Ulcerative Colitis and Crohn’s Diseas

Question 1

Where is Ulcerative Colitis located?

Answer 1

Just in the large intestine

Question 2

Crohn’s Disease

Answer 2

inflammation and erosion of the ____ileum

anywhere in the small or large
intestines.

Question 3

Crohn’s Disease is also called

Answer 3

Regional Enteritis

Question 4

S/s

Answer 4

Diarrhea

b. Rectal bleeding
c. Weight loss
d. Vomiting
e. Cramping
f. Dehydration
g. Blood in stools
h. Anemia
i. Rebound tenderness
j. Fever

Question 5

What is rebound tenderness? Push in → let go→ _______________________
• What does it mean? _____________________________

Answer 5

What is rebound tenderness? Push in → let go→ _____and it hurts __
What does it mean? Peritoneal ___ inflammation

Question 6

3Dx

Answer 6

1. CT- in some cases
2. Colonoscopy
3. Barium Enema

Question 7

What is done pre op colonoscopy?

Answer 7

________clear_ liquid diet for 12­-24 hours.

_________NPO 6-­8 hours pre­procedure

Question 8

What is a polyethylene glycol (Go­LYTELY®)

How do we get the client to drink it more easily ?

They shouldn’t drink it with a ____?

Answer 8

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

Question 9

What should avoid with a colonoscopy?

Answer 9

NSAIDs

Question 10

What should we watch for post op colonoscopy?

Answer 10

Post­op watch for _________ perforation__. We are going to assume the WORST!.

Question 11

What are the signs of perforation?

Answer 11

The signs of perforation are pain or unusual ______ discomfort___

Question 12

Is the client sedated for colonoscopy?

Answer 12

Yes

Question 14

Tx

Answer 14

DIET:low fiber diet
Avoid cold foods or hot foods and smoking

MEDS

1. Antidiarrheals
2. Antibiotics
3. Steroids

Question 15

UC has two types of surgey

Answer 15

1. Total Colectomy (ilesostomy formed)

2. Koch’s ileostomy or a J Pouch (no external bag)

Question 16

Describe a Total Colectomy (ilesostomy formed)

?

Answer 16

They may take out your entire colon so the only thing left is the ileum

Question 17

Describe a Koch’s ileostomy or a J Pouch (no external bag)

Answer 17

­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

Question 18

In Crohn’s we try not to do surgery

But they may ___?

Answer 18

May remove only the ________affected_ area.

The client may end up with an ileostomy or a colostomy. It just depends on the area affected.

Question 19

What is a ileostomy?

Answer 19

An ostomy in the ileum

Question 20

What is a colostomy_?

Answer 20

an ostomy in the colon i

Question 21

What is the barium enema also called?

When is it used ?

Answer 21

Lower GI series

Done if colonoscopy is incomplete.

Question 22

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 _________________)

Answer 22

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_)

Question 23

Colostomy Care:
• What happens as waste moves through the colon?
Water and nutrients are being absorbed and the _____________ is
forming.

Answer 23

Water and nutrients are being absorbed and the ___stool is

forming.

Question 24

Colostomy → ascending and transverse→ semi __________ stools

• Colostomy→ descending or sigmoid→ semi formed or ____________.

Answer 24

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.

Question 25

• 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.

Answer 25

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.