UC and Crohn's Flashcards
UC patho?
Ulcerative inflammatory bowel disease
Where is UC?
Large intestines
Crohn patho?
Inflammation and erosion of the ileum but it can be found anywhere in small or large intestines
S/s
GI
Diarrhea Vomiting Cramping Weight loss Rebound tenderness
S/s
Blood
Rectal bleeding
Blood in stools
Anemia
S/s
Temp
Fever
What is rebound tenderness?
Push in and let go and pain hurts on the rebound
*means peritoneal inflammation
Diagnosis
CT
Colonoscopy
Barium enema
Colonoscopy
What pre procedure
Clear liquid diet for 12-24 hours
Colonoscopy
NPO when?
6-8 hours pre-procedure
Colonoscopy
Avoid?
NSAIDS (several days prior)
Colonoscopy
What until clear?
Laxatives or enemas
Colonoscopy
How to drink polyethylene glycol easier?
To help your client drink a colon prep more easily, get it icy cold –drink 8oz every 10 min
Colonoscopy
Sedated or awake during procedure
Sedated
Colonoscopy
Post op ?
Watch for perforation
*we are going to assume the worst!!!
Colonoscopy
Signs of perforation?
Pain and unusual discomfort!!!
Barium enema?
Lower GI
Done if colonoscopy is incomplete
Chalky stools–drink fluids!
Treatment: Diet
Low or high fiber?
Low
*trying to limit GI motility to help save fluid
Treatment: Diet
Avoid what? why?
Cold foods, hot foods, and smoking
All of these can increase motility!
Treatment: Meds
What meds?
Antidiarrheals
Antibiotics
Steroids (decrease inflammation)
Treatment: Meds
Antidiarrheals only given with what?
Mildly symptomatic UC–does not work in severe cases
Treatment: Meds
Biologics examples?
Adalimimab
Infliximab
Treatment: Meds
How do biologics work?
Interfering with the body’s immune response
Surgery: UC
2 options?
Total colectomy (ileostomy formed)
Kock’s ileostomy or a J pouch (no external bag)
Surgery: UC
What is a Kock’s ileostomy?
A nipple valve that opens and closes to empty intestines
Surgery: UC
What is J pouch?
Procedure that removes the colon and attaches ileum to rectum (liquid stools)
Surgery: Crohn’s
T/F: Try not to do surgery
T
Surgery: Crohn’s
May remove only the __
affected area
Surgery: Crohn’s
The client may end up with an ileostomy or colostomy. Just depends on?
Area affected
Surgery: Crohn’s
An ostomy in the ileum is called ?
Ileostomy
Surgery: Crohn’s
Ostomy in the colon is ?
Colostomy
Post op ileostomy
Drain what?
Liquid all the time
Post op ileostomy
Need to irrigate ileostomies?
No
Post op ileostomy
Avoid foods that are hard to digest and rough foods. Why?
Increase motility
Post op ileostomy
What to drink in summer?
Gatorade or a similar electrolyte replacement
Post op ileostomy
At risk for?
Kidney stones
Post op colostomy
What happens as waste moves through colon?
Water and nutrients are being absorbed and stool is forming
Post op colostomy
Ascending and transverse
Semi liquid stools
Post op colostomy
Descending or sigmoid
Semi formed or solid/formed
Post op colostomy
Which ones do you irrigate?
Descending and sigmoid
Post op colostomy
Why irrigate descending and sigmoid?
For regularity
Post op colostomy
When is the best time to irrigate?
Same time everyday
After a meal
Post op colostomy
The further down the colon the stoma is, the more formed the stool all be because ___ is being drawn out. The stool is more normal
H20
Post op colostomy
When irrigating an ostomy, use the same principles as if administering an enema. Position matter?
Doesnt matter with side position bc not normal GI tract
Post op colostomy
Anytime you give an enma, if the client starts to cramp, do what?
Stop the fluids
Lower bag and check temp of fluid
