UC and Crohn's

Question 1

UC patho?

Answer 1

Ulcerative inflammatory bowel disease

Question 2

Where is UC?

Answer 2

Large intestines

Question 3

Crohn patho?

Answer 3

Inflammation and erosion of the ileum but it can be found anywhere in small or large intestines

Question 4

S/s

GI

Answer 4

Diarrhea
Vomiting
Cramping
Weight loss 
Rebound tenderness

Question 5

S/s

Blood

Answer 5

Rectal bleeding
Blood in stools
Anemia

Question 6

S/s

Temp

Answer 6

Fever

Question 7

What is rebound tenderness?

Answer 7

Push in and let go and pain hurts on the rebound

*means peritoneal inflammation

Question 8

Diagnosis

Answer 8

CT
Colonoscopy
Barium enema

Question 9

Colonoscopy

What pre procedure

Answer 9

Clear liquid diet for 12-24 hours

Question 10

Colonoscopy

NPO when?

Answer 10

6-8 hours pre-procedure

Question 11

Colonoscopy

Avoid?

Answer 11

NSAIDS (several days prior)

Question 12

Colonoscopy

What until clear?

Answer 12

Laxatives or enemas

Question 13

Colonoscopy

How to drink polyethylene glycol easier?

Answer 13

To help your client drink a colon prep more easily, get it icy cold –drink 8oz every 10 min

Question 14

Colonoscopy

Sedated or awake during procedure

Answer 14

Sedated

Question 15

Colonoscopy

Post op ?

Answer 15

Watch for perforation

*we are going to assume the worst!!!

Question 16

Colonoscopy

Signs of perforation?

Answer 16

Pain and unusual discomfort!!!

Question 17

Barium enema?

Answer 17

Lower GI
Done if colonoscopy is incomplete

Chalky stools–drink fluids!

Question 18

Treatment: Diet

Low or high fiber?

Answer 18

Low

*trying to limit GI motility to help save fluid

Question 19

Treatment: Diet

Avoid what? why?

Answer 19

Cold foods, hot foods, and smoking

All of these can increase motility!

Question 20

Treatment: Meds

What meds?

Answer 20

Antidiarrheals
Antibiotics
Steroids (decrease inflammation)

Question 21

Treatment: Meds

Antidiarrheals only given with what?

Answer 21

Mildly symptomatic UC–does not work in severe cases

Question 22

Treatment: Meds

Biologics examples?

Answer 22

Adalimimab

Infliximab

Question 23

Treatment: Meds

How do biologics work?

Answer 23

Interfering with the body’s immune response

Question 24

Surgery: UC

2 options?

Answer 24

Total colectomy (ileostomy formed)

Kock’s ileostomy or a J pouch (no external bag)

Question 25

Surgery: UC What is a Kock's ileostomy?

Answer 25

A nipple valve that opens and closes to empty intestines

Question 26

Surgery: UC What is J pouch?

Answer 26

Procedure that removes the colon and attaches ileum to rectum (liquid stools)

Question 27

Surgery: Crohn's T/F: Try not to do surgery

Answer 27

T

Question 28

Surgery: Crohn's May remove only the __

Answer 28

affected area

Question 29

Surgery: Crohn's The client may end up with an ileostomy or colostomy. Just depends on?

Answer 29

Area affected

Question 30

Surgery: Crohn's An ostomy in the ileum is called ?

Answer 30

Ileostomy

Question 31

Surgery: Crohn's Ostomy in the colon is ?

Answer 31

Colostomy

Question 32

Post op ileostomy Drain what?

Answer 32

Liquid all the time

Question 33

Post op ileostomy Need to irrigate ileostomies?

Answer 33

No

Question 34

Post op ileostomy Avoid foods that are hard to digest and rough foods. Why?

Answer 34

Increase motility

Question 35

Post op ileostomy What to drink in summer?

Answer 35

Gatorade or a similar electrolyte replacement

Question 36

Post op ileostomy At risk for?

Answer 36

Kidney stones

Question 37

Post op colostomy What happens as waste moves through colon?

Answer 37

Water and nutrients are being absorbed and stool is forming

Question 38

Post op colostomy Ascending and transverse

Answer 38

Semi liquid stools

Question 39

Post op colostomy Descending or sigmoid

Answer 39

Semi formed or solid/formed

Question 40

Post op colostomy Which ones do you irrigate?

Answer 40

Descending and sigmoid

Question 41

Post op colostomy Why irrigate descending and sigmoid?

Answer 41

For regularity

Question 42

Post op colostomy When is the best time to irrigate?

Answer 42

Same time everyday | After a meal

Question 43

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

Answer 43

H20

Question 44

Post op colostomy When irrigating an ostomy, use the same principles as if administering an enema. Position matter?

Answer 44

Doesnt matter with side position bc not normal GI tract

Question 45

Post op colostomy Anytime you give an enma, if the client starts to cramp, do what?

Answer 45

Stop the fluids | Lower bag and check temp of fluid