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42 Cards in this Set

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Define gastroenteritis?
an increase in frequency and water content of stools or vomiting as a result of inflammation of mucous membranes of stomach and intestinal tract
What organ does gastroenteritis primarily affect?
small bowel...can be either viral or bacterial...both forms have similar manifestations...all cause watery diarrhea
Dysenteries affect large or small bowel?
large
Gastroenteritis affects large or small bowel?
small
GI illnesses can be caused by what 3 mechanisms?
noninflammatory
inflammatory
penetrating
Define enterotoxin?
a noninflammatory toxic substance specific to intestinal mucosa...what is released by infecting organism which causes watery diarrhea (ex: E. coli)
Shigella or Campylobacter release enterotoxins similar to E. coli, but these 2 organisms also?
can attach themselves to mucosal epithelium without penetrating it...cells of intestinal villi are then destroyed...malabsorption results...then diarrhea
What might be found in the stool due to invasion of intestine by mcos?
WBCs and RBCS...due to possible ulceration of intestine by mcos
Is GI motility increased or decreased due to mcos invading?
increased...with fluids and electrolytes being secreted into intestine at rapid rates
Who do rotaviruses affect?
children
Norwalk virus affects who?
adults and children year round
Hhow is Norwalk virus spread?
oral-fecal route
What are the 3 common bacterial gastroenteritis types?
E. coli diarrhea
(traveler's disease)
Campylobacter enteritis
(another traveler's
diarrhea")
Shigellosis (bacillary
dysentery)
The reservoir for E. coli is?
human...often asymptomatic...transmitted through fecally contaminated
food, water, or fomites
The reservoir for Campylobacter jejuni is?
domestic or wild animals and birds...transmitted through fecal-oral route by ingestion of water or food contaminated with feces or be direct contact with infected animals or infants...incubation from 1-10 days...communicable for 2 to 7 weeks
The reservoir for Shigellosis is?
human or other carrier...transmission is fecal-oral..incubation 1-7 days..communicable for up to 4 weeks...carrier can carry for months...occurs most frequently in children under age 10
What is the symptom that occurs in the first 1 or 2 days of gastroenteritis?
diarrhea
Symptoms of epidemic viral gastroenteritis include?
myalgia (muscle aches)
headache
malaise
abdominal distention
hyperactive bowel sounds
diffuse tenderness palpated
dehydration

there should be NO REBOUND TENDERNESS, which might indicate peritonitis
Dehydration may be manifested by?
poor skin turgor
dry mucosa membranes
orthostatic b.p. changes
hypotension
oliguria
Prolonged dehydration may cause patient to go into?
shock
Norwalk virus is not too severe and has the following symptoms?
rapid onset of nausea, abdominal cramps, vomiting, diarrhea...lasts 24 to 48 hours
Campylobacter is more severe than Norwalk virus and has the following symptoms?
foul-smelling stools
10 day diarrhea
Shigella symptoms?
stools containing blood and mucus, continuing up to 5 days
Gram stain of stool is usually done before?

If there are many WBCs on Gram stain, then it's which organism?

If there are WBCs and RBCs in the stool, then which type of gastroenteritis is it?
culture

shigellosis

Campylobacter
The following 5 interventions are indicated with gastroenteritis?
fluid replacement
diet therapy
drug therapy
skin care
health teaching
Upon admission, nurse should get what information?
weight
orthostatic b.p.
VS
What type of IV might be prescribed?
hypotonic
ex: half-strength NS
(0.45% sodium chloride)
A rapid gain or loss of 1 kg or 2.2. pounds of body weight is equal to the gain or loss of?
1 Liter of fluid...so continue to monitor I&O, weight, VS
It is mandatory that every case of ______ be reported to the local health department.

In some endemic areas, Campylobacter is reported on a case by case basis
(endemic means its found in a specific population or particular region of the world)
shigellosis
What is the difference between endemic and epidemic?
endemic means its found in a specific population or particular region of the world

epidemic means it affects a large group of persons in a geographic region or defined population group
If not actively vomiting, patient may receive small volumes of clear liquids with electrolytes for ____ hrs
24

increase if n&v not present..withhhold foods if n&v present...instuct client NOT TO DRINK WATER as it doesn't contain replacement electrolytes
After 24 hours of clear liquids, the patient may start a diet of?
crackers, toast, jelly...if this stays down, then start bland diet of nonfat soup, custard, yogurt, cottage cheese, mashed or baked potatoes, cooked vegetables..
AVOID CAFFEINE as it increases intestinal motility
What type of drugs are not routinely given for bacterial or viral gastroenteritis?
anticholinergics and antiemetics...both suppress intestinal motility...use of these drugs can suppress infecting organisms from being eliminated from the body
What might physician prescribe if antiperistalic measures are needed?
an initial dose of loperamide (Imodium) 4 mg orally, followed by 2 mg after each loose stool, up to 16 mg daily
What might a doctor prescribe to reduce watery volume of stool?
bismuth subsalicylate (Pepto-Bismol) 30 mL or 2 tabs every 30 minutes for 8 doses...Pepto-Bismol has aspirin (salicylate) in it, so make sure okay for patient to use
Bacterial infection with fever and diarrhea may require rx for?
antibiotics
ex: norfloxacin (Chibroxin,
(Noroxin) 400 mg twice
daily PO

ciprofloxacin (Cipro)
500 mg twice daily PO
for 3 days
If gastroenteritis is due to shigellosis, an anti-infective agent such as _________/________ may be administered.
trimethoprim/sulfamethoxazole
When diarrhea persists, check for ________ or _______
to determine what kind of medicine to give.
Salmonella
parasite
It's probably NOT gastroenteritis if diarrhea persists for longer than ____
days.
10
Because of the diarrhea, the anal area is irritated so teach patient to avoid ______ _______ and harsh _____. It's ideal to clean with warm water or absorbent
_______ and dry with _____.
Use cream, oil, or gel to remove _____.
___________ cream or protective barrier should be applied to skin between stools. ______ ______ compresses (ex: Tucks) and
______ baths for 10 minutes, two to three times daily can also relieve discomfort
toilet paper
soaps

cotton
cotton

excrement

hydrocortisone

witch hazel
sitz
What should nurse do if leakage of stool is a problem?
put absorbent cotton next to anal orifice, keep in place with snug underwear...
if incontinent, keep perineal and buttock aras clean and dry...use of incontinent pads instead of briefs allows air to circulate skin and prevent iritation
Measures to prevent transmission of gastroenteritis include?
wash hands with antibacterial soap...
don't share dishes, glasses,
toothpaste...
keep commode clean to prevent exposure to stool...
don't prepare or handle food that will be consumed by others...if it's Shigella, then adhere to precautions for 7 weeks or several months