Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing 2 Exam 4 > Unit 19 Bowel Disease of The Lower GI Tract > Flashcards

Unit 19 Bowel Disease of The Lower GI Tract Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

What is Irritable Bowel Syndrome (IBS)?

A

-Non-inflammatory, FUNCTIONAL disorder of intestinal mobility
-Pain/discomfort from visceral hypersensitive (organ pain)
> Changes in peristaltic waves and fecal movement
at specific segments in the colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are contributing factors to IBS?

A 
Smoking
Gas-producing foods 
Female Reproductive Hormones
Alcohol 
High fat diet 
Anxiety**
Depression**
Psychological stress**
Aspirin
Caffeine 
Gluten Intolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are signs and symptoms of IBS?

A
  • Diarrhea or constipation or both
  • Abdominal pain
  • Abdominal distention
  • Excessive flatulence
  • Defecation urgency
  • Sensation of incomplete evacuation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the diagnostic for IBS?

A

No real diagnosis test needed, based on symptoms
1st Pain relieved by deification
2nd- Change in frequency
3rd- Change in appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the medications for constipation?

A

Bulk forming laxatives

  • polyethylene glycol
  • psyllium

Stool softener
-docustate sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are medications for diarrhea?

A

Antidiarrheal
-loperamide

Anticholinergic/Antispasmodic
-pro-pantheline

  • Antidepressants
  • Probiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the management for IBS?

A
  • Nutrition management
  • Food diary
  • Diet change
  • Chew foods slowly & thoroughly
  • Fluids between meals not with meals
  • Stress management & relaxation techniques
  • Alternative therapies (hypnosis, acupuncture)
  • Follow up care trusting relationship with care provider is essential
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the goals for IBS?

A

relieve abdominal pain

control symptoms & stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe Inflammatory Bowel Disease (IBD).

A
  • Refers to two chronic inflammatory GI disorders: -Regional enteritis (Crohn’s Disease) and Ulcerative colitis (UC)
  • Autoimmune
  • Characterized by chronic, recurrent inflammation of the intestinal tract
  • Periods of remission interspread with periods of exacerbation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe Ulcerative Colitis, where the pain is located usually, and what is a way to cure it.

A
  • Inflammation of the mucosal and submucosal layers of the descending colon and rectum
  • Multiple ulcerations
  • LLQ pain, descending colon***
  • Severe diarrhea, bright red hemorrhage, toxic megacolon, perforation
  • Total colectomy is curative for it
  • auto-immune
  • often accompanied by skin and eye lesions, joint abnormalities and liver disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe Crohn’s Disease/Regional Enteritis.

A
  • RLQ pain unrelieved with defecation***
  • Mouth to anus, distal ilium, ascending colon most common
  • Crampy pains after meals
  • Weight loss, malnutrition, small bowel obstruction
  • Thin and emaciated
  • Inflammation extends all layers of the bowel: granulomas, skip lesions, and cobble stoning appearance on colonoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the diagnostics for IBD?

A 
CBC
WBC (would be elevated)
ESR (elevated)
Albumin/pre-albumin 
Sigmoid/colonoscopy
Barium enema: strong sign (specific for Crohn's Disease)
Stool of occult blood (needs bowel prep)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are examples of what needs a bowel prep?

A

Colonoscopy

Barium enema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the aspects of a bowel prep.

A

-Laxative and enemas until clear
1 gal. polyethylene

  • 24 hr clear liquid diet
  • Explain procedure: barium by enema or use of a flexible scope and sedation will be used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the goals of IBD treatment?

A
  • Decrease inflammation
  • Bowel rest
  • Correct malnutrition deficits
  • Improve QOL
  • Suppress immune response
  • Achieve and maintain remission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 5 major classes of medications for IBD?

A

Aminosalicylates

Antibiotics

Corticosteroids

Immunosuppressant

Biologics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What prefix of drugs have photosensitivity allergies?

A

Sulfa drugs

18
Q

Name and describe the aminosalicylates used to treat IBD.

A
  • sulfasalazine
  • mesalamine

Decreases inflammation
Maintains remission, suppresses immune response

SE: turns urine orange in color, photosensitivity, decreased urine output and flu-like symptoms

19
Q

Name and describe the antibiotic and corticosteroids used to treat IBD.

A

THEY DO NOT MAINTAIN REMISSION

  • metronidazole (antibiotic)
  • treats secondary infections: abscesses, perforation, peritonitis
  • prednisone (corticosteroid) oral
  • hydrocortisone IV
  • budesonide rectal enema
  • Assists in reduction of inflammation, pain, and for comfort
20
Q

Name and describe the immunosuppressants and biological therapies used to treat IBD.

A
  • azathiopine (immunosuppressant)
  • methotrexate (immunosuppressant)
  • natizumab (biologic)
  • infliximab (biologic)

they maintain remission

21
Q

What are nutritional considerations for IBD?

think why? PT has diarrhea, losing electrolytes-malabsorption, bleeding

A
  • Iron supplementation
  • Vitamins B12, Zinc, Folate, calcium, Vit D, Vit C
  • Parenteral nutrition
  • Nutritional supplementation
  • Adequate fluids
  • Balanced diet: High in calorie, high protein, low residue
22
Q

What are teaching points for PTs with IBD?

A
  • Importance of rest and diet management
  • Action and side effects of drugs
  • Symptoms of recurrence
  • When to seek medical care (signs of infection)
  • Must stay on medication
23
Q

What is Diverticulosis?

A
  • Part of bowel where muscle gets weak and causes pouches

- Disease/Condition in which small, bulging pouches develop in the digestive tract

24
Q

What is Diverticulitis?

A
  • Inflammation or infection in one or more small pouches in the digestive tract.
  • Potential for Peritoneal perforation from erosion of the bowel wall
25
Q

What are the clinical manifestations of Diverticulitis?

A

> Symptoms specific to sigmoid colon

(Most common)

  • Left lower quadrant abdominal pain
  • Fever
  • Leukocytosis
  • Palpable abdominal mass
  • N/V
26
Q

What are the complications of Diverticulitis?

A
  • Perforation “popped balloon” (Assess abdomen, if board-like = perforation)
  • Peritonitis
  • Obstruction
  • Fistula
  • Bleeding
27
Q

What is Peritonitis?

A
  • Leakage of contents from abdominal organs into the abdominal cavity
  • Inflammation of the membrane lining the abdominal wall and covering the abdominal organs.
  • Board-like abdomen
28
Q

What is a fistula?

A

An abnormal or surgically made passage between a hollow or tubular organ and the body surface, or between two hollow or tubular organs.

29
Q

Describe Appendicitis.

A
  • Obstruction
  • Inflamed
  • Most prevalent in the young
  • R sided epigastric/periumbilical pain
  • Low grade fever
  • Can lead to rupture-perforation
  • Symptoms may differ in the elderly
  • Constipation
30
Q

What is Mc’Burney’s point?

A
  • 2/3 away from the umbilicus towards the right side

- Deep tenderness at McBurney’s point, known as McBurney’s sign, is a sign of acute appendicitis

31
Q

What is the treatment for Appendicitis?

A
  • No laxatives in acute phase
  • Surgery
  • IV fluids
  • Antibiotics
  • Pain management
  • Post-op care
  • If rupture more intense care seen in peritonitis
32
Q

What are the clinical manifestations of Peritonitis?

A

“acute abdomen”

  • Tenderness over the involved area (universal sign)
  • Muscle rigidity: board-like
  • Increased temp and pulse rate, decreased BP
  • The PT lies very still R/T severe pain on movement
33
Q

What is the collaborative care for Peritonitis?

A
  • Fluid resuscitation
  • O2 via nasal canula
  • NGT
  • Pain management
  • Surgery
  • Post-op care
  • IV antibiotics
34
Q

What are the diagnostics for Diverticulosis/itis/Appendicitis?

A
  • History and Physical
  • CT with oral contrast
  • Barium Enema
  • Colonoscopy or Sigmoidoscopy
  • Blood cultures
35
Q

Where are ileostomies and colostomies usually done?

A

ileostomies- right side

colostomies-left side

36
Q

What is the non-pharmacologic disease therapy for Diverticulosis?

A
  • High fiber diet: fruits and vegetables
  • Exercise regularly
  • Weight reduction: DECREASE intra-abdominal pressure
  • No evidence regarding avoidance of seeds and nuts
37
Q

What is the medication management for Diverticulosis and what shouldn’t be taken?

A

Stool softeners
Mineral oil
Bulk laxatives
Fiber supplementation

(Don’t take NSAIDs, increased risk of perforation)

38
Q

What is paralytic ileus?

A

Inability of the intestine (bowel) to contract normally and move waste out of the body

39
Q

What should be done post barium enema?

A

Give fluids and laxatives to flush barium

40
Q

What should be assessed post colonoscopy?

A

Abdominal cramping, assess for rectal bleeding and signs of perforation

Nursing 2 Exam 4 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions