Week 4 Slide Notes

Question 1

Medical and Nursing Management of Diverticulitis *

Answer 1

Uncomplicated
Rest,
Cla

Question 2

Surgical Management

Answer 2

Two types of surgery:
One stage resection
Hartmann’s procedure

Question 3

Hartmanns Procedure

Answer 3

Proctosigmoidectomy

Sigmoid colon and rectum may be removed in the first part

Second part is to create a colostomy

Question 4

IBD

Answer 4

Is Crohn’s disease AND Ulcerative colitis
Is the inflammation and or the ulceration of the bowel. The inflammation is due to an immune response. It can have extra intestinal manifestations.

Question 5

RF of IBD

Answer 5

Age
Race
Family history
Smoking and Tobacco use
Viral illness
NSAIDS

Question 6

Crohns Disease

Answer 6

Subacute and chronic inflammation of the GI Tract.
It goes through all layers of the bowel wall (known as transmural)

Question 7

Crohns disease location

Answer 7

Can occur anywhere in the GI tract, though is most common in the ascending colon and the distal ileum.
Has a very cobblestone like appearance.

Question 8

Crohn’s Disease Complications

Answer 8

Bowel thickening can lead to fibrosis and the narrowing of the lumen.

Also puts people at risk for strictures, intestinal obstruction, colon CA, fistulas and absesses.

Question 9

Crohn’s Disease CM

Answer 9

Can be progressive, exacerbated, or even in remission.

CM:
Chronic diarrhea
Crampy Abd pain (RLQ0
Anorexia
Wt loss
Fever and Leukocytosis
Malnutrition

Question 10

Crohns disease Diagnosis

Answer 10

Abd US
Abd CT scan
Labs will be on lytes, CBC, albumin, and protein.
Abd MRI
Barium enema’z

Question 11

UC

Answer 11

Ulcer in the colon. It’s inflammatory and can cause bleeding along with difuse lesions.

Question 12

UC affects what

Answer 12

The superficial mucosa DOES NOT GO THROUGH BOWEL WALL

Question 13

UC CM

Answer 13

Bloody, profuse diarrhea. Its 6 plus with intermittent tenesmus (Feeling of needing to pass a bowel movement but unable to do so)

LLQ pain and cramping
Anorexia
Wt loss, dehydration
vomiting
Extra intestinal manifestations

Question 14

Diagnosis of UC

Answer 14

Colonoscopy, Fecal occult, CBC, stool studies to rule out other causes. Barium enema

Question 15

UC Complications

Answer 15

Perforation
Bleeding
Toxic Megacolon

Question 16

Toxic Megacolon S/S

Answer 16

Fever, vomiting, abd pain and distension.
Needs surgery and NGT along with abx and corticosteroids.
Can evolve quickly

Question 17

Management of IBD

Answer 17

Goal is remission
Assess stools
monitor wt
rest adn reduce anxiety
prevent skin breakdown
assess for complications

Question 18

Diet management of IBD

Answer 18

and diet is:
Small frequent meals as tolerated.
Low fiber diet, high protein and high calorie
PO/IV fluids
no irritating foods, and cold food
Smoking cessation (ENDS electronic nicotine device)
yes to Probiotics
Dietitian consult

Question 19

Medication management of IBD

Answer 19

Aminosalicylates are first line
corticosteroids are short term
immunosuppressants’
Biologics
Antibiotics
Antidiarrheals
Analgesia
B12

Question 20

Surgical Management

Answer 20

Indicated for UC, Colon CA, toxic megacolon, strictures.
Crohn’s: Abscess, perforation, hemorrhage

Proctocolectomy (Curative for UC. Ileostomy may be temporary or permanent

Ileal pouch - Kpouch

Question 21

Colostomy poop types

Question 22

Stoma color and post op care.

Answer 22

Bright red and shiny is good
Dark red, purple, black and unusual bleeding is bad.
Will be clear liquid