NURS 5333 Gastro up to Diverticulitis Study
Guide + Questions with Accurate Solutions
Gastroenteritis Salmonella
nausea, vomiting, cramps, fever and bloody stools.
Salmonella, antibiotics are not recommended unless it's in patients with valvular heart
disease or they're immunocompromised. These patients would get Bactrim or
Ciprofloxacin.
Gastroenteritis Shigella
add watery diarrhea & wBCs in stool
For shigella, Bactrim would be given twice daily for three to five days and if it's acquired
outside of the United States the patient would get Ciprofloxacin for 10 days.
Gastroenteritis Ecoli
same as salmonella but NO FEVER
For E. coli Bactrim twice daily for three days or Ciprofloxacin may be used in adults
Campylobacter jejuni
same but add loose stools and quick onset( 1 to 7 days)
A stool culture is needed to confirm diagnosis
Complications can be Guillain-Barré syndrome and reactive arthritis
. Campylobacter Erythromycin four times daily for five days or Ciprofloxacin twice
daily for seven days.
Staph aureus
,all same but change to soft stool
Severe disease can be defined as abnormal vital signs, severe abdominal pain, clinical
signs of dehydration or sepsis
For staphylococcus aureus, antibiotics are not recommended.
Giardia
foul smelling stools, abdominal pain and flatulence.
Giardia is treated with Metronidazole 250 milligrams three times daily for five to seven
days
Clostridium difficile
in hospitalized patients that have had antibiotics long term like clinda
diagnosed with a PCR lab diagnosis
aggressive rehydration
clostridium difficile is Metronidazole 500 milligrams three times daily or 250 milligrams
four times per day and Vancomycin 125 milligrams four times daily.
first thing would be a complete blood count.
Suspect a patient has C Diff?
constipation
Hard, slow stools that are difficult to eliminate; often a result of too little fiber in the
diet
In geriatric patients, warm water enemas should be used instead of sodium phosphate
enemas due to the fact that sodium phosphate enemas have been associated with
fatalities and severe electrolyte disturbances
Constipation Treatment Goals
, Relieve constipation and reestablish normal bowel function
Establish dietary and exercise habits that aid in preventing recurrences
Promote safe and effective use of laxative products
N& V and tx for kids?
Promethazine should not be given in children less than two and it can cause fatal
respiratory depression in children less than two, it can cause respiratory depression in
adults when given with other central nervous system depressants.
Selective 4-HT3 receptor antagonists such as Ondansetron are much preferred over
Promethazine, ondasentron can also be given in pregnancy and can be used to prevent
nausea and vomiting
+++++BUT NO ZOFRAN TO KIDS UNDER 4++++
pediatric population consider Hirschsprung disease which is the absence of colonic
ganglion cells, associated with inherited conditions such as Down syndrome
Constipated kids??
How can you prevent constipation?
General prevention is high fiber diet, adequate fluids, exercise and training to obey
the urge to defecate. Don't hold it in, so you need to tell your patients not to hold the
stool in when they have the urge to defecate. evaluate their diet, lifestyle,
prescription and over the counter medication use and identify any reversible causes.
with primary constipation the pain and bloating are relieved by adequate defecation
but not so in irritable bowel syndrome
Risk factors are very young and very old, polypharmacy, sedentary lifestyle, improper
diet and inadequate fluid intake.
Risks for constipation?
Guide + Questions with Accurate Solutions
Gastroenteritis Salmonella
nausea, vomiting, cramps, fever and bloody stools.
Salmonella, antibiotics are not recommended unless it's in patients with valvular heart
disease or they're immunocompromised. These patients would get Bactrim or
Ciprofloxacin.
Gastroenteritis Shigella
add watery diarrhea & wBCs in stool
For shigella, Bactrim would be given twice daily for three to five days and if it's acquired
outside of the United States the patient would get Ciprofloxacin for 10 days.
Gastroenteritis Ecoli
same as salmonella but NO FEVER
For E. coli Bactrim twice daily for three days or Ciprofloxacin may be used in adults
Campylobacter jejuni
same but add loose stools and quick onset( 1 to 7 days)
A stool culture is needed to confirm diagnosis
Complications can be Guillain-Barré syndrome and reactive arthritis
. Campylobacter Erythromycin four times daily for five days or Ciprofloxacin twice
daily for seven days.
Staph aureus
,all same but change to soft stool
Severe disease can be defined as abnormal vital signs, severe abdominal pain, clinical
signs of dehydration or sepsis
For staphylococcus aureus, antibiotics are not recommended.
Giardia
foul smelling stools, abdominal pain and flatulence.
Giardia is treated with Metronidazole 250 milligrams three times daily for five to seven
days
Clostridium difficile
in hospitalized patients that have had antibiotics long term like clinda
diagnosed with a PCR lab diagnosis
aggressive rehydration
clostridium difficile is Metronidazole 500 milligrams three times daily or 250 milligrams
four times per day and Vancomycin 125 milligrams four times daily.
first thing would be a complete blood count.
Suspect a patient has C Diff?
constipation
Hard, slow stools that are difficult to eliminate; often a result of too little fiber in the
diet
In geriatric patients, warm water enemas should be used instead of sodium phosphate
enemas due to the fact that sodium phosphate enemas have been associated with
fatalities and severe electrolyte disturbances
Constipation Treatment Goals
, Relieve constipation and reestablish normal bowel function
Establish dietary and exercise habits that aid in preventing recurrences
Promote safe and effective use of laxative products
N& V and tx for kids?
Promethazine should not be given in children less than two and it can cause fatal
respiratory depression in children less than two, it can cause respiratory depression in
adults when given with other central nervous system depressants.
Selective 4-HT3 receptor antagonists such as Ondansetron are much preferred over
Promethazine, ondasentron can also be given in pregnancy and can be used to prevent
nausea and vomiting
+++++BUT NO ZOFRAN TO KIDS UNDER 4++++
pediatric population consider Hirschsprung disease which is the absence of colonic
ganglion cells, associated with inherited conditions such as Down syndrome
Constipated kids??
How can you prevent constipation?
General prevention is high fiber diet, adequate fluids, exercise and training to obey
the urge to defecate. Don't hold it in, so you need to tell your patients not to hold the
stool in when they have the urge to defecate. evaluate their diet, lifestyle,
prescription and over the counter medication use and identify any reversible causes.
with primary constipation the pain and bloating are relieved by adequate defecation
but not so in irritable bowel syndrome
Risk factors are very young and very old, polypharmacy, sedentary lifestyle, improper
diet and inadequate fluid intake.
Risks for constipation?
