part 10 Flashcards
- surgery for Crohn’s disease
- opens up narrowed areas obstructing bowel
- reduces risk of developing short-bowel syndrome and associated complications
strictureplasty
What are the 2 types of intestinal obstruction?
- mechanical: physical obstruction of intestinal lumen
- nonmechanical: results from neuromuscular or vascular disorder
What is the most common type of nontechnical obstruction?
paralytic ileus: lack of peristalsis
What is a common type of mechanical obstruction?
surgical adhesion in small bowel
these can occur days or years after a surgery
What happens in the intestines when there is a bowel obstruction?
- bowel pressure rises proximal to obstruction
- there is leakage into peritoneal cavity
- below obstruction peristalsis stop
- reduction in circulating blood volume
- leads to hypotension and shock
What are the clinical manifestations of an intestinal obstruction?
abd pain
vomiting
distention
constipation
What is the management for intestinal obstruction?
- NPO
- NG tube suction
- IV fluid
- analgesics
- surgery: total colectomy, colostomy, or ileostomy if extensive necrosis is present
What should you verify before adding potassium to IV fluids?
verify renal function
What are the types of ostomies?
- ileostomy: more for Crohn’s or colitis
- colostomy: ascending, descending, sigmoid, transverse
- end: proximal end becomes stoma
- double barreled stoma: usually temporary, proximal is functioning stoma and distal is the mucus fistula
- loop stoma: one stoma but drains feces and mucus
LVN and UAP can provide much of the care for an ostomy. When do RN’s need to provide all the care for the ostomy?
its with new ostomies: they require frequent assessment, planning, interventions, and evaluation by an RN
When should an ostomy be emptied and changed?
emptied: before 1/3 full
change: at first sign of leakage
