Unit 2 Ch 34 Lower GI disorders Flashcards
Lower G.I. system
Small intestine
Large intestine
Rectum
Anus
What does the small intestine do?
Absorbs nutrients
What does the large intestine do?
Absorbs water, and gathers undigested material
Appendicitis
Inflammation of the appendix
Pain in the right lower quadrant
Signs and symptoms of appendicitis
Fever, nausea, vomiting, anorexia pain in the right lower quadrant
McBurney point
Diagnostic test for appendicitis
Complete blood count
Checking for neutrophil being increased
Ultrasound or MRI
What is Rovig sign?
Where you put pressure on one side but you feel pain on the opposite side
Therapeutic interventions for appendicitis
NPO
Surgery
Complications could include an abscess
Diverticulitis
Inflammation and infection of the diverticulum
Diverticulosis
Multiple diverticula
Diverticulum
Outpouching of a bowel mucus membrane
Causes of diverticulosis and diverticulitis
Chronic constipation
Decrease intake of dietary fiber
Risk factors for diverticulosis and diverticulitis
Low fiber, and high animal fat diet
Obesity
Sedentary lifestyle
Smoking
Medication’s
Signs and symptoms of diverticulosis and diverticulitis
No symptoms
Constipation or diarrhea
Cramping
Bleeding
Abdominal tenderness
Diagnostic testing for diverticulosis and diverticulitis
Flexible, sigmoidoscopy or colonoscopy
CT scan
Therapeutic interventions, for mild cases of diverticulosis and diverticulitis
Tylenol antibiotics liquid diet
Therapeutic interventions, for severe cases of diverticulosis and diverticulitis
Pain control
NPO
IV antibiotics
IV. Fluids and nutrients.
Surgery
Diverticulum
Singular
Diverticulosis
More than one
Other concerns of appendicitis
Rupture or perforation, where contents spill into cavity peritonitis
If the appendix ruptures
Symptoms will disappear and they cannot have surgery until infection is controlled
Medication for diverticulosis or diverticulitis
NSAID opioids steroids
Diverticulosis
Out pouches
Diverticulitis
Means it’s inflamed or infected
Crohn disease
Autoimmune inflammatory bowel disease
Involves any part of the intestine
Remissions and exacerbations
Causes unknown
Hereditary
Crohn’s disease, signs and symptoms
Abdominal pain or cramping
Weight loss
Diarrhea
Fluid and electrolyte imbalance
Crohn’s disease diagnostic testing
Laboratory testing
Endoscopy with biopsy
Ultrasound
CT
MRI
Therapeutic interventions for Crohn’s disease
Medication’s
5-aminosalicylates
Anti-diarrhea
Biologic response modifiers
Corticosteroids
Immunomodulators
Avoid offending foods
Surgery if necessary
Elemental formula or parental nutrition
Support and education
Complications of Crohn’s disease
Malnutrition
Obstruct
Fissures
Abscess
Fistula
Perforation
Bleeding
Ulcerative colitis
Inflammatory bowel disease
Affects large intestines and rectum
remissions and exacerbations occur
Exact cause unknown
Infection, allergy and autoimmune response possible
Signs and symptoms of ulcerative colitis
Abdominal pain
5 to 10 liquid stools daily
Rectal bleeding
Fecal urgency
Anorexia
Weight loss
Cramping
Vomiting
Fever
Dehydration 
Complications of ulcerative colitis
Hemorrhage
Toxic megacolon
Perforation
peritonitis
Osteoporosis
Increase risk of colorectal cancer
Ulcerative, colitis diagnostic testing
CBC
Stool specimen
Electrolytes
Protein level
Colonoscopy with biopsy
Leukocyte scintigraphy 
Ulcerative colitis therapeutic interventions
Avoid offending foods
Medications
5 aminosalicylates
Antidiarrheals
Biologic response modifiers corticosteroids
Immunomodulators
Abdominal hernias
Protrusion of organ or structure through weakness, or tear in wall of abdomen
Weakness in abdominal wall with increased intra-abdominal pressure
Types of abdominal hernias
Umbilical
Inguinal, direct, or indirect
Femoral
Signs and symptoms of abdominal hernias
Could be no symptoms
Bulging
Complications would include strangulated, incarcerated, hernia this is a medical emergency
Strangulated incarcerated hernia
Pain
Nausea and vomiting
Increased temperature
The strangulation is cutting off blood and oxygen perfusion
Therapeutic interventions for abdominal hernias
None
Observation
Support devices binders
Surgery
Teachings for abdominal hernias
Lifting
No coughing or lifting
Support devices
Lose weight
No smoking
High fiber
Hemiorrhaphy
Surgery for abdominal hernias
Hemioplasty
The use of mesh for a abdominal hernia surgery
Education for abdominal hernias
No coughing or lifting
Signs of complications
Support garments
No smoking
High fiber
Deep breathing
Incentive spirometer
Intestinal obstruction
Flow of intestinal contents is blocked
Partial or complete where everything stops
Mechanical blocking
Nonmechanical
Small intestine is more involved with flatus and gas
A mechanical obstruction
Blockage occurs within the intestine
Bowel sounds are high-pitched, tingling
You will hear something
Non-mechanical obstruction
Parastasis is impaired
Bowel sounds are absent
You will not hear anything
Intussusception
The bowel Seeps and telescopes back
Volvulus
Where the bowel is twisted
Signs and symptoms of an intestinal obstruction
Abdominal pain
Blood and mucus rectum
Feces and flatus cease
Fecal vomiting may occur
Abdominal distention
Fluid and electrolyte imbalance
What to do in a ball obstruction with abdominal distention
Use an NG tube to relieve pressure with low suction tube should be in the stomach
When there is a intestinal obstruction and fluid and electrolyte and balances
Do labs
Check skin trigger
And do weights
What should be the pH of the stomach with an NG tube?
0-5.5
Diagnostic test for an intestinal obstruction
Abdominal x-ray
CT scan
CBC and electrolytes
Intestinal obstruction therapeutic interventions
NPO
Oral care
NG tube
Fluid and electrolyte replacement
Medication
Antibiotics
Antiemetics
Analgesics
Surgery
Antiemetics
Stop nausea and vomiting
Ostomy
Surgically created, opening divert stool, or urine to outside the body
Stoma
The portion of the bowel sutured into the abdomen
Ileostomy
Small intestine
Colonoscopy
Large intestine
Ileostomy contents
Contain higher discharge that are liquid non-formed and constantly drain
Colonoscopy contents
Semi solid or liquid depending on placement
Ileostomy
Terminal ilium to abdomen wall after total cholectomy
Types of ileostomies
Conventional
Small Soma in right lower quadrant
Continuous flow of liquid effluent
Continent, ileostomy, Kock pouch
Internal reservoir with nipple valve
Empty reservoir 3 to 4 times daily
Ilioanal, ileorectal anastomosis
Ileana anastomosis
J pouch
Colostomy
Effluent, becomes less liquid and more solid, as location of ostomy, becomes more distal in colon
End, stoma colostomy
Proximal bowel end brought to abdominal wall
Loop stoma
Loop of bowel outside abdomen with bridge under it
Double barrel stoma
Temporary ostomy
Both ends of colon outside abdominal wall from two stomas
Proximal stoma is functioning
Distal stoma is mucus fistula