Inflammation/Immunity N440 (Exam 1)
Questions with Complete Solutions
What do you worry about with a leaking ostomy? skin breakdown
How often to change ostomy system 3-7 days, at least once a week
When to empty pouch of ostomy: when 1.5 to a third full
Diet/hydration/nutrition w ostomy: make sure drinking enough fluids, make sure pt.
eating foods that are easy to digest
What to watch for with ostomy: if stoma becomes black/white/anything other than
red/pink, significant increase or decrease in output, more at risk for dehydration, look for
blockage w decreased output
Ileostomy vs. Colostomy Ileostomy-- small intestine, stool more liquid.
Colostomy-- large intestine, stool more formed
,Crohn's Disease: what area is affected? small intestine, colon, or both. can potentially
affect GI tract from mouth to anus.
What happens to the bowels with CD? bowels thicken, strictures and deep ulcerations are
present which causes malabsoprtion and diarrhea
Cause of CD unknown
Clinical manifestations of CD: diarrhea, steatorrhea, weight loss, right lower quad
constant abdominal pain, anemia, low grade fever, nutritional problems, stools rarely bright red
Why does UC have bloodier stools than CD? UC bloodier because located near rectum
Nutritional therapy for CD: severe exacerbations: bowel rest and TPN, ensure used for
extra calories and nutrients, Viconex plus, teach to avoid stimulants
,Side effects of Aminosalicylates (Sulfasalazine and Mesalamine) headache, nausea, loss
of appetite, vomiting, rash, fever, decreased WBC count, decreased sperm production and
function
Side effects of Glucocorticoids (Prednisone) increased appetite, weight gain, water
retention, osteoporosis, increased BP and Glucose
Side effects of Anti-Diarrheals (Lomotil and Immodium): constipation, flatulance,
headache, nausea, dizziness
Side effects of Immunomodulators (Remicaid and Humira): N/V, diarrhea, hepatitis,
pancreatitis, rash, fever, low WBC
Side effects of Immunosuppressants (CD) (Imuran) infections, malignancies, liver
problems, nausea, diarrhea, loss of appetite
CD complications: hemorrhage/perforation, malabsorption, fistulas, osteoporosis
, UC complications: increased risk of cancer, extra-intestinal complications, abscess
formation
What is toxic megacolon? paralysis of the colon causes dilation and distention, causes
inability to remove gas or feces from body, complication of both CD and UC.
What could happen as a result of toxic megacolon? may cause colitis
What is a fistula? abnormal tract between 2 or more body areas
Where can fistulas occur? between bowel and bladder, between 2 bowel segments,
between skin and bowel
Fistula complications: systemic infections, skin problems, impaired fluid and electrolytes,
malnutrition
Fistula priorities: adequate nutrition (high protein and vitamin c diet)
Questions with Complete Solutions
What do you worry about with a leaking ostomy? skin breakdown
How often to change ostomy system 3-7 days, at least once a week
When to empty pouch of ostomy: when 1.5 to a third full
Diet/hydration/nutrition w ostomy: make sure drinking enough fluids, make sure pt.
eating foods that are easy to digest
What to watch for with ostomy: if stoma becomes black/white/anything other than
red/pink, significant increase or decrease in output, more at risk for dehydration, look for
blockage w decreased output
Ileostomy vs. Colostomy Ileostomy-- small intestine, stool more liquid.
Colostomy-- large intestine, stool more formed
,Crohn's Disease: what area is affected? small intestine, colon, or both. can potentially
affect GI tract from mouth to anus.
What happens to the bowels with CD? bowels thicken, strictures and deep ulcerations are
present which causes malabsoprtion and diarrhea
Cause of CD unknown
Clinical manifestations of CD: diarrhea, steatorrhea, weight loss, right lower quad
constant abdominal pain, anemia, low grade fever, nutritional problems, stools rarely bright red
Why does UC have bloodier stools than CD? UC bloodier because located near rectum
Nutritional therapy for CD: severe exacerbations: bowel rest and TPN, ensure used for
extra calories and nutrients, Viconex plus, teach to avoid stimulants
,Side effects of Aminosalicylates (Sulfasalazine and Mesalamine) headache, nausea, loss
of appetite, vomiting, rash, fever, decreased WBC count, decreased sperm production and
function
Side effects of Glucocorticoids (Prednisone) increased appetite, weight gain, water
retention, osteoporosis, increased BP and Glucose
Side effects of Anti-Diarrheals (Lomotil and Immodium): constipation, flatulance,
headache, nausea, dizziness
Side effects of Immunomodulators (Remicaid and Humira): N/V, diarrhea, hepatitis,
pancreatitis, rash, fever, low WBC
Side effects of Immunosuppressants (CD) (Imuran) infections, malignancies, liver
problems, nausea, diarrhea, loss of appetite
CD complications: hemorrhage/perforation, malabsorption, fistulas, osteoporosis
, UC complications: increased risk of cancer, extra-intestinal complications, abscess
formation
What is toxic megacolon? paralysis of the colon causes dilation and distention, causes
inability to remove gas or feces from body, complication of both CD and UC.
What could happen as a result of toxic megacolon? may cause colitis
What is a fistula? abnormal tract between 2 or more body areas
Where can fistulas occur? between bowel and bladder, between 2 bowel segments,
between skin and bowel
Fistula complications: systemic infections, skin problems, impaired fluid and electrolytes,
malnutrition
Fistula priorities: adequate nutrition (high protein and vitamin c diet)
