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

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Answer
Chron's disease   chronic inflammation of the intestinal tract  
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Sphincter   a ring of muscle  
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Diverticula   abnormal side pockets in a hollow organ such as the large intestines  
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Constipation   difficult defecation with hard and dry fecal matter  
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Toxic Megacolon   dilation and paralysis of the colon, occurs in approximately 5% of patints with ulcerative colitis  
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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  
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What are the 9 segments of the lower GI   Cecum/appendix, ascending colon, hepatic flexuree, transverse colon, splenic flexure, descending colon, sigmoid, rectum, anus  
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Tx of constipation   increase fluids/fiber, exercise, treat underlying cause  
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Medications for constipation   Bulk forming lax. (Metamucil, Fibercon); Stool softener (Colace)  
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Causes of diarrhea   infection, medication, diet, disease  
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Tx of diarrhea   dependent on underlying cause; maintain hydration, monitor labs, provide meticulous skin care BSC for debilitate pts.  
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Meds for diarrhea   Bismuth subsalicylate (Pepto), Diphenoxylate HCL & Atropine sulfate (Lomotil)  
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Appendicitis   Inflammation of th vermiform appendix  
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Cause of appendicitis   unsure; obstruction from feces, tumors, foreign bodies, lead to infection, increase pressure leads to hypoxia, eventually gangrene  
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S/S of appendicitis   Abd pain, rebound tenderness, vague to specific, fever may or may not be present, /D or constipation, N/V  
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Dx of appendicitis   Abd US, CT scan, Lab work - WBC's usually elevated; Urinalysis to r/o urinary issues  
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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  
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Post-op appendicitis   teach pt to splint abd when coughing/deep breath, change drsg as ordered, monitor for s/s of infection  
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Diverticula   sac like outpouchings of the colon's mucosa  
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Diverticulosis   Asymptomatic disease  
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Diverticulitis   acute inflammation  
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Causes of diverticulitis   increased risk from low residue, highly refined diet; reduced fecal bulk reduces lumen of colon - this can lead to increased pressure  
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S/S of diverticulitis   vague, may have cramping pain, /D, constipation, distention or flatulence may occur after eating  
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If diverticula become inflamed or abcessed   fever, leukocytosis, pain/tenderness  
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Complications of diverticulitis   Perforation, Peritonitis, Hemorrhage, Bowel obstruction, Fistula formation  
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Dx of diverticulitis   Sigmoidoscopy, Colonscopy, Barium enema can be administered - but not preferred  
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Tx of diverticulitis   Increase dietary fiber, Avoid seeds, peels, nuts; encourage fluid intake to decrease stool hardness, realize that surgery may be necessary eventually  
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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  
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Skip lesions   affects alternate sides of colon in Chron's disease;  
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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)  
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Dx of Chron's disease   Hx, Sigmoidoscopy/Colonscopy; Barium enema; Stool culture - to r/o infection  
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Tx of Chron's disease   Dependent on severity; Sulfa&ASA, Steroids, Flagyl for infection  
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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  
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S/S of ulcerative colitis   Intermittent periods of exacerbation & remission;  
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S/S of severre ulcerative colitis   Fever; 10-20 diarrhea stools/day; Bloody stools; Cramping; Wt. Loss; Anemia  
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Complications of ulcerative colitits   Anal fissures, hemorrhoids, perirectal abcess, hemorrhage (rare), obstruction of colon  
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Tx of Ulcerative colitis   Very similar to Chron's, possible TPN for malnourish pts, IVF, surgical resection if meds ineffective  
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IBS   Functional problem with bowel, does not cause structural changes, does not predispose to CA, Symptoms usually mild  
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Causes of IBS   Unknown, possibly r/t neural control changes, hormones, foods, stress, infection  
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S/S of IBS   Gas, bloating, diarrhea, abd cramping  
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Dx of IBS   Hx, Sigmoidoscopy/Colonscopy to r/o polyps/tumor/lesions; lactose intolerance testing, Celiac disease testing  
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Meds for IBS   Lotronex - relaxes the colon; Zelnorm - only effective for women, used in constipated form of IBS  
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When should people have a colonscopy   over the age of 50  
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S/S of colon and rectal CA   may imitatet othe types of bowel disorders  
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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  
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Tx of colon and rectal CA   Surgical excision, Ostomy, Chemotherapy/Radiation  
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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  
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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  
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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  
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Dx of Celiac disease   Stool content analysis or Bx  
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Tx of Celiac disease   Gluten free diet; Lactose free diet  
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