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GI ✔︎ > Ulcerative Colitis and Crohn's disease: IBD > Flashcards

Ulcerative Colitis and Crohn's disease: IBD Flashcards

1
Q

What is ulcerative colitis?

A

Ulcerative inflammatory bowel disease just in the large intestine

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2
Q

What is crohn’s disease also called?

A

Regional enteritis

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3
Q

What is Crohn’s disease?

A

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

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4
Q

What are S/S of IBD?

A
  • Diarrhea
  • Rectal bleeding
  • Vomiting
  • Weight loss
  • Cramping
  • Dehydration
  • Blood in stools
  • Anemia
  • Rebound tenderness
  • Fever
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5
Q

What is rebound tenderness?

A

push in, let go and it hurts the client

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6
Q

What does rebound tenderness indicate?

A

Peritoneal inflammation

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7
Q

How do you diagnose IBD?

A
  • CT or MRI
  • Colonoscopy (most common test for diagnosing)
  • Barium enema
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8
Q

What should you watch for post colonoscopy?

A

Perforation

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9
Q

What are the signs of perforation?

A

Pain or unusual discomfort

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10
Q

How do you treat IBD?

A
  • Diet
  • Meds
  • Surgery
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11
Q

What kind of diet should people with IBD have?

A
  • Low residue (limit GI motility)

- Avoid cold foods and smoking (increase motility)

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12
Q

What meds are given for the treatment of IBD?

A
  • Antibiotics
  • Steroids (to decrease inflammation)
  • Biologics and immunomodulators
  • Aminosalicylates (decrease inflammation)
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13
Q

What surgeries are done for ulcerative colitis?

A
  • Total colectomy (proctocolectomy) - ileostomy is formed

- Kock’s ileostomy or an Ideal Pouch Anal Anastamosis (IPAA) - with these two procedures, there is no external bag.

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14
Q

What is formed with a total colectomy?

A

an ileostomy

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15
Q

With a Kock’s ileostomy or a IPAA, is there an external bag?

A

No

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16
Q

What type of pouch has a nipple valve that opens and closes to empty the intestines?

A

Kock’s pouch

17
Q

What procedure removes the colon and attaches the ileum to the rectum? (most popular)

A

IPAA procedure

18
Q

Do they try not to do surgery with Crohn’s?

A

Yes

19
Q

With surgery for Crohn’s, what is removed?

A

Only affected area

20
Q

With surgery for Crohn’s the client may end up with what?

A

Ileostomy or colostomy (depends on area affected)

21
Q

What is an ostomy in the ileum called?

A

Ileostomy

22
Q

What is a ostomy in the colon called?

A

Colostomy

23
Q

Do we irrigate ileostomies?

A

No, it’s going to drain liquid all the time.

24
Q

Ileostomy care

A
  • Don’t have to irrigate.
  • Avoid foods hard to digest and rough foods (they increase motility).
  • Gatorade or similar electrolyte replacement drink in the summer.
  • At risk for kidney stones (d/t being always a little dehydrated)
25
Q

What happens as waste moves through the colon?

A

Water and nutrients are being absorbed and the stool is formed

26
Q

What types of stool will a colostomy in the ascending and transverse colon produce?

A

Semi-liquid stools

27
Q

What type of stools will a colostomy in the descending or sigmoid colon produce?

A

Semi-formed or formed

28
Q

Which colostomies do you irrigate?

A

Descending and sigmoid

29
Q

Why do we irrigate descending and sigmoid colostomies?

A

For regularity

30
Q

When is the best time to irrigate a colostomy?

A

Same time everyday and after a meal (increased peristalsis)

31
Q

The further down the colon the stoma is, the more formed the stool will be, why?

A

Because water is being drawn out, the stool is more normal.

32
Q

When irrigating an ostomy, should you use the same principles as if administrating an enema?

A

Yes

33
Q

Anytime you give an enema, if the client starts to cramp, what should you do?

A

Stop the fluid, lower the bag and/or check the temperature of the fluid

34
Q

Pre and post-procedure nursing care for colonoscopy

A
  • Clear liquid diet for 12-24 hrs pre-procedure.
  • NPO 6-8 hours pre-procedure.
  • Avoid NSAIDs to reduce bleeding risk.
  • Laxatives or enemas until clear.
  • Polyethylene glycol (Go-Lytely)
  • To help client drink a colon prep more easily, get it icy cold.
  • Sedated for procedure.

Post-colonoscopy
- Watch for perforation.

35
Q

What should we watch for post-colonoscopy?

A

Perforation

*watch for signs of perforation - pain and unusual discomfort.

GI ✔︎ (11 decks)

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