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Acute Abdominal Inflammatory Disorders

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Question
Answer
What are the five categories of laxatives?   *Bulk forming *Emollient (Lubricants & softeners) *Hyperosmotic *Saline *Stimulant  
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What laxatives are used in Tx of acute constipation?   *Bulk forming *Stimulant  
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What laxatives are used in Tx of chronic constipation?   *Bulk formin *Hyperosmotic  
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What laxatives are used for bowel prep?   *Hyperosmotic *Saline *Stimulant *(HS2)  
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How do bulk forming laxatives work?   High fiber, absorb h20 to increase bulk, distend bowels to initiate reflex bowel activity  
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What are bulk forming laxatives indicated for?   *Constipation (Acute & Chronic) *IBS *DIVERTICULITIS  
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What are Osmotic Cathartics (hyperosmotic laxative) indicated for?   *Chronic constipation *Bowel prep  
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How do Osmotic Cathartics (hyperosmotic laxative) work?   increases fecal h20 content, bowel distention, increased peristalsis>>evacuation  
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How do Saline Laxatives work?   draws h2o into the colon to increase stool mass, stretch musculature causing increased peristalsis and producing watery stools  
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What are Saline Laxatives indicated for?   *Constipation *Bowel prep  
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How do Stimulant laxatives work?   causes peristalsis via intestinal nerve stimulation ; act on colon by reducing H2o and electrolyte absorption increasing H2o and ions into the intestine  
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What are Stimulant Laxatives indicated for?   *Acute constipation *Bowel prep  
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What are the general side effects of laxatives?   *Nausea *Diarrhea *Abdominal cramps  
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What are the general contraindications for laxatives?   *Hypersensitivity *Persistent abdominal pain *Nausea *Vomiting of unknown cause  
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ALL laxative tablets should be taken how and with what?   Swallowed whole (never crushed or chewed) and with 6 to 8 ounces of water  
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What should be encouraged as an alternative to laxative use?   A healthy, high-fiber diet and increased fluid intake  
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What can long term use of laxatives lead to?   decreased bowel tone and dependency  
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What is appendicitis?   the inflammation of the vermiform appendix located at the tip of the cecum in the right lower quadrant (RLQ) of the abdomen  
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Who is appendicitis most common in?   Most common in adolescents and young adults (mainly men), but can occur at any age  
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How does appendicitis occur?   Occurs when the opening of the appendix becomes obstructed  
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What is the name of the location where abdominal pain from appendicits generalizes?   McBurney's Point  
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List four S/Sx of appendicitis:   *Vomiting *Low-grade fever (99° to 102° F) *Elevated white blood cell count *Abdominal pain/rebound tenderness at McBurneys point *Rigid abdomen *Decreased or absent bowel sounds  
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Whya are analgesics avoided in appendicitis?   Analgesics may mask symptoms  
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What is Diverticulosis?   the presence of pouch-like herniations through the muscular layer of the colon, particularly the sigmoid colon  
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What is Diverticulitis?   the inflammation or infection of one or more diverticula  
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What may diverticulosis be the result of?   Chronic constipation or the result of the modern, highly refined, low-residue diet  
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What can be the result of repeated inflammation of diverticuli?   the lumen of the colon narrows and may become obstructed  
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What can result if diverticulitis remains untreated?   Septicemia and septic shock  
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What will the PT experience if intestinal obstruction from diverticulosis occurs?   abdominal distention, nausea and vomiting  
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What is the test of choice to diagnose diverticulitis?   CT scan with oral contrast  
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What test is done to rule out carcinoma in a PT with diverticula?   Colonoscopy  
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What diagnostic test should NOT be performed on a PT with diverticulitis and why?   A patient with acute diverticulitis should not have a barium enema or colonoscopy because of the possibility of perforation and peritonitis  
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When is surgical management mandatory for diverticular disorders?   if obstruction, perforation, abscesses or hemorrhage occur  
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What is Peritonitis?   inflammation of the abdominal peritoneum  
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What characterizes peritonitis?   Severe abdominal pain, where the PT often assumes the supine position with the knees flexed to relax the abdominal muscles; any movement is painful  
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What position should the PT with peritonitis be placed in and why?   Place patient on bed rest in semi-Fowler’s position to help localize purulent exudates in lower abdomen or pelvis  
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