Black and tarry
What is TPN? How is it given? What is the base solution?
parenteral nutrition; IV; lipids
What consistency of stool do you expect from an ileostomy? Why?
Thin or thick liquid; it bypasses the large intestine which is responsible for stool bulking
