Nutrition & Elimination part 2 (GAS#11 & Gas#12)

Question 1

Irritable Bowel Syndrome is associated with..

Answer 1

Stress

Question 2

s/s of Irritable Bowel Syndrome

Answer 2

constipation, diarrhea, feeling urge to defecate, abdominal pain, cramping, improves with defecation

Question 3

Irritable Bowel Syndrome treatment

Answer 3

elimination diet, 6-8 glasses, Exercise, antispasmodics, soluble fiber

Question 4

Diverticulosis occurs in which part of intestine

Answer 4

it can occur anywhere but most common in sigmoid colon

Question 5

Diverticulosis

Answer 5

food gets caught in sac like herniation of the lining of the bowel usually in the sigmoid colon (or anywhere in small intestine or colon) and then gets infected which turns into diverticulitis; ppl can have this for years and not know it

Question 6

Diverticulitis

Answer 6

infection from food or bacteria being retained

Question 7

s/s of Diverticulitis

Answer 7

fever, N/V, chills, cramping, constipation, bleeding (usually stops)

Question 8

Diverticulitis can result in

Answer 8

abscess, fistulas, obstruction, perforation, peritonitis, hemorrhage

Question 9

Management of Diverticulosis

Answer 9

High fiber Diet!

Question 10

Management of Diverticulitis

Answer 10

bowel rest by liquids only then once inflammation subsides, high fiber, low fat diet and rest, antibiotics and pain meds

Question 11

What should be avoided with Diverticular disease?

Answer 11

morphine should be avoided because it can increase pressure on colon & NSAIDS because they increase risk of perforation

Question 12

Peritonitis

Answer 12

inflammation of the peritoneum ( can be caused by diverticulitis

Question 13

s/s of Peritonitis

Answer 13

pain, tender, distention, rigid muscles, n,v, decreased perstalsis, increased WBC, altered electrolytes, hypovolemia

Question 14

management of Peritonitis

Answer 14

increase fluids! because hypovolemia occurs & electrolytes go from intestines to peritonial cavity

Question 15

Crohns Disease

Answer 15

WBC accumulate in intestine which create ulcers, can be located anywhere in the GI tract

Question 16

two main s/s of Crohns disease

Answer 16

diarrhea, abdominal pain in Right lower quadrant

Question 17

During an acute phase of crohns disease what is important for patient to be?

Answer 17

NPO

Question 18

Crohns disease management

Answer 18

steroids, antibiotics, amodium, surgery, TPN then clear liquids as tolerated

Question 19

Inflammatory Bowel Diseases

Answer 19

Crohns Disease & Ulcerative Colitis

Question 20

Ulcerative Colitis

Answer 20

continual inflammation, effects mucosa & submucosa. Mucosa becomes inflammed & sluffs off, bleeding is common which usually goes away

Question 21

what is a common side effect of ulcerative colitis?

Answer 21

Diarrhea

Question 22

What can severe attacks of ulcerative colitis lead to?

Answer 22

hemmorrage

Question 23

Only cure for ulcerative colitis?

Answer 23

surgery where they remove the colon & rectum (which also decreases their risk for cancer)

Question 24

Surgery for ulcerative colitis is only for which people?

Answer 24

people with precancerous cells and the very severe

Question 25

With ulcerative colitis, during the acute phase, what happens to their calorie & protein levels? & whats important to teach them about it

Answer 25

they go down so make sure they have a diet high in calories & protein

Question 26

Celiac Disease

Answer 26

inflammation of the small intestine triggered by gluten

Question 27

Is celiac disease genetic?

Answer 27

yes

Question 28

what can celiac disease lead to

Answer 28

osteoporosis, infertility, cancer

Question 29

s/s of celiac disease

Answer 29

abdominal pain, fatigue, HA, foggy, tingling in extremities, depression//anxiety, missed menstrual periods, bone/jt pain, dermatitis Herpetiformis, pale foul smelling stool (children)

Question 30

What diseases cause the villi to be destroyed in the small intestine & what happens with the patients nutrition

Answer 30

Celiac disease;they become malnourished

Question 31

what foods should patients with celiac disease avoid?

Answer 31

pasta, baked goods, cereal

Question 32

Celiac Disease treatment

Answer 32

avoid gluten! kids start with rice cerel

Question 33

Celiac Disease parent teaching

Answer 33

teach there is "hidden" gluten such as "hydrolyzed vegetable protein" in food

Question 34

Polyp formation

Answer 34

disruption of normal cell proliferation to replace epithelial cells, may be benign, malignant

Question 35

s/s of Polyps

Answer 35

RECTAL BLEEDING, change in bowel habits, feeling of incomplete emptying, weakness/fatigue, wt loss

Question 36

what is found in the blood when polyps lead to cancer

Answer 36

tumor markers

Question 37

with a small bowel obstruction patient will have which electrolyte imbalance?

Answer 37

they will be hypokalemia & will have a decrease in HCL

Question 38

Small bowel obstruction treatment

Answer 38

Decompression of the bowel through an NG tube, vs

Question 39

Large Bowel obstructions are usually seen where?

Answer 39

sigmoid colon

Question 40

what is a major cause of a large bowel obstruction?

Answer 40

cancer

Question 41

what can a large bowel obstruction lead to?

Answer 41

gangrene & perforation

Question 42

s/s of bowel obstruction

Answer 42

constipation, colicky pain, distended abdomen above site, high pitched tinkling bowel sounds, localized tenderness, vomiting (late sign)

Question 43

Irritable bowel syndrome teaching to patient

Answer 43

Eat at regular times, chew food slowly and throughly, fluid shouldn't be taken with meals to avoid abdominal distention

Question 44

Predisposing factor of diverticulosis

Answer 44

A low intake of dietary fiber

Question 45

A Small bowel obstruction can cause which acid base imbalance?

Answer 45

Metabolic alkalosis

Question 46

Difference between small bowel and large bowel obstruction

Answer 46

Small bowel=small intestine large bowel=large intestine; large bowel obstruction progress relatively slowly compared to small bowel obstruction

Question 47

Stomach cancer complications post op

Answer 47

volvulus (twisting of the bowels), wound dehiscence, peritontitis

Question 48

Necrotizing Entercolitis

Answer 48

immature GI motility

Question 49

Necrotizing Entercolitis s/s

Answer 49

not emptying completely, xray shows air in abdomen, distended abdomen, blood in stool, apnea

Question 50

3 things needed for necrotizing entercolitis

Answer 50

inadequate 02, invassive bactria, enternal feeding

Question 51

Necrotizing Entercolitis management

Answer 51

NPO, may have NG tube, antibiotics, ventilator, 02

Question 52

What do you have to do as a nurse for an infant with Necrotizing Entercolitis?

Answer 52

measue abdominal circumference, check to make sure they are going to the bathroom

Question 53

Atresia

Answer 53

congenital absence or closure of a normal body opening

Question 54

anal atresia

Answer 54

lack of passage of meconium stool

Question 55

Intussusception

Answer 55

integration of one portion of the intestine into another

Question 56

s/s of intussusception

Answer 56

"currant jelly" stools; parents think baby is just colicky

Question 57

Hirschsprung's (megacolon)

Answer 57

ansence of innervation to the muscle of a section of the bowel

Question 58

s/s of Hirschsprung's (megacolon)

Answer 58

no peristalsis (so it becomes enlarged), chronic constipation, RIBBON like stools, dilation of the bowel

Question 59

Hirschsprung's(megacolon): failure to pass meconium(1st stool) within how many hours after birth?

Answer 59

24-48

Question 60

Why are diagnostic tests done with caution with Hirschsprung's (megacolon)?

Answer 60

because they don't want to rupture bowel

Question 61

What will the diagnostic tests show with Hirschsprung's (megacolon)

Answer 61

will show a lack of stool

Question 62

Hirschsprung's (megacolon) treatment

Answer 62

may have temporary or permanent colostomy (depends how bad it is)

Question 63

what do you teach parents about Hirschsprung's (megacolon) before they leave?

Answer 63

teach colostomy care!

Question 64

Pre surgery for Hirschsprung's (megacolon)

Answer 64

edemas, NPO, TPN, decrease fiber with vitamin supplements

Question 65

Post op surgery for Hirschsprung's (megacolon)

Answer 65

foley cath, NG tube, asses bowel sounds, liquids after 24 hrs, teach care & management