ER* ATI ch 52 inflammatory bowel disease

what drugs are good for diverticulitis ?

antimicrobials- treat infections (decrease inflammation) cipro flagyl

folic acid and B12 is decreased in

crohns

suppress the immune response. an antibody used to reduce tumor necrosis factor.

immunomodulatorss (infliximab)

what are the antidiarrheal drugs

lomotil and imodium

peritonitis results from infection of the peritoneum due to ____,____, or rupture of part of the GI tract

puncture, septicemia

an ileostomy may drain as much as ___ per day

1,000ml

___ is an antiflammatory drug that reduces the inflamation of the intestinal mucosa

5-ASA sulfonamides

the client is hospitalzed when the clinical findings are more severe (severe pain, high fever). the client is NPO, has NG suctioning, is receiving IV fluids, IV antibiotics, and TPN, and opiod analgesics for pain

Divericultis

surgical procedures for crowns disease

Stricuroplasty surgical repair of fistulas

Edema and inflammation of the rectum and sigmoid colon. may expand the length of the colon. mucosa and submucosa are affected and may abscess

Ulcerative colitis

bowel obstruction may occur, intestinal mucosal cells changes may cause colon cancer or insufficient production of intrinsic factor, resulting in insufficient absorption of vitamin B12 (pernicious anemia)

Ulcerative colitis

medications used for ulcerative colitis and crowns disease

anti-inflammatories corticosteroids immunosppressants immunomodulators antidiarrheals

may cause supra infection. instruction client to observe for findings or thrush or yeast infection risk for achilles tendon rupture may darken urine

antimicrobials cipro and flagly

complications of Ulcerative colitis, crohns disease, and diverticulitis includes ____,___ and ____

bleeding, fluid and electrolyte imbalances

with ulcerative colitis and crohns disease, patients should avoid ___ and _____, and take a multivitamin that contains iron

caffeine and alcohol

____ is characterized by diarrhea- up to 20 stools per day, cramps abdominal pain, excerbations/remission

chronic IBD

surigcal procedure for ulcerative colitis

colectomy with or without ileostomy

Chronic IBD includes ____,___ and _____.

colitits, crowns disease and diverticulitis

surgical procedures for diverticulitis

colon resection double barrel colostomy treatment of complications- peritonitis, abscess, obstruction, fistula, bleeding

use ___ in low doses to minimize adverse effects. monitor BP monitor electrolytes and glucose. may slow healing. used for inflation and pain

corticoseriods ulcerative colitis and crohns

abdominal pain/ cramping: often right lower quadrant pain anorexia and weight loss

crohns disease

can involve the entire GI tract from the mouth to the anus. Malabsorption and malnutrition may develop when the jejunum and ileum become involved. Supplemental vitamins and mineral including vitamin B12 injections may be necessary

crohns disease

fever diarrhea: 5 loose stools/per day with mucus or pus abdominal distention, tenderness and/or firmness upon palpation high pitched bowel sounds steatorrhea

crohns disease

inflammation and ulceration of the GI tract, often at the distal ileum. All bowel layers may become involved; lesions are sporadic Fistulas are common

crohns disease

small intestine ulcerations and narrowing may be consistent with ___

crowns disease

Abcsed ad fistula formation occurs due to the ____ of the bowel wall, leading to infection

destrcution

diverticula may bleed and the loss of blood may be minimal or severe diverticula may perforate and cause peritonitis

deverticulitis

Inflammation of the diverticula (hernia in intestinal wall) that frequently occurs in the colon

diverticulitis

____ is inflammation and infection of the bowel mucosa caused by bacteria or fecal matter trapped in one or more diverticula (pouches in the intestine).

diverticulitis

abdominal pain in left lower quadrant nause and vomitting

diverticulitis

about 10% of clients who have diverticula develop ______.

diverticulitis

objective dats includes fever chills tachycardia

diverticulitis

provide client with instructions to promote normal bowel function and consistency (may take bulk-forming laxatives only, drink adequate fluids, avoid use of enemas

diverticulitis

with _____ educate the patient to consume a clear liquid diet until manifestations subside. then to a low fiber diet

diverticulitis

avoid seeds that can block the diverticulum (nuts, popcorn, seeds

diverticulitits

_____ is the presence of many small pouches in the colon with or without infammation. many people who have ____ never develop diverticulitis

diverticulosis

a barium enema may show the presence of ____ and is contraindicated in the presence of diverticulitis due to the risk or perforation

diverticulosis

with ____ instruct the patient to add fiber to the diet when they can handle solid foods without manifestations. then to high fiber

diveticulitis

signs of bowel obstruction of perforation

fever, severe abdominal pain, vomiting

a diet low in ___ may predispose a client to ulcerative colitis and the development of diverticula

fiber

peritonitis nursing complitations

fowlers position give O2, TCDB NG suction NPO IV antibiotics

____, or inflammation of the stomach and small intestine, is triggered by infection

gastroenteritis

vomiting and frequent, watery stools place the client at increased risk for fluid and electrolyte imbalance and impaired nutrition with _____

gastroenteritis

with ulcerative colitis and crohns disease, patients should eat foods high in ____ and calories and low in _____

high protein low fiber

the adverse effects are not as serious as sulfasalazine. may be contraindicated in sulfa allergy. monitor CBC, renal, hepatic function.

nonsulfonamides

____ is a 5-ASA anti-inflammatory drug for ulcerative colitis and crohns disease

nonsulfonamides Mesalamine

Appendicitis, or inflammation of the appendix related to ____

obstruction young adults and teens at risk

Diverticulitits occurs more often in ____ and affects men more than women

older adults

_____, or inflammation of the peritoneum.

peitonitis

____ is a life threatening inflammation of the peritoneum and lining of the abdominal cavity. caused by bacteria in the peritoneal cavity

peritonitis

rigid, boardlike abdomen*** nausea, vomiting, rebound tenderness tachycardia fever

peritonitis

with ulcerative colitis and crowns disease, monitor for electrolyte imbalances, especially ____

potassium

___ is given by renting enema

rowasa anti-inflammatory nonsulfonamide

these meds may be contraindicated if the client has a sulfa allergy.

sulfonamides

sulfonamides teaching

take with food avoid sun increase fluids urine color change

___ occurs due to inactivity of the colon. massive dilation of the colon occurs and the client is at risk for perforation

toxic magecolon

barium enema is used to diagnose ____

ulcerative colitis

the incidence of ____ peaks at adolescents to young adulthood (more often in females) and older adults (more often in males)

ulcerative colitis

ulcerations and inflammation of the sigmoid colon and rectum may be significant for ____

ulcerative colitis

H&H is decreased in

ulcerative colitis crohns disease diverticulitis

C-reactive protein is increased in

ulcerative colitis crohns

K+, Mg, and C is decreased in

ulcerative colitis crohns

platelet count is increased in

ulcerative colitis crohns

serum albumin is decreased in

ulcerative colitis crohns

WBC is increased in

ulcerative colitis crohns diverticulitis

what two disorders have a genetic risk factor

ulcerative colitis and Crohn's disease

ESR is increased in

ulcerative colitis and crohns

antidiarrheals are used in ____ and ____.

ulcerative colitis and crohns

monitor I & O and assess for dehydration educate the client regarding he use of Vitamin B12 supps

ulcerative colitis and crohns

abdominal pain/cramping: often left lower quadrant pain. anorexia and weight loss

ulcerative colitits

fever diarrhea up to 15 to 20 liquid stools per day mucus, blood, or pus can be present. abdominal distention, tenderness, and firmness when palpated high pitched bowel sounds rectal bleeding

ulcerative colitits

fluid and electrolyte imbalance occurs due to loss of fluid through ___ and ____, any may occur with NG suctioning

vomiting and diarrhea