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68wm6 p2 inf in bow
Infection and Inflammation of the Bowels
| Question | Answer |
|---|---|
| What is the most common route entry of intestinal infection? | through the mouth by contaminated food or water |
| What is the most common clinical sign of intestinal infections? | Diarrhea |
| What may be present if the intestinal mucosa is directly invaded by infection? | Blood and mucus in the stool. |
| What is the primary diagnostic test for intestinal infections? | Stool culture |
| In the case of intestinal infections, why may anti-diarrheals b contraindicated? | They may prolong the contact of the infection in the intestines |
| What is the most common symptom of irritable bowel syndrome? | abdominal pain associated with a change in bowel habits |
| List 4 symptoms of IBS | *Pain *Distension *Excessive flatulence *Urge to defacate *Sensation of incomplete evacuation |
| In IBS, what is present in the stool? | Mucus |
| What should be added to the diet of a PT with IBS? | At least 20g/day of dietary fiber |
| If PT with IBS cannot get enough dietary fiber from food, what can be used? | Metamucil |
| What characterzes Ulcerative Colitis? | Inflammation and ulceration of the colon and rectum. |
| True or False: With Ulcerative Colitis, the PT suffers from the ulcers chronically. | False. There are alternating periods of exacerbation and remission |
| In a PT with Ulcerative Colitis, what produces purulent drainage sloughing of the mucosa and subsequent ulceration? | Abcesses |
| What does Ulcerative Colitis cause? | Bleeding capillaries that cause diarrhea containing pus and blood, as well as the formation of possibly cancerous Pseudopolyps. |
| What are the major symptoms of Ulcerative Colitis? | Bloody diarrhea and abdominal pain. |
| How many stools a day would a PT with active Ulcerative colitis have? | 10 to 20 liquid stools a day, containing blood, mucus and pus |
| What occurs in 5% of PTs with Ulcerative Colitis? | Toxic megacolon |
| What is Toxic Megacolon? | dilation of the large bowel in which the bowel can perforate |
| Chronic Ulcerative Colitis lasting 10 -15 years can lead to what in what percentage of PTs? | carcinoma of the colon in 50% of the cases |
| List 3 S/Sx of Ulcerative Colitis? | *Weight loss *Abdominal distension *Tachycardia *Fever *Leukocytosis *Bloody stools |
| What percentage of cases of Ulcerative Colitis require surgery? | 15% to 20% |
| What is a Total Proctocolectomy? | Construction of an internal reservoir and valve (Kock pouch). |
| Why is emotional support especially important for a PT with Ulcerative Colitis? | because these patients have a tendency to be insecure, dependent and sensitive |
| What is Crohns disease associated with? | altered immune mechanisms |
| What is Crohns disease characterized by? | by inflammation of segments of the GI tract |
| Where dose most inflammation from Crohns disease appear? | mostly seen in the ileum |
| How do ulcers form in Crohns disease? | vertically and longitudinally in specific areas along the colon creating a cobblestone appearance. |
| What is the age range for Crohns disease? | 15 to 30 yrs |
| After the first occurence of Crohns, when does it reach its second peak? | In the 6th decade |
| What is the major problem with Crohns disease in the small intestine? | Malabsorption |
| What may result from malabsorption of Vitamin b12? | Megaloblastic (pernicious) anemia |
| What are the principal symptoms of Crohns disease? | Abdominal pain and non-bloody diarrhea. |
| In the PT with Crohns, what do you assess the stools for? | Assess stools for mucus and pus (this disease does not cause blood in the stools). |
| True or False: Anal fissures are common in Crohns disease. | True. |
| What are complications of Crohns to be aware of? | Fever and anemia |
| What is the most definative test for Crohns disease? | Colonoscopy with multiple biopsies of the colon and terminal ileum |
| What first line drugs are indicated for mild to moderate cases of Crohns? | Anti-inflammatory drugs such as sulfasalazine |
| What first line drugs are administered for more severe cases of Crohn's disease | Corticosteroids such as Prednisone |
| What are the second line drugs for Crohns? | *Immunosuppressive agents such as Imuran *Multivitamins and b12 injections |
| What is the only medication specifically indicated for the treatment of Crohn’s disease? | Infliximab |
| What are eliminated form the diet of the PT with Crohns? | Foods that can cause increased diarrhea |
| What dieta have shown to induce remission in 90% of patients with Crohn’s disease and why? | Elemental diets like Criticare because they require minimal digestion and reduce stool volume |
| When do you hold anti-anxiety medication and notify the physician? | If systolic b/p drops 20mmHg |
| What do you check prior to administration of antianxiety drugs? | Blood pressure |
| What may be masked by corticosteroid medications? What are S/Sx you'll assess for? | Infection. Fever and sore throat |
| What do you monitor for in a PT on Corticosteroids? | *Infection *Adrenal insufficiency |
| What are the S/Sx of adrenal insufficiency? | *Lethargy *Nausea *Anorexia |
| True or False: Check the blood glucose level on a regular basis for ALL patients receiving corticosteroids | True |
| In a PT taking corticosteroids, what adverse reactions should you notify the physician of? | *Dizziness *Severe Headaches *SoB |
| What drugs slow intestinal motility and propulsion? | *Diphenoxylate/atropine *difenoxin/atropine *loperamide |
| What drugs affect fluid content of the stool? | Kaolin/pectin and bismuth subsalicylate |
| What drug acts as an antidiarrheal by taking on water within the bowel lumen to create a formed stool? | Polycarbophil |
| What drug can be used to treat both constipation and diarrhea? | Polycarbophil |
| What drug is used specifically for diarrhea associated with GI endocrine tumors? | Octreotide |
| List 3 adverse effects of anti-diarrheals? | *Angioneurotic edema *paralytic ileus *toxic megacolon constipation *nausea *abdominal pain |
| Taking digoxin with an absorbent such as Pepto-Bismol may result in what? | decreased absorption of the digoxin. |
| Tarchycardia due to thyrotoxicosis or cardiac insufficiency Myasthenia gravis is the contraindication for what drug? | Trimethobenzamide |
| How does trimethobenzamide affect the absorption of other drugs? | May alter GI absorption of other drugs by inhibiting GI motility and increasing transit time. |
| Constipations may become a problem with what drug group? | Anticholenergics |
| What is the action/purpose of Anticholinergics? | to Reduce motility and decrease the amount of acid secreted by the stomach |
| What drug for GI issues is also good for motion sickness? | Anticholinergics |
Created by:
Shanejqb
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