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Lower GI disorders


Inflamatory Bowel Disease (IBD) 1. IBS 2. Crohn Dz 3. Ulcerative Colitis
Crhon Dz non bloody mucus through out intestines Cobble stones appearance
Ulcerative Colitis Bloody in colon
Fluid loss through GI via Vomiting and diarrhea is .... 100 - 200 ml/day
nrsg dx Fluid volume deficit
1st priority fluid replacement
diarrhea causes what acid/base imbalance? metabolic acidocis
vomiting causes what acid/base imbalance? metabolic alkalosis
what med and nursing intervention will require blood glucose checks often? and why? steroids TPN they increase glucose
What VS will change fast w/ Peritonitis? Temp spike = perforation
w/ UC what are the pts at risk for? anemia
meds for IBD's: steroids antidiarrheals Sulfasalazine (Azulfadine)
Azulfadine is a ..... that has ...... and ...... properties antirheumatic Abx and anti-inflamatory
what education is needed w/ an ileostomy? stoma care
what affect do narcotics have on the GI? slowa mitility = constipation
if narcotics are needed what needs to be done and why? monitor closely b/c of the risk of intestinal perforation
DIVERTICULAR DZ 1. diverticulosis 2.diverticulitis
Diverticulosis formation of a lot of pouches no pain
diverticulitis inflamation of pouches pain
what potential problems can happen w/ diverticulitis obstruction infection hemorrhage
Symptoms of diverticular dz LLQ pain (location of sigmoid and descending colon) inc. flatus rectal bleeding
signs of obstruction alternating constipation and diarrhea ABD distention Low-grade fever
to dx diverticulitis Barium enema + colonoscopy
Intestinal obstructions partial complete
cx of obstructions mechanical neurogenic vascular
MECHANICAL (5) 1. scarr tissue (adhesions) 2. strangulated hernia 3. volvulus (twisting of the gut) 4. Intussusception (telescoping of the gut within itself) 5. tumors (feces lodges against the tumor. stools will look like ribbons)
NEUROGENIC 1. paralytic ileus 2. spinal cord lesion
paralytic ileus gut is sleep
spinal cord lesion sluggishe peristolsis r/t nerve blockage
VASCULAR occluded mesenteric artery (leads to gut infarction)
Symptoms of obstructions sudden abd pain/guarding / hx Abd surgery/ Abd distention / bowl sounds (high-picthed = early mechanical/ absent = neurogenic, late mechanical)/ N/V
ABG analysis 1. Alkalotic = high sml intestines obstruction 2. Acidic = lower bowl obstruction
Nrsg interventions 1. NPO, IV F&E 2. I&O, Foley cath 3. NGT (int/ doc q8h/irrigate NS 30-60 ml)
why do you want the NGT in low int. suction? prevent damage to the lining and further electrolyte losses
what is a Cantor, Miller-Abbot, Harris tube? tube from nose all the way to rectum (by MD)
monitor ABD for 1. distention (measure abd girth) 2. rigidity 3. bowel sounds
prevention - cruficerous veggies (cabbage family) - increase fiber intake - wt management - decrease animal fat
EXAMS - DRE (digital rectal ex)q year > 40 - Ocult blood q year > 50 - colonoscopy q 3-5 year > 50 (more freq depending on family Hx)
tx surgery radiation antineoplastics
dx made by DRE colonoscopy biopsy barium enema
how do you evaluate effectiveness of tx? CEA (carcinoembryonic antigen) serum level
symptoms early : rectal bleeding, changes in bowel habits, sense of imcomplete evacuation late: abd pain, N/V, wt loss (cachexia)
Created by: luwetherrbee