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NURS 2514 > Week 6 - Obstruction > Flashcards

Week 6 - Obstruction Flashcards

1
Q

what is intestinal obstruction

A
  • any situation where there is an impaired movement of the intestinal contents
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2
Q

where does intestinal obstruction commonly occur in? where can it occur in?

A
  • can occur in both large & small intestine

- most commonly in small tho

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3
Q

list 2 causes of intestinal obstruction

A
  1. mechanical

2. functional

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4
Q

what is mechanical obstruction of the intestine

A
  • occurs when there is physical obstruction in the intestine
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5
Q

list 8 examples of mechanical obstruction

A
  • tumor
  • scar tissue
  • adhesions from previous surgery
  • diverticular disease
  • inguinal hernia
  • volvulus
  • intussusception
  • infarction
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6
Q

what is functional obstruction of the intestineq

A

-results from neuro impairment or failure of propulsion in the intestine

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7
Q

what is functional obstruction of the intestine often called

A
  • paralytic ileus
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8
Q

list 8 examples of causes of functional obstruction

A
  • peritonitis
  • pancreatitis
  • crohn’s disease
  • ulcerative colitis
  • electrolyte abnorm
  • mesentric thrombus
  • spinal cord injury
  • sever medical illness
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9
Q

list 7 symptoms of intestinal obstruction

A
  • borborygmi if mechanical obstruction
  • absence of BS if functional
  • pain
  • distension
  • vomiting
  • hypovolemic shock
  • ischemia/necrosis
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10
Q

describe how mechanical obstruction causes borborygmi

A
  • mechanical obstruction results in audible rumbling sounds as the intestine attempt to push its contents forward
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11
Q

list 7 symptoms of intestinal obstruction

A
  • borborygmi if mechanical obstruction
  • absence of BS if functional
  • pain
  • distension
  • vomiting
  • decreased BP & hypovolemic shock
  • ischemia/necrosis
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12
Q

what does ischemia and necrosis lead to in intestinal obstruction

A
  • causes increased permeability = peritonitis
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13
Q

what does ischemia and necrosis lead to in intestinal obstruction? how?

A
  • peritonitis
  • prolonged ischemia causes increased permeability of the wall = intestinal bacteria to enter the blood & peritoneal cavity
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14
Q

what causes severe vomiting in intestinal obstruction? what can this lead to?

A
  • from distension & pain

- can lead to electrolyte imbalance & dehydration

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15
Q

what causes hypovolemic shock in intestinal obstruction

A
  • increased pressure on the wall causes fluid to shift into the intestine = 3rd spacing fluid shift
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16
Q

describe the onset of a small vs large intestinal obstruction

A
  • small = rapid

- large = gradual

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17
Q

describe vomiting in small vs large intestinal obstruction

A
  • small = frequent & copious

- large = late manifestation

18
Q

describe pain in small vs large intestinal obstruction

A
  • small = colicky, cramplike, intermittent (w peristaltic activity)
  • large = low-grade, cramping, abdominal pain
19
Q

describe bowel movement in small vs large intestinal obstruction

A
  • small = feces for short time

- large = absolute constipation

20
Q

describe abdominal distension in small vs large intestinal obstruction

A
  • small = dependent on location of obstruction; minimal to greatly increased
  • large = greatly increased
21
Q

what are diverticula

A
  • herniations of the mucosa and submucosa thru the muscularis layer of the colon wall
22
Q

what part of the colon do diverticular commonly involve

A
  • sigmoid colon
23
Q

are more people asymptomatic or symptomatic with diverticular disease

A
  • 80% asymptomatic except for constipation and/or diarrhea
24
Q

occasionally, diverticula may become… (2)

A
  • inflammed

- or bleed

25
Q

what are diverticula that are inflammed called

A
  • diverticulitis
26
Q

list 3 risk factors for diverticulosis

A
  • consumption of highly refined foods
  • less dietary fiber
  • chronic constipation
27
Q

how do the risk factors for diverticulosis increase the risk?

A
  • increase the pressure within the GI lumen which can cause herniation

low fibre –> constipation –> increased luminal pressure –> muscle hypertrophy –> herniation of mucosa

28
Q

list manifestations of diverticulosis (4)

A
  • mild abdominal pain
  • constipation
  • diarrhea
  • flatulence
29
Q

what causes abdominal pain & constipation in diverticulosis

A
  • increased muscle contraction necessary to maintain forward propulsion of feces
30
Q

how long does pain associated with diverticulosis last? what relives it?

A
  • hours to days

- relived by passing flatus or feces

31
Q

episodes of constipation, diarrhea, and flatulence in diverticulosis suggest…

A
  • a link to irritable bowel syndrome
32
Q

list manifestations of diverticulitis (4)

A
  • lower left abdominal pain
  • melena or occult blood in stool
  • slight fever
  • leukocytosis
33
Q

what can cause inflammation of the diverticula

A
  • fecal stasis
34
Q

list 4 complications of diverticulitis

A
  • obstruction
  • perforation
  • abcess formation
  • peritonitis
35
Q

describe the treatment for diverticulosis (3)

A
  • increasing fecal bulk
  • encouraging regular defacation
  • antibiotics if necessary
36
Q

what is a polyp

A
  • overgrowth of epithelial cells
37
Q

what are 2 types of polyps

A
  • hyperplastic

- adenomatous

38
Q

what are adenomatous polyps

A
  • pre cancerous or cancerous polyp
39
Q

what are hyperplastic polyps

A
  • benign polyps
40
Q

describe the diagnostic studies and collaborative care for polyps

A
  • colonscopy

- removal

NURS 2514 (75 decks)

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