Ulcerative Colitis and Crohn’s Diseas Flashcards
Where is Ulcerative Colitis located?
Just in the large intestine
Crohn’s Disease
inflammation and erosion of the ____ileum
anywhere in the small or large
intestines.
Crohn’s Disease is also called
Regional Enteritis
S/s
Diarrhea
b. Rectal bleeding
c. Weight loss
d. Vomiting
e. Cramping
f. Dehydration
g. Blood in stools
h. Anemia
i. Rebound tenderness
j. Fever
What is rebound tenderness? Push in → let go→ _______________________
• What does it mean? _____________________________
What is rebound tenderness? Push in → let go→ _____and it hurts __
What does it mean? Peritoneal ___ inflammation
3Dx
- CT- in some cases
- Colonoscopy
- Barium Enema
What is done pre op colonoscopy?
________clear_ liquid diet for 12-24 hours.
_________NPO 6-8 hours preprocedure
What is a polyethylene glycol (GoLYTELY®)
How do we get the client to drink it more easily ?
They shouldn’t drink it with a ____?
A colon prep
To help your client drink a colon prep more easily, get it ____ Icy cold by putting it in the freezer____. Don’t let them drink it with a straw because it is going to call G.I. upse
What should avoid with a colonoscopy?
NSAIDs
What should we watch for post op colonoscopy?
Postop watch for _________ perforation__. We are going to assume the WORST!.
What are the signs of perforation?
The signs of perforation are pain or unusual ______ discomfort___
Is the client sedated for colonoscopy?
Yes
Tx
DIET:low fiber diet
Avoid cold foods or hot foods and smoking
MEDS
- Antidiarrheals
- Antibiotics
- Steroids
UC has two types of surgey
- Total Colectomy (ilesostomy formed)
2. Koch’s ileostomy or a J Pouch (no external bag)
Describe a Total Colectomy (ilesostomy formed)
?
They may take out your entire colon so the only thing left is the ileum
Describe a Koch’s ileostomy or a J Pouch (no external bag)
this is the most popular! It removes the colon and attaches the ileum into rectum! In other words they take out the sick part and we hook everything normally
K Pouch has a nipple valve that opens and closes to
___empty their intestines
!
The client emptys Using a catheter so they can wear normal clothes
In Crohn’s we try not to do surgery
But they may ___?
May remove only the ________affected_ area.
The client may end up with an ileostomy or a colostomy. It just depends on the area affected.
What is a ileostomy?
An ostomy in the ileum
What is a colostomy_?
an ostomy in the colon i
What is the barium enema also called?
When is it used ?
Lower GI series
Done if colonoscopy is incomplete.
Ileostomy Care:
• It’s going to drain ___________________ all the time.
• Avoid foods hard to digest; rough foods ______________ motility.
• Gatorade® in the summer
• At risk for kidney stones (always a little _________________)
Ileostomy Care:
It’s going to drain ________liquid__ all the time. Don’t have to
irrigate ileostomies.
Avoid foods hard to digest and rough foods, __hard motility.
because it increases motility Gatorade® in the summer Because
they’re sweating even more
At risk for kidney stones (always a little ______bit dehydrated_)
Colostomy Care:
• What happens as waste moves through the colon?
Water and nutrients are being absorbed and the _____________ is
forming.
Water and nutrients are being absorbed and the ___stool is
forming.
Colostomy → ascending and transverse→ semi __________ stools
• Colostomy→ descending or sigmoid→ semi formed or ____________.
Colostomy → ascending and transverse→ semi ____liquid stools
Colostomy→ descending or sigmoid→ semi formed or ___semi form or form because most
of the water is gone.
• Which one do you irrigate? __________________ & ______________
• Why irrigate? ____________________________________________
• When is the best time to irrigate?
Same ______________ everyday
After a __________________________
• The further down the colon the stoma is, the more formed the stool will be because ________________is being drawn out. The stool is more normal.
Which ones do you irrigate? _ descending_ & _ sigmoid
Why irrigate? _For regularity you want to keep in regular___
When is the best time to irrigate?
Same _______time_ everyday
because you’re trying to develop a routine After a __meal__
The further down the colon the stoma is, the more formed the stool will be
because ___water__is being drawn out. The stool is more normal.
When you are irrigating an ostomy, you use the same principles as if you were administering an enema.
Anytime you are giving an enema, if the client starts to cramp, ______sttop__ the fluids, lower the bag and/or check the ________temp__ of the fluid.
