Intestinal

46問 • 2年前

ユーザ名非公開

通報

問題一覧

Select the non-inflammatory intestinal disorders.

Intestinal obstruction, Colorectal cancer, IBS, Herniation, Hemorrhoids, Malabsorption syndrome

Absence of peristalsis due to neuromuscular disturbance is what kind of intestinal obstruction?

Non-mechanical

An intestinal obstruction that is physically blocked.

Mechanical obstruction

Select examples of causes of mechanical obstructions

Fecal impactions, Hernias, Strictures (crohns, radiation, etc), Adhesions, Tumors, Intussusception (intestine telescopes on self), Volvulus (twisting of GI tract, Med/surgical emergency)

Select the complications of intestinal obstructions.

Intestinal contents accumulate (at or above obstruction), Distention results (at obstruction), Peristalsis ⬆️(⬆️ing secretions), ⬆️in peristalsis leads to more secretions being produced, Bowel becomes edematous and increases capillary permeability, Plasma leaks into the peritoneal cavity, Fluid trapped in the intestine-decreased absorption of fluid and electrolytes into vascular space, Reduced circulatory blood volumes-hypovolemia, Electrolytes disturbances

Select statements true to non-mechanical paralytic ileus.

Related to handling of intestines during abdominal surgery “STUNNED BOWELS”, Can result from peritonitis, Can result in intestinal ischemia

What type of bowel sounds would be heard with a mechanical bowel obstruction?

High pitched

What type of bowel sounds would be heard in a non-mechanical bowel obstruction?

Absent or decreased

What is obstipation?

Complete constipation

Select the symptoms associated with small bowel obstructions.

Abdominal discomfort/pain could be accompanied by visible peristaltic waves in upper and middle abdomen, Upper or epigastric abdominal Distention, Nause and early profuse vomiting (may contain fecal matter), Obstipation, Severe fluid and electrolyte imbalances, Metobolic alkalosis (not always present)

Select the symptoms of large-bowel obstructions.

Intermittent lower abdominal pain, Lower abdominal distention, Minimal or no vomiting, Obstipation or ribbon like stools, No major fluid and electrolyte imbalances, Metabolic acidosis (not always present)

Select the diagnostics associated with bowel obstructions.

No definitive lab tests, CBC usually normal, HGB, HCT, creatinine, BUN usually elevated due to dehydration, Serum Na chloride and potassium usually decreased, due to ⬇️absorption in intestines, CT scan/MRI Distention with fluid&gas in small intestine w/out gas in colon intestinal obstruction

Select the planning/interventions for intestinal obstruction.

Monitor VS for indications of fluid volum status (pulse, BP), Assess abdomen for bowel sounds, flatus, distention, Monitor fluid and electrolyte status, NG tube care (normal drainage brown,yellow,green, NOT RED), Give analgesics for pain as perscribed, Maintaing IV therapy for fluid and electrolyte replacement, Parenteral nutrition if perscribed, Entereg as perscribed, Remobval of fecal impactions

Select the surgical interventions for bowel obstruction.

Exploratroy laparoscopy (to determine cause& possible removal), Partial colectomy, Lysis of adhesions

Select statements true of colorectal cancers.

Colorectal- refers to colon&rectum, which together make up the large intestine, Most CRCs are adenocarcinomas, Risk factors: Age>50, Genetic predisposition, long-term smoking, obesity, alcohol., Related to low residue, high fat diets and highly refined foods, 3rd most common cancer in US, Metestasis to liver, lungs, kidney, and bone

Screening recommendation for colon cancer/ other intestinal diseases.

Fecal occult yearly, And ONE of the following: Sigmoidoscopy q5yrs, Double contrast barium enema q5yrs, colonoscopy q10yrs

Select assessment data related to colon cancer.

History of cancer, Rectal bleeding (Melina-black tarry stools, hematochezia-passage of fresh blood), Anemia, Change in stool consistency or shape, Palpable masses, Distention, Symptoms of mechanical obstruction

Select diagnostics for colon cancer.

HGB/HCT: may be ⬇️, Liver enzymes may be ⬆️with metastasis, Fecal occult blood positive (3+ tests!, not very accurate), Carcinoembryonic antigen (CEA) positive, Double contrast barium enemas, MRI/CT, Colonoscopy (definitive)

Select BOTH surgical and non-surgical interventions for colon cancer.

Chemotherapy, Radiation, Colon resection: tumor and regional lymph nodes, Abdominoperineal resection: removal of sigmoid colon, rectum&anus, Colectomy: colon removal with ostomy

What type of colostomy is pictured?

Ascending colostomy done for right sided tumors. Liquid somewhat acidic drainage.

What type of colostomy is pictured?

Transervs (double-barreled) colostomy. Often done during emergencies bc can be done quickly. One stoma drains mucous and one drains stool(soft/pasty).

What type of colostomy is pictured here?

Descending colon done for left sided tumors. Firmer pasty stools.

What type of colostomy is shown here?

Sigmoid colostomy done for rectal tumors. Formed solid stool as usual.

Select the post-op nursing care for colostomies.

Similar to those with any abdominal surgery, NGT possible, Pain management: IC PCA 24-36hrs, Wound care essential, Colostomy mgmt: First stools 2-3 days post-op, pt teaching, supplies, consistency of stool per location.

Select what the nurse is monitoring post-op colostomy.

Pain, Electrolytes, Fluid status, Nutritional intake, Weight gain/loss, N/V, Stool characteristics/ bowel sounds, Emotional/psycological status/ coping skills of pt and family, Conditon of stoma/peristomal skin, Continuation of care after hospitalization

Select what is included in colostomy care.

Normal appearance of stoma “Beefy red”, S/S of complications, Measurment of stoma, Choice, use, care application of appropriate appliance over stoma, Dietary measures to control gas and odor, Resumption of normal activities

Select the assessment data for IBS

History, Falre up: Worsening cramps, abd pain, diarrhea/constipation, in LLQ

Select the statements true of hernias.

Weakness of abd wall, Segment of bowel or other structure protrudes, Causes: congenital or acquired muscle weakness, ⬆️abd pressure

Select assessment data of hernias.

“Lump or protrusion” in abd, May disappear when pt lies down, Absent bowel sounds may indicate obstruction or strangulation!

Select interventions for hernias.

Non-surg belt or binder to push back in, Surgical rapier, Post op- no lifting>10lbs, avoid constipation

Select the inflammatory intenstinal disorders.

Peritonitis, Appendicitis, Gastroenteritis, Ulcerative colitis, Crohn’s, Celiac disease, Anorectal abscess/anal fissure/ anal, Parasitic infections

What is fluid or pus in abdominal cavity causing inflammation of abd contents.

Peritonitis

Select assessment data of peritonitis.

Cardinal signs: Abd pain, tenderness, and distention, WBC often elevated to 20,000, Rigid board like abd, N/V anorexia, Diminished bowel sounds, Inability to pass flatus or stool, Rebound tenderness in abd, High fever, Tachycardia, Dehydration from high fever, ⬇️Urinary output, Hiccups

Select interventions for peritonitis.

Monitor for S/S of sepsis, Surgical and non surgical interventions, Restore fluid volume: NGT, NPO, Hypertonic IVs, Pain control analgesics

Select the assessment data for appendicitis.

History of present illness (track sequence of symptoms), Cramping pain in the epigastric of periumbilical area, progressing to the RLQ (McBurney’s point), Anorexia, Moderate elevation of WBC 10,000-15,000, Ultrasound may show enlargement

What point is in the middle in the picture?

McBurney’s point

Select interventions for appendicitis

3-5 days in hospital after surgery for abx, Surgical removal of appendix, Pain management, Post-op: Possible NGT, abx, possible drain, IV, pain mgmt, Return to activity 4-6 wks after

Gastroenteritis

Causes N/V, diarrhea can be viral or bacterial, also known as stomach flu

Select assessment data for gastroenteritis.

History: recent travel especially a 3rd world country eat at a restaurant in the past 24-36 hrs, N/V, Abd cramping, Diarrhea, Weakness, Electrolyte disturbances

Select interventions for gastroenteritis.

Fluid replacement-oral Gatorade pedialyte etc, Avoind meds that ⬇️intestinal motility, Abx: Ciprflaxin, Azythromycin, Skin care for freq. diarrhea, Pt/fam teaching regarding transmission prevention: Washing hands for at least 30 seconds, maintain clean bathroom facilities, don’t prep or handle food that will be consumed by others, dedicated eating utensils, dishes, cups, toothpaste

What is pouch like herniations of mucosa through the muscular wall of any porting of the gut (most commonly the colon)/

Diverticula

What is the presence of many abnormal pouch like herniations in the wall of the intestines?

Diverticulosis

What is inflammation of one or more diverticula?

Diverticulitis

Select assessment data associated with diverticulitis.

LLQ pain, Distention, May have ⬆️temp, Inceased WBC, May have ⬇️HGB/ HCT, Diagnostics, X-ray, Ultrasound, Colonoscopy 4-8wks after acute episode

Select assessment data for diverticular disease.

LLQ pain, Distention, May have ⬆️temp, ⬆️WBC, May have ⬇️ HGB/HCT- chronic, Diagnostic: X-ray, ultrasound, colonoscopy 4-8wks after acute episode

Select BOTH surgical and non surgical interventions for diverticular disease.

Broad spectrum abx, Mild analgesic for pain, Nutrition therapy-low fiber or clear liquids, Bowel rest avoid laxative and enemas., Surgery emergent with perforation, Colon resection with or w/out colostomy

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問題一覧

Select the non-inflammatory intestinal disorders.

Intestinal obstruction, Colorectal cancer, IBS, Herniation, Hemorrhoids, Malabsorption syndrome

Absence of peristalsis due to neuromuscular disturbance is what kind of intestinal obstruction?

Non-mechanical

An intestinal obstruction that is physically blocked.

Mechanical obstruction

Select examples of causes of mechanical obstructions

Fecal impactions, Hernias, Strictures (crohns, radiation, etc), Adhesions, Tumors, Intussusception (intestine telescopes on self), Volvulus (twisting of GI tract, Med/surgical emergency)

Select the complications of intestinal obstructions.

Select statements true to non-mechanical paralytic ileus.

Related to handling of intestines during abdominal surgery “STUNNED BOWELS”, Can result from peritonitis, Can result in intestinal ischemia

What type of bowel sounds would be heard with a mechanical bowel obstruction?

High pitched

What type of bowel sounds would be heard in a non-mechanical bowel obstruction?

Absent or decreased

What is obstipation?

Complete constipation

Select the symptoms associated with small bowel obstructions.

Select the symptoms of large-bowel obstructions.

Select the diagnostics associated with bowel obstructions.

Select the planning/interventions for intestinal obstruction.

Select the surgical interventions for bowel obstruction.

Exploratroy laparoscopy (to determine cause& possible removal), Partial colectomy, Lysis of adhesions

Select statements true of colorectal cancers.

Screening recommendation for colon cancer/ other intestinal diseases.

Fecal occult yearly, And ONE of the following: Sigmoidoscopy q5yrs, Double contrast barium enema q5yrs, colonoscopy q10yrs

Select assessment data related to colon cancer.

Select diagnostics for colon cancer.

Select BOTH surgical and non-surgical interventions for colon cancer.

Chemotherapy, Radiation, Colon resection: tumor and regional lymph nodes, Abdominoperineal resection: removal of sigmoid colon, rectum&anus, Colectomy: colon removal with ostomy

What type of colostomy is pictured?

Ascending colostomy done for right sided tumors. Liquid somewhat acidic drainage.

What type of colostomy is pictured?

Transervs (double-barreled) colostomy. Often done during emergencies bc can be done quickly. One stoma drains mucous and one drains stool(soft/pasty).

What type of colostomy is pictured here?

Descending colon done for left sided tumors. Firmer pasty stools.

What type of colostomy is shown here?

Sigmoid colostomy done for rectal tumors. Formed solid stool as usual.

Select the post-op nursing care for colostomies.

Select what the nurse is monitoring post-op colostomy.

Select what is included in colostomy care.

Select the assessment data for IBS

History, Falre up: Worsening cramps, abd pain, diarrhea/constipation, in LLQ

Select the statements true of hernias.

Weakness of abd wall, Segment of bowel or other structure protrudes, Causes: congenital or acquired muscle weakness, ⬆️abd pressure

Select assessment data of hernias.

“Lump or protrusion” in abd, May disappear when pt lies down, Absent bowel sounds may indicate obstruction or strangulation!

Select interventions for hernias.

Non-surg belt or binder to push back in, Surgical rapier, Post op- no lifting>10lbs, avoid constipation

Select the inflammatory intenstinal disorders.

Peritonitis, Appendicitis, Gastroenteritis, Ulcerative colitis, Crohn’s, Celiac disease, Anorectal abscess/anal fissure/ anal, Parasitic infections

What is fluid or pus in abdominal cavity causing inflammation of abd contents.

Peritonitis

Select assessment data of peritonitis.

Select interventions for peritonitis.

Monitor for S/S of sepsis, Surgical and non surgical interventions, Restore fluid volume: NGT, NPO, Hypertonic IVs, Pain control analgesics

Select the assessment data for appendicitis.

What point is in the middle in the picture?

McBurney’s point

Select interventions for appendicitis

3-5 days in hospital after surgery for abx, Surgical removal of appendix, Pain management, Post-op: Possible NGT, abx, possible drain, IV, pain mgmt, Return to activity 4-6 wks after

Gastroenteritis

Causes N/V, diarrhea can be viral or bacterial, also known as stomach flu

Select assessment data for gastroenteritis.

History: recent travel especially a 3rd world country eat at a restaurant in the past 24-36 hrs, N/V, Abd cramping, Diarrhea, Weakness, Electrolyte disturbances

Select interventions for gastroenteritis.

What is pouch like herniations of mucosa through the muscular wall of any porting of the gut (most commonly the colon)/

Diverticula

What is the presence of many abnormal pouch like herniations in the wall of the intestines?

Diverticulosis

What is inflammation of one or more diverticula?

Diverticulitis

Select assessment data associated with diverticulitis.

LLQ pain, Distention, May have ⬆️temp, Inceased WBC, May have ⬇️HGB/ HCT, Diagnostics, X-ray, Ultrasound, Colonoscopy 4-8wks after acute episode

Select assessment data for diverticular disease.

LLQ pain, Distention, May have ⬆️temp, ⬆️WBC, May have ⬇️ HGB/HCT- chronic, Diagnostic: X-ray, ultrasound, colonoscopy 4-8wks after acute episode

Select BOTH surgical and non surgical interventions for diverticular disease.