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
