Exam 3 GI: IBD, Appendicitis, peritonitis, UC, crohns, diverticula.
Ulcerative colitis what is different from crohns S/S
10-20 stools a day unpleasant and urgent need to deficate (tenesmus) lower abdomen is colicky and is relieved by defecation, whole GI is inflamed NOT ONLY SPOTS, bloody stools
Sodium normal levels
135-145 mEq/L
Potassium normal lab value
3.5-5.0 mEq/L
chloride normal lab value
95-105 mEq/L
What are the four things to most likely cause peritonitis?
Appendicitis, diverticulitis, penetrating abdominal trauma, bowel obstruction
What deficiencies will be common with crohns since it is in the small intestine
Folate, iron, and b12
How do we treat peritonitis
IV fluids, antibiotics, NPO, hold opioids so you dont mask symptoms, respiratory support/semi fowlers, and surgery
s/s of diverticulosis/diverticulitis
Left lower quad pain, fever, bowel irreg, leukocytosis, hgb/hct, FOB, imaging
Daily diet changes for UC patients?
Low residue
diverticulm
ONE small pouch, or sac, found in the lining, or wall of a tubular organ such as the colon
Appendicitis S/S
RLQ pain, low grade fever, nausea, rebound tenderness at McBurney's point, and leukocytosis (elevated wbc)
surgical intervention for ulcerative colitis
RPC-IPAA is the gold standard
What does RPC-IPAA for UC do?
Removal of the colon and most of the rectum
What labs are increased in ulcerative colitis
WBC, and c reactive protein
Diverticula
abnormal side pockets in the intestinal wall
Low residue diet includes:
avoiding whole wheat and grains, no wild rice, no raw fruits and veggies, seeds/nuts/beans need to be avoided as well, low lactose foods, no caffeine, no carbonated beverages
What are the diet changes for crohns?
bowel rest, TPN, low residue diet, vit and min supplements, and avoiding GI stim
Crohns S/S
cobblestone appearance in small intestine, weight loss, 5-6 loose stools a day, steatorrhea,
Crohns increases your chances of getting:
colon cancer, fistulas and abscesses
To treat appendicitis prior to surgery what do we do?
fluid and electrolyte therapy, NPO, no laxatives, enemas or heat therapy
Diverticulitis
inflammation of the diverticula
What is peritonitis?
inflammation of the peritoneal cavity
your patient with appendicitis complains of increased pain with coughing and states the only thing that helps is fetal position, what is this a sign of?
peritonitis
What will diet look like for the UC patients during severe illness
possible tpn and NPO low-fiber diet fluid, electrolytes, protein blood loss corrections,
Peritonitis S/S
rebound tenderness, muscular rigidity, laying still w/fast shallow breaths, distended abd, fever, and dehydration
What labs are decreased from ulcerative colitis
sodium, chloride, and potassium
If UC flare up is less severe what will their diet changes be?
supplemental formulas that absorb in the small intestine
Ulcerative colitis complications are:
toxic megacolon, arthritis, bili disease, perforation, and colon cancer
Gastroenteritis S/S
vomiting and nausea BEFORE pain