Med-Surg: GI, Hepatic, Pancreatic/3 Flashcards
diverticular disease
includes three conditions that involve numerous small sacs or pockets in the wall of the colon
diverticulosis
the presence of pouchlike herniations (diverticula) along the wall of the intestines; most common in sigmoid colon
where is diverticulosis most common
sigmoid colon
diverticular bleeding
results from injury of small vessels near the diverticula
diverticulitis
inflammation of one or more diverticula
DD contributing factors
4
- aging
- constipation
- diet - low fiber, high fat, red meat
- CT disorder causing weakness in the colon wall
diverticulitis manifestations
5
- alternating diarrhea with constipation
- painful cramps or tenderness in LLQ
- chills or fever
- tachycardia
- NV
NI diverticulitis diet
2
- begin with clear liquids
2. advance to a low fiber diet
NI diverticulosis diet
1
- high fiber diet
DD - high fiber diet
diverticulosis
DD NI diet - teach about avoiding foods with
3
- nuts
- seeds
- kernels (popcorn)
DD - increase fluid intake to
3L/day
DD - laxatives
avoid
DD - monitor for complications such as
3
- obstruction
- hemorrhage
- infection
DD and morphine
contraindicated because it can increase pressure in the colon, exacerbating symptoms
DD med - analgesic
meperidine
DD - emergency colon resection for
3
- peritonitis
- bowel obstruction
- abscess
abd hernia - absent bowel sounds
can indicate strangulation, which cuts off blood supply to bowel; medical emergency
abd hernia strangulation s/s
6
- abd distention
- nausea
- vomiting
- pain
- fever
- tachycardia
abd hernia contributing factors
8
- aging
- male gender
- obesity
- heavy lifting, straining
- abd surgery
- pregnancy
- muscle weakness
- ascites, distention
abd hernia NI
3
- wear abd binder
- encourage fluid intake
- monitor for complications - strangulation, perforation
abd hernia post op care
- allow to stand to void
- inguinal repair - evaluate scrotum and apply ice
- teach to avoid coughing during recovery period
- teach to avoid lifting or straining for 4-6 weeks
peritonitis manifestations
5
- rigid board-like abd (hallmark sign)
- NV
- tachycardic
- febrile
- rebound abd tenderness
peritonitis NI
5
- position fowlers to semi fowlers
- NG tube on low intermittent
- oxygen
- monitor fluid and electros
- antibiotics
intestinal obstruction contributing factors
6
- Crohn’s disease
- radiation
- fecal impaction
- narcotics
- hypokalemia
- diverticulitis
intestinal obstruction manifestations
4
- inability to pass flatus or stool for greater than 8 hours
- abd distention
- hyperactive bowel sounds above site of obstruction
- hypoactive or active bowel sounds below site
intestinal obstruction: small bowel or large intestine - sporadic, colicky pain
small bowel
intestinal obstruction: small bowel or large intestine - visible peristaltic waves
small
intestinal obstruction: small bowel or large intestine - profuse, projectile vomit
small
intestinal obstruction: small bowel or large intestine - diffuse and constant pain
large
intestinal obstruction: small bowel or large intestine - significant abd distention
large
intestinal obstruction: small bowel or large intestine - infreq vomiting
large
