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Final Exam 331

Gastrointestinal

TermDefinition
what needs to be done before a colonoscopy bowel prep, avoid fiber for up to 72 hours, clear liquid or full liquid diet 24 hours before
after colonscopy considerations may have abdominal cramps, teach about pain, if lasts more than 24 hours, notify HCP, observe for rectal bleeding
after EGD keep pt NPO until gag reflex returns, check q 15-30 mins for 1-2 hours
mechanical obstruction physical obstruction of intestinal lumen
small bowel obstruction causes adhesions, hernia, cancer, stricture
large bowel obstruction causes colorectal cancer, diverticular disease, volvulus
nonmechanical obstruction reduced or absent peristalsis due to altered neuromuscular transmission of the parasympathetic innervation to the bowel
small intestine clinical manifestations rapid onset, sporadic colicky pain, vomiting is very common, metabolic alkalosis
large intestine clinical manifestations gradual onset, persistent cramping pain, infrequent vomiting, abdominal distention- metabolic acidosis
interprofessional management of a bowel obstruction NPO, NG tube to low intermittent suction, IV fluids and electrolyte replacement (antiemetics), encourage ambulation, prepare for possible surgery
risk factors for colorectal cancer first degree relative with CRC, personal history of CRC, inflammatory bowel disease, diabetes mellitus, CRC syndrome Red meat > or equal to 7 servings/wk Cigarette smoking Alcohol > or equal to 4 drinks per week BMI > or equal to 7 servings/wk
interprofessional care colonoscopy, abdominal CT scan, ultrasound, or MRI, liver function tests, DRE
rose-brick red stoma means the stoma is viable
pale stoma means there could be anemia
if stoma is blanching, dark-red or purple then it indicates there is inadequate blood supply to stoma or bowel
teaching for ostomy self-care show how to remove old skin barrier, cleanse the skin and correctly apply new skin barrier, apply empty, clean and remove the pouch, empty the pouch before it is one-third full to prevent leakage, eat well-balanced diet, fluid intake of 300 mL/day
diverticulitis inflammation of the diverticula
diverticulosis pouchlike herniations in the colon wall
diverticulitis care antibiotics, NPO, IV fluids, NG suction, high fiber, low fat diet
diverticulosis signs asymptomatic, abdominal pain, bloating, flatulence, changes in bowel habits
cholelithiasis stones in the gallbladder
cholecystitis inflammation of the gallbladder wall
risk factors for gallbladder disease obesity, sedentary lifestyle, familial tendency, pregnancy, women, older than 40 on estrogen therapy
cholelithiasis clinical manifestations pain more intense with stone movement or obstruction, RUQ, pain 3-6 hours after high fat meal or when person lies down
obstruction in the common bile duct clay-colored stools: steatorrhea, jaundice, dark amber or brown urine, pruitis, intolerance to fatty foods
cholecystitis clinical manifestations indigestion, n/v, pain and tenderness in RUQ, fever, fat intolerance, dyspepsia, heartburn
cholelithiasis nursing care bile acid therapy, ERCP with sphinerotomy, ESWL
acute cholecystitis management NPO, NG to suction, IV fluids, manage symptoms- analgesics, antispasmodic, antiemetic, observe for obstructions and infection
Post-ERCP bed rest for several hours, NPO until gag reflex returns
Post-op teaching remove bandages on puncture site the day after surgery, shower, notify if redness or swelling or pus is present, take time to return to normal activity, take time to resume to normal activities, prevent respiratory complications, low fat diet
Created by: ellabrewer3
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