Davis CH 30: Disorders of the Large Intestine

The nursing instructor is discussing ulcerative colitis with a group of nursing students. Which statement(s) by a student nurse indicates the need for correction? Select all that apply. "Ulcerative colitis affects the small and large intestines." "Ulcerative colitis affects the inner lining of the large intestine." "Ulcerative colitis is more common in caucasians." "In ulcerative colitis, pseudopolyps may be seen on examination of the colon." "Ulcerative colitis causes skip lesions and cobble-stoning."

"Ulcerative colitis affects the small and large intestines." "Ulcerative colitis affects the inner lining of the large intestine." "Ulcerative colitis causes skip lesions and cobble-stoning."

Albert has pain in his abdomen that increases when he coughs or takes a deep breath. During his physical exam, he yelps in pain after you deeply palpate the abdomen in the RLQ. What disorder does Albert have?

Appendicitis Appendicitis is inflammation of the appendix. Appendicitis often presents with acute, sharp pain in the right upper quadrant of the abdomen. Palpation of this area often induces greater pain, as the inflamed tissue is compressed.

Which disorders of the large intestine produce alteration in the motility? Select all that apply. Appendicitis Crohn's disease Ulcerative colitis Bowel obstruction Irritable bowel syndrome

Bowel obstruction Irritable bowel syndrome

Nick complains of abdominal pain and bouts of diarrhea. He thinks that there may be blood in his stool. He has lost 15 pounds since his last visit 6 months ago. What disorder does Nick have?

Crohn's Disease Crohn's disease is an inflammatory condition that may affect the entire GI tract, from mouth to anus. The inflammation present may damage the intestinal wall, resulting in blood appearing in the stools. As the intestinal wall is damaged, absorption of food is compromised. Coupled with diarrhea, weight loss can be significant in those suffering active Crohn's disease.

Which disorders of the large intestine produce alteration in the intestinal wall's integrity? Select all that apply. Crohn's disease Appendicitis Ulcerative colitis Bowel obstruction Irritable bowel syndrome

Crohn's disease Appendicitis Ulcerative colitis

Which of the following characteristics is NOT associated with Crohn's disease? Crohn's disease is a condition of altered motility. Crohn's disease can affect the entire length of the GI tract. Crohn's disease affects the entire thickness of the intestinal wall. Crohn's disease results from inflammation. Crohn's disease produces skip lesions and cobble-stoning.

Crohn's disease is a condition of altered motility.

Claire's rectal exam revealed dilated, swollen veins in the rectum. What disorder does Claire have?

Hemorrhoids Hemorrhoids are dilated veins in the rectum or anus. These veins may enlarge and dilate due to excess straining, or any time there is increased pressure within these structures, such as occurs with pregnancy. Hemorrhoids may be located internally or more superficially. Bleeding and itching in the affected area may occur.

Wendell complains that there is blood in his stool and the stools seem darker than normal. What condition explains Wendell's symtoms?

Melena Melena occurs when there is a darkening of the stools due to the presence of digested blood. When bleeding happens in the lower portions of the colon or anal region, blood in the feces will appear bright red in color, as it is not digested. The dark color associated with melena indicates a bleed in the upper portions of the GI tract, with the dark color due to digestion of hemoglobin in the blood from the bleed.

The diagnostic reports of a patient show inflammation of the colon, but not the small intestine, and the formation of pseudopolyps. What condition do you suspect the patient may have? Appendicitis Crohn's disease Ulcerative colitis Irritable bowel syndrome Diverticulitis

Ulcerative colitis

John is bent over in pain due to cramping and colicky abdominal pains. He said he started vomiting suddenly, and pain in his abdomen followed the vomiting. What condition is consistent with John's symptoms?

Volvulus Volvulus is twisting of the intestines. This results in pain, as portions of the intestine that are twisted experience ischemia. Cramping of the intestines occurs as gas and fluid collect in the obstructed area. Because contents cannot travel through the intestine, vomiting results.

An inability to pass gas or produce a bowel movement may represent _____________. an intestinal obstruction an appendicitis ulcerative colitis Celiac disease pseudopolyps

an intestinal obstruction

Henry complains of constipation and has a low-grade fever. When reviewing his diet, you notice that there is a lack of dietary fiber. What disorder do you suspect?

diverticular disease A diet high in fiber is very helpful in preventing diverticular disease. Diverticula are small outpouchings found most commonly in the large intestine, and develop in weakened areas. Sometimes, the pouches can become inflamed. This condition is known as diverticulitis.

The condition in which outpouchings of a weakened intestinal wall that may become inflamed is known as ________. volvulus appendicitis hemorrhoids diverticulitis ulcerative colitis

diverticulitis

Bouts of constipation, diarrhea, and abdominal distention are associated with _____________. Crohn's disease ulcerative colitis diverticulosis irritable bowel syndrome appendicitis

irritable bowel syndrome

Stephanie complains of abdominal pain that has been off and on for the past 6 months. She thought it would go away but noticed she was having lasting bouts with diarrhea and constipation. What disorder does Stephanie's symptoms indicate?

irritable bowel syndrome Irritable bowel syndrome is a disorder of intestinal motility. Alternating bouts of diarrhea and constipation occur. The large intestine is affected. Unlike Crohn's disease and ulcerative colitis, signs of inflammation are not present. Lifestyle modifications, including dietary changes, are often helpful.

Large intestine obstructions___________. Select all that apply. always result from mechanical obstructions. may occur with volvulus formation. may result from weakened intestinal muscles. result in hiatal hernias. usually present with no signs or symptoms.

may occur with volvulus formation. may result from weakened intestinal muscles.

Naomi has symptoms which could be ulcerative colitis or Crohn's disease. Upon examination of the colon, the physician finds pseudopolyps. What disorder does Naomi have?

ulcerative colitis Pseudopolyps are structures that develop in ulcerative colitis, but not Crohn's disease. The pseudopolyps are actually masses of scar tissue that form in response to the inflammatory damage associated with ulcerative colitis.

The number one risk factor for diverticula is __________. NSAID use bacterial infection autoimmune condition weakened intestinal wall increased stomach acid secretion

weakened intestinal wall