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60 Cards in this Set

  • Front
  • Back
Three classifications of Diarrhea
Decreased Fluid Absorption
Increased Fluid Secretion
Motility Disturbances
A patient is having an issue with decreased fluid absorption and is experience diarreah, why?
The pt. large intestine is not reabsorbing fluids. The lg. intestine's job is to reabsorb fluids.
A patient has experience food poision from eating at a local restrurant and is experience diarrhea, why?
The patient is having a motility disturbance-increase in peristalsis to push out the bad.
A patient comes into the doctors office with compliants of increased stress and anxiety and recent diarrhea why is this pt. experience diarrhea?
The pt. is having an increase in peristalsis. Motility disturbance.
An acute bout of diarreah is either
bacterial and viral and is self-limiting
A pt. is having a bout of chronic diarrhea (lasts 2 or more weeks and reoccurs) what type of complications can this pt. have
dehydration and electrolyte imbalances.
A pt. reports to the doctors office and reports recent diarreah what may the nurse want to know about this patient? (Assessment)
History of travel, diet, medication use, previous surgery (dumping syndrome), family history and personal contacts.
What diagnostic tests are done for diarrhea?
CBC, LFT's, iron/folate levels, O&P, Endoscopy, GI series with barium swallows.
Why would the doctor want to do LFT's on a pt. with complaints of diarrhea?
The liver produces bile that emuisifies fat and if there is a metabolism issue then fats will be in stool and will give the pt. diarrhea.
True or False Laxative abuse can cause diarrhea?
Causes of Decreased fluid absorption diarreah?
Laxative abuse, mucosal damage: Crohn's disease, radiation, Ulcerative colitis (UC), ischemic bowel disease (IBD)
Causes of Increased fluid secretion diarreha?
infectious bacterial endotoxins, antibiotics, foods containing sorbitol, hormonal (adenoma of pancreas)
Antibiotics can cause?
C-diff-pt. will be put into isolation. C-diff is an intestinal bacteria that is kept in check by normal intestinal flora and when normal flora is destroyed the C-diff is now free to cause problems.
Motility Disturbances of diarrhea
IBS (Irritable bowel syndrome); gastroectomy (dumping syndrome).
A 38 year old patient with a spinal cord injury can have fecal incontinence due to a
neruo-muscular issue (sensory problem)
If the muscles of the anus become flacid and cannot contract the patient may become
fecal incontinent
What sensory problems are common with fecal incontinence?
MS, Parkensons, ALS, stroke, spinal cord injury, dementia
When there is a fecal impaction what is commonly seen
seepage (liquid stools) that are able to get around the impaction due to an increase in fluid secreations.
Diagnostics of Fecal Incontinence are
rectal exam, abdominal X-Ray's, sigmoidoscopy
Managment of fecal incontinence
antidiarrheal meds if non infections cause (Immodium), bowel and bladder training programs, suppositories to reestablish regularity, high fiber diet and increased fluid intake, and exercise (if non-neruo/muscular).
When assessing a pt. for constipation what is important for the nurse to know?
What is the normal bowel movement pattern for this patient? If the patient only goes on a regular basis every 3 days then they will most likley not be constiptated.
Signs and symptoms of constipation are?
adbominal pain, distention, bloating, headache, nausea, flatulence, palpable mass, decrease in frequency of bowel movements.
True or False an anticholinergic will not cause a pt. to become constipated?
False. Anticholinergics cause the bowel and bladder to slow. They can cause constipation.
True or False Hypothyroidism is a cause of constipation
True or False Diabetes is not a cause of constipation
False, it is a causative factor
True or False a Megacolon is not a cause of constipation
False, it is a cause
T/F: Scleroderma (a Collagen Vascular issue) is a cause of constipation?
T/F IBS can cause constipation?
Why is the Valsalva maneuver and syncope an issue with constipation?
This is due to straining. When you push you stimulate the vagus nerve (CN 10-goes all way down to anus) when stimulated it decreased heartrate, blood profusion to brain and one can then pass out (syncope-faint).
Complications of Constipation are
Valsalva maneuver and syncope, diverticulosis, obstipation (fecal impaction) secondary to constipation may cause bowel perforation.
Aviod what type of enema for constipation?
Soap sud enema should be avoided
What type of enema can be used to alleviate constipation?
oil retenion to soften feces
True or False Laxatives can be used without caution for constipation?
T/F the fluid intake of the pt. should be increased to 3000mL/day when constipated?
Types of fiber
Insoluble fiber-whole wheat, bran
Soluble fiber-oat bran, fruits, vegetables
Etiology of Appendicitis
obstruction in the lumen caused by feces, foreign bodies (ex. poppy seeds), tumors.
Where is the pain felt for appendicitis?
RLQ pain to the umbilicius area
Pt. reports to the ER nurse that his RLQ pain has suddenly subsided and the nurse notes that his abdomen is distended, hard and rigid-what does this tell the nurse?
That the appendix has perforated (this is bad b/c the fecal matter is no longer in the bowel and this causes massive infection-peritonitis).
What is McBirney's point?
half way between the umbilicus/right illiac crest-this is where the appendicitis pain localizes.
What is rebound tenderness
press down on the part of the body where it hurts and pain stops, release and the pain is felt again.
A pt. comes to the ER with RLQ pain, muscle guarding of the abdomen, rebound tenderness of RLQ and a positive Rovsing's sing what might this patient have?
Why does the nurse perform a urine analysis for a pt. that is suspected of having appendicitis?
The doctor wants to make sure there is no issue with the urters as there is one in the RLQ as well)
Diagnostic for appendicitis
history and physical, CBC (to check for elevated WBC) and urine analysis.
Surgery for appendicitis is MOSTLY performed when (though sometimes if this does not happen surgery is performed)
perforation occurred
The pt. is NPO, ice bag to the RLQ, IV fluids are given and pt. is on antibiotics what might this pt. have?
All GI problems (except one) are given pain meds only when?
A diagnosis is made b/c pain meds can mask symptoms.
An inflammatory process in the peritonium that results in extracellular fluid shifts are
What can cause peritonitis?
blood born infections, cirrhosis of the liver, pancreatitis, peritoneal dialysis, abdominal surgery, perforations/ruptures of the bowel, appendix.
Does Renae Hate GI/GU True or False
S/S of peritonitis are
high fever (101.0 and above), tachycardia, tachypena, nausea, vomiting, abdominal pain, tenderness, distention, rigidity, alteration in bowel sounds.
Diagnostic studies for peritonitis
CBC, serum electrolytes, abdominal x-ray, CAT scan, ultrasound, abdominal paracentesis
SHOCK is inadequate
profusion of organs, lactic acid builds up in the blood, cells of body die. Several causes-cardiac, hypovolumic shock etc...)
iron deficiency anemia is closely corr. with
ascending colon cancer
Bowel Disorder Diagnostics
CBC, Serum electrolytes, occult blood in stool, pus, and mucous, stool culture to r/o infection, sigmoidoscope/colonscopy/biopsy, barium enema
Ulcerative Colitis involves the
mucosa and submucos of rectum, sigmoid colon and upper colon-ulcers in the bowel.
T/F pseudopopls and shortening of the colon are a result of UC
A pt comes in with the following s/s: fluid and electrolyte imbalances, protein loss and multiple abscess/ulcerations, fever, tachycardia, weight loss, and lower abdominal pain, bleeding and diarrhea-what could be the cause
UC (Ulcerative Colitis)
True/False: Sulfa drugs are not used to treat UC?
False, they are used to treat UC (sulfasalazine-Azulfidine)
What microbal is used often to tx. UC?
Rowasa (mesalamine)
Can a pt. with UC get Kayopectate?
NO!! it is not absorbed well.