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Differences in IBS, Crohns, Ulcerative Colitis - ANSWER-Symptoms are often the same in
both Crohn's disease and ulcerative colitis.
Bloody stools are more common with ulcerative colitis. (Think about near rectum)
Weight loss is more common in Crohn's disease because inflammation of the small intestine
impairs nutrient absorption. (think about small intestine- mouth to anus)
Clinical Manifestations of bowel obstructions - ANSWER-S/S dependent upon where
obstruction is located, and to what degree the bowel is obstructed
N/V
Abdominal pain and distention
Alteration in passage of feces, intestinal fluids
Proximal obstructions usually exhibit with bile colored emesis
Distal obstructions usually exhibit less vomiting, but may progress to fecal smelling
Mechanical obstructions- - ANSWER-pain comes & goes- peristalsis still intact
Paralytic ileus- - ANSWER-constant more generalized pain
Small bowel obstructions- - ANSWER-less distention, more vomiting, bile colored
Large bowel obstructions- - ANSWER-more distention, less vomiting, then if vomiting,
might smell like feces
Ostomies that are described according to location and type. - ANSWER-
The more distal the ostomy - ANSWER-the more the intestinal contents resemble feces that is
eliminated from an intact colon and rectum...also the more odor it produces.
Postoperative Care of Ostomies - ANSWER-Assessment of the stoma (Table 43-27)
,Color
Edema
Bleeding
What does a healthy appearing stoma look like?
Provision of an appropriate pouching system
Skin barrier
Drainage collection-one piece or two piece
Size of stoma-use a measuring card
Fit snugly
Things to look for post-op after a stoma - ANSWER-Normal is rose to brick red- mild edema-
small amount of blood oozing because it is so vascular!
Pale or dark purple not normal
The volume, color, and consistency of the drainage are recorded. Each time the pouch is
changed, the condition of the skin is observed for irritation. A pouch should never be placed
directly on irritated skin without the use of a skin barrier.
Diverticular Disease - Nursing Management ACUTE ATTACK - ANSWER-Hospitalized if
symptoms severe: fever, pain, unable to tolerate fluids, or advanced age
NPO- rest bowel, Gastric tube to rest bowel, IV fluid replacement, Antibiotics,
Bedrest,Opiods
Surgery for ruptured diverticula
Observe for S/S worsening pain, distention, infection, peritonitis
Therapeutic Interventions: Prevent constipation, high fiber diet, adequate fluids, weight
reduction, physical exercise, avoid straining
After acute attack - ANSWER-Bulk forming laxatives
High fiber diet-diet instruction
Salivary glands—parotid - ANSWER-parotid, submaxillary, and sublingual—produce saliva.
, Gastric secretions - ANSWER-Chief cells secrete pepsinogen
Parietal cells secrete hydrochloric acid (HCl), water, and intrinsic factor
Hydrochloric acid makes the gastric juice acidic, which aids in protection against ingested
organisms.
The ileocecal valve - ANSWER-prevents reflux of contents from the large intestine.
A nurse is providing teaching to a parent f a child who has Hirschsprung Disease is scheduled
for initial surgery. Which of the following statements by the parent indicates an
understanding of the teaching? - ANSWER-I'm glad that my child's ostomy is only temporary
A nurse is caring for a child who is admitted with suspected acute appendicitis. Which of the
following manisfestations should indicate to the nurse that the child's appendix is perforated?
- ANSWER-Sudden decrease in abdominal pain
A nurse is caring or a child who has suspected appendicitis. Which of the following provider
prescriptions should the nurse clarify? - ANSWER-Administer sodium biphosphate/sodium
phosphate
A nurse is caring for a 6-month old infant who has a prescription for clear liquids by mouth
after a repair of an intussesception. Which of the following fluids should the nurse select for
the infant? - ANSWER-Oral Electrolyte Solution
A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids.
The nurse should anticipate providing which of the following types of fluid? - ANSWER-
Oral Rehydration Solution
A nurse is caring for an infant who has inadequate motility of part of an intestine resulting in
a mechanical obstruction. The nurse should identify this finding as a manisfestation of which
of the following disorders? - ANSWER-Hirschsprung's Disease
A nurse is caring for an infant who has gastroesophageal reflux. The nurse should recognize
that which of the following finding's are associated with this condition? - ANSWER-
Vomiting, Weight Loss, Wheezing