med surg chapter 29 *lower GI disorders*

signs and symptoms of obstructions in the colon

-abdominal distention -vomiting -pain that lasts several minutes and correspond to peristalsis waves

diagnosis of intestinal obstructions

-abdominal radiographs -insertion of a NG tube

signs and symptoms of IBS

-alteration in bowel elimination -abdominal pain or bloating -absence of detectable organic disease -

the most common place for a hernia

-center of the abdomen at the site of the umbilicus -lower abdomen at the points where the inguinal ring and the femoral canal begin -may form at an old abdominal incision

bowel ischemia is diagnosed by

-computed tomography angiography -magnetic resonance angiography

signs and symptoms of diverticulosis (of the intestine)

-diarrhea or constipation -acute left lower abdominal pain -bloating -nausea -vomiting

signs and symptoms of IBD

-diarrhea that is bloody or contain mucus -abdominal pain -malaise -fever -weight loss

signs and symptoms of esophageal diverticula

-dysphagia -regurgitation -nocturnal cough -halitosis

treatment for diverticulosis

-high fiber diet -increased fluid -bulk laxative or stool softeners to control constipation

factors that could cause diverticula

-increases in intra-abdominal pressure from constipation and straining to defecate -obesity -low fiber diet

foods that should be avoided in IBS

-legumes -cabbage -coffee -tea -carbonated beverages -alcohol -milk

discharge instructions for a patient after hernia repair

-lifting restrictions are implemented for 1-2 weeks -support site with hand if coughing or sneezing

nonmechanical intestinal obstructions include

-paralytic ileus after abdominal surgery -infection -consequence of hypokalemia -heavy metal poisoning

nursing management of intestinal obstruction

-place in a fowlers postion -fluid and electrolytes are monitored -measure abdominal girth -pain control is essential

signs and symptoms of intestinal obstructions high in the intestinal tract

-sharp, brief pains in upper abdomen -frequent, high pitched sounds heard above the obstruction -bowel sounds are absent below the obstruction -vomiting -rapid dehydration -slight abdominal distention

contributing factors in the development of a hernia

-straining to lift heavy objects -chronic cough -staining to void or pass stool -ascites

signs and symptoms of bowel ischemia

-sudden severe abdominal pain -nausea -vomiting -diarrhea -abdominal cramps -tender to palpation -guarding of abdomen -bowel sounds minimal or absent -WBC elevated

mechanical intestinal obstructions include

-tumors -adhesions -strangulated hernia -twisting of the bowel -barium impaction -gallstones

the standard treatment of bowel ischemia is

IV heparin

treatment of bowel ischemia

NPO and NG tube in place -intravanious hydration is ordered -foley inserted to monitor output

diverticulum

a small, blind pouch resulting from a protrusion of the mucous membranes of a hollow organ through weakened areas of the organ's muscular wall and is found primarily in the colon

acute mesenteric ischemia can result from

arterial emboli or thrombosis

crohns disease more often affects the

ascending colon and small intestine

bowel ischemia

blood supply to the bowel is insufficient to support metabolic needs.

treatment and nursing management for IBS

bulk-forming agents antidiarrheals -antidepressants -high fiber diet

crohns disease

chronic inflammation that can involve any part of the GI tract but most commonly affects the distal ileum and proximal colon

if there is a defect in the muscular wall of the abdomen, the intestine may break through the defect. this protrusion is called a

hernia

the surgical procedure used in the treatment of a hernia is called

herniorrhaphy. *if the hernia is large, a herniplasty is done with mesh

inflammartory bowel disease

includes both ulcerative colitis and crohn disease

ulcerative colitis

inflammation with formation of ulcers of the mucosa of the colon

diagnosis of IBD

obtain history -colonoscopy -flexible sigmoidoscopy -mucosal biopsy -barium enema -stool analysis

ulcerative colitis more often affects the

rectosigmoid and left colon

blood tends to be ____ when the bleeding location is lower in the intestine

redder

intestinal obstruction

sudden or gradual blockage of the intestinal tract that prevents the normal passage of GI contents through the intestines. abdominal adhesions are a common cause of intestinal obstruction

irritable bowel syndrome

the result from a hypersensitivity of the bowel wall that leads to disruption of the normal function of the intestinal muscles. familial disposition, stress, caffeine, and sensitivity to certain foods seem to trigger this

esophageal diverticula

there is a herniation of esophageal mucous and submucosa into surrounding tissue