Foreman Test Part 2 Hacc

Front 1

What defines pubertal delay in girls?

Back 1

They do ot get breast buds by e age of 13 or do not get their first period within 4 years of breast bud formation

Front 2

What defines pubertal delay in boys?

Back 2

Testicular enlargement between ages 13.5-14 or if genital growth is not complete within 4 years of testicular enlargement

Front 3

What is the cure for UC?

Back 3

Removal of the entire Colin is the only cure

Front 4

A disease where the body attacks itself causing inflammation, and then ulcers form where inflammation kills cells.

Back 4

Ulcerative collitis

Front 5

Intestinal disease that only occurs in the top lining of the rectum and colin

Back 5

UC

Front 6

Left sided abdonminal pain is an indication of

Back 6

UC and diverticulitis

Front 7

Presenting symptoms are abdominal pain, bleeding, excessive diarrhea (up to 10-20 per day) dehydration

Back 7

UC

Front 8

How is ulcerative colitis diagnosed?

Back 8

Labs, colonoscopy, sigmoidoscopy, barium enema

Front 9

When do you not give a patient with a bowel condition a colonoscopy?

Back 9

When the bowel is inflamed. Give the bowel time to rest

Front 10

What are the steps prior to a colonoscopy that a patient must do?

Back 10

Clear liquid only the day before, nothing with dye in it, NPO at midnight, a cup every 15 min of golite until stools run clear (yellow)

Front 11

If patient is unable to drink golite prior to colonoscopy and stools are ot clear, an alternative to clear the bowel is to...

Back 11

Give patient an enema

Front 12

How does a patient lay when getting an enema?

Back 12

Lay on left side, same as when getting an egd

Front 13

What nursing assessments must be done after a colonoscopy

Back 13

Monitor bleeding, distention, BS, gas, VS. Patient will have a sense of fullness

Front 14

How dies a sigmoidoscopy differ from a colonoscopy?

Back 14

Sigmoidoscopy only examines the lower 1/3 of the colon and the colonoscopy can examine the entire colon

Front 15

Define total proctocolectomy with permanent ileostomy

Back 15

Take out Colin and rectum with perm. Ileostomy

Front 16

Describe a stoma post op

Back 16

Initially inflamed, red bud that is swelled, will get smaller over time. Drainage in bag is a small amount p/o.

Front 17

How often should one change an ileostomy bag?

Back 17

Every 5-7 days or if the bag is leaking

Front 18

When should an ileostomy bag be emptied

Back 18

When it is 2/3 rds full, but empty the gas out of it often to prevent it from bursting

Front 19

Procedure that removes the entire Colin and rectum and creates a permanent ileostomy

Back 19

Total proctocolectomy with permanent ileostomy

Front 20

Describe a total colectomy with ileoanal anastomosis

Back 20

Remove entire Colin and take ileum and attach it to anus. Done in 2 stages 6-12 wks apart. Loop ileostomy while it heals first time

Front 21

What are the concerns with colectomy with ileoanal, anastomosis

Back 21

Separation of the 2 parts, and skin integrity from loose stools

Front 22

Define total colectomy with continent ileostomy

Back 22

Remove Colin, create stoma, create pouch out of bowel that drains through stoma with foley catheter

Front 23

Surgery process for UC that leaves patient still continent

Back 23

colectomy with continent ileostomy (initially can hold 50-60 mls but can grow to hold 500)

Front 24

Condition that occurs anywhere from mouth to anus but is primarily located in the terminal iliac

Back 24

Crohns disease

Front 25

Pain in the right lower quadrant

Back 25

Crohns

Front 26

GI disease that affects all layers of the bowel

Back 26

Crohns

Front 27

Presenting symptoms include N/V, bleeding, constipation/ sometimes diarrhea, fever, weight loss, malabsorption/malnutrition

Back 27

Crohns

Front 28

What type of diet is essential for crohns patients

Back 28

Low fat low fiber diets, high calorie, reduce foods that would create GI upset

Front 29

What isnthe different between UC and crohns

Back 29

UC follows a tract of inflammation where crohns is patchy (crohns generally deflates where resection occurs)

Front 30

What GI inflammatory drugs are used for crohns and UC?

Back 30

Corticosteroids and aminosalicylates

Front 31

Common corticosteroids used for GI diseases

Back 31

Prednisone (systemic) and budesonide (targets GI tract)

Front 32

Medications names for aminosalicylates?

Back 32

Sulfasalazine -ideal but not always pt tolerated,
Pentasa, asacol, colazol (5ASA)

Front 33

If 5ASAs aren't tolerated in patients what are alternative medications?

Back 33

Immunosuppresive agents- imuran, sandimmune (prone to more infections), monoclonal antibodies- remicade, antibodies like flagyl and cipro

Front 34

What was remicade originally used for?

Back 34

Used to treat RA but found that it also helps with crohns

Front 35

3pt complications of crohns and UC?

Back 35

1. Intestinal perforation/fistulas, 2. Toxic megacolon, 3. Hemorrhage, 4. Colon cancer, 5. Abscess formation, 6. Malabsorption, 7. Bowel obstruction

Hint 35

More common in: 1 crohns, 2 UC 3 crohns 4 UC 5 6 and 7 all crohns

Front 36

What causes bowel obstruction- a complication of UC and crohns?

Back 36

Constant inflammation

Front 37

How do you treat toxic megacolon?

Back 37

Antibiotics

Front 38

Acute inflammation that can occur from local obstruction of a diverticulum by mucus or fecal matter

Back 38

Diverticulitis

Front 39

Most common cause of GI bleeding (stops on it's own)

Back 39

Diverticulitis (s&s resolve within 48 hrs)

Front 40

How do you diagnose Diverticulitis

Back 40

Cat scan, barium enema, proctosigmoidoscopy

Front 41

What is the treatment for Diverticulitis

Back 41

Rest bowel, NPO, clear liquids. Bland, low fiber diet when on a flare (if repeated flare will take out affected bowel)

Front 42

What medications are used for Diverticulitis

Back 42

Flagyl and cipro ( also advise pt not to strain, and avoid nuts and seeds)