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68wm6 p2 inf in bow

Infection and Inflammation of the Bowels

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