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35 Cards in this Set
- Front
- Back
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Colorectal Cancer
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Malignant tumors arising in colon or rectum
90% Cured, if it spreads outside colon, chances of being cured drops to 10% Risk Factors: family history, alcoholism, obesity, smoking, IBS history, high intake of beef Warning Signs: change in bowel habits not explained by diet, chronic abdominal discomfort, sudden weight loss, rectal bleeding, loss of appetite |
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Crohn's Disease
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effects small intestine
regional enteritis mucosa becomes inflammed with edema, and thickening of the mucosa, ulcers being to appear (cobblestone) Symptoms: diarrhea, cramping in R lower quadrant, anemia, weight loss, fever, fatigue. |
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Ulcerative Colitis
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Common in large intestine
affects superficial mucosa of colon w/recurrent ulcerative & inflammation edema->inflammation->ulcers->eventually bowel narrows and thickens due to muscular hypertrophy and fat deposits Symptoms: 5-30 stools a day cramping in L lower quadrant weight loss passage of pus and mucus |
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Surgical Procedures for Diverticular Disease
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Bowel resection w/anastomosis -> infected area removed and remaining ends attached.
Stage 2 Hartmann -> affected portion removed, and one end of bowel brought to abdominal wall, other end left in. can be reconnected later |
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Colorectal Cancer Tests
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Stoolblood test ->turns blue if positive
digital rectal exam -> feels like little bumps colonoscopy x-ray w/barium enema CEA (carcinoembryonic antigan) blood test -> if CEA elevated that could be indicative of cancer |
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Chronic Inflammatory Bowel Disorder
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Crohn's disease & Ulcerative colitis
affect primarily 14-30 yo's genetic component involved more prevalent in Jewish people smoking, alcohol, stress, dietary, & high fat diet make it worse |
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Diverticular Disease
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Occurances increase with increased age
Sac like oermiations that extend through mucousal to muscle. Can happen anywhere in GI tract, but most common in sigmoid colon Signs and Symptoms usually mild w/bowel irregularity, w/intervals of diarrhea, nausea, bloating & distension Usually diagnosed w/colonoscopy |
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Diverticulosis
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Multiple diverticula are present w/o inflammation or symptoms.
Low intake of dietary fiber may be a predisposing factor. If inflammation occurs, narrowing of large colon can occur causing narrow stools, chronic constipation w/ episodic L abdominal pain |
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Diverticulitis
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Food and bacteria get trapped in the pouches and cause inflammation and infection, which can leak to perforation, abcess, and fistulas.
Symptoms: onset of mild to severe pain in L lower quadrent. nausea, vomiting, fever, chills distended abdomen loss of bowel sounds |
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Biliary Disease
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affect women, elderly, obese.
gallstones most common disorder very high in Native Americans |
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Spina Bifida Cystica
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Meninocele: sac like protrusion containing meninges and CSF
Myelomeningocele: Sac like protrusion including spinal cord -Associated with Hydrocephalus and neurogenic bladder |
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Cholelithiasis
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-Gallstones
-Develop more frequently in women, use of oral contraceptives, estrogen, increased age, diabetes, obesity -Cholesterol gallstones ->dissolved with meds (chenix) -Pigment gallstones-> cannot be dissolved, removed surgically |
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Medications for I.B.S
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-Bentyl -> decrease secretions
-antidiarrheal ->Immodium->decrease diarrhea -Pro-Banthine->decreases smooth muscle spasms and decreases cramping |
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Irritable Bowel Syndrome
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-Motility Disorder & Spasms
-More Common in women -Will have abdominal pain relieved w/defecation,stool changes, passage of mucuous. -No dietary solution -decrease gassy foods and increase fiber -excercise can increase motility -reduction of stress |
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Acute Cholecystitis
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-Inflammation of Gallbladder
-Commonly caused by a gallstone or biliary sludge -Symptoms: Pain, tenderness & rigidity in R upper quadrant or R shoulder. nausea, vomiting, restlessness |
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Biliary Colic
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-Gallstone obstructs cystic duct, gallbladder becomes distended, inflamed, and eventually infected, gallbladder contracts vigorously to try to free stone
-causes severe upper R abdomen pain, nausea, vomiting. -Morphine used for pain -PT may be jaundice, have dark urine, gray stool, vitamin deficiency of A,D,E & K (fat soluble) -ultrasound used to see stones |
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Meds for C I B D
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-Immunosuppresant->sulfasazine->decrease inflammation.
-immunomodulators->mercaptopurine (6-MP)->bad side effects -Anti-spasmodics->probanthine -Antidiarrheal->Immodium |
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Clinical Manifestations of Spina Bifida
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-Mobility defect
-Sensory disturbance - increase in alpha-fetoprotein@16-18 weeks gestation Initial Actions: -Prevention of infection -Neurological assessment -early closure |
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Spina Bifida
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-malformation of the spinal canal
-congenital neural defect characterized by incomplete closure of the vertebrae and neural tube. -folic acid deficiency thought to be a cause -.4mg/day, 4mg if they've had a child with spina bifida |
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Spina Bifida Occulta
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-occurs between L5-S1 vertebrae
-no external defect visible -failure of vertebrae to completely fuse -dimple/small tuft of hair may be visible |
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Cerebral Palsy
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-Non-progressive, impaired posture & movement
-Born with it -accompanied w/perceptual problems, language deficits, or intellectual problems. -Spastic movements -Safety is important |
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Neurogenic Bladder
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-Common w/myelominigocele
-Becomes incontinent -Clean intermittent catherization-> keeps pressure low -Vesicostomy-> direct ostomy to bladder |
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Hydrocephalus
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-Common w/Myelominigocele
-rapid head growth w/CSF -bulging anterior fontanel -distended scalp veins -shunt inserted to drain CSF |
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Muscular Dystrophies
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-Genetic
-progressive muscle weakness and atrophy -diagnosed at 3-5 years of age -determined through muscle biopsy -progresses to death -important to keep remaining muscles in shape, keep movement |
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Medications for Cerebral Palsy
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-Skeletal muscle relaxant-> intrathecal baclofen
-Local nerve block -> stops impulses to decrease spastic movement -Anti-seizure -bathelfib-> controls spasm -botulism-> kills nerves |
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Diagnoses of Cerebral Palsy
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-not diagnosed til second half of first year
-has persistant primitive reflexes, delayed gross motor -early recognition is key to success |
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Gastric peptic ulcer
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-Most common in women. elderly, & poor
-occur in lesser curvature of stomach -pain occurs 1/2-1 hr after a meal, may be relieved by vomiting -hemmorhage more likely w/presence of hematemesis. -H.Pylori, ulcerogenic drugs (aspirin, motrin), alcohol, smoking, carbonation and corticosteroids increase risk. |
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peptic ulcer disease
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a hollowed-out area in the mucosal wall of the stomach or duodenum. The erosion can extend as deeply as the muscles or through the muscle to the peritoneum.
-most common between ages 40-60 -people w/type-O blood more susceptible. |
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Duchene muscular dystrophy
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-most severe and only affects men
-progressive muscle weakness and wasting, calfs lg due to atrophy -ambulation loss @ 9-10 yrs old -progresses to death in late teens due to resp. or cardiac failure -want to maintain ambulation as long as possible with therapy, braces, &surgery. |
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Peptic ulcer disease perforation
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-Perforation through to peritoneal cavity
-Symptoms: --severe upper abd pain (right shoulder too --hemotemesis, or mellena --vomiting --fainting --tender-rigid abdomen --shock -Nursing Tasks: --prepare for surgery --Iron , NG tube --monitor vitals every 15 min --morphine --I&O |
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Medications for Peptic Ulcer disease
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-Antibiotic ->flagyl -> reduces H.Pylori-> take w/meals, causes metallic taste in mouth, avoid alcohol, increases effects of coumadin.
-Anti-diarrheal-> Pepto-Bismol-> reduces H.Pylori, helps with healing of ulcer-> given w/antibiotics, take on empty stomach -h2 Receptor antagonists-> Pepcid -> decreased HCL produced by stomach-> best for critically ill, little drug-drug reactions -Proton Pump Inhibitor-> Protonix -> reduces HCL production-> take before meals, may cause diarrhea, hyperglycemia, headache, abdominal pain -Carafate->combines with gastric acid and forms a jelly like barrier-> take w/o food but with plenty of water->meds should be taken 2hrs before this. |
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Duodenal peptic ulcer
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-Occurs mostly in men, 35-45 YO
-accounts for 80% of peptic ulcers -occurs when HCL acid increases w/increased vagal nerve activity (eating,hiccup,defecation) and increased gastric secretions. -People with COPD, cirrhosis, renal failure are at increased risk. -Pain occurs 2-3hrs after a meal, often awakened @ 1-2am -ingestion of food relieves pain |
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Dumping Syndrome
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-results when portion of stomach & pyloric is removed
-associated w/meals of hyperosmolarity -Symptoms: --profuse sweating, nausea, dizziness and weakness after eating followed by diarrhea. -Management: increase protein&calorie diet , w/ small dry meals -drink liquids 2hrs after meals, not with -low fowlers for 30 min after eating -Vitamin b12 & iron needed |
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Surgical Procedure for P.U.D
Bilroth 2 |
-pylorus removed, proximal end of the duodenum sutured closed and remaining portion attached to the jejunum.
-dumping syndrome, anemia, malabsorption and weight loss may occur -recurrance rate of ulcer is 10-15% |
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Surgical Procedure for P.U.D
Bilroth 1 |
-pyloric portion of the stomach is removed and the remaining stomach is attached to the duodenum.
-patient may feel full, have diarrhea, or dumping syndrome -recurrance rate of ulcer is 1% |
