Ulcerative Colitis Flashcards
What is a chronic IBD that causes inflammation in the digestive tract and can involve the entire colon and isn’t patchy but a continuous inflammation t/o?
Ulcerative colitis
Where is ulcerative colitis most commonly located?
Rectum and/or sigmoid colon
What are the onset of ages for ulcerative colitis?
15-35 and again @ 50-70
Ulcerative colitis can go into what for months or even years?
Remission
S/S of ulcerative colitis?
Stools containing blood/mucus, LLQ pain/tenderness that can be relieved by defecation, fever and possible anorexia, fatigue or weakness
How many stools a day can a pt. w/ ulcerative colitis have?
15+ liquid stools
What are some common multi-system effects that can occur w/ IBD?
Sclerosing cholangitis, uveitis, skin/mucous membrane lesions, anemia, ankylosing spondylitis, or arthritis
What is inflammation/scarring that can lead to narrowing of bile ducts and may need a liver transplant?
Sclerosing cholangitis
What is an inflammation of the middle layer of the eye uvea?
Uveitis
What is an inflammatory arthritis affecting the spine and large joints, also known as “poker spine”?
Ankylosing spondylitis
Albumin/protein levels are usually what?
Decreased
CBC, BMP, albumin/protein, ESR and liver function tests are all what?
Important lab studies
A stool analysis should be taken from?
The blood, mucus and/or infection site
Colonoscopy, sigmoidoscopy, barium enema or EGD are?
Diagnostic tests
What are some complications?
Hemorrhage, toxic megacolon, perforation, peritonitis, colorectal cancer
What complication can appear w/ fever, increase HR/RR, decrease BP, abd pain, very distended abd, hypoactive to eventually absent bowel sounds?
Toxic megacolon
What is the paralysis of the colon that can result in increased perforation that can lead to peritonitis?
Toxic megacolon
Toxic megacolon is more common in what IBD and when taking what?
Ulcerative colitis; anti-diarrheals
When a pt. is showing cancer signs after having long-standing (>10yrs) s/s of UC, when chronic UC doesn’t respond to other therapies, or when there are life-threatening complications like hemorrhage, perforation, or toxic megacolon what is done?
Surgery
What are the 3 most common surgeries?
Total proctocolectomy w/ permanent ileostomy (Brooke)
Total colectomy w/ continent ileostomy (Kock)
Restorative proctocolectomy w/ ileal pouch-anal anastomosis (RPC-IPAA)
What procedure removes the entire colon, rectum and anus so pt is left w/ s.intestine?
Total proctocolectomy w/ ileostomy
How do the stools look like in the total proctocolectomy w/ ileostomy procedure?
Initially loose liquidy, dark green containing some blood to a more paste yellow-green yellow-brown mushy type
What is the procedure that takes out the entire L.intestine (colon) and creates a pouch w/ a cath out to drain?
Total colectomy w/ continent ileostomy (Kock)
How much can the pouch of the Kock procedure initially hold? and how much will it stretch to?
50-75ml; 500-1000ml
What procedure eliminates the need for permanent ileostomy?
RPC-IPAA
What procedure removes the entire colon and most of rectum leaving anus and anal sphincter intact, an internal pouch is created from terminal ileum that is sutured directly to the anus and a temp loop ileostomy is created then closed after 1-3mon?
RPC-IPAA
What is important to teach if a pt has had a RPC-IPAA procedure?
Meticulous peri-anal care bc of possible leakage @ night
In postop when would a NGT be removed it if was placed for/after surgery?
When bowel pt has positive bowel sounds and flatus appears
