Nutrition & Elimination part 2 (GAS#11 & Gas#12) Flashcards
Irritable Bowel Syndrome is associated with..
Stress
s/s of Irritable Bowel Syndrome
constipation, diarrhea, feeling urge to defecate, abdominal pain, cramping, improves with defecation
Irritable Bowel Syndrome treatment
elimination diet, 6-8 glasses, Exercise, antispasmodics, soluble fiber
Diverticulosis occurs in which part of intestine
it can occur anywhere but most common in sigmoid colon
Diverticulosis
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
Diverticulitis
infection from food or bacteria being retained
s/s of Diverticulitis
fever, N/V, chills, cramping, constipation, bleeding (usually stops)
Diverticulitis can result in
abscess, fistulas, obstruction, perforation, peritonitis, hemorrhage
Management of Diverticulosis
High fiber Diet!
Management of Diverticulitis
bowel rest by liquids only then once inflammation subsides, high fiber, low fat diet and rest, antibiotics and pain meds
What should be avoided with Diverticular disease?
morphine should be avoided because it can increase pressure on colon & NSAIDS because they increase risk of perforation
Peritonitis
inflammation of the peritoneum ( can be caused by diverticulitis
s/s of Peritonitis
pain, tender, distention, rigid muscles, n,v, decreased perstalsis, increased WBC, altered electrolytes, hypovolemia
management of Peritonitis
increase fluids! because hypovolemia occurs & electrolytes go from intestines to peritonial cavity
Crohns Disease
WBC accumulate in intestine which create ulcers, can be located anywhere in the GI tract
two main s/s of Crohns disease
diarrhea, abdominal pain in Right lower quadrant
During an acute phase of crohns disease what is important for patient to be?
NPO
Crohns disease management
steroids, antibiotics, amodium, surgery, TPN then clear liquids as tolerated
Inflammatory Bowel Diseases
Crohns Disease & Ulcerative Colitis
Ulcerative Colitis
continual inflammation, effects mucosa & submucosa. Mucosa becomes inflammed & sluffs off, bleeding is common which usually goes away
what is a common side effect of ulcerative colitis?
Diarrhea
What can severe attacks of ulcerative colitis lead to?
hemmorrage
Only cure for ulcerative colitis?
surgery where they remove the colon & rectum (which also decreases their risk for cancer)
Surgery for ulcerative colitis is only for which people?
people with precancerous cells and the very severe
With ulcerative colitis, during the acute phase, what happens to their calorie & protein levels? & whats important to teach them about it
they go down so make sure they have a diet high in calories & protein
Celiac Disease
inflammation of the small intestine triggered by gluten
Is celiac disease genetic?
yes
what can celiac disease lead to
osteoporosis, infertility, cancer
s/s of celiac disease
abdominal pain, fatigue, HA, foggy, tingling in extremities, depression//anxiety, missed menstrual periods, bone/jt pain, dermatitis Herpetiformis, pale foul smelling stool (children)
What diseases cause the villi to be destroyed in the small intestine & what happens with the patients nutrition
Celiac disease;they become malnourished
what foods should patients with celiac disease avoid?
pasta, baked goods, cereal
Celiac Disease treatment
avoid gluten! kids start with rice cerel
Celiac Disease parent teaching
teach there is “hidden” gluten such as “hydrolyzed vegetable protein” in food
Polyp formation
disruption of normal cell proliferation to replace epithelial cells, may be benign, malignant
s/s of Polyps
RECTAL BLEEDING, change in bowel habits, feeling of incomplete emptying, weakness/fatigue, wt loss
what is found in the blood when polyps lead to cancer
tumor markers
with a small bowel obstruction patient will have which electrolyte imbalance?
they will be hypokalemia & will have a decrease in HCL
Small bowel obstruction treatment
Decompression of the bowel through an NG tube, vs
Large Bowel obstructions are usually seen where?
sigmoid colon
what is a major cause of a large bowel obstruction?
cancer
what can a large bowel obstruction lead to?
gangrene & perforation
s/s of bowel obstruction
constipation, colicky pain, distended abdomen above site, high pitched tinkling bowel sounds, localized tenderness, vomiting (late sign)
Irritable bowel syndrome teaching to patient
Eat at regular times, chew food slowly and throughly, fluid shouldn’t be taken with meals to avoid abdominal distention
Predisposing factor of diverticulosis
A low intake of dietary fiber
A Small bowel obstruction can cause which acid base imbalance?
Metabolic alkalosis
Difference between small bowel and large bowel obstruction
Small bowel=small intestine large bowel=large intestine; large bowel obstruction progress relatively slowly compared to small bowel obstruction
Stomach cancer complications post op
volvulus (twisting of the bowels), wound dehiscence, peritontitis
Necrotizing Entercolitis
immature GI motility
Necrotizing Entercolitis s/s
not emptying completely, xray shows air in abdomen, distended abdomen, blood in stool, apnea
3 things needed for necrotizing entercolitis
inadequate 02, invassive bactria, enternal feeding
Necrotizing Entercolitis management
NPO, may have NG tube, antibiotics, ventilator, 02
What do you have to do as a nurse for an infant with Necrotizing Entercolitis?
measue abdominal circumference, check to make sure they are going to the bathroom
Atresia
congenital absence or closure of a normal body opening
anal atresia
lack of passage of meconium stool
Intussusception
integration of one portion of the intestine into another
s/s of intussusception
“currant jelly” stools; parents think baby is just colicky
Hirschsprung’s (megacolon)
ansence of innervation to the muscle of a section of the bowel
s/s of Hirschsprung’s (megacolon)
no peristalsis (so it becomes enlarged), chronic constipation, RIBBON like stools, dilation of the bowel
Hirschsprung’s(megacolon): failure to pass meconium(1st stool) within how many hours after birth?
24-48
Why are diagnostic tests done with caution with Hirschsprung’s (megacolon)?
because they don’t want to rupture bowel
What will the diagnostic tests show with Hirschsprung’s (megacolon)
will show a lack of stool
Hirschsprung’s (megacolon) treatment
may have temporary or permanent colostomy (depends how bad it is)
what do you teach parents about Hirschsprung’s (megacolon) before they leave?
teach colostomy care!
Pre surgery for Hirschsprung’s (megacolon)
edemas, NPO, TPN, decrease fiber with vitamin supplements
Post op surgery for Hirschsprung’s (megacolon)
foley cath, NG tube, asses bowel sounds, liquids after 24 hrs, teach care & management
