MEDSURG II FINAL EXAM STUDY GUIDE RATED A

1 Crohn's basic info: - Crohn’s disease is a type of IBD (most common in the distal small intestine or proximal colon) - Causes major inflammation and ulceration in the GI tract. - It is found through the whole GI tract but is most prominent in the terminal ileum and beginning of the colon. - Chronic inflammatory Disease that can involve the entire GI tract (most common in the distal small intestine or proximal colon) and all layer of the. Bowelwall. Characterized by periods pf remissions and exacerbations. RF: Autoimmune disorders, genetics, smoking, NSAID use. S/S: Diarrhea (5-6 loose stools/day) steatorrhea, RLQ pain, weight loss, anemia, fever, fatigue. Diagnostic test ● CT scan ● Magnetic resonance eterography (MRE) is performed to determine bowel activity and motility ● Barium enemas with air contrast can show differences between UC and Crohn’s disease. Colonoscopy: Pre-procedure: ● Clear liquid diet, laxatives (Polyethylene Glycol) ● Educate the patient NPO after midnight and avoid any time of food red, orange or purple in color as their residue can appear to be blood. ● Unlicensed assistive personnel (UAP) can Reinforce “NPO” status. Post-procedure: ● Patient in left lateral position to less discomfort and quicker passage of flatus. ● Assess VS every 15 to 30 minutes until the client is alert, assess for rectal bleeding or severe pain. ● Confirm the client has arranged for another person to drive home to get rest. ● After a colonoscopy with a biopsy, a small amount of bleeding is normal. . Crohn’s disease. Diagnostic test. Colonoscopy ● IF symptoms of fever, bleeding, severe pain, dizziness, tachycardia, tachypnea, and abdominal distention (rigid board like abdomen) PERITONITIS=Perforated bowel. Question: The nurse receives the following information about a 51-yr-old female patient who is scheduled for a colonoscopy. Which information should be communicated to the health care provider before sending the patient for the procedure? a. The patient has a permanent pacemaker to prevent bradycardia. b. The patient is worried about discomfort during the examination. c. The patient has had an allergic reaction to both shellfish and iodine in the past. d. The patient declined to drink the prescribed polyethylene glycol (GoLYTELY). ● ANS: D If the patient has had inadequate bowel preparation, the colon cannot be visualized, and the procedure should be rescheduled. Because contrast solution is not used during colonoscopy, the iodine allergy is not pertinent. A pacemaker is a contraindication to magnetic resonance imaging but not to colonoscopy. The nurse should instruct the patient about the sedation used during the examination to decrease the patient’s anxiety about discomfort.