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Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018
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56 - Care of Patients With Noninflammatory Intestinal Disorders

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Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018 | Registered Nurse (RN) School Study Aid

56 - Care of Patients With Noninflammatory Intestinal Disorders
16 Picmonics to Learn | 30 mins
Intestinal Obstruction
Partial/Early Obstruction
Severe Abdominal Pain
Vomiting
High Pitched Bowel Sounds
Abdominal Distention
Increased Peristalsis
Total/Neurogenic Obstruction
Absent Bowel Sounds
Paralytic Ileus
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1 min
Types of Intestinal Obstruction
Mechanical
Adhesions
Hernia
Volvulus
Intussusception
Tumor
Non-Mechanical
Mesenteric Artery Occlusion
Spinal Injury
Paralytic Ileus
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2 mins
Metabolic Alkalosis Assessment
Signs and Symptoms
Increased pH > 7.45
Increased HCO3 > 26
Excitable State
Arrhythmias
Paresthesias
Muscle Cramps
Muscle Weakness
Decreased Respiratory Effort
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1 min
Metabolic Acidosis Assessment
Characteristics
Decreased pH < 7.35
Decreased HCO3 < 22
Signs & Symptoms
Abdominal Pain
CNS Depression
Coma
Hypotension
Arrhythmias
Increased Respirations
Kussmaul Respirations
Flushed, Warm, Dry Skin
Muscle Weakness
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2 mins
Intussusception
Pathophysiology
Telescoping of Bowel Segments
Lead Point
Assessment
Episodic Abdominal Pain
Diarrhea
Sausage-Shaped Mass
Red Currant Jelly Stools
Diagnosis
Ultrasound/CT
Target Sign
Considerations
More Common in Children
Rotavirus Vaccine Contraindicated
Management
Air or Hydrostatic Enema
Surgical Reduction
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3 mins
Colorectal Cancer Assessment
3rd Most Common Cancer
Assessment
Change in Bowel Habits
Bowel Obstruction
Rectal Bleeding
Anemia
Weight Loss
Ascites
Considerations
Colonoscopy
FOBT and FIT
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2 mins
Colorectal Cancer Interventions
Interventions
Surgical Colon Resection
Radiation
Chemotherapy
Considerations
Bowel Cleansing
Screening
Colostomy
Dietary Consult
Body Image
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3 mins
Colostomy Care
Wash with Warm Water
Cut 1/8 inch Around Stoma
Decreases Skin Irritation
Empty When 1/3 to 1/2 Full
Change 3-7 Days
Considerations
Avoid Odor Causing Foods
Irrigate at Same Time
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2 mins
Irritable Bowel Syndrome (IBS) Assessment
Abdominal Pain
Relieved by Defecation
Alternating Diarrhea and Constipation
Fatigue
Excessive Flatulence
Sensation of Incomplete Evacuation
Considerations
Stressors
Food Intolerances
More Common in Women
Rule Out Other Disorders
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2 mins
Irritable Bowel Syndrome (IBS) Interventions
Interventions
Identify Triggers
Increase Fiber Intake
Probiotics
Anticholinergics
Tricyclic Antidepressants (TCAs)
Loperamide
Linaclotide
Medications for Women
Tegaserod (Zelnorm)
Lubiprostone (Amitiza)
Alosetron (Lotronex)
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2 mins
Tricyclic Antidepressants (TCAs)
Mechanism of Action
Inhibits Reuptake of Norepinephrine and Serotonin
Indications
Depression
Bipolar Disorder
Fibromyalgia
Side Effects
Sedation
Orthostatic Hypotension
Anticholinergic Effects
Cardiac Toxicity
Considerations
Delayed Effect
Do Not Stop Abruptly
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2 mins
Tricyclic Antidepressants (TCAs) Indications
Indications
Major Depression
Bedwetting
Fibromyalgia
OCD
Drugs
-Iptyline or -Ipramine Suffix
Amitriptyline
Desipramine
Clomipramine
Imipramine
Nortriptyline
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2 mins
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
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1 min
Hernia Interventions
Reduce Intra Abdominal Pressure
Avoid Straining and Lifting
Open Mouth Sneezing
Excision
Herniorrhaphy
Hernioplasty
Consideration
Scrotal Support
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1 min
Cobalamin (Vitamin B12)
Mechanism
Vitamin B12
Indications
Vitamin Deficiency
Pernicious Anemia
Side Effects
Hypokalemia
Arthralgia
Dizziness
Considerations
IM Injection for Pernicious Anemia
Never Give IV
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2 mins
Interventions for Impaired Skin Integrity
Assessment
Signs of Skin Breakdown
Pain
Redness
Decreased Skin Turgor
Bleeding
Bony Prominences
Intervention
Reposition Q2H
Pressure Relief
Maintain Clean and Dry Skin
Adequate Nutrition and Hydration
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2 mins

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