NUR 113: Ch.47 intestinal and rectal disorders

Pre-operative appendicitis

IV fluids, ABX, analgesics

Things to avoid with appendicitis

Laxative, enemas, heat

Most prominent sign of IBD

Mild diarrhea, fever, abdominal discomfort

Intessusception of the bowel

One part telescopes into another portion of the intestine

The physician has written the following orders for a new client admitted with pancreatitis: bed rest, nothing by mouth (NPO), and administration of total parenteral nutrition (TPN) . Which does the nurse attribute as the reason for NPO status?

To avoid inflammation of the pancreas

When the nurse is caring for a patient with acute pancreatitis, what intervention can be provided in order to prevent atelectasis and prevent pooling of respiratory secretions?

Frequent changes of positions

Which condition in a client with pancreatitis makes it necessary for the nurse to check fluid intake and output, check hourly urine output, and monitor electrolyte levels?

Frequent vomiting, leading to loss of fluid volume

Post operative appendicitis

High Fowler's, diet as tolerated, incentive spirometer, I&O, pain

A health care provider suspects a client may have developed pancreatitis. Which laboratory value will confirm this diagnosis?

High serum amylase and lipase

When caring for the client with acute pancreatitis, which of these alterations does the nurse recognize is consistent with the disease?

Hyperglycemia

A client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of the TPN?

Measure blood glucose concentration every 4 to 6 hours

A client is admitted to the health care center with hyperglycemia, a 15-pound weight loss, and reports of vague upper and midabdominal pain that increases in intensity at night. The client' health history indicates alcoholism, smoking of a pack of cigarettes daily, and diabetes for the past 20 years. Upon examination the nurse finds swelling in the feet and abdominal ascites. Based on the clinical manifestations, which condition is the most likely diagnosis?

Pancreatic carcinoma

When caring for a client with acute pancreatitis, the nurse should use which comfort measure?

Positioning the client on the side with the knees flexed

The nurse is admitting a patient to the intensive care unit with a diagnosis of acute pancreatitis. What does the nurse expect was the reason the patient came to the hospital?

Severe abdominal pain

A student nurse is preparing a plan of care for a client with chronic pancreatitis. What nursing diagnosis related to the care of a client with chronic pancreatitis is the priority?

Impaired nutrition: less than body requirements

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client?

Inflammatory bowel disease

Signs and symptoms of peritonitis

Vomiting, abdominal tenderness, rigidity, and tachycardia

After assessing a client with peritonitis, how would the nurse most likely document the client's bowel sounds?

Absent

A critical care nurse is caring for a client with acute pancreatitis. One potentially severe complication involves the respiratory system. Which of the following would be an appropriate intervention to prevent complications associated with the respiratory system?

Maintain the client in a semi-Fowler's position.

A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client?

Administering morphine I.V. as ordered

A nursing instructor is lecturing to a class about chronic pancreatitis. Which of the following does the instructor list as major causes?

Alcohol consumption and smoking

When assessing the client with acute pancreatitis, which of these diagnostic tests, consistent with the disease, does the nurse anticipate will be altered?

Amylase and lipase

Elevated WBC, neutrophils, C-reactive protein, CT Scan shows enlargement, Ultrasound

Appendicitis

Most common acute abdominal issue

Appendicitis

Pain in RLQ, low grade fever, anorexia

Appendicitis

Stimulant laxatives

Bisacodyl Senna

Risk of overuse of laxatives

Can cause destruction of nerve endings in colon

What is actual measure of bowel regularity?

Stool consistency and client comfort

A 70-year-old client is admitted with acute pancreatitis. The nurse understands that the mortality rate associated with acute pancreatitis increases with advanced age and attributes this to which gerontologic consideration associated with the pancreas?

Decreases in the physiologic function of major organs

Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes melitus. Which of the following explains the cause of this secondary diabetes?

Dysfunction of the pancreatic islet cells

A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is characteristic of this disorder?

Edema and inflammation

A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find?

Elevated urine amylase levels

Diet modifications for IBD

Low residue, high protein, high calorie. Vitamin and iron

Acid base imbalance that results in vomiting

Metabolic alkalosis

Bulk forming laxatives

Psyllium (Metamucil)

Crohn's Disease pain location

RLQ

A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client?

Relieving abdominal pain

Primary nursing Dx of appendicitis

Risk for infection

IBD (inflammatory bowel disease) cause

Unknown

Most common cause of chronic pancreatitis

alcohol abuse

infection

any disease caused by the growth of pathogenic microbes inthe body

Pain at McBurney's point

appendicitis

RLQ pain

appendicitis

Rovsing's sign

appendicitis

Total parental nutrition (TPN) should be used cautiously in clients with pancreatitis because they

cannot tolerate a high glucose concentration

Chronic pancreatitis

chronic inflammation from recurrent pancreatitis

Most common cause of acute pancreatitis

gallstones and alcohol abuse

Pancreatitis

inflammation of the pancreas

Saline Laxatives

magnesium hydroxide (Milk of Magnesia)

Lubricant laxatives

mineral oil

acute pancreatitis

quick onset of inflammation of pancreatitis