week 4 lower GI

Question 1

irritable bowel syndrome & diagnosis

Answer 1

diagnosis of exclusion idiopathic

To diagnose pt must have:

• symptoms in 3 days in a month for 3 months
• abdominal pain & change in bowel for 6mo
• 2 or more :
  
  • pain relief w bowel movement
  • onset change in stool FREQUENCY
  • onset change in stool APPEARANCE

Question 2

s/s of IBS

Answer 2

*BLOATING
abdominal pain
diarrhea / constipation
tenezmus (feel like going but can’t)

Question 3

diet recommendations for IBS

Answer 3

LIMIT =dairy (yogurt), eggs, legumes/beans, FRUIT, caffeine, & alcohol

INCREASE: fiber (30-40g) & fluid – bread, fish, and granola

Question 4

3 meds for diarrhea

Answer 4

Loperamide
psyllium
Alosetron

Question 5

Psyllium

Answer 5

bulk forming agent – take w 8oz water

Question 5

Alosetron considerations

Answer 5

RESTRICTED–watch w females

• for diarrhea

increases stool firmness
decreases frequency/urgency

*risk for ischemic colitis

Question 6

Loperamide

Answer 6

antidiarrheal – slows GI motility

Question 7

2 meds for constipation

Answer 7

Lubiprostone
Linaclotide

Question 8

Lubiprostone considerations

Answer 8

treats constipation – opioid induced

take w food & water

adv effects = decreased LOC & fluid imbalance

Question 9

Linaclotide considerations

Answer 9

treats constipation
take 30 min before breakfast

adv effects= decreased LOC & fluid imbalance

Question 10

s/s of small bowel obstruction

Answer 10

RAPID onset
*vomiting
COLICKY pain- sporadic
abdominal distention

metabolic alkalosis – bc n/v

Question 11

s/s of large bowel obstruction

Answer 11

diffuse CONSTANT pain
fecal fluid
small frequent liquid stools

metabolic acidosis - hyperventilation

Question 12

sounds of an intestinal obstruction

Answer 12

HYPERactive ABOVE obstruction

and

HYPOactive BELOW obstruction

*tinkling sounds = partial obstruction