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Lower GI

Adult 1 GI site Group 1Mr.Justice (wendy, tonya, tina, frances, tamara, anisssa)

dFlap 1Answer
Chron's disease chronic inflammation of the intestinal tract
Sphincter a ring of muscle
Diverticula abnormal side pockets in a hollow organ such as the large intestines
Constipation difficult defecation with hard and dry fecal matter
Toxic Megacolon dilation and paralysis of the colon, occurs in approximately 5% of patints with ulcerative colitis
What do Anticholinergics do r/t IBS Inhibits action of acetylcholine on postganglionic, parasympathetic muscarinic receptors, decreasing GI motility. Also possesses local anesthetic properties that may be partly responsible for spasmolysis
What are the 9 segments of the lower GI Cecum/appendix, ascending colon, hepatic flexuree, transverse colon, splenic flexure, descending colon, sigmoid, rectum, anus
Tx of constipation increase fluids/fiber, exercise, treat underlying cause
Medications for constipation Bulk forming lax. (Metamucil, Fibercon); Stool softener (Colace)
Causes of diarrhea infection, medication, diet, disease
Tx of diarrhea dependent on underlying cause; maintain hydration, monitor labs, provide meticulous skin care BSC for debilitate pts.
Meds for diarrhea Bismuth subsalicylate (Pepto), Diphenoxylate HCL & Atropine sulfate (Lomotil)
Appendicitis Inflammation of th vermiform appendix
Cause of appendicitis unsure; obstruction from feces, tumors, foreign bodies, lead to infection, increase pressure leads to hypoxia, eventually gangrene
S/S of appendicitis Abd pain, rebound tenderness, vague to specific, fever may or may not be present, /D or constipation, N/V
Dx of appendicitis Abd US, CT scan, Lab work - WBC's usually elevated; Urinalysis to r/o urinary issues
Nursing considerations of appendicitis Keep pt NPO, pain med is ok by MD, reposition for comfort, prepare pt. for surgery, be sure consents are signed
Post-op appendicitis teach pt to splint abd when coughing/deep breath, change drsg as ordered, monitor for s/s of infection
Diverticula sac like outpouchings of the colon's mucosa
Diverticulosis Asymptomatic disease
Diverticulitis acute inflammation
Causes of diverticulitis increased risk from low residue, highly refined diet; reduced fecal bulk reduces lumen of colon - this can lead to increased pressure
S/S of diverticulitis vague, may have cramping pain, /D, constipation, distention or flatulence may occur after eating
If diverticula become inflamed or abcessed fever, leukocytosis, pain/tenderness
Complications of diverticulitis Perforation, Peritonitis, Hemorrhage, Bowel obstruction, Fistula formation
Dx of diverticulitis Sigmoidoscopy, Colonscopy, Barium enema can be administered - but not preferred
Tx of diverticulitis Increase dietary fiber, Avoid seeds, peels, nuts; encourage fluid intake to decrease stool hardness, realize that surgery may be necessary eventually
Chron's Disease Results in inflammation of segments of the GI tract; involves all layers of the intestinal wall; creates fissures with edema; coblestone appearance
Skip lesions affects alternate sides of colon in Chron's disease;
S/S of Chron's disease Minimal specific s/s; IBS for many years; Non-bloody diarrhea, Wt. loss; Abd pain; Involvement of ileum (pernicious anemia)
Dx of Chron's disease Hx, Sigmoidoscopy/Colonscopy; Barium enema; Stool culture - to r/o infection
Tx of Chron's disease Dependent on severity; Sulfa&ASA, Steroids, Flagyl for infection
Ulcerative Colitis Eroded & patchy looking; causes destruction of mucosa with pain & bleeding; /D with blood & purulent mucous; loss of absorptive surface leads to a large volume of watery diarrhea
S/S of ulcerative colitis Intermittent periods of exacerbation & remission;
S/S of severre ulcerative colitis Fever; 10-20 diarrhea stools/day; Bloody stools; Cramping; Wt. Loss; Anemia
Complications of ulcerative colitits Anal fissures, hemorrhoids, perirectal abcess, hemorrhage (rare), obstruction of colon
Tx of Ulcerative colitis Very similar to Chron's, possible TPN for malnourish pts, IVF, surgical resection if meds ineffective
IBS Functional problem with bowel, does not cause structural changes, does not predispose to CA, Symptoms usually mild
Causes of IBS Unknown, possibly r/t neural control changes, hormones, foods, stress, infection
S/S of IBS Gas, bloating, diarrhea, abd cramping
Dx of IBS Hx, Sigmoidoscopy/Colonscopy to r/o polyps/tumor/lesions; lactose intolerance testing, Celiac disease testing
Meds for IBS Lotronex - relaxes the colon; Zelnorm - only effective for women, used in constipated form of IBS
When should people have a colonscopy over the age of 50
S/S of colon and rectal CA may imitatet othe types of bowel disorders
Dx of colon and rectal CA stool for occult blood (no red meat or NSAIDS before test); colonscopy; Hx; Labs - CBC, CEA, Liver fnct test; CT of abd
Tx of colon and rectal CA Surgical excision, Ostomy, Chemotherapy/Radiation
Anal abcess pus filled cavity within the anus; obstruction of the anal glands; abcess drained surgically; may require a drain; usually will form a fistula after draining
Anal fistula can occur between anus and vaginal wall; can be caused by TB, CA or inflammatory bowel disease; fistulectomy usual tx; recurrance occurs freq; may lead to inconttinence in high; make sure BM is coming from colon not vagina
Anal Fissure A tear in the tissue; usually occurs from passing large hard stool; acute types heal spontaneously; chronic may need surgery; Teach dietay changes & /or stool softners
Dx of Celiac disease Stool content analysis or Bx
Tx of Celiac disease Gluten free diet; Lactose free diet
Created by: okrecota