Exam 2 chapter 24 Flashcards Preview

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Flashcards in Exam 2 chapter 24 Deck (25)
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1

condition characterized by intermittent and recurrent abdominal pain and stool pattern irregularities?

Irritable Bowel Syndrome (IBS)

2

symptoms of IBS

constipation
diarrhea
alternating diarrhea/constipation
abdominal distention
Excessive flatulence

3

The Rome III criteria

abd pain and discomfort lasting 3 months
starting at least 6 months ago
The pain has
relieved by defecation
onset assoc with change in fx of stool
onset assoc with change in stool appearance

4

Problems not associated with IBS

Anemia
fever
persistent diarrhea
rectal bleeding
severe constipation
weight loss

5

Nutritional therapy for patient with IBS

eliminate gas producing foods
brown beans
Brussels sprouts
cabbage
cauliflower
raw onions
Grapes
plums
raisins

6

what should patient with IBS add to their diet

yogurt
fiber
probiotics

7

what medication may be given to a patient with IBS to control diarrhea and fecal urgency

Loperamide (Imodium)

8

why may anticholinergic be prescribe for a patient with IBS

Pantheline (Pro Banthine)
to decrease smooth muscle spasm decreasing cramping and constipation

9

what medication may be prescribed to treat women with IBS whose chief complaint is chronic constipation

Tegaserod (Zelnorm)
it increases the effects of serotonin in the intestines, thereby increasing motility.
SE: diarrhea
Teach pts to report severe diarrhea accompanied by dizziness or orthostatic hypotension.

10

Patient teaching for IBS

avoid alcohol and cigarettes
eat at regular times
chew food slowly and thoroughly
fluids should not be taken with meals = abd distention.

11

inflammatory Bowel Disease

characterized by recurrent inflammation of the intestinal tract.
periods of remission interspersed with periods of exacerbation
cause is unknown
no cure
Tx relies on medications to treat inflammation and maintain remission.

12

Types of inflammatory bowel diease

Ulcerative colitis
Crohn's disease

13

Ulcerative colitis

diffuse inflammation
beginning in the rectum and spreading up the colon in a continuous pattern.
inflammation and ulcerations occur in mucosa and submucosa.
bowel occluded
multiple abscesses develop, break through into submucosa, leaving ulceration.
bleeding and perforation

14

clinical manifestations of ulcerative colitis

anorexia
diarrhea (blood common)
fatigue/malaise
abd tenderness/cramping
weight loss
fever
dehydration and electrolyte imbalances
anemia
Vitamin K deficiency

15

what are some complications for ulcerative colitis

toxic megacolon
perforation
bleeding
vascular engorgement
highly vascular granulation tissue

16

symptoms of toxic megacolon in patient with ulcerative colitis

fever
abd pain and distention
vomiting
fatigue

17

what type of surgery will be indicated for a patient with toxic megacolon who does not respond within 24 to 72 hours to medical management?

Total colectomy

18

why do patient with IBD have significantly increase risk for osteoporotic fractures

decreased bone mineral density
corticosteroid therapy

19

what are some labs to monitor for in patient with ulcerative colitis

WBC
H and H
albumin
electrolyte

20

adverse sequelae to the use of corticosteroids are

hypertension
fluid retention
cataracts
hirsutism (abnormal hair growth)
adrenal suppression
steroid induced diabetes mellitus
poor wound healing
loss of bone density

21

what is a common procedure performed for strictures of the small intestines?

Laparoscope guided strictureplasty
the blocked or narrowed sections of the intestines are widened, leaving the intestines intact.

22

surgical removal of colon

colectomies

23

complete excision of colon, rectum and anus

proctocolectomy with ileostomy
recommended when the rectum is severely diseased

24

what is the procedure of choice when a rectum can be preserved for a patient with ulcerative colitis

restorative proctocolectomy with ileal pouch

25

chronic, nonspecific inflammatory bowel disorder of unknown origin that can affect any part of the GI

Crohn's disease